Department of Psychology, University of Rochester.
Department of Psychiatry, University of Rochester Medical Center.
J Clin Child Adolesc Psychol. 2022 Jan-Feb;51(1):32-48. doi: 10.1080/15374416.2020.1741377. Epub 2020 Apr 2.
: 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.: 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.: 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.: 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.
:本研究旨在探讨在急性精神科护理出院后,有自杀意念和行为的高危青少年中进行强化生态瞬时评估(EMA)的可行性和可接受性。:研究共招募了 53 名 12-18 岁的青少年及其父母,他们在急性精神科护理出院后因自杀风险而接受研究。研究包括基线评估(青少年和父母)、28 天的 EMA 调查(每天 5 次)和腕部活动记录仪(青少年)以及 28 天监测期结束时的访谈(青少年)。青少年的门诊临床医生也接受了有关该研究的调查。:研究的可行性表明,入组率合理,佩戴活动记录仪的依从性高,以及 EMA 调查的依从性好(第一周最高,随后几周显著下降)。青少年报告他们对研究的总体体验是积极的,问题是可以理解的,他们对问题的回答通常是准确的,调查的负担最小。研究程序似乎没有造成医源性伤害;自杀企图和再住院与研究无关,发生率与招募地点的其他青少年相当。青少年的临床医生报告说,这项研究对他们来说有些积极,负担最小,对他们的患者和家庭也有些积极。:本研究表明,在急性精神科护理出院后,有自杀风险的高危青少年中,强化 EMA 设计是可行和可接受的。提供了具体的程序来确保青少年在强化 EMA 研究期间的安全,包括有关风险和安全监测计划的详细信息。