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

Open access
Kivelä, Liia, van der Does, Willem A. J., Riese, Harriëtte, Antypa, Niki·2022·Frontiers in Digital Health
DOI 10.3389/fdgth.2022.876595PMC PMC9120419
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Abstract

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.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review of 45 articles covering 23 ecological momentary assessment (EMA) studies finds that suicidal ideation fluctuates substantially over hours and days, and that EMA is feasible and generally safe for assessing suicidal thoughts and behaviors. Prior suicidal ideation remains the strongest predictor of later ideation, while some momentary predictors such as negative affect, hopelessness, burdensomeness, and sleep characteristics show promise but need replication.

Key findings

  • Across 45 articles and 23 studies, agreement to participate in EMA research was moderate to high (median = 77%), and compliance was similar to other clinical samples (median response rate = 70%; attrition median = 6%). More individuals reported suicidal ideation through EMA than through traditional retrospective self-report measures.
  • Suicidal ideation fluctuated substantially over short periods: within-day, about one third of ratings differed from the previous rating by at least one within-person standard deviation, and individuals with higher mean ideation also had more fluctuations. Higher suicidal ideation instability predicted suicide attempt at 1-month follow-up in a pilot study of 83 adult psychiatric inpatients.
  • Most studies failed to establish prospective predictors beyond prior ideation itself. The most consistent evidence was for momentary negative affect, hopelessness, and burdensomeness predicting increased within-day ideation; short sleep duration, poor subjective sleep quality, and increased sleep latency predicted next-day ideation.
  • No evidence was found of systematic reactivity of mood or suicidal ideation to repeated EMA assessments of suicidal thoughts and behaviors, and no suicide mortality was reported in any reviewed study.

Methods

  • Systematic review conducted according to PRISMA guidelines. Web of Science and PubMed were searched in December 2021 using terms for EMA/ESM/ambulatory assessment and suicide/suicidal.
  • The search produced 372 results; after duplicates, 280 remained; 40 met inclusion criteria and 5 additional articles were identified through other sources, yielding 45 articles reporting on 23 studies.
  • Inclusion required electronic EMA (PDAs, mobile phones, smartwatches) and ≥1 EMA item assessing suicidal thoughts and behaviors; studies using paper-and-pen diaries, focusing solely on non-suicidal self-injury, or not written in English were excluded. Data abstraction covered sample characteristics, aims, EMA variables, STB operationalization, duration, sampling, device/software, methodological characteristics, main findings, adverse events, and safety procedures.

Limitations

  • The paper states that considerable heterogeneity in study characteristics and reporting, together with diverse aims and samples, prevented meta-analyses. It also notes insufficient reporting: 12 (55%) studies did not report acceptability, 3 (14%) did not report any compliance index, 14 (63%) did not report attrition, 12 (55%) did not report adverse events, and 11 (50%) did not report whether safety measures were implemented.
  • The paper states that conclusions about reactivity are tentative because few studies directly assessed reactivity and there was a general lack of control groups; adverse events were also seriously limited in assessment and reporting.
  • Evident from the text: the reviewed studies focused exclusively on adolescents and adults, mostly from high-risk clinical or community samples, so findings may not generalize to older populations or non-Western societies; the paper explicitly calls for further research in these groups.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fdgth.2022.876595

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 275 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    No evidence was found of systematic reactivity of mood or suicidal ideation to repeated assessments of STBs.

    “no evidence was found of systematic reactivity of mood or suicidal ideation to repeated assessments of STBs.”
    • Also stated in: § Abstract · hedged
      “While repeated EMA assessments do not appear to result in systematic reactivity in STBs”
    Quote in the paperSubstantial claim
  • Findingnone given

    More individuals reported suicidal ideation through EMA than through traditional retrospective self-report measures.

    “More individuals reported suicidal ideation through EMA than traditional (retrospective) self-report measures.”
    Quote in the paperSubstantial claim
  • Findingnone given

    Few studies succeeded in establishing prospective predictors of suicidal ideation beyond prior ideation itself.

    “Few studies succeeded in establishing prospective predictors of suicidal ideation beyond prior ideation itself.”
    Quote in the paperSubstantial claim
  • Findingnone given

    Negative affect, hopelessness and burdensomeness predict increased suicidal ideation within-day.

    “Some studies show negative affect, hopelessness and burdensomeness to predict increased ideation within-day”
    Quote in the paperSubstantial claim
  • Findingown data

    Compliance rates in EMA suicide research are similar to those in other clinical samples (median response rate = 70%).

    “compliance rates similar to those in other clinical samples (median response rate = 70%)”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 26
  • May combine two claims. 70

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The literature search yielded 45 articles for the review (372 initial results, 280 after duplicates, 40 meeting inclusion criteria, plus 5 from alternate sources).

    “the search produced 372 results. After excluding duplicate records, 280 remained. Of these, 40 met the inclusion criteria given below. Another 5 articles were identified through alternate sources (i.e., review papers and other articles), resulting in a total of 45 articles for the present review.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the included articles, 36 reported studies where EMA was used to measure STBs, and nine specifically addressed methodological issues of using EMA to measure STBs.

    “Of these, 36 articles were reports where EMA was used to measure STBs (Table 1), and nine specifically addressed methodological issues (acceptability, feasibility and validity) of using EMA to measure STBs (Table 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    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)].”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [42] Husky, 2017, Predictors of daily life suicidal ideation in adults recently discharged after a serious suicide attempt: a pilot study, Psychiatry Res source

      Not checked in the free run.

    • cites [47] Kleiman, 2017, Examination of real-time fluctuations in suicidal ideation and its risk factors: results from two ecological momentary assessment studies, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [51] Littlewood, 2019, Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study, Psychol Med source

      Not checked in the free run.

    • cites [58] Rizk, 2019, Variability in suicidal ideation is associated with affective instability in suicide attempters with borderline personality disorder, Psychiatry. source

      Not checked in the free run.

    • cites [61] Armey, 2020, Ecologically assessed affect and suicidal ideation following psychiatric inpatient hospitalization, Gen Hosp Psychiatry. source

      Not checked in the free run.

    • cites [65] Oquendo, 2020, Highly variable suicidal ideation: a phenotypic marker for stress induced suicide risk, Mol Psychiatry. source

      Not checked in the free run.

    • cites [69] Al-Dajani, 2021, The after-effects of momentary suicidal ideation: a preliminary examination of emotion intensity changes following suicidal thoughts, Psychiatry Res source

      Not checked in the free run.

    • cites [71] Hallard, 2021, Metacognition, rumination and suicidal ideation: an experience sampling test of the self-regulatory executive function model, Psychiatry Res source

      Not checked in the free run.

    • cites [79] Wang, 2021, A pilot study using frequent inpatient assessments of suicidal thinking to predict short-term postdischarge suicidal behavior, JAMA source

      Not checked in the free run.

