Effect of frequent assessment of suicidal thinking on its incidence and severity: high-resolution real-time monitoring study

Coppersmith, Daniel D L; Fortgang, Rebecca; Kleiman, Evan M.; Millner, Alexander J.; Yeager, April L.; Mair, Patrick; Nock, Matthew K.

doi:10.1192/bjp.2021.97

Cited by 34 publications

(28 citation statements)

References 8 publications

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“…On this one participant said: “ My first instinct is to say, if I'm getting messages or notifications, I'm more likely to start thinking, and I'm not thinking about self-harm at all, and then I get a notification from an app that has to do with self-harm, I'm going to start thinking about self-harm” (P5) . Though research has shown that studies utilizing such prompts on suicide and self-harm through ecological momentary assessment do not increase likelihood of harm ( 39 – 43 ), this participant's comment highlights the importance of meeting participants where they are at and respecting their needs.…”

Section: Resultsmentioning

confidence: 92%

How Technologies Can Support Self-Injury Self-Management: Perspectives of Young Adults With Lived Experience of Nonsuicidal Self-Injury

Kruzan

Mohr

Reddy

2022

Front. Digit. Health

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BackgroundThere is growing interest in the design of digital interventions to improve conditions for young people who engage in high-risk behaviors, like nonsuicidal self-injury (NSSI). However, few studies have focused on how young people self-manage NSSI, or their existing, and historic, use of technologies to support their goals related to NSSI behavior change. Such an understanding has the potential to inform the design of digital interventions that meet this population's unique needs.ObjectivesThis study aims to (a) understand the self-management practices of young adults who engage in NSSI, (b) explore how they currently use technologies for self-injury self-management, and (c) identify the ways they can envision an app-based technology supporting their self-management.Methods and MaterialsTwenty young adults (aged 18–24) with lived experience of NSSI, and who were not currently enrolled in therapy, were recruited from online venues. Participants completed baseline measures to assess mental health and NSSI characteristics, followed by a virtual 1-h semi-structured interview where they were invited to share their experience of self-management, their goals, and their thoughts on supportive technology. Interview scripts were transcribed and analyzed via thematic analysis.ResultsThemes and sub-themes are organized under two broad domain areas: (1) How young adults self-manage NSSI thoughts and behaviors and (2) Opportunities and challenges for digital interventions to assist young adults in their recovery process. We found that young adults had varied experiences with, and goals related to, NSSI. Participants reported a lack of effective strategies to reduce NSSI urges and a desire for an app-based technology to track patterns and deliver personalized suggestions for self-management. Participants reported existing use of technologies as part of self-management, as well as early information and support seeking for NSSI online.ConclusionsThis study contributes a greater understanding of young people's experiences with self-injury, their self-management practices, and their desire to engage with technology. Our findings highlight the need for design flexibility in developing digital interventions that support individual goals, unique presentations of NSSI, and needs at different phases of recovery. Implications for the design of highly personalized and relevant digital interventions to address NSSI are discussed.

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Section: Resultsmentioning

confidence: 92%

How Technologies Can Support Self-Injury Self-Management: Perspectives of Young Adults With Lived Experience of Nonsuicidal Self-Injury

Kruzan

Mohr

Reddy

2022

Front. Digit. Health

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“…Multiple studies on the effects of frequently assessing suicidal thoughts and behaviors have found no effect of the assessment on suicidal thoughts and behaviors. 50,51 Two metaanalyses support the notion that the assessment of suicidal thoughts does not change suicidal thoughts or behaviors. 52,53 The current evidence suggests self-monitoring should not be considered an intervention component.…”

Section: Example Of Jitai For Suicide Preventionmentioning

confidence: 95%

Just-in-Time Adaptive Interventions for Suicide Prevention: Promise, Challenges, and Future Directions

Coppersmith¹,

Dempsey

Kleiman³

et al. 2022

Psychiatry

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The suicide rate (currently 14 per 100,000) has barely changed in the United States over the past 100 years. There is a need for new ways of preventing suicide. Further, research has revealed that suicidal thoughts and behaviors and the factors that drive them are dynamic, heterogeneous, and interactive. Most existing interventions for suicidal thoughts and behaviors are infrequent, not accessible when most needed, and not systematically tailored to the person using their own data (e.g., from their own smartphone). Advances in technology 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), which use smartphones and wearables, 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 (e.g., measurement, ethics), and possible solutions to these challenges.

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“…Disclosure of suicidal ideation was instead associated with relief ( 45 ). Repeated assessment of suicidal ideation in the context of AA studies did not increase suicidal ideation either ( 46 ). However, it has been noted that digital monitoring studies of mental health outcomes pose particular ethical issues, such as whether researchers should intervene, and if so, how, if participants report suicidal ideation or self-harm (impulses) ( 42 , 47 ).…”

Section: Methods and Analysismentioning

confidence: 99%

Study Protocol for an Ecological Momentary Assessment Study: TempRes “Temporal Variability of Risk and Resilience Factors for Suicidal Ideation”

et al. 2022

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Suicide prevention is an important public mental health issue that can be significantly brought forward by recent advances in psychological research methods and assessment. The project “TempRes” aims to harness the power of Ecological Momentary Assessment (EMA) to investigate the transdiagnostic risk and resilience factors associated with suicidal ideation drawn from the most recent research in suicide prevention and personality assessment. Participants will comprise the general population (planned: N = 100) and a risk group (patients currently in psychosomatic or psychiatric treatment) (planned: N = 50). After a comprehensive baseline assessment, they will complete up to ten short assessments per day over the course of 10 days at roughly equidistant intervals. In detail, the project examines the interplay of biography (previous suicidal behavior, experiences of childhood maltreatment), individual differences (level of personality functioning), and time-varying factors (entrapment, loneliness, mood) with respect to the emergence and fluctuation of suicidal ideation. There are two main research foci: First, the project will provide an operationalization and empirical verification of a core assumption of the integrated motivational-volitional model of suicide (IMV model). It will test whether the interaction of the time-varying predictors entrapment with loneliness (as a motivational moderator) explains reports of suicidal ideation over time. Second, it will be the first to examine personality functioning (a transdiagnostic, psychodynamically grounded conceptualization of vulnerability to psychological crises over the life span) as a time-invariant predictor of suicidal ideation assessed within an intensive longitudinal study design. The main analyses will be built on linear mixed models. The overarching aim of the project is to gain a better understanding of the psychological dynamics underlying suicidal ideation in different populations by bringing together concepts from different theoretical traditions. This will inform prevention efforts geared toward the general public as well as intervention in clinical populations.

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Effect of frequent assessment of suicidal thinking on its incidence and severity: high-resolution real-time monitoring study

Cited by 34 publications

References 8 publications

How Technologies Can Support Self-Injury Self-Management: Perspectives of Young Adults With Lived Experience of Nonsuicidal Self-Injury

How Technologies Can Support Self-Injury Self-Management: Perspectives of Young Adults With Lived Experience of Nonsuicidal Self-Injury

Just-in-Time Adaptive Interventions for Suicide Prevention: Promise, Challenges, and Future Directions

Study Protocol for an Ecological Momentary Assessment Study: TempRes “Temporal Variability of Risk and Resilience Factors for Suicidal Ideation”

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