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Palm Pilots Bridge Communication Gap between Therapists and Patients

MU researcher says device helps measure mood variability in borderline personality disorder patients

Dec. 1, 2008

Story Contact:  Kelsey Jackson, (573) 882-8353,

COLUMBIA, Mo. – Palm Pilots already perform a variety of functions, and in the future, they may be used as a therapeutic tool that benefits people with personality disorders.  In a new study, a University of Missouri researcher used Palm Pilots as electronic diaries to record and analyze mood variability in patients with borderline personality disorder (BPD) and found that the devices helped bridge an important communication gap between therapists and patients.

"In the clinical setting, patients are not good at assessing their mood retrospectively," said Tim Trull, professor of psychology in the MU College of Arts and Science. “Previously, we asked BPD patients to recall and describe when a mood change occurred. This description could vary greatly depending on the patient’s current state of mind and how comfortable the patient felt with the therapist.  Electronic diaries help solve this problem by requiring that the patient reflect on and rate the degree to which a specific mood is present at that moment. At the same time, the device does not require that the individual makes a decision about when a mood change has occurred.” 

In the study, patients carried electronic diaries for one month and were prompted randomly to rate their mood on a scale of 1 to 5 up to six times each day. One group of patients had BPD and the other group of patients had depressive disorders. Researchers found that patients with BPD did not have significantly different overall levels of positive or negative moods. However, the patients with BPD displayed significant variability in their positive and negative moods throughout the month, demonstrated more instability, and reported more extreme changes across successive occasions. 

“We may not have known the extent of the mood variability in the BPD patients without the assistance of the Palm Pilots, and the potential use of the device in psychological therapy is very exciting,” Trull said. “Eventually, programmed Palm Pilots may act as proxy therapists and provide patients with advice on coping skills and other therapeutic interventions, as problems occur in patients’ natural environment.” 

According to the National Institute of Mental Health, BPD is more common than schizophrenia or bipolar disorder and is estimated to affect 2 percent of the population. It is characterized by pervasive instability in moods, interpersonal relationships, self-image and behavior, and can lead to suicidal behavior, substance abuse and failed relationships. People with BPD experience mood shifts of depression, irritability, anger, anxiety and fear that can last from a few hours to a few days.  

Trull's study “Affective Instability:  Measuring a Core Feature of Borderline Personality Disorder with Ecological Momentary Assessment,” was published in the Journal of Abnormal Psychology.