Using ecological momentary assessment to investigate short-term risk factors of suicidal ideation among adolescents

This study drew on the Interpersonal Theory of Suicide (IPTS) and the Integrated Motivational-Volitional Model of Suicidal Behavior (IMV) to analyze thwarted belongingness (TB), perceived burdensomeness (PB), entrapment, and interactions among them as short-term risk factors of passive and active suicidal ideation (SI) among adolescents.

51 psychiatric inpatients (74.5% female, aged 12-18 years) participated in 7 days of Ecological Momentary Assessment (EMA) and reported on momentary TB, PB, entrapment, passive SI, and active SI 7 times per day. We conducted longitudinal multilevel regression analyses to test whether the three risk factors co-occurred with higher SI at the same measurement occasion and whether they predicted SI at the next measurement occasion (approximately 2 h later).

Participants responded to 1941 out of 2485 surveys (78.1%). TB, PB, and entrapment were associated with higher passive and active SI at the same measurement occasion. However, only PB predicted higher passive SI at the next measurement occasion. The interaction models (TB*PB, entrapment*PB, entrapment*TB) yielded similar results: Passive and active SI generally amplified when higher TB coincided with higher PB, higher entrapment coincided with higher PB, and higher entrapment coincided with higher TB at the same measurement occasion. Still, none of the interactions predicted SI at the next measurement occasion.

Although hypotheses derived from the IPTS and the IMV were confirmed in concurrent models, the findings challenge the potential of PB, TB, and entrapment to predict subsequent SI.