Feasibility and acceptability of ecological momentary assessment with high-risk suicidal adolescents following acute psychiatric care
Abstract
Objective: The study purpose was to examine the feasibility and acceptability of intensive ecological momentary assessment (EMA) among high-risk adolescents with suicidal thoughts and behaviors following discharge from acute psychiatric care.Method: Fifty-three adolescents, 12–18 years old, and their parents, were recruited following discharge from acute psychiatric care for suicide risk. The study included a baseline assessment (adolescent and parent), 28 days of EMA surveys (5x per day) and wrist actigraphy (adolescent), and an interview at the end of the 28-day monitoring period (adolescent). Adolescents’ outpatient clinicians were also surveyed about the study.Results: Study feasibility was indicated by a reasonable enrollment rate, high adherence to wearing the actigraphy device, and good adherence to EMA surveys (highest in the first week with significant drop-off in subsequent weeks). Adolescents reported their overall experience in the study was positive, the questions were understandable, their responses to questions were generally accurate, and the surveys were minimally burdensome. The study procedures did not appear to be iatrogenic; suicide attempts and rehospitalizations were not study related and occurred at a rate comparable to other adolescents at the recruitment site. Adolescents’ clinicians reported that the study was somewhat positive and minimally burdensome for them, and somewhat positive for their patients and families.Conclusions: This study demonstrated that intensive EMA designs are feasible and acceptable among high-risk suicidal youth following acute psychiatric care. Specific procedures are provided for keeping adolescents safe during intensive EMA studies, including detailed information about the risk and safety monitoring plan.
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Most reviewed studies (78%, n = 18) were conducted in adult samples, and less frequently in adolescent samples (22%, n = 5).
“Most studies (78%, n = 18) were conducted in adult, and less frequently in adolescent samples [22%, n = 5; (45, 67, 72, 80, 85)].”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
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 [85]
Compliance rates were not significantly related to suicide history or current depressive symptom or suicidal ideation severity.
“Compliance rates were not significantly related to suicide history or current depressive symptom or suicidal ideation severity (65, 66, 71, 85, 88).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
Compliance rates declined over time, indicating participant fatigue effects.
“Compliance rates declined over time (i.e., participants exhibited fatigue effects) (80, 84, 85).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
In general, participants reported their experiences overall as neutral-to-positive but time consuming or burdensome, and that they would be open to participating in similar research in the future.
“In general, participants reported their experiences overall as neutral-to-positive but time consuming (or burdensome), and that they would be open to participating in similar research in the future (80, 84, 85).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
In three studies following adolescents recently discharged from inpatient treatment after a suicide attempt or severe ideation, the incidence of suicide attempts over 28 days was 6%, 8%, and 9%.
“Three studies followed adolescents who were recently discharged from inpatient treatment after a suicide attempt or severe ideation. In 28 days, the incidence of suicide attempts was 6% (55), 8% (72), and 9% (85).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
Two reviewed studies required that each participant had an individualized safety plan in place established by their treating physician, and another study instructed participants on how to make one prior to participation.
“Two studies required that each participant had an individualized safety plans in place established by their treating physician (61, 85), and another study instructed participants on how to make one prior to participation (88).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
Maintaining compliance with EMA remains a challenge, especially when assessment periods grow long, as compliance decreases over time with each subsequent week of EMA.
“Regardless, maintaining compliance with EMA remains a challenge, especially when assessment periods grow long, as compliance decreases over time with each subsequent week of EMA [see e.g., (80, 85)].”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
Many of the reviewed studies used monetary rewards for increasing or sustaining compliance.
“Many of the reviewed studies used monetary rewards for increasing or sustaining compliance [see e.g., (85, 88)].”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [85]
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- Authors
- Glenn, C. R., Kleiman, E. M., Kearns, J. C., Santee, A. C., Esposito, E. C., Conwell, Y., & Alpert-Gillis, L. J.
- Affiliations
- University of Rochester Medicine (US)
- Rutgers, The State University of New Jersey (US)
- University of Rochester (US)
- Department of Psychiatry, University of Rochester Medical Center
- Corresponding author
- Glenn, Catherine R.
- ORCID
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2020-04-02
- Volume
- 51
- Issue
- 1
- Pages
- 32-48
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- OpenAlex
- W3014688601
- Cited by
- 104
- References
- 37
- Citations by year
- 2026: 14 · 2025: 24 · 2024: 16 · 2023: 16 · 2022: 17 · 2021: 15 · 2020: 1
- FWCI
- 11.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Foundation for Suicide Prevention (YIG-1-054-16)
- Medical Center, University of Rochester (pilot)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- ecological momentary assessment, suicidal adolescents, suicide risk, at-risk youth, acute psychiatric care, post-discharge monitoring, wrist actigraphy, feasibility, acceptability, clinician perspectives
- MeSH terms
- Ecological Momentary Assessment, Adolescent, Child, Feasibility Studies, Humans, Surveys and Questionnaires, Suicide, Attempted, Suicidal Ideation
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