Citation

Czyz EK, King CA, Nahum-Shani I. Psychiatry Res. 2018; 267: 566-574.

Affiliation

Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.psychres.2018.06.031

PMID

30031317

Abstract

Despite its potential to yield information about the dynamic course of suicidal ideation/behavior in individuals' natural environment, Ecological Momentary Assessment (EMA) has been strikingly underutilized among suicidal teens. This study reports on feasibility and acceptability of ecological assessment of daily suicide risk-related outcomes ("daily diaries," a special case of EMA) among adolescent inpatients in the critical post-discharge period. Thirty-four adolescents (76% female; ages 13-17) responded to daily electronic surveys for four weeks after discharge. Survey adherence was 69% (n = 650 days) and decreased each week. Adherence was half as likely among adolescents without attempt history (OR = 0.50, CI = 0.27-0.95). Mid- and end-point study responses indicated high acceptability of daily diaries. Most adolescents reported no change or more positive change in their thoughts/mood after daily surveys. Suicidal ideation was reported on 24.4% (n = 159) of the days. In the month post discharge, more teens reported suicidal thoughts using daily surveys (70.6%) compared to end-of-study assessment (45.2%) (Chi-square = 4.24, p = .039). Two participants (5.9%) reported an attempt. Ideation frequency and duration varied across time, suggesting utility of frequent assessments in this context. EMA data collection with high-risk adolescents offers a feasible approach to examining real-time suicidal ideation/behavior, yielding nuanced information that is critical to advancing suicide prevention efforts.

Copyright © 2018 Elsevier B.V. All rights reserved.

Language: en

Keywords

Adolescents; Daily diary; Ecological momentary assessment; Suicidal ideation; Suicide attempts