    • cites [83] Torous, 2015, Utilizing a personal smartphone custom app to assess the patient health questionnaire-9 (PHQ-9) depressive symptoms in patients with major depressive disorder, JMIR Mental Health. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    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)].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [67] Vine, 2020, Adolescent suicide risk and experiences of dissociation in daily life, Psychiatry Res. source

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    • cites [72] Czyz, 2021, Short-term associations between nonsuicidal and suicidal thoughts and behaviors: a daily diary study with high-risk adolescents, J Affect Disord source

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    • cites [80] Czyz, 2018, Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: lessons about feasibility and acceptability, Psychiatry Res source

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    • cites [85] Glenn, 2022, Feasibility and acceptability of ecological momentary assessment with high-risk suicidal adolescents following acute psychiatric care, J Clin Child Adolesc Psychol. source

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  • May combine two claims.

    Findingown data

    The number of scheduled EMA prompts per day in the reviewed studies ranged from 1 to 11, with a median of 5 (n = 21).

    “The number of (scheduled) EMA prompts per day ranged from 1 to 11 (median = 5, n = 21).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The duration of EMA monitoring in the reviewed studies ranged from 4 to 60 days, with a median of 14 days (n = 23).

    “The duration of EMA monitoring ranged from 4 to 60 days (median = 14, n = 23).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    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.”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [83] Torous, 2015, Utilizing a personal smartphone custom app to assess the patient health questionnaire-9 (PHQ-9) depressive symptoms in patients with major depressive disorder, JMIR Mental Health. source

      Not checked in the free run.

    • cites [84] Forkmann, 2018, Assessing suicidality in real time: a psychometric evaluation of self-report items for the assessment of suicidal ideation and its proximal risk factors using ecological momentary assessments, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [86] Gratch, 2021, Detecting suicidal thoughts: the power of ecological momentary assessment, Depress Anxiety. source

      Not checked in the free run.

    • cites [58] Rizk, 2019, Variability in suicidal ideation is associated with affective instability in suicide attempters with borderline personality disorder, Psychiatry. source

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    • cites [64] Kaurin, 2020, Momentary interpersonal processes of suicidal surges in borderline personality disorder source

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    • cites [82] Law, 2015, Does assessing suicidality frequently and repeatedly cause harm? a randomized control study, Psychol Assess. source

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    Findingcitation

    Contextual factors of suicidal thoughts among adolescents included being alone, experiencing arguments/conflict, or recalling negative memories.

    “Contextual factors of suicidal thoughts among adolescents included being alone, experiencing arguments/conflict or recalling negative memories (45).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The most frequently measured predictor variables in the reviewed studies included contextual factors, affect, and constructs from the Interpersonal Psychological Theory of Suicide; protective factors such as coping and social support were less frequently assessed.

    “The most frequently measured predictor variables included contextual factors (incl. location, activity, social company), affect, and constructs from the Interpersonal Psychological Theory of Suicide [IPTS: hopelessness, burdensomeness and thwarted belongingness (91)]. Protective factors, such as coping and social support, were less frequently assessed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [91] Chu, 2017, The interpersonal theory of suicide: a systematic review and meta-analysis of a decade of cross-national research, Psychol Bull source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The reviewed studies were heterogeneous in their operationalization of suicidal thoughts and behaviors, and no clear delineation emerged over time on preferred methodologies or use of specific EMA items.

    “Studies were heterogenous in their operationalization of STBs, and no clear delineation emerged over time on preferred methodologies or use of specific EMA items.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    In adolescent samples, suicidal ideation was reported by 34-82% of the sample during EMA (median = 71%, n = 3), and 2-39% of observations had suicidal ideation ratings > 0 (median = 25%, n = 3).

    “In adolescent samples, suicidal ideation was reported by 34–82% of the sample during EMA (median = 71%, n = 3), and overall, 2–39% of observations had suicidal ideation ratings >0 (median: 25% n = 3).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Two reviewed studies used a turn-over system where a subset of questions was randomly presented at a certain time point to limit repetition.

    “Two studies used a turn-over system where a subset of questions was randomly presented at a certain time point to limit repetition (83, 87).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [83] Torous, 2015, Utilizing a personal smartphone custom app to assess the patient health questionnaire-9 (PHQ-9) depressive symptoms in patients with major depressive disorder, JMIR Mental Health. source

      Not checked in the free run.

    • cites [87] Porras-Segovia, 2020, Smartphone-based ecological momentary assessment (EMA) in psychiatric patients and student controls: a real-world feasibility study, J Affect Disord source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In adolescent samples, suicidal thoughts occurred once a week on average and typically lasted 1 to 30 minutes.

    “These thoughts occurred once a week on average, and typically lasted 1 to 30 min [based on a binary measure of ideation (45)].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The number of EMA items on suicidal thoughts and behaviors ranged from 1 to 9, with a median of 2 (n = 22).

    “The number of EMA items on STBs ranged from 1 to 9 (median = 2, n = 22).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    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)”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [80] Czyz, 2018, Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: lessons about feasibility and acceptability, Psychiatry Res source

      Not checked in the free run.

    • cites [82] Law, 2015, Does assessing suicidality frequently and repeatedly cause harm? a randomized control study, Psychol Assess. source

      Not checked in the free run.

    • cites [88] Rogers, 2021, Feasibility and acceptability of ecological momentary assessment in a fully online study of community-based adults at high risk for suicide, Psychol Assess. source

      Not checked in the free run.

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    Findingown data

    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.”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [47] Kleiman, 2017, Examination of real-time fluctuations in suicidal ideation and its risk factors: results from two ecological momentary assessment studies, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [61] Armey, 2020, Ecologically assessed affect and suicidal ideation following psychiatric inpatient hospitalization, Gen Hosp Psychiatry. source

      Not checked in the free run.

    • cites [69] Al-Dajani, 2021, The after-effects of momentary suicidal ideation: a preliminary examination of emotion intensity changes following suicidal thoughts, Psychiatry Res source

      Not checked in the free run.

    • cites [85] Glenn, 2022, Feasibility and acceptability of ecological momentary assessment with high-risk suicidal adolescents following acute psychiatric care, J Clin Child Adolesc Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    EMA items on suicidal thoughts and behaviors were typically rated on a 5-point Likert scale; seven studies (32%) used binary items, or a combination of an initial binary item followed by ratings on frequency, intensity and/or duration (18%, n = 4).

    “The items were typically rated on a 5-point Likert-scale; seven (32%) studies used binary items, or a combination of an initial binary item on the presence of STBs, followed by ratings on frequency, intensity and/or duration (18%, n = 4).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    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.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [81] Husky, 2014, Feasibility and validity of ecological momentary assessment in the investigation of suicide risk, Psychiatry Res. source

      Not checked in the free run.

