Instability of Suicidal Ideation in Patients Hospitalized for Depression: An Exploratory Study Using Smartphone Ecological Momentary Assessment

Peters, Evyn M.; Dong, Lisa Yue; Thomas, Teena; Khalaj, Siavash; Balbuena, Lloyd; Baetz, Marilyn; Osgood, Nathaniel D.; Bowen, Rudy

doi:10.1080/13811118.2020.1783410

Cited by 28 publications

(20 citation statements)

References 53 publications

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“…The number of (scheduled) EMA prompts per day ranged from 1 to 11 (median = 5, n = 21). All studies used some form of signal-contingent sampling: (pseudo)random sampling schedules were most frequently used [57%, n = 13 (42,47,51,58,61,65,69,71,79,83,85,86,88)], followed by fixed sampling [26%, n = 6 (45,66,67,72,80,82)], and protocols that combined both fixed and (pseudo)random sampling [13%, n = 3 (47,56,60)]. Fixed schedules were almost exclusively used in studies with once-daily prompts (as well as three older studies with PDAs (45,81,82)), whereas pseudorandom schedules were typically used for repeated withinday assessments.…”

Section: Schedulesmentioning

confidence: 99%

Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research

Kivelä

Does

Riese

et al. 2022

Front. Digit. Health

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Suicide and suicide-related behaviors are prevalent yet notoriously difficult to predict. Specifically, short-term predictors and correlates of suicide risk remain largely unknown. Ecological momentary assessment (EMA) may be used to assess how suicidal thoughts and behaviors (STBs) unfold in real-world contexts. We conducted a systematic literature review of EMA studies in suicide research to assess (1) how EMA has been utilized in the study of STBs (i.e., methodology, findings), and (2) the feasibility, validity and safety of EMA in the study of STBs. We identified 45 articles, detailing 23 studies. Studies mainly focused on examining how known longitudinal predictors of suicidal ideation perform within shorter (hourly, daily) time frames. Recent studies have explored the prospects of digital phenotyping of individuals with suicidal ideation. The results indicate that suicidal ideation fluctuates substantially over time (hours, days), and that individuals with higher mean ideation also have more fluctuations. Higher suicidal ideation instability may represent a phenotypic indicator for increased suicide risk. Few studies succeeded in establishing prospective predictors of suicidal ideation beyond prior ideation itself. Some studies show negative affect, hopelessness and burdensomeness to predict increased ideation within-day, and sleep characteristics to impact next-day ideation. The feasibility of EMA is encouraging: agreement to participate in EMA research was moderate to high (median = 77%), and compliance rates similar to those in other clinical samples (median response rate = 70%). More individuals reported suicidal ideation through EMA than traditional (retrospective) self-report measures. Regarding safety, no evidence was found of systematic reactivity of mood or suicidal ideation to repeated assessments of STBs. In conclusion, suicidal ideation can fluctuate substantially over short periods of time, and EMA is a suitable method for capturing these fluctuations. Some specific predictors of subsequent ideation have been identified, but these findings warrant further replication. While repeated EMA assessments do not appear to result in systematic reactivity in STBs, participant burden and safety remains a consideration when studying high-risk populations. Considerations for designing and reporting on EMA studies in suicide research are discussed.

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Section: Schedulesmentioning

confidence: 99%

Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research

Kivelä

Does

Riese

et al. 2022

Front. Digit. Health

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“…Third, MI holds a temporal property since mood uctuations can change from moment to moment, which is unlikely to be recalled accurately, such as which day and what time during the day it occurred (102). Two recent studies reported that paper-and-pen measures of MI do not agree with smartphone measured MI (103,104). Finally, the VAS used to assess antenatal MI is not previously validated.…”

Section: Discussionmentioning

confidence: 99%

Mood Symptoms and Other Maternal Factors in Pregnancy and Adverse Neonate Outcomes

