{"doi":"10.1111/camh.70039","title":"Advancing the measurement of psychotherapy outcomes for youth with irritability using in vivo ecological momentary assessment: an exploratory observational study","abstract":"BACKGROUND: Ecological momentary assessment (EMA) can reveal naturalistic within-person changes in symptoms and behaviors, essential for examining psychotherapy's effectiveness. However, no prior study has leveraged EMA to assess real-time, naturalistic changes of clinical symptoms during psychotherapy in youth with clinically impairing irritability. The present study uses EMA to assess changes in both child-reported irritability symptoms and caregiver-reported parental behaviors over the course of treatment, as well as to explore real-time associations between changes in parental behaviors and youth symptoms. METHOD: = 11.26 years [SD = 1.89 years]; 35.9% female; 79.5% White) undergoing exposure-based cognitive behavioral therapy, and their parent undergoing parent management skill training (PMT), completed EMA surveys three times a day for 7 days at pre-, mid-, and post-treatment. Given the nested nature of the data, multilevel analyses were conducted to observe change and associations over time. RESULTS: Results from multilevel modeling showed that both youth and parents reported a statistically significant decrease in real-time irritability symptoms over the course of treatment (βs ≤ -.27, ps ≤ .02). Parents reported a statistically significant increase in adaptive parental behaviors as taught during the PMT portion of treatment (βs ≥ |.22|, ps < .04). Furthermore, statistically significant associations were found between increased levels of adaptive parental behaviors and decreased levels of youth irritability symptoms. CONCLUSION: This study supports the utility of EMA in measuring psychotherapy symptom progress, outcomes, and change in therapy-targeted behavior. Results suggest that parental behavior could play a substantively important role in the treatment of youth with irritability.","journal":"Child and Adolescent Mental Health","year":2025,"id":577204,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9532,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1432945,"name":"Urmi Pandya","orcid":"0009-0001-1865-4761","position":1,"is_corresponding":false},{"id":906793,"name":"Shannon Shaughnessy","orcid":"0000-0002-9128-9705","position":2,"is_corresponding":false},{"id":713165,"name":"Ramaris E. German","orcid":"0000-0002-8574-5997","position":3,"is_corresponding":false},{"id":729792,"name":"Lauren M. Henry","orcid":"0000-0003-0286-9319","position":4,"is_corresponding":false},{"id":397270,"name":"Katharina Kircanski","orcid":"0000-0002-6546-5584","position":5,"is_corresponding":false},{"id":351828,"name":"Melissa A. Brotman","orcid":"0000-0002-9859-4702","position":6,"is_corresponding":false},{"id":713164,"name":"Reut Naim","orcid":"0000-0002-0424-5094","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T02:58:04.622308Z","pmid":"41059673","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}