    • cites [82] Law, 2015, Does assessing suicidality frequently and repeatedly cause harm? a randomized control study, Psychol Assess. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Between days, short sleep duration (both objective and subjective), poor subjective sleep quality and increased sleep latency predicted mean next-day suicidal ideation.

    “Between days, short sleep duration (both objective and subjective), poor subjective sleep quality and increased sleep latency (i.e., time to fall asleep) predicted (mean) next-day suicidal ideation (51, 74).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [51] Littlewood, 2019, Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study, Psychol Med source

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    • cites [74] Kaurin, 2021, Sleep and next-day negative affect and suicidal ideation in borderline personality disorder, Pers Disord Theory Res Treat source

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    Findingcitation

    Although negative daily life events were generally not associated with suicidal ideation, negative interpersonal events increased the probability of ideation.

    “Although negative daily life events were generally not associated with suicidal ideation, negative interpersonal events increased the probability of ideation (42, 64)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [42] Husky, 2017, Predictors of daily life suicidal ideation in adults recently discharged after a serious suicide attempt: a pilot study, Psychiatry Res source

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    • cites [64] Kaurin, 2020, Momentary interpersonal processes of suicidal surges in borderline personality disorder source

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  • May combine two claims.

    Findingcitation

    Within-day, approximately one third of ratings differed from the previous one by at least one within-person standard deviation, illustrating both sharp increases and decreases in ideation over a time frame of hours (4-8 h).

    “Within-day, approximately one third of ratings differed from the previous one by at least one (within-person) standard deviation, illustrating both sharp increases and decreases in ideation in a time frame of hours [4–8 h (47)].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [47] Kleiman, 2017, Examination of real-time fluctuations in suicidal ideation and its risk factors: results from two ecological momentary assessment studies, J Abnorm Psychol. source

      Not checked in the free run.

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    Findingcitation

    Among adults, being alone, at home or at work, and inactivity increased the probability of suicidal ideation, while being with family and friends or engaged in leisure activities decreased the probability of ideation.

    “Among adults, being alone, at home or at work, and inactivity increased the probability of suicidal ideation, while being with family and friends or engaged in leisure activities decreased probability of ideation (42).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [42] Husky, 2017, Predictors of daily life suicidal ideation in adults recently discharged after a serious suicide attempt: a pilot study, Psychiatry Res source

      Not checked in the free run.

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    Findingown data

    Most reports failed to establish independent temporal predictors of suicidal ideation severity: of twelve articles fitting temporal prediction models, four failed to establish significant predictors after accounting for ideation at the previous time point, and five did not control for prior ideation.

    “Most reports failed to establish independent temporal predictors of suicidal ideation severity: of twelve articles fitting temporal prediction models (47, 51, 52, 55–57, 60, 73, 74, 76, 77), four failed to establish significant predictors after accounting for ideation at the previous time point (47, 52, 55), and five did not control for prior ideation (51, 60, 73, 74, 76).”
    Quote in the paperSubstantial claim0 of 10 sources checked
    • cites [47] Kleiman, 2017, Examination of real-time fluctuations in suicidal ideation and its risk factors: results from two ecological momentary assessment studies, J Abnorm Psychol. source

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    • cites [51] Littlewood, 2019, Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study, Psychol Med source

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    • cites [52] Coppersmith, 2019, The dynamics of social support among suicide attempters: a smartphone-based daily diary study, Behav Res Ther source

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    • cites [55] Czyz, 2019, Short-term change and prediction of suicidal ideation among adolescents: a daily diary study following psychiatric hospitalization, J Child Psychol Psychiatry Allied Discip source

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    • cites [56] Hallensleben, 2019, Predicting suicidal ideation by interpersonal variables, hopelessness and depression in real-time: an ecological momentary assessment study in psychiatric inpatients with depression, Eur Psychiatry source

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    • cites [57] Rath, 2019, Modelling suicide ideation from beep to beep: application of network analysis to ecological momentary assessment data, Internet Interv. source

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    • cites [60] Victor, 2019, I. want you to want me: interpersonal stress and affective experiences as within-person predictors of nonsuicidal self-injury and suicide urges in daily life, Suicide Life Threat Behav. source

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    • cites [73] Glenn, 2021, Thwarted belongingness mediates interpersonal stress and suicidal thoughts: an intensive longitudinal study with high-risk adolescents source

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    • cites [74] Kaurin, 2021, Sleep and next-day negative affect and suicidal ideation in borderline personality disorder, Pers Disord Theory Res Treat source

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    • cites [76] Schatten, 2021, Differential time varying associations among affective states and suicidal ideation among adolescents following hospital discharge, Psychiatry Res. source

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  • May combine two claims.

    Findingcitation

    Risk factors (negative affect, hopelessness, loneliness, burdensomeness, connectedness, thwarted belongingness) occurred with similar variability and were concurrently associated with suicidal ideation.

    “Risk factors (negative affect, hopelessness, loneliness, burdensomeness, connectedness, thwarted belongingness) occurred with similar variability, and were concurrently associated with suicidal ideation (47, 55, 56, 68, 78).”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [47] Kleiman, 2017, Examination of real-time fluctuations in suicidal ideation and its risk factors: results from two ecological momentary assessment studies, J Abnorm Psychol. source

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    • cites [55] Czyz, 2019, Short-term change and prediction of suicidal ideation among adolescents: a daily diary study following psychiatric hospitalization, J Child Psychol Psychiatry Allied Discip source

      Not checked in the free run.

    • cites [56] Hallensleben, 2019, Predicting suicidal ideation by interpersonal variables, hopelessness and depression in real-time: an ecological momentary assessment study in psychiatric inpatients with depression, Eur Psychiatry source

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    • cites [68] Aadahl, 2021, Metacognitive beliefs and suicidal ideation: an experience sampling study, Int J Environ Res Public Health source

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    • cites [78] Victor, 2021, Prospective and concurrent affective dynamics in self-injurious thoughts and behaviors: an examination in young adult women, Behav Ther. source

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    Findingcitation

    The decline in compliance over time was not replicated by all studies: one study reported no decrease over time, another reported fluctuation before stabilizing after about 2 weeks, and another reported increased compliance over time during a 1-week EMA study.

    “However, this effect was not replicated by all: rather than declining in a linear manner, one study reported that compliance rates did not decrease over time (66), fluctuated before stabilizing after ~2 weeks (83), or that compliance increased over time during a 1-week EMA study (81).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [66] Peters, 2022, Instability of suicidal ideation in patients hospitalized for depression: an exploratory study using smartphone ecological momentary assessment, Arch Suicide Res. source

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    • cites [83] Torous, 2015, Utilizing a personal smartphone custom app to assess the patient health questionnaire-9 (PHQ-9) depressive symptoms in patients with major depressive disorder, JMIR Mental Health. source

      Not checked in the free run.