Li¹,

Bowen²,

Bowen³

et al. 2020

Preprint

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Background Antenatal women experience a higher level of mood symptoms, which have negative effects on mothers’ mental and physical health and their newborns. The relation of maternal moods including depression and anxiety and other maternal factors in pregnancy and neonate outcomes are well-studied with inconsistent findings. Although antenatal women experience a higher level of mood instability (MI), the association between antenatal MI and neonatal outcomes has not been investigated. We aimed to address this gap and to contribute to the pregnancy-neonate outcomes literature by examining the relationship between antenatal mood symptoms and other maternal factors and neonatal outcomes.Methods A prospective cohort of women (n = 555) participated in this study at early pregnancy (T1, 17.4 ± 4.9 weeks) and late pregnancy (T2, 30.6 ± 2.7 weeks). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal depressive symptoms, the EPDS anxiety subscale was utilized to measure anxiety symptoms, and mood instability was measured using a visual analogue scale. These mood states together with stress, social support, as well as healthy and unhealthy behaviours were also examined in relation to neonatal outcomes using chi-square tests and logistic regression models. Results Depression and MI were unrelated to adverse neonatal outcomes and anxiety was related to Apgar score with marginal statistical significance. Higher stress, lack of partner support, smoking, and primiparous status were associated with some adverse outcomes.Conclusions The current study identified no associations between antenatal mood symptoms and neonatal outcomes. Our findings further support and extend previous evidence on smoking abstinence or cessation, and the provision of resources for stress management and social support that could help prevent or alleviate adverse neonatal outcomes.

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“…The program was delivered using the Ethica platform co-designed and codeveloped by the coauthor NO and Ethica Data Services. The Ethica platform is designed to aid in the creation, delivery, and data collection of smartphone-based apps [ 36 , 37 ]. A computer science student (JN) customized functionalities on the Ethica system to reflect the co-designed program.…”

Section: Methodsmentioning

confidence: 99%

An App-Based Mindfulness-Based Self-compassion Program to Support Caregivers of People With Dementia: Participatory Feasibility Study

Goodridge¹,

Reis²,

Neiser³

et al. 2021

JMIR Aging

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Background The number of persons with dementia is steadily growing, as is the number of individuals supporting persons with dementia. Primary caregivers of persons with dementia are most often family members or spouses of the persons with dementia, and they are more likely to experience increased stress and other negative effects than individuals who are not primary caregivers. Although in-person support groups have been shown to help buffer the negative impacts of caregiving, some caregivers live in isolated or rural communities and are unable to make the burdensome commitment of traveling to cities. Using an interdisciplinary approach, we developed a mobile smartphone support app designed for primary caregivers of persons with dementia, with the goal of reducing caregiver burden and easing stress. The app features a 12-week intervention, largely rooted in mindfulness-based self-compassion (MBSC), because MBSC has been linked to minimizing stress, depression, and anxiety. Objective The primary objectives of our program are twofold: to explore the feasibility of a 12-week mobile support program and to conduct an initial efficacy evaluation of changes in perceived caregiver burden, coping styles, and emotional well-being of caregivers before and after the program. Methods Our feasibility study used a 2-phase participatory pretest and posttest design, focusing on acceptability, demand, practicality, implementation, and efficacy. At phase I, we recruited 57 primary caregivers of persons with dementia (mean age 76.3, SD 12.9 years), comprising spouses (21/57, 37%), children (21/57, 37%), and friends or relatives (15/57, 26%) of persons with dementia, of whom 29 (51%) completed all measures at both pre- and postprogram. The content of the program featured a series of MBSC podcasts. Our primary outcome measure was caregiver burden, with secondary outcome measures including coping styles and emotional well-being. Daily ecological momentary assessments enabled us to ask participants, “How are you feeling today?” Phase II of our study involved semistructured follow-up interviews with most participants (n=21) who completed phase I. Results Our findings suggest that our app or program meets the feasibility criteria examined. Notably, participants generally accepted the program and believed it could be a useful resource. Emotional well-being increased significantly (P=.04), and emotion-based coping significantly decreased (P=.01). Participants generally considered the app or program to be a helpful resource. Conclusions Although there were no significant changes in caregiver burden, we were encouraged by the increased emotional well-being of our participants following the completion of our program. We also conclude that our app or program demonstrated feasibility (ie, acceptability, practicality, implementation, and efficacy) and can provide a much-needed resource for primary caregivers of persons with dementia. In the subsequent version of the program, we will respond to participant feedback by incorporating web-based weekly sessions and incorporating an outcome measure of self-compassion.

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Instability of Suicidal Ideation in Patients Hospitalized for Depression: An Exploratory Study Using Smartphone Ecological Momentary Assessment

Cited by 28 publications

References 53 publications

Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research

Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research

Mood Symptoms and Other Maternal Factors in Pregnancy and Adverse Neonate Outcomes

An App-Based Mindfulness-Based Self-compassion Program to Support Caregivers of People With Dementia: Participatory Feasibility Study

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