Feasibility and validity of ecological momentary assessment in the investigation of suicide risk

Background: Many suicide risk factors have been identified, but traditional clinical methods do not allow the accurate prediction of suicide behaviors. To face this challenge, we developed emma, an app for Ecological Momentary Assessment/Intervention (EMA/EMI) and prediction of suicide risk in high risk patients.Objective: We wanted to test the feasibility of implementing this mHealth-based suicide risk assessment and prevention tool and its impact in subjects at high risk of suicide in real world conditions.Methods: The EMMA Study is an ongoing longitudinal interventional multicenter trial in which patients at high-risk for suicide (n=100) use emma for 6 months. During this period, they complete four EMA types (daily, weekly, monthly, spontaneous) and may use EMI modules. Participants undergo clinical assessment at month 0, 1, 3 and 6 after inclusion.Results: Among the 43 patients already recruited in the EMMA Study, 14 participants had completed the follow-up. Their data were analyzed to evaluate emma implementation and impact on suicide risk management. EMA completion rates were extremely heterogeneous among the 14 participants with a sharp decrease over time. The completion rates of the weekly EMA (25% to 87.5%) were higher than for the daily EMA (0% to 53.3%). Most patients (n=10/14) answered the EMA questionnaires spontaneously. Similarly, the Safety Plan Modules use was very heterogeneous (2 to 75 times). Specifically, 11 patients used the Call Module (1 to 29 times), designed by our team to help them to get in touch with healthcare professionals and/or relatives during a crisis. All patients used the Breathing Space Module and 8 the Emotion Regulation Module (1 to 46 times). The diversity of patient profiles and use of the EMA and EMI modules proposed by emma was highlighted by three case reports.Conclusions: These preliminary results suggest that it is possible and acceptable to collect longitudinal fine-grained contextualized data (EMA) and to offer personalized intervention (EMI) in real time to people at high risk of suicide. Patients have different clinical and digital profiles and needs that require a highly scalable, interactive and customizable app. To become a complementary tool for suicide prevention, emma should be integrated in the existing emergency procedures.

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Ecological momentary assessment of mental health in adults at suicide risk: An observational study protocol

Journal of Advanced Nursing ◽

10.1111/jan.15142 ◽

2022 ◽

Author(s):

Hyein Kim ◽

Sunyoung Park ◽

Youkyung Kim ◽

Seongae Kwon ◽

Heejung Kim

Keyword(s):

Mental Health ◽

Observational Study ◽

Study Protocol ◽

Ecological Momentary Assessment ◽

Suicide Risk ◽

Ecological Momentary ◽

Momentary Assessment

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Patients at high risk of suicide before and during a COVID-19 lockdown: ecological momentary assessment study

BJPsych Open ◽

10.1192/bjo.2021.43 ◽

2021 ◽

Vol 7 (3) ◽

Author(s):

Aurora Cobo ◽

Alejandro Porras-Segovia ◽

María Mercedes Pérez-Rodríguez ◽

Antonio Artés-Rodríguez ◽

Maria Luisa Barrigón ◽

...

Keyword(s):

High Risk ◽

Ecological Momentary Assessment ◽

Suicide Risk ◽

Assessment Study ◽

Wish To Die ◽

History Of ◽

Physical Barriers ◽

Suicide Risk Factors ◽

Ecological Momentary ◽

Momentary Assessment

The coronavirus disease 2019 (COVID-19) outbreak may have affected the mental health of patients at high risk of suicide. In this study we explored the wish to die and other suicide risk factors using smartphone-based ecological momentary assessment (EMA) in patients with a history of suicidal thoughts and behaviour. Contrary to our expectations we found a decrease in the wish to die during lockdown. This is consistent with previous studies showing that suicide rates decrease during periods of social emergency. Smartphone-based EMA can allow us to remotely assess patients and overcome the physical barriers imposed by lockdown.

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A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study (Preprint)

10.2196/preprints.15741 ◽

2019 ◽

Author(s):

Margot Morgiève ◽

Catherine Genty ◽

Jérôme Azé ◽

Jonathan Dubois ◽

Marion Leboyer ◽

...

