Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;38(1):8-16.
doi: 10.1002/da.23043. Epub 2020 May 22.

Detecting suicidal thoughts: The power of ecological momentary assessment

Ilana Gratch  1   2 , Tse-Hwei Choo  2   3 , Hanga Galfalvy  2   3 , John G Keilp  1   2 , Liat Itzhaky  1   2 , J John Mann  1   2 , Maria A Oquendo  4 , Barbara Stanley  1   2
Affiliations

Detecting suicidal thoughts: The power of ecological momentary assessment

Ilana Gratch et al. Depress Anxiety. 2021 Jan.

Abstract

Background: Researchers and clinicians have typically relied on retrospective reports to monitor suicidal thoughts and behaviors. Smartphone technology has made real-time monitoring of suicidal thoughts possible via mobile ecological momentary assessment (EMA). However, little is known about how information gleaned from EMA compares with that obtained by retrospective reports. The authors sought to compare suicidal ideation (SI) assessed over 1 week using EMA with a retrospective gold-standard interviewer-administered measure covering the same period.

Methods: Fifty-one adults with major depressive disorder completed 1 week of EMA (6×/day) assessing SI. Following completion of EMA, participants completed an interviewer-administered Scale for Suicide Ideation (SSI) retrospectively assessing the same week.

Results: SI severity assessed through EMA was positively correlated with scores on the retrospective SSI. However, 58% of participants reporting ideation with EMA denied any past-week ideation on the SSI. Participants who endorsed SI during EMA but not on the SSI were no less likely to have a history of suicidal behavior than those who reported SI in both formats.

Conclusion: EMA captures instances of suicidal thinking that go undetected through retrospective report and thereby may help us to identify an at-risk subgroup otherwise missed.

Keywords: ecological momentary assessment; major depressive disorder; suicidal ideation; symptom assessment.

PubMed Disclaimer

References

REFERENCES

    1. Apter, A., Bleich, A., King, R. A., Kron, S., Fluch, A., Kotler, M., & Cohen, D. J. (1993). Death without warning?: A clinical postmortem study of suicide in 43 Israeli adolescent males. Archives of General Psychiatry, 50, 138-142. https://doi.org/10.1001/archpsyc.1993.01820140064007
    1. Batterham, P. J., Ftanou, M., Pirkis, J., Brewer, J. L., Mackinnon, A. J., Beautrais, A., … Christensen, H. (2015). A systematic review and evaluation of measures for suicidal ideation and behaviors in population-based research. Psychological Assessment, 27, 501-512. https://doi.org/10.1037/pas0000053
    1. Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The scale for suicide ideation. Journal of Consulting and Clinical Psychology, 47, 343-352. https://doi.org/10.1037/0022-006X.47.2.343
    1. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
    1. Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861-865. https://doi.org/10.1037/h0037562

Publication types