    • cites [81] Husky, 2014, Feasibility and validity of ecological momentary assessment in the investigation of suicide risk, Psychiatry Res. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The clinicians of another adolescent sample reported the study, on average, to have had neutral to somewhat positive impact on their patients, including increased awareness into one's condition.

    “The clinicians of another adolescent sample reported the study, on average, to have had “neutral” to “somewhat positive” impact on their patients [incl. increased awareness into one's condition (72)].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Czyz, 2021, Short-term associations between nonsuicidal and suicidal thoughts and behaviors: a daily diary study with high-risk adolescents, J Affect Disord source

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  • May combine two claims.

    Findingcitation

    A feasibility study in adult suicide attempters, clinical controls, and healthy controls found no effects of study duration on the intensity of negative affect or frequency of suicidal ideation, indicating no symptom worsening with repeated prompts.

    “A feasibility study in adult suicide attempters (recent or past attempt history), clinical controls (i.e., depressed patients without suicide attempt history), and healthy controls, found no effects of study duration on the intensity of negative affect or frequency of suicidal ideation, indicating no symptom worsening with repeated prompts (81).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [81] Husky, 2014, Feasibility and validity of ecological momentary assessment in the investigation of suicide risk, Psychiatry Res. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Practice effects were observed by participant response times decreasing over time.

    “Practice effects were also observed by participant's response times decreasing over time (81).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Husky, 2014, Feasibility and validity of ecological momentary assessment in the investigation of suicide risk, Psychiatry Res. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    More severe depressive symptoms were reported through EMA than with a traditional retrospective questionnaire, and EMA reports of suicidal ideation were notably higher than questionnaire scores for 69% of the participants.

    “More severe depressive symptoms were reported through EMA than with a traditional retrospective questionnaire, and EMA reports of suicidal ideation were notably higher than questionnaire scores for 69% of the participants (83).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [83] Torous, 2015, Utilizing a personal smartphone custom app to assess the patient health questionnaire-9 (PHQ-9) depressive symptoms in patients with major depressive disorder, JMIR Mental Health. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Variability in momentary suicidal ideation correlated moderately with the SBQ-R (r = 0.41), the BSSI (r = 0.49), and the GCSQ (r = 0.30).

    “Variability in momentary SI correlated moderately with the Suicide Behaviors Questionnaire - Revised [SBQ-R (96)] (r = 0.41), the BSSI (r = 0.49), and the Capability for Suicide Questionnaire [GCSQ (97)] (r = 0.30) (63).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [96] Osman, 2001, The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples, Assessment. source

      Not checked in the free run.

    • cites [97] Cwik, 2020, Validation of the German capability for suicide questionnaire (GCSQ) in a high-risk sample of suicidal inpatients, BMC Psychiatry. source

      Not checked in the free run.

    • cites [63] Hadzic, 2020, The association of trait impulsivity and suicidal ideation and its fluctuation in the context of the interpersonal theory of suicide, Compr Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    A one-item EMA measure (How suicidal are you right now?) correlated highly with the BSSI (r = 0.71) and moderately with the BDI (r = 0.41).

    “A one-item EMA measure (“How suicidal are you right now?”) correlated highly with the BSSI (r = 0.71) and moderately with the Beck Depression Inventory [BDI (95)] [r = 0.41 (71)].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [95] Beck, 1961, An inventory for measuring depression, Arch Gen Psychiatry. source

      Not checked in the free run.

    • cites [71] Hallard, 2021, Metacognition, rumination and suicidal ideation: an experience sampling test of the self-regulatory executive function model, Psychiatry Res source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In an adolescent sample, suicidal ideation was reported in EMA by 71% of the participants, and in 45% of the interviews post-EMA.

    “In an adolescent sample, suicidal ideation was reported in EMA by 71% of the participants, and in 45% of the interviews post-EMA (80).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [80] Czyz, 2018, Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: lessons about feasibility and acceptability, Psychiatry Res source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Response rates were higher in the afternoons and on weekend days.

    “Response rates were higher in the afternoons (83) and on weekend days (84).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [83] Torous, 2015, Utilizing a personal smartphone custom app to assess the patient health questionnaire-9 (PHQ-9) depressive symptoms in patients with major depressive disorder, JMIR Mental Health. source

      Not checked in the free run.

    • cites [84] Forkmann, 2018, Assessing suicidality in real time: a psychometric evaluation of self-report items for the assessment of suicidal ideation and its proximal risk factors using ecological momentary assessments, J Abnorm Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In a sample of adolescents assessed after 1 month of EMA, most participants reported no change in mood after filling out EMA (69%) or that they felt better (28%); one participant reported worse mood after completing EMA.

    “In a sample of adolescents assessed after 1-month of EMA, most participants reported that they generally felt no change in mood after filling out EMA (69%) or that they felt better (28%); one participant reported that they had worse mood after completing EMA (80).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [80] Czyz, 2018, Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: lessons about feasibility and acceptability, Psychiatry Res source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    There was a decrease in positive affect among recent and past suicide attempters, and a decrease in hopelessness among recent suicide attempters with increasing study duration across seven days.

    “However, there was a decrease in positive affect among recent and past suicide attempters, and a decrease in hopelessness among recent suicide attempters with increasing study duration (across seven days) (81).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Husky, 2014, Feasibility and validity of ecological momentary assessment in the investigation of suicide risk, Psychiatry Res. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In another study, the EMA software was programmed to send automatic email alerts to the study's on-call clinician if the participant endorsed a suicide attempt or severe ideation with suicidal intent and/or a plan, in which case the clinician made contact; less than 1% of responses met this threshold and required contact.

    “In another study, the EMA software was programmed to send out automatic email alerts to the study's on-call clinician if the participant endorsed a suicide attempt or severe ideation with suicidal intent and/or a plan, in which case the clinician made contact with the participant; <1% of the responses recorded met this threshold and required contact by the study personnel (80).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [80] Czyz, 2018, Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: lessons about feasibility and acceptability, Psychiatry Res source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    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).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [69] Al-Dajani, 2021, The after-effects of momentary suicidal ideation: a preliminary examination of emotion intensity changes following suicidal thoughts, Psychiatry Res source

      Not checked in the free run.

    • cites [70] Cobo, 2021, Patients at high risk of suicide before and during a COVID-19 lockdown: ecological momentary assessment study, BJPsych Open. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    While only 36% (n = 8) of reviewed studies reported on safety procedures, 80% (n = 4) of studies in adolescent samples had safety measures in place.

    “Of note is that while only 36 % (n = 8) of studies reported on safety procedures, 80% (n = 4) of studies in adolescent samples had safety measures in place.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Ten reviewed studies reported whether any suicide attempts occurred during the study period; in four studies no such events occurred.

