Human Development & Family Studies, The Pennsylvania State University.
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles.
J Clin Child Adolesc Psychol. 2021 Jan-Feb;50(1):141-153. doi: 10.1080/15374416.2020.1815208. Epub 2020 Oct 13.
Mobile technology has facilitated rapid growth in the use of intensive longitudinal methods (ILM), such as ecological momentary assessments (EMA), that help identify proximal indicators of risk in real-time and real-world settings. To realize the potential of ILM for advancing knowledge regarding suicidal and self-injurious thoughts and behaviors (SITB), this article aims to provide a systematic review of safety protocols in published ILM studies of youth SITB, highlight considerations for maximizing safety, and offer an agenda for future research.
We conducted a systematic review of risk management strategies in published studies applying ILM to assess SITB in youth.
The review indicated diverse safety strategies, with near-universal use of preventive strategies before beginning ILM surveys. Strategies for participant protection during the survey period included automated protective messages to seek support when elevated risk was detected; and staff-led strategies, some of which included active outreach to parents/caregivers when youth responses suggested elevated risk. Studies assessing suicidality all provided staff-led follow-up. There was minimal information on youth reactivity to intensive longitudinal assessments of SITB. Available evidence did not suggest increased suicidal ideation, suicide attempts, self-injurious behavior, or deaths with ILM.
Based on the review, we propose a research agenda to inform safety procedures in ILM research and a model for managing risk in future ILM studies of youth SITB. This model begins with a needs assessment and proposes a "goodness of fit" approach for matching safety procedures to the specific needs of each ILM study.
移动技术促进了密集纵向方法（ILM）的快速发展，例如生态瞬时评估（EMA），这有助于实时和真实环境中识别风险的近端指标。为了实现 ILM 在推进自杀和自残思想和行为（SITB）知识方面的潜力，本文旨在对青年 SITB 的已发表 ILM 研究中的安全协议进行系统回顾，强调最大限度地提高安全性的注意事项，并为未来的研究提供议程。
我们对应用 ILM 评估青年 SITB 的已发表研究中风险管理策略进行了系统回顾。
该综述表明存在各种安全策略，在开始 ILM 调查之前几乎普遍使用预防策略。调查期间参与者保护策略包括在检测到风险升高时自动发送保护性消息以寻求支持；以及工作人员主导的策略，其中一些策略包括在青年反应表明风险升高时主动与父母/照顾者联系。评估自杀倾向的研究均提供工作人员主导的后续措施。关于青年对 SITB 的密集纵向评估的反应的信息很少。现有证据表明，ILM 不会增加自杀意念、自杀企图、自残行为或死亡。
基于综述，我们提出了一个研究议程，以告知 ILM 研究中的安全程序，并为未来青年 SITB 的 ILM 研究中的风险管理提供模型。该模型始于需求评估，并提出了一种“适合度”方法，将安全程序与每个 ILM 研究的具体需求相匹配。
