Can Text Messages Identify Suicide Risk in Real Time? A Within-Subjects Pilot Examination of Temporally Sensitive Markers of Suicide Risk.

Objective tools to assess suicide risk are needed to determine someone is at imminent risk. This pilot laboratory investigation utilized a within-subjects design to identify patterns in text messaging (SMS) unique to high-risk periods preceding suicide attempts. Individuals reporting a history of suicide attempt (=33) retrospectively identified past attempts and periods of lower risk (e.g., suicide ideation). Language analysis software scored 189,478 text messages to capture three psychological constructs: self-focus, sentiment, and social engagement. Mixed-effects models tested whether these constructs differed in general (means) and over time (slopes) two weeks before a suicide attempt, relative to lower-risk periods. Regarding mean differences, no language features uniquely differentiated suicide attempts from other episodes. However, when examining patterns , anger increased and positive emotion decreased to a greater extent as one approached a suicide attempt. Results suggest private electronic communication has the potential to provide real-time digital markers of suicide risk.