Department of Psychology, Harvard University, Cambridge, MA 02138.
Department of Methodology and Statistics, Utrecht University, 3508 TC Utrecht, The Netherlands.
Proc Natl Acad Sci U S A. 2023 Apr 25;120(17):e2215434120. doi: 10.1073/pnas.2215434120. Epub 2023 Apr 18.
This study aims to identify the timescale of suicidal thinking, leveraging real-time monitoring data and a number of different analytic approaches. Participants were 105 adults with past week suicidal thoughts who completed a 42-d real-time monitoring study (total number of observations = 20,255). Participants completed two forms of real-time assessments: traditional real-time assessments (spaced hours apart each day) and high-frequency assessments (spaced 10 min apart over 1 h). We found that suicidal thinking changes rapidly. Both descriptive statistics and Markov-switching models indicated that elevated states of suicidal thinking lasted on average 1 to 3 h. Individuals exhibited heterogeneity in how often and for how long they reported elevated suicidal thinking, and our analyses suggest that different aspects of suicidal thinking operated on different timescales. Continuous-time autoregressive models suggest that current suicidal intent is predictive of future intent levels for 2 to 3 h, while current suicidal desire is predictive of future suicidal desire levels for 20 h. Multiple models found that elevated suicidal intent has on average shorter duration than elevated suicidal desire. Finally, inferences about the within-person dynamics of suicidal thinking on the basis of statistical modeling were shown to depend on the frequency at which data was sampled. For example, traditional real-time assessments estimated the duration of severe suicidal states of suicidal desire as 9.5 h, whereas the high-frequency assessments shifted the estimated duration to 1.4 h.
本研究旨在利用实时监测数据和多种不同的分析方法，确定自杀思维的时间尺度。参与者为 105 名过去一周有自杀想法的成年人，他们完成了为期 42 天的实时监测研究（总观察次数=20255）。参与者完成了两种形式的实时评估：传统的实时评估（每天间隔几个小时）和高频评估（1 小时内间隔 10 分钟）。我们发现自杀思维变化迅速。描述性统计和马尔可夫转换模型都表明，自杀思维的升高状态平均持续 1 到 3 小时。个体在报告升高的自杀思维的频率和持续时间方面表现出异质性，我们的分析表明，自杀思维的不同方面在不同的时间尺度上运作。连续时间自回归模型表明，当前的自杀意图可预测未来 2 到 3 小时的意图水平，而当前的自杀欲望可预测未来 20 小时的自杀欲望水平。多个模型发现，升高的自杀意图的持续时间平均短于升高的自杀欲望。最后，基于统计模型对自杀思维个体内动态的推断取决于数据采样的频率。例如，传统的实时评估估计严重自杀欲望状态的持续时间为 9.5 小时，而高频评估则将估计的持续时间缩短到 1.4 小时。
