Stull SW, Lanza ST. Affect-laden risk profiles derived from two days of EMA predict substance use and quality of life three- and six-months after SUD treatment. J Subst Use Addict Treat. 2025;170:209613. doi:10.1016/j.josat.2024.209613
This secondary analysis of clinical trial data aimed to provide novel insights into utilizing affect-related ecological momentary assessments (EMA) to predict subgroups of risk that may help clinicians identify individualized risk factors for individuals after treatment. The analytic sample for this study (n =198, adults) included individuals from a clinical trial assessing the efficacy of smartphone-based recovery interventions for SUD who completed EMA as part of the trial. Participants had all recently completed SUD treatment and lived in Chicago. Participants were prompted to complete EMAs five times a day for six months. Each EMA could be on one of six topics: persons, places, activities, feelings/affect, other internal or external factors, or recovery outcomes. The data from this analysis was focused on the feelings/affect items. Participants also completed quarterly assessments on their quality of life and current substance use and symptoms. Nine person-level indicators of future substance use (risk and protective) factors were seen with high reliability (all >0.8) based on two days of data soon after treatment completion. Increased positive affect was related to decreased odds of substance use at 3, but not 6 months post-treatment. Lower positive affect was linked to higher risk, including craving, pain, and negative affect. Overall, these results encourage future assessment of models for understanding individuals’ risk for substance use after treatment as soon as they leave treatment. This knowledge can better equip both clinicians and patients when transitioning out of treatment facilities.