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Cited by 82Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologyMental Health Research Topics

Does assessing suicidality frequently and repeatedly cause harm? a randomized control study

Open access
Law, Mary Kate, Furr, R. Michael, Arnold, Elizabeth Mayfield, Mneimne, Malek, Jaquett, Caroline, Fleeson, William·2015·Psychological Assessment
DOI 10.1037/pas0000118PMC PMC4615260
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Abstract

Assessing suicidality is common in mental health practice and is fundamental to suicide research. Although necessary, there is significant concern that such assessments have unintended harmful consequences. Using a longitudinal randomized control design, the authors evaluated whether repeated and frequent assessments of suicide-related thoughts and behaviors negatively affected individuals, including those at-risk for suicide-related outcomes. Adults (N = 282), including many diagnosed with borderline personality disorder (BPD), were recruited through psychiatric outpatient clinics and from the community at large, and were randomly assigned to assessment groups. A control assessment group responded to questions regarding negative psychological experiences several times each day during a 2-week main observation phase. During the same observation period, an intensive suicide assessment group responded to the same questions, along with questions regarding suicidal behavior and ideation. Negative psychological outcomes were measured during the main observation phase (for BPD symptoms unrelated to suicide and for BPD-relevant emotions) and/or at the end of each week during the main observation phase and monthly for 6 months thereafter (for all outcomes, including suicidal ideation and behavior). Results revealed little evidence that intensive suicide assessment triggered negative outcomes, including suicidal ideation or behavior, even among people with BPD. A handful of effects did reach or approach significance, though these were temporary and nonrobust. However, given the seriousness of some outcomes, the authors recommend that researchers or clinicians who implement experience sampling methods including suicide-related items carefully consider the benefits of asking about suicide and to inform participants about possible risks.

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  • The most frequent primary co-morbid diagnoses in the reviewed studies were depressive disorders and borderline personality disorder, but inclusion was typically based on a recent history of self-reported suicidal thoughts and behaviors.

    “Most frequent primary co-morbid diagnoses were depressive disorders (83, 84, 86) and borderline personality disorder [BPD (58, 64, 82)]; however, inclusion was typically based on (recent) history of self-reported STBs to ensure sufficient number of observations of STBs during the assessment period.”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [82]

  • Fixed schedules were almost exclusively used in studies with once-daily prompts, whereas pseudo-random schedules were typically used for repeated within-day assessments.

    “Fixed schedules were almost exclusively used in studies with once-daily prompts (as well as three older studies with PDAs (45, 81, 82)), whereas pseudo-random schedules were typically used for repeated within-day assessments.”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [82]

  • All reviewed studies included EMA items on suicidal ideation, and four studies (18%) also assessed the occurrence of suicide attempts via EMA.

    “While all studies included EMA items on suicidal ideation, four studies (18%) also assessed the occurrence of suicide attempts via EMA (45, 80, 82, 88)”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [82]

  • In another study comparing two 14-day EMA protocols (one with items on suicidal ideation and a control EMA protocol), there were no differences in the occurrence of suicidal ideation, self-harm or suicide attempts between the two conditions for either clinical (patients with BPD) or non-clinical controls based on weekly retrospective measures.

    “In another study comparing two 14-day EMA protocols (one with items on suicidal ideation, and a control EMA protocol), there were no differences in the occurrence of suicidal ideation, self-harm or suicide attempts between the two conditions for either clinical (patients with BPD) or non-clinical controls based on weekly retrospective measures (82).”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [82]

  • In a study of 248 adults with and without BPD, approximately 5% of participants made a suicide attempt during the entire study period, including a 6-month follow-up.

    “in a study of 248 adults with and without BPD, approximately 5% of participants made a suicide attempt during the entire study period (including a 6-month follow-up) (82).”

    From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [82]

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Research works printed but not linked: 1

  1. Furr RM Bacharach VR 2014 Psychometrics: An Introduction 2 Thousand Oaks, CA Sage Publications

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Authors
Law, M. K., Furr, R. M., Arnold, E. M., Mneimne, M., Jaquett, C., & Fleeson, W.
Affiliations
  • Wake Forest University (US)
  • Wake Forest University Health Sciences (US)
ORCID
Venue
Psychological Assessment
Publisher
American Psychological Association (APA)
Published
2015-12
Volume
27
Issue
4
Pages
1171-1181
ISSN
  • 1040-3590 (ISSN-L)
  • 1939-134X
DOI
10.1037/pas0000118
PMC
PMC4615260
OpenAlex
W2029807691
Cited by
82
References
37
Citations by year
2026: 3 · 2025: 7 · 2024: 6 · 2023: 11 · 2022: 12 · 2021: 12 · 2020: 10 · 2019: 8 · 2018: 7 · 2017: 4 · 2016: 2
FWCI
5.38
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychological Assessment (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (R01MH70571)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
suicide assessment, repeated assessment, suicidal ideation, suicidal behavior, borderline personality disorder, ecological momentary assessment, suicide risk
MeSH terms
Adolescent, Adult, Aged, Borderline Personality Disorder, Female, Humans, Longitudinal Studies, Male, Middle Aged, Psychiatric Status Rating Scales, Suicide, Suicide, Attempted, Case-Control Studies, Young Adult, Suicidal Ideation

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