Psychiatry. 2022 Winter;85(4):317-333. doi: 10.1080/00332747.2022.2092828. Epub 2022 Jul 18.
The suicide rate (currently 14 per 100,000) has barely changed in the United States over the past 100 years. There is a need for new ways of preventing suicide. Further, research has revealed that suicidal thoughts and behaviors and the factors that drive them are dynamic, heterogeneous, and interactive. Most existing interventions for suicidal thoughts and behaviors are infrequent, not accessible when most needed, and not systematically tailored to the person using their own data (e.g., from their own smartphone). Advances in technology offer an opportunity to develop new interventions that may better match the dynamic, heterogeneous, and interactive nature of suicidal thoughts and behaviors. Just-In-Time Adaptive Interventions (JITAIs), which use smartphones and wearables, are designed to provide the right type of support at the right time by adapting to changes in internal states and external contexts, offering a promising pathway toward more effective suicide prevention. In this review, we highlight the potential of JITAIs for suicide prevention, challenges ahead (e.g., measurement, ethics), and possible solutions to these challenges.
美国过去 100 年来的自杀率(目前为每 10 万人 14 人)几乎没有变化。需要寻找新的方法来预防自杀。此外,研究表明,自杀念头和行为以及驱动这些念头和行为的因素是动态的、异质的和相互作用的。大多数现有的自杀念头和行为干预措施频率较低,在最需要的时候无法获得,并且没有系统地根据使用者自己的数据(例如,从自己的智能手机)进行个性化定制。技术的进步为开发新的干预措施提供了机会,这些措施可能更能匹配自杀念头和行为的动态、异质和相互作用的性质。即时自适应干预措施(Just-In-Time Adaptive Interventions,JITAI)使用智能手机和可穿戴设备,旨在通过适应内部状态和外部环境的变化,在正确的时间提供正确类型的支持,为更有效的自杀预防提供了有前途的途径。在这篇综述中,我们强调了 JITAI 在预防自杀方面的潜力、面临的挑战(例如,测量、伦理)以及这些挑战的可能解决方案。