    “Ten studies reported whether any suicide attempts occurred during the study period: in four studies no such events occurred (45, 47, 84).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [47] Kleiman, 2017, Examination of real-time fluctuations in suicidal ideation and its risk factors: results from two ecological momentary assessment studies, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [84] Forkmann, 2018, Assessing suicidality in real time: a psychometric evaluation of self-report items for the assessment of suicidal ideation and its proximal risk factors using ecological momentary assessments, J Abnorm Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Another study reported twice-daily manual checks on the participants' entries; 32% of the adolescent participants were contacted for a risk assessment during the 4-week study.

    “Another study reported twice-daily (manual) checks on the participants entries; 32% of the adolescent participants were contacted for a risk assessment during the 4-week study (72).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Czyz, 2021, Short-term associations between nonsuicidal and suicidal thoughts and behaviors: a daily diary study with high-risk adolescents, J Affect Disord source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Among 237 high-risk adults from the community, 9% reported they had experienced the EMA as occasionally distressing, emotionally taxing, and triggering bad thoughts, compared to 3% who reported a decrease in the frequency of and urge to act on suicidal thoughts due to study participation.

    “Among 237 high risk adults from the community, 9% reported they had experienced the EMA as “occasionally' distressing,”' “emotionally taxing,” and, “triggering bad thoughts,” (p. 6) in comparison to 3% who reported a decrease in the frequency of and urge to act on suicidal thoughts due to study participation (88).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [88] Rogers, 2021, Feasibility and acceptability of ecological momentary assessment in a fully online study of community-based adults at high risk for suicide, Psychol Assess. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    In a study using PDAs, participants were instructed to upload their data on a server each night for evaluation, and research personnel phoned participants in case responses indicated imminent risk or if no data had been uploaded for 72 hours.

    “In a study using PDAs, participants were instructed to upload their data on a server each night for evaluation, and research personnel phoned participants in case responses indicated imminent risk or if no data had been uploaded for 72 h (45).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Nock, 2009, Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults, J Abnorm Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    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).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [61] Armey, 2020, Ecologically assessed affect and suicidal ideation following psychiatric inpatient hospitalization, Gen Hosp Psychiatry. source

      Not checked in the free run.

    • cites [85] Glenn, 2022, Feasibility and acceptability of ecological momentary assessment with high-risk suicidal adolescents following acute psychiatric care, J Clin Child Adolesc Psychol. source

      Not checked in the free run.

    • cites [88] Rogers, 2021, Feasibility and acceptability of ecological momentary assessment in a fully online study of community-based adults at high risk for suicide, Psychol Assess. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Four reviewed studies implemented automatic messages sent out by the EMA device.

    “Four studies implemented automatic messages sent out by the EMA device.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    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).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [80] Czyz, 2018, Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: lessons about feasibility and acceptability, Psychiatry Res source

      Not checked in the free run.

    • cites [84] Forkmann, 2018, Assessing suicidality in real time: a psychometric evaluation of self-report items for the assessment of suicidal ideation and its proximal risk factors using ecological momentary assessments, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [85] Glenn, 2022, Feasibility and acceptability of ecological momentary assessment with high-risk suicidal adolescents following acute psychiatric care, J Clin Child Adolesc Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    There was insufficient reporting of other study characteristics: 12 (55%) studies did not report acceptability, three (14%) did not report any index of compliance, 14 (63%) did not report attrition, 12 (55%) did not report adverse events, and 11 (50%) did not report whether any safety measures were implemented.

    “Further, there was insufficient reporting of other study characteristics: 12 (55%) studies did not report acceptability, three (14%) did not report any index of compliance (with further inconsistencies in how compliance was defined), 14 (63%) did not report on attrition, 12 (55%) did not report adverse events, and 11 (50%) did not report whether any safety measures were implemented.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Compliance was good and not substantially lower than in other clinical or non-clinical populations.

    “Meanwhile, compliance was good and not substantially lower than in other clinical (103) or non-clinical populations [see e.g., (104)].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [103] Johnson, 2009, Computerized ambulatory monitoring in psychiatry: a multi-site collaborative study of acceptability, compliance, and reactivity, Int J Methods Psychiatr Res. source

      Not checked in the free run.

    • cites [104] Courvoisier, 2012, Compliance to a cell phone-based ecological momentary assessment study: the effect of time and personality characteristics, Psychol Assess. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The review did not uncover systematic negative mood reactivity to EMA, and importantly, there was no evidence of reactivity on suicidal thoughts and behaviors specifically.

    “Our review did not uncover systematic (negative) mood reactivity to EMA, and importantly, there was no evidence of reactivity on STBs specifically (81, 82).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [81] Husky, 2014, Feasibility and validity of ecological momentary assessment in the investigation of suicide risk, Psychiatry Res. source

      Not checked in the free run.

    • cites [82] Law, 2015, Does assessing suicidality frequently and repeatedly cause harm? a randomized control study, Psychol Assess. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Three (14%) reviewed studies did not provide EMA item descriptions, two (9%) did not report sampling frequency, and three (14%) did not report sampling technique.

    “Notably, three (14%) studies did not provide EMA item descriptions, two (9%) did not report sampling frequency, and three (14%) did not report sampling technique (i.e., fixed or random).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    How to adequately measure EMA item reliability and validity remains to be established.

    “Finally, how to adequately measure EMA item reliability and validity remains to be established (although first initiatives have started, such as the Experience Sampling Method (ESM) Item Repository (https://osf.io/kg376/).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    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)].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [80] Czyz, 2018, Ecological assessment of daily suicidal thoughts and attempts among suicidal teens after psychiatric hospitalization: lessons about feasibility and acceptability, Psychiatry Res source

      Not checked in the free run.

    • cites [85] Glenn, 2022, Feasibility and acceptability of ecological momentary assessment with high-risk suicidal adolescents following acute psychiatric care, J Clin Child Adolesc Psychol. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    While EMA measures showed high correlations with traditional self-report, more individuals reported suicidal ideation through EMA, and more severe instances of ideation were detected through EMA than retrospective measures.

    “While EMA measures showed high correlations with traditional self-report, more individuals reported suicidal ideation through EMA, and more severe instances of ideation were detected through EMA than retrospective measures.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    In addition to suicidal ideation itself, a number of its risk factors (including negative affect, hopelessness, loneliness, burdensomeness, and thwarted belongingness) were also found to exhibit similar variability patterns and to associate with momentary ideation.

    “In addition to suicidal ideation itself, a number of its risk factors (incl. negative affect, hopelessness, loneliness, burdensomeness, thwarted belongingness) were also found to exhibit similar variability patterns and associate with momentary ideation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    The use of EMA in suicide research has grown rapidly in the past years.

    “The use of EMA in suicide research has grown rapidly in the past years”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Some specific predictors of subsequent suicidal ideation have been identified, but these findings warrant further replication.

