Feasibility of ecological momentary assessment to assess suicidality among inpatient adolescents

Matthias LÜHR¹, Tamara GROSSMANN¹, Nadine BAYER¹, Jana HOERGER¹, Ulrich REININGHAUS², Nathalie OEXLE¹

¹Department of Psychiatry II, University of Ulm and BKH Guenzburg, Ulm, Germany
²Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany

Introduction. Ecological momentary assessment (EMA) is a new method of data collection that allows frequent assessments of suicide ideation in participants’ everyday life through smartphones. Few recent US studies suggest that EMA designs are feasible and acceptable among high-risk suicidal adolescents following acute psychiatric care. However, conducting EMA surveys during inpatient psychiatric care may pose different challenges for researchers. To date, little is known about the feasibility of EMA studies to assess suicide ideation among adolescents in inpatient psychiatric care.

Methods. Adolescents (12-21 years old) were recruited during inpatient psychiatric care in Germany. After a baseline assessment, adolescents participated in 7 days of EMA surveys (7 x per day at randomized times between 7:00 am and 09:00 pm), administered via a smartphone application. The EMA survey contained 16 questions about momentary suicide ideation and potential psychological correlates (i.e. perceived burdensomeness, thwarted belongingness, feelings of defeat and entrapment). Following the 7 days of EMA surveys, we asked participants about their overall experience of participation with standardized items and by conducting a brief qualitative interview.

Results. Preliminary results suggest a high compliance (i.e. percentage of answered surveys above 70%) among participating adolescents. Participants generally reported a high satisfaction with their study participation and indicated that they would participate in a similar study again. If adolescents reported any burdens, they mainly referred to technical problems of the smartphone.

Discussion. The results of this study suggest that EMA studies to assess suicide ideation among adolescents in inpatient psychiatric care are feasible and accepted by participants. Compared to studies with adolescents after discharge from psychiatric care, study designs may be adjusted to consider the different context of data collection and the demands of the clinical team.