检测自杀意念：生态瞬间评估的力量。
Detecting suicidal thoughts: The power of ecological momentary assessment.
机构信息
Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York City, New York.
Department of Psychiatry, Columbia University Medical Center, New York City, New York.
出版信息
Depress Anxiety. 2021 Jan;38(1):8-16. doi: 10.1002/da.23043. Epub 2020 May 22.
BACKGROUND
Researchers and clinicians have typically relied on retrospective reports to monitor suicidal thoughts and behaviors. Smartphone technology has made real-time monitoring of suicidal thoughts possible via mobile ecological momentary assessment (EMA). However, little is known about how information gleaned from EMA compares with that obtained by retrospective reports. The authors sought to compare suicidal ideation (SI) assessed over 1 week using EMA with a retrospective gold-standard interviewer-administered measure covering the same period.
METHODS
Fifty-one adults with major depressive disorder completed 1 week of EMA (6×/day) assessing SI. Following completion of EMA, participants completed an interviewer-administered Scale for Suicide Ideation (SSI) retrospectively assessing the same week.
RESULTS
SI severity assessed through EMA was positively correlated with scores on the retrospective SSI. However, 58% of participants reporting ideation with EMA denied any past-week ideation on the SSI. Participants who endorsed SI during EMA but not on the SSI were no less likely to have a history of suicidal behavior than those who reported SI in both formats.
CONCLUSION
EMA captures instances of suicidal thinking that go undetected through retrospective report and thereby may help us to identify an at-risk subgroup otherwise missed.
背景
研究人员和临床医生通常依赖回顾性报告来监测自杀念头和行为。智能手机技术通过移动生态瞬间评估（EMA）使实时监测自杀念头成为可能。然而，对于从 EMA 中收集到的信息与通过回顾性报告获得的信息相比如何，我们知之甚少。作者试图比较使用 EMA 评估的为期一周的自杀意念（SI）与回顾性的、由访谈者管理的、涵盖同一时期的量表评估的结果。
方法
51 名患有重度抑郁症的成年人完成了为期一周的 EMA（每天 6 次），评估 SI。完成 EMA 后，参与者通过访谈者管理的自杀意念量表（SSI）回顾性地评估同一周的情况。
结果
通过 EMA 评估的 SI 严重程度与回顾性 SSI 的得分呈正相关。然而，58%的参与者通过 EMA 报告有想法