    “Some specific predictors of subsequent ideation have been identified, but these findings warrant further replication.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Known risk factors for suicide, including psychiatric and demographic variables such as depression, gender and stress, are poor predictors of short-term suicidal behavior or are non-modifiable.

    “However, these factors have quite limited clinical use: they are poor predictors of short-term behavior, or are non-modifiable (e.g., gender, past STBs).”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [28] Borges, 2010, Twelve-month prevalence of and risk factors for suicide attempts in the world health organization world mental health surveys, J Clin Psychiatry. source

      Not checked in the free run.

    • cites [29] Nock, 2008, Suicide and suicidal behavior, Epidemiol Rev. source

      Not checked in the free run.

    • cites [30] van Orden, 2010, The interpersonal theory of suicide, Psychol Rev. source

      Not checked in the free run.

    • cites [31] Franklin, 2017, Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research, Psychol Bull source

      Not checked in the free run.

    • cites [32] Large, 2011, The validity and utility of risk assessment for inpatient suicide, Australasian Psychiatry. source

      Not checked in the free run.

    • cites [33] Large, 2016, Meta-analysis of longitudinal cohort studies of suicide risk assessment among psychiatric patients: heterogeneity in results and lack of improvement over time, PLoS ONE. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Suicide and suicide-related phenomena represent a major cause of mortality and disability worldwide.

    “Suicide and suicide-related phenomena [ideation i.e., thoughts or fantasies about one's death (27), attempts] represent a major cause of mortality and disability worldwide (28, 29).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Borges, 2010, Twelve-month prevalence of and risk factors for suicide attempts in the world health organization world mental health surveys, J Clin Psychiatry. source

      Not checked in the free run.

    • cites [29] Nock, 2008, Suicide and suicidal behavior, Epidemiol Rev. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Asking individuals about their suicidal thoughts and behaviors does not induce suicidal ideation in asymptomatic individuals, nor does it increase risk in those affected.

    “It has been demonstrated that asking individuals about their suicidal thoughts and behaviors does not induce suicidal ideation in asymptomatic individuals, nor does it increase risk in those affected.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [39] Smith, 2010, The effect of participating in suicide research: does participating in a research protocol on suicide and psychiatric symptoms increase suicide ideation and attempts?, Suicide Life Threat Behav. source

      Not checked in the free run.

    • cites [40] Gould, 2005, Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial, JAMA. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review was conducted in accordance with PRISMA guidelines.

    “The review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines (44).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Moher, 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, BMJ. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both suicidal ideation and its risk factors can fluctuate substantially over short periods of time (days and hours).

    “Both suicidal ideation and its risk factors can fluctuate substantially over short periods of time (days and hours) (37).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [37] Witte, 2006, Naturalistic evaluation of suicidal ideation: variability and relation to attempt status, Behav Res Ther. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sleep duration and subjective sleep quality predicted next-day suicidal ideation in adults with current suicidal ideation.

    “Sleep duration, subjective sleep quality predicted next-day SI”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Littlewood et al. (51) Littlewood, 2019, Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study, Psychol Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted).

    Premisecitation

    Between-day variability in suicidal ideation may be a better predictor of suicide than its intensity or duration.

    “it has been suggested that (between-day) variability in suicidal ideation may be a better predictor of suicide than its intensity or duration (37, 38).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [37] Witte, 2006, Naturalistic evaluation of suicidal ideation: variability and relation to attempt status, Behav Res Ther. source

      Not checked in the free run.

    • cites [38] Witte, 2005, Variability in suicidal ideation: a better predictor of suicide attempts than intensity or duration of ideation?, J Affect Disord. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The study of STBs needs a new focus and methodology, for which EMA holds promise.

    “In summary, the study of STBs needs a new focus and methodology, for which EMA holds promise.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Recent reviews indicate that EMA is an acceptable and feasible data collection method in psychiatric samples.

    “These reviews indicate that EMA is an acceptable and feasible data collection method in psychiatric samples as well”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [10] Bos, 2019, Insights of patients and clinicians on the promise of the experience sampling method for psychiatric care, Psychiatr Serv. source

      Not checked in the free run.

    • cites [11] Colombo, 2019, Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review, J Clin Med source

      Not checked in the free run.

    • cites [12] Walz, 2014, Experience sampling and ecological momentary assessment for studying the daily lives of patients with anxiety disorders: a systematic review, J Anxiety Disord. source

      Not checked in the free run.

    • cites [13] Smith, 2019, Moving beyond self-report data collection in the natural environment: a review of the past and future directions for ambulatory assessment in eating disorders, Int J Eat Disord. source

      Not checked in the free run.

    • cites [14] Santangelo, 2014, Ecological momentary assessment in borderline personality disorder: a review of recent findings and methodological challenges, J Pers Disord. source

      Not checked in the free run.

    • cites [15] Bell, 2017, Ecological momentary assessment and intervention in the treatment of psychotic disorders: a systematic review, Psychiatr Serv. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Binary items generally lack the characteristics needed to assess natural fluctuations in momentary experience while limiting floor and ceiling effects.

    “General guidelines for EMA research emphasize that items should be formulated in a way that allows for the assessment of the natural fluctuations in momentary experience, while limiting potential floor and ceiling effects (101). Binary items generally lack these characteristics.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [101] Hektner, 2007 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In similar high-risk populations with last-year suicidal ideation or attempt, the estimated 1-year prevalence of suicide attempts is between 13 and 20%, with the risk being higher for those with recent attempt history.

    “In comparison, in similar high-risk populations (with last-year suicidal ideation or attempt) the estimated 1-year prevalence of suicide attempts is between 13 and 20% (98, 99), with the risk being higher for those with recent attempt history (99).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [98] Han, 2015, Prevalence and correlates of past 12-month suicide attempt among adults with past-year suicidal ideation in the United States, J Clin Psychiatry. source

      Not checked in the free run.

    • cites [99] Parra-Uribe, 2017, Risk of re-attempts and suicide death after a suicide attempt: a survival analysis, BMC Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Risk of suicide attempt is further heightened among those with an earlier age of occurrence of first attempt, as well as those with borderline personality disorder features.

    “Risk is further heightened among those with an earlier age of occurrence of first attempt, as well as those with borderline personality disorder (features) (100).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [100] Aouidad, 2020, Borderline personality disorder and prior suicide attempts define a severity gradient among hospitalized adolescent suicide attempters, BMC Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Witte and colleagues have proposed that variability in suicidal ideation may provide a more reliable index of suicide risk than the severity or duration of ideation alone.

    “Witte and colleagues (37, 38) have proposed that such variability in suicidal ideation may provide a more reliable index of suicide risk than the severity or duration of ideation alone.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [37] Witte, 2006, Naturalistic evaluation of suicidal ideation: variability and relation to attempt status, Behav Res Ther. source

      Not checked in the free run.

