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Dynamic course and acute risk factors of suicidal ideation. Real time assessment using the experience sampling method (ESM) in an inpatient sample with major depression

Subject Area Personality Psychology, Clinical and Medical Psychology, Methodology
Term from 2014 to 2019
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 262143638
 
Background: The relevance and prevalence of suicidal behavior and suicidal ideation is contradicted by the limited empirical knowledge with regards to its acute risk factors and temporal dynamics. Gaining such knowledge is mandatory for the development of monitoring or intervention concepts (especially in high-risk populations such as psychiatric inpatients). The Interpersonal Theory of Suicide (IPTS, Joiner, 2005; Van Orden et al., 2010) offers a theoretical framework explaining the occurrence of suicidal behavior and suicidal ideation. The IPTS postulates two constructs (perceived burdensomeness [PB], thwarted belongingness [TB]) that fluctuate within a short time frame and might serve as acute risk factors predicting suicidal ideation. While cross-sectional studies support the validity of the IPTS and its assumptions (Wachtel & Teismann, 2013), longitudinal studies analyzing the temporal dynamics of suicidal ideation and its association with PB and TB are lacking. Objectives: This is the first longitudinal prospective study investigating the temporal dynamics of suicidal ideation and its associations with PB and TB and other predictors under discussion (e.g. hopelessness). To address this question adequately, we use the experience sampling method (ESM) to ensure that the temporal dynamics of the variables under study are captured by the assessment strategy (i.e. within hours). Methods: During 16 months, N=75 psychiatric and psychosomatic inpatients at the University Clinic of Leipzig will be recruited and diagnostically assessed (e.g. diagnostic interview, questionnaires) twice within a two-week interval (T0 and T1). The ESM phase (i.e. patients responding to questions regarding suicidal ideation and predictors of interest) containing 60 sampling points within 6 to 10 days takes place between T0 and T1 (technically realized by smartphone app, software movisensXS). During a three-month pilot phase, an adequate sampling strategy (frequency, interval) will be developed and ESM items will be validated with regards to their sensitivity to change. In several sequential multilevel multiple regressions, suicidal ideation will be modeled as dependent variable, whereas the predictors under study will be modeled as independent variables (concepts of the IPTS and competing variables assessed by ESM on level 1, trait-like variables [T0] on level 2). Relevance: This study is the first analyzing longitudinally the temporal dynamics of suicidal ideation and its association with the central constructs of the IPTS (PB, TB) applying ESM. We expect the results to significantly improve the prediction of suicidal ideation. Analyzing acute risk factors of suicidal behavior in clinical settings within a theoretical framework is mandatory before monitoring and intervention concepts (possibly in real-time) can be developed.
DFG Programme Research Grants
 
 

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