Project Details
Projekt
APOS+R: Acute risk factors for post-discharge suicidal behaviors and Reactivity of EMA on suicide-related thoughts and behaviors
Subject Area
Personality Psychology, Clinical and Medical Psychology, Methodology
Term
since 2021
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 460438176
Background: After inpatient treatment of acute suicidality, the risk for suicide attempts/suicides is dramatically increased. This contrasts with limited empirical findings on proximal risk factors, which are prerequisites for the development of clinical monitoring and intervention measures. Since August 2021, the APOS project has been investigating the predictive significance of key variables from three suicide theories (Interpersonal Theory of Suicidal Behavior, ITSV; Integrative Motivational-Volitional Model, IMV; Suicide Crisis Syndrome, SCS) as well as physiological parameters (heart rate variability, heart rate) for suicide attempts, taking into account their temporal dynamics and interaction. For this purpose, a high-risk population after hospital discharge is prospectively studied with Ecological Momentary Assessments (EMA) in high temporal resolution. Due to technical-organizational problems, recruitment was delayed. So far, N = 250 patients could be included. Objective: The follow-up project APOS+R should enable us to reach the targeted sample size to validate the postulates of the three suicide theories with regard to the occurrence of suicide attempts. In addition, individual and subgroup-specific trajectories of suicidal ideation will be analyzed (using phenotyping and idiographic analysis methods). Furthermore, quantitative and qualitative indicators of reactivity of EMA will be considered. Methodology: A total of N=344 participants, who were treated as inpatients for acute suicidal crisis or suicide attempts, will be recruited in Duisburg-Essen and Leipzig. After a baseline assessment (core constructs of suicide theories, control variables, heart rate variability), participating patients will receive a smartphone app and will be prompted to respond to 31 momentary items on suicidal ideation and predictors of interest four times a day for up to 24 days after discharge. Thereafter, they will receive this item set on two random consecutive days per week (four times each) for 26 weeks. In addition, their heart rate will be recorded using the Polar Unite. Suicide attempts are assessed event-contingent and signal-contingent (once per week). After three weeks (T1) and six months (T2), an interview-based follow-up is conducted in which suicide attempts and suicidal thoughts are recorded. Relevance: APOS+R tests for the first time the prediction of suicide attempts in a high-risk population in a prospective and temporally high-resolution study design by variables of ITSV, IMV model, and SCS (compared to each other) and will thus help to understand the development and dynamics of suicidal ideation and behavior in clinically relevant time windows. The integration of idiographic, phenotypic, and reactivity analyses will allow further research gaps in the field of EMA research to be addressed.
DFG Programme
Research Grants