    • cites [38] Witte, 2005, Variability in suicidal ideation: a better predictor of suicide attempts than intensity or duration of ideation?, J Affect Disord. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The notion that suicidal ideation variability may index suicide risk is tentatively supported by findings of higher variability among patients with more severe ideation, those with a prior suicide attempt history, and by higher EMA variability predicting attempts at 1-month follow-up.

    “This notion is tentatively supported by findings of higher suicidal ideation variability among patients with more severe suicidal ideation (47, 65, 66), as well as those with a prior suicide attempt history (66), and by higher EMA suicidal ideation variability predicting attempts at 1-month follow-up (79).”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [47] Kleiman, 2017, Examination of real-time fluctuations in suicidal ideation and its risk factors: results from two ecological momentary assessment studies, J Abnorm Psychol. source

      Not checked in the free run.

    • cites [65] Oquendo, 2020, Highly variable suicidal ideation: a phenotypic marker for stress induced suicide risk, Mol Psychiatry. source

      Not checked in the free run.

    • cites [66] Peters, 2022, Instability of suicidal ideation in patients hospitalized for depression: an exploratory study using smartphone ecological momentary assessment, Arch Suicide Res. source

      Not checked in the free run.

    • cites [79] Wang, 2021, A pilot study using frequent inpatient assessments of suicidal thinking to predict short-term postdischarge suicidal behavior, JAMA source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Suicidal ideation alone is not the only permissive characteristic preceding suicidal acts; a transition from ideation to attempt requires acquired capability, that is, additional cognitive and behavioral processes such as decreased fear of death and increased pain tolerance.

    “Further, suicidal ideation alone is not the only permissive characteristic preceding suicidal acts; a transition from ideation to attempt requires acquired capability, that is, additional cognitive and behavioral processes, such as decreased fear of death and increased pain tolerance (30).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] van Orden, 2010, The interpersonal theory of suicide, Psychol Rev. source

      Not checked in the free run.

  • May combine two claims.

    Premisereasoning

    Contemporaneous associations derived from EMA data reflect associations beyond simple co-occurrences; rather, they reflect systematic covariances between variables, and can signal the presence of temporal associations occurring very close in time.

    “While longitudinal modeling is often regarded as superior in traditional research designs, contemporaneous associations derived from EMA data reflect associations beyond simple co-occurrences; rather, they reflect systematic covariances between variables, and can signal the presence of temporal associations occurring very close in time.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    While the review supports the general acceptability of EMA in suicide research, the burden of EMA measures may be less tolerable for those currently experiencing very severe symptoms, analogous to findings in individuals with depressive disorders.

    “While our review supports the general acceptability of EMA in suicide research, the burden of EMA measures may be less tolerable for those currently experiencing very severe symptoms, analog to findings in individuals with depressive disorders (102).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [102] van Genugten, 2020, Experienced burden of and adherence to smartphone-based ecological momentary assessment in persons with affective disorders, J Clin Med source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The conclusions about reactivity are tentative at best due to the low number of studies directly assessing reactivity and the general lack of control groups across studies.

    “However, these conclusions are tentative at best due to the low number of studies directly assessing reactivity, and the general lack of control groups across studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Participants may not always provide accurate reports of their experiences for fear of intervention, as many people planning suicide explicitly deny such intentions.

    “Further, participants may not always provide accurate reports of their experiences for fear of intervention, as many people planning suicide explicitly deny such intentions (115).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [115] Busch, 2003, Clinical correlates of inpatient suicide, J Clin Psychiatry. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A recent review of EMA of NSSI noted similar study heterogeneity and lack of reporting on compliance.

    “A recent review of EMA of NSSI noted similar study heterogeneity and lack of reporting on compliance (17).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Rodríguez-Blanco, 2018, Use of ecological momentary assessment (EMA) in non-suicidal self-injury (NSSI): a systematic review, Psychiatry Res. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Alternative incentives, such as personalized feedback based on EMA data, may be regarded as more valuable.

    “Alternative incentives, such as personalized feedback based on EMA data, may be regarded as more valuable (112).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [112] Folkersma, 2021, Patients' experience of an ecological momentary intervention involving self-monitoring and personalized feedback for depression, Internet Interv source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Kaurin et al. outlined the ongoing discourse in EMA literature over the relative value of time-lagged versus concurrent (or contemporaneous) modeling approaches.

    “Kaurin et al. (64) outlined the ongoing discourse in EMA literature over the relative value of time-lagged vs. concurrent (or contemporaneous) modeling approaches.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64] Kaurin, 2020, Momentary interpersonal processes of suicidal surges in borderline personality disorder source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Correlations with retrospective measures, or moment-to-moment reliability statistics, may not provide adequate indications of good psychometric fit, as EMA ratings are expected to vary over time rather than stay constant.

    “Correlations with retrospective measures, or moment-to-moment reliability statistics may not provide adequate indications of good psychometric fit, as EMA ratings are expected to vary over time rather than stay constant.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    More frequent assessments may not reduce compliance, or may even increase compliance, as long as questionnaires are kept brief.

    “It has also previously been reported that more frequent assessments may not reduce compliance (106), or may even increase compliance (107), as long as questionnaires are kept brief (108).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [106] Jones, 2019, Compliance with ecological momentary assessment protocols in substance users: a meta-analysis, Addiction. source

      Not checked in the free run.

    • cites [107] Wen, 2017, Compliance with mobile ecological momentary assessment protocols in children and adolescents: a systematic review and meta-analysis, J Med Internet Res. source

      Not checked in the free run.

    • cites [108] Eisele, 2020, The effects of sampling frequency and questionnaire length on perceived burden, compliance, and careless responding in experience sampling data in a student population, Assessment. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Overly lengthy measures can induce fatigue and reduce compliance, as well as impact data quality due to increased careless responding or skipping questions.

    “However, overly lengthy measures can induce fatigue and reduce compliance, as well as impact data quality due to increased careless responding or skipping questions (108, 110).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [108] Eisele, 2020, The effects of sampling frequency and questionnaire length on perceived burden, compliance, and careless responding in experience sampling data in a student population, Assessment. source

      Not checked in the free run.

    • cites [110] Daniëls, 2021, Factors that influence the use of electronic diaries in health care: scoping review, JMIR mHealth uHealth. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    While preliminary findings warrant further replication, they indicate that suicidal ideation variability may represent a promising marker for suicide risk.

    “While these preliminary findings warrant further replication, they indicate that suicidal ideation variability may represent a promising marker for suicide risk.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A previous review of EMA studies on NSSI also identified affective variability as a risk factor for engaging in self-harm behavior.

