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The after-effects of momentary suicidal ideation: a preliminary examination of emotion intensity changes following suicidal thoughts

Al-Dajani, Nadia, Uliaszek, Amanda A.·2021·Psychiatry Research
DOI 10.1016/j.psychres.2021.114027
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Abstract

Research using ecological momentary assessments has highlighted the importance of negative emotions as predictors of day-to-day suicidal thoughts. Yet only one study has examined the real-time consequences of these thoughts. This preliminary investigation examined changes in emotion intensity following suicidal thoughts. It also explored associations between these changes and endorsement of suicide functions as an escape and/or as a solution, examined both as momentary thoughts and intractable beliefs about suicide. Thirty-nine community participants endorsing suicidal ideation were followed for two-weeks and completed multiple daily surveys related to suicidal thoughts, functions of suicide, and emotion intensity. Participants reported heightened emotion intensity immediately following a suicidal thought across six emotions, with delayed reductions in stress and anxiety following ideation onset. When assessed in the moment, suicide as a solution to a problem predicted increases in hopelessness, sadness, stress and general negative affect immediately following a thought, while suicide as an escape predicted increases in anger immediately after a thought. When measured as intractable beliefs, only stronger belief in suicide as a solution to a problem predicted delayed reductions in stress following ideation. Increased intensity of negative emotions immediately following suicidal ideation suggests a potential vicious cycle of heightened emotion intensity and suicidality.

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  • Pseudo-random sampling schedules were most frequently used (57%, n = 13), followed by fixed sampling (26%, n = 6), and combined fixed and pseudo-random sampling (13%, n = 3).

    “(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)].”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [69]

  • Studies frequently (57%, n = 13) reported that participants could provide input about their daily schedules, allowing EMA prompt windows to be adjusted for each participant.

    “Studies frequently (57%, n = 13; (47, 51, 58, 60, 61, 69, 71, 79–81, 85, 86)) reported that participants could provide input about their daily schedules (incl. sleep and wake times), allowing EMA prompt windows to be adjusted for each participant”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [69]

  • Prevalence rates in two community-based samples with current self-reported ideation were comparable to the pooled prevalence rates (86-100% of participants and 20-22% of all entries indicated suicidal ideation).

    “While the majority of studies recruited participants with heightened risk profiles (such as those recently discharged after a suicide attempt), prevalence rates in two community-based samples with current self-reported ideation were comparable to the pooled prevalence rates (86–100% participants and 20–22% of all entries indicated suicidal ideation (69, 88).”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [69]

  • Approximately one fourth (26%; n = 6) of reviewed studies supplemented signal-contingent sampling with event-contingent sampling, but none used event-contingent sampling alone.

    “Approximately one fourth (26%; n = 6) of studies supplemented signal-contingent sampling with event-contingent sampling [i.e., participants were encouraged to self-initiate additional entries when experiencing STBs (45, 47, 61, 69, 85)], but none of the studies used event-contingent sampling alone.”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [69]

  • In two studies, research personnel conducted an unspecified suicide risk assessment halfway through the 2-week EMA period, and in another study participants completed the CSSRS at baseline and follow-up and test assistants referred acute cases to the emergency department.

    “In two studies, research personnel conducted an unspecified suicide risk assessment halfway through the 2-week EMA period (69), and in the other study participants completed the CSSRS at baseline and at follow-up and test assistants referred acute cases to the emergency department (70).”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [69]

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Authors
Al-Dajani, N., & Uliaszek, A. A.
Affiliations
University of Toronto Scarborough (CA)
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2021-08
Volume
302
Pages
114027
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2021.114027
OpenAlex
W3165055492
Cited by
22
References
42
Citations by year
2026: 5 · 2025: 5 · 2024: 4 · 2023: 2 · 2022: 6
FWCI
2.05
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
University of Toronto at Scarborough
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health via Writing
Keywords
suicidal ideation, emotional intensity, negative emotions, hopelessness, stress, anxiety, anger, ecological momentary assessment
MeSH terms
Ecological Momentary Assessment, Emotions, Humans, Surveys and Questionnaires, Suicide, Suicidal Ideation

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