The suicide rate has not changed in the United States over the past 100 years and there is a need for new ways of preventing suicide. Research has revealed that suicidal thoughts and behaviors and the factors that drive them are dynamic, heterogeneous, and interactive. Most existing interventions are infrequent (e.g., weekly sessions), not accessible when most needed, and not systematically tailored to the person using their own data. Advances in technology and statistics offer an opportunity to develop new interventions that may better match the dynamic, heterogeneous, and interactive nature of suicidal thoughts and behaviors. Just-In-Time Adaptive Interventions (JITAIs) are designed to provide the right type of support at the right time by adapting to changes in internal states and external contexts, offering a promising pathway towards more effective suicide prevention. In this review, we highlight the potential of JITAIs for suicide prevention, challenges ahead for developing JITAIs for suicide prevention, and possible solutions to these challenges.
Researchers, clinicians, and patients are increasingly using real-time monitoring methods to understand and predict suicidal thoughts and behaviors. These methods involve frequently assessing suicidal thoughts, but it is unknown if asking about suicide repeatedly is iatrogenic. We tested two questions about this approach: (1) does repeatedly assessing suicidal thinking over short periods of time increase suicidal thinking? (2) is more frequent assessment of suicidal thinking associated with more severe suicidal thinking? In a real-time monitoring study (N = 81, number of surveys = 9,819), we found no evidence to support the notion that repeated assessment of suicidal thoughts is iatrogenic.
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