    “In line with these findings, a previous review of EMA studies on NSSI also identified affective variability as a risk factor for engaging in self-harm behavior (17).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Rodríguez-Blanco, 2018, Use of ecological momentary assessment (EMA) in non-suicidal self-injury (NSSI): a systematic review, Psychiatry Res. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Digital phenotyping of suicidal ideators based on EMA data has been discussed by many.

    “The prospect of digital phenotyping of suicidal ideators (such as identifying those with high/low variability) based on EMA data has been discussed by many [see e.g., (121, 122)]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [121] Ballard, 2021, New methods for assessing rapid changes in suicide risk, Front Psychiatry. source

      Not checked in the free run.

    • cites [122] Barrigon, 2019, Precision medicine and suicide: an opportunity for digital health, Curr Psychiatry Rep. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Identifying meaningful subtypes of suicidal ideators could improve risk assessments and choice of treatment targeting specific symptom profiles.

    “highlighting the importance of identifying meaningful subtypes of suicidal ideators that could improve risk assessments and choice of treatment targeting specific symptom profiles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Suicidal ideation variability may be an especially valuable target for EMA monitoring and/or interventions in clinical practice.

    “this characteristic of ideation may be an especially valuable target for EMA monitoring and/or interventions in clinical practice.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Suicidal ideation variability may serve as a potential marker for increased suicide risk.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The network theory is subject to certain pitfalls that still need to be solved before it can be implemented in clinical practice.

    “the network theory is subject to certain pitfalls that still need to be solved before it can be implemented in clinical practice (24, 123).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [24] Bos, 2021

      Not checked in the free run.

    • cites [123] von Klipstein, 2020, Using person-specific networks in psychotherapy: challenges, limitations, and how we could use them anyway, BMC Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    In clinical practice, the focus is on individual patients.

    “in clinical practice, the focus is on individual patients (120).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [120] Zuidersma, 2020, Single-subject research in psychiatry: facts and fictions, Front Psychiatry. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Risk profiling may represent next steps in EMA research and in improved treatment of patients with suicidal ideation.

    “Such risk profiling may hence represent next steps not only in EMA research, but in the improved treatment of patients with suicidal ideation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    For patients experiencing persistent suicidal ideation, demonstrating that ideation is variable and malleable may provide relief.

    “for patients experiencing (persistent) suicidal ideation, demonstrating that ideation is variable, and hence malleable, may provide relief.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationnone given

    These observations still warrant replication.

    “these observations still warrant replication.”
    Quote in the paperNot a substantial claim
90 of 90

  • The paper relies on this without support.

    The validity of EMA measures of STBs is uncertain.

    “The validity of EMA measures of STBs is also uncertain.”

  • The paper relies on this without support.

    Limited evidence exists on whether asking about STBs as frequently as with EMA schedules does not increase risk.

    “Limited evidence exists, however, on the question of whether this also holds for as frequently repeated assessments as with EMA schedules.”

  • The paper relies on this without support.

    Suicidal ideation variability may serve as a potential marker for increased suicide risk.

    “In accordance with the finding that suicidal ideation variability may serve as a potential marker for increased suicide risk”

  • The paper relies on this without support.

    Databases of established EMA items are lacking.

    “Databases of established EMA items are lacking.”

  • The paper relies on this without support.

    Questions from traditional questionnaire measures may not directly translate to the purposes of EMA.

    “Questions from traditional questionnaire measures may not directly translate to the purposes of EMA.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Suicidal ideation and related risks and warning signs show substantial between- and within-subject variance.

    “Research has shown that suicidal ideation and related risks and warning signs show substantial between- and within subject variance (79).”

    From Ambivalence model of suicidality [ABS-model]: an orientation model for the treatment of suicidal individuals (2024) · cites this paper as [79]

    The Results > Main Findings section reports substantial within-person variation in suicidal ideation across and within days, with similar variability in several risk factors. It also notes differences between individuals in how much their ideation varies, but does not establish substantial between-subject variance in suicidal ideation or warning signs themselves. No page number is available in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Ambivalence is a fluid state characterized by inter- and intra-individual variability.

    “Ambivalence is a fluid state that is characterized by inter- and intra-individual variability.”

    From Ambivalence model of suicidality [ABS-model]: an orientation model for the treatment of suicidal individuals (2024) · cites this paper as [79]

    The Results (Main Findings) describe within-person variability in suicidal ideation, and the Discussion (Future Directions) notes differences in suicide symptom profiles between individuals. Neither passage addresses ambivalence as a state; a search for “ambivalence” found no passage that does, so the claim cannot be verified from our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Ecological momentary assessment can enable the collection and integration of multimodal data passively, continuously, and objectively and may be useful in assessing how depressive symptoms, including suicidal thoughts and behaviors, unfold in real-world contexts.

    “Ecological momentary assessment can enable the collection and integration of multimodal data passively, continuously, and objectively and may be useful in assessing how depressive symptoms, including suicidal thoughts and behaviors, unfold in real-world contexts.”

    From Digital health technologies and major depressive disorder (2023) · cites this paper as [138]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Affective-instability finding reverses the table result

    Major

    The narrative says general affective instability was associated with suicidal ideation variability in the inpatient study, whereas Table 1 says it was not.

  • Study 47 is cited for a prediction it did not find

    Minor

    The prediction summary cites study 47 as evidence that these variables predicted subsequent ideation, but Table 1 says its hopelessness and burdensomeness measures did not prospectively predict ideation.

  • Temporal-prediction article count differs from citation list

    Minor

    The passage claims twelve articles but cites eleven: eight individual references plus the three covered by 55-57.

3 of 3

The citation lists haven’t been fetched yet

References 126 · Cited by 163

Research works printed but not linked: 1

  1. Barta, 2012, Measurement reactivity in diary research, 108

Authors
Kivelä, L., van der Does, W. A. J., Riese, H., & Antypa, N.
Affiliations
  • Leiden University (NL)
  • University Medical Center Groningen (NL)
Corresponding author
Antypa, Niki
ORCID
Venue
Frontiers in Digital Health
Publisher
Frontiers Media SA
Published
2022-05-06
Volume
4
Pages
876595-876595
ISSN
2673-253X (ISSN-L)
DOI
10.3389/fdgth.2022.876595
PMC
PMC9120419
OpenAlex
W4229037311
Semantic Scholar
ae8aa0a8faf4842741f639c8a4025639515e479d
Cited by
163
References
126
Citations by year
2026: 62 · 2025: 44 · 2024: 34 · 2023: 19 · 2022: 3
FWCI
4.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Digital Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
  • Leiden Repository (Leiden University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
  • DataverseNL (cc-by)
Funders
Nederlandse Organisatie voor Wetenschappelijk Onderzoek (406.18.521)
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
ecological momentary assessment, suicidal ideation, suicide risk, suicidal thoughts and behaviors, digital phenotyping, negative affect, hopelessness, perceived burdensomeness, sleep characteristics, reactivity, participant burden, suicide risk prediction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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