Keyword(s):

Case Report ◽

High Risk ◽

Ecological Momentary Assessment ◽

Suicide Risk ◽

Completion Rates ◽

Emergency Procedures ◽

Ecological Momentary ◽

Suicidal Thoughts And Behaviors ◽

Suicidal Crisis ◽

Momentary Assessment

BACKGROUND Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. OBJECTIVE The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions. METHODS The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. RESULTS EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports. CONCLUSIONS These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures. CLINICALTRIAL ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381

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A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study

JMIR mhealth and uhealth ◽

10.2196/15741 ◽

2020 ◽

Vol 8 (10) ◽

pp. e15741 ◽

Cited By ~ 1

Author(s):

Margot Morgiève ◽

Catherine Genty ◽

Jérôme Azé ◽

Jonathan Dubois ◽

Marion Leboyer ◽

...

Keyword(s):

Case Report ◽

High Risk ◽

Ecological Momentary Assessment ◽

Suicide Risk ◽

Completion Rates ◽

Emergency Procedures ◽

Ecological Momentary ◽

Suicidal Thoughts And Behaviors ◽

Suicidal Crisis ◽

Momentary Assessment

Background Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. Objective The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions. Methods The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. Results EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports. Conclusions These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures. Trial Registration ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381

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Emotionsregulation bei Depression

Psychologische Rundschau ◽

10.1026/0033-3042/a000172 ◽

2013 ◽

Vol 64 (4) ◽

pp. 235-243 ◽

Cited By ~ 14

Author(s):

Sven Barnow ◽

Maren Aldinger ◽

Ines Ulrich ◽

Malte Stopsack

Keyword(s):

Ecological Momentary Assessment ◽

Ecological Momentary ◽

Momentary Assessment

Die Anzahl der Studien, die sich mit dem Zusammenhang zwischen Emotionsregulation (ER) und depressiven Störungen befassen, steigt. In diesem Review werden Studien zusammengefasst und metaanalytisch ausgewertet, die den Zusammenhang zwischen ER und Depression mittels Fragebögen bzw. Ecological Momentary Assessment (EMA) erfassen. Dabei zeigt sich ein ER-Profil welches durch die vermehrte Nutzung von Rumination, Suppression und Vermeidung bei gleichzeitig seltenerem Einsatz von Neubewertung und Problemlösen gekennzeichnet ist. Mit mittleren bis großen Effekten, ist der Zusammenhang zwischen Depression und maladaptiven Strategien besser belegt als bei den adaptiven Formen, wo die Effekte eher moderat ausfielen. EMA-Messungen bestätigen dieses Profil. Da EMA-Studien neben der Häufigkeit des Strategieeinsatzes auch die Erfassung anderer ER-Parameter wie Effektivität und Flexibilität ermöglichen, sollten solche Designs in der ER-Forschung zukünftig vermehrt Einsatz finden.

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Using Personal Cell Phones for Ecological Momentary Assessment

European Psychologist ◽

10.1027/1016-9040/a000127 ◽

2013 ◽

Vol 18 (1) ◽

pp. 3-11 ◽

Cited By ~ 42

Author(s):

Emmanuel Kuntsche ◽

Florian Labhart

Keyword(s):

Data Collection ◽

Ecological Momentary Assessment ◽

Communication Systems ◽

Cell Phones ◽

Personal Digital Assistants ◽

Natural Environments ◽

Mobility Patterns ◽

Standard Data ◽

Ecological Momentary ◽

Momentary Assessment

Ecological Momentary Assessment (EMA) is a way of collecting data in people’s natural environments in real time and has become very popular in social and health sciences. The emergence of personal digital assistants has led to more complex and sophisticated EMA protocols but has also highlighted some important drawbacks. Modern cell phones combine the functionalities of advanced communication systems with those of a handheld computer and offer various additional features to capture and record sound, pictures, locations, and movements. Moreover, most people own a cell phone, are familiar with the different functions, and always carry it with them. This paper describes ways in which cell phones have been used for data collection purposes in the field of social sciences. This includes automated data capture techniques, for example, geolocation for the study of mobility patterns and the use of external sensors for remote health-monitoring research. The paper also describes cell phones as efficient and user-friendly tools for prompt manual data collection, that is, by asking participants to produce or to provide data. This can either be done by means of dedicated applications or by simply using the web browser. We conclude that cell phones offer a variety of advantages and have a great deal of potential for innovative research designs, suggesting they will be among the standard data collection devices for EMA in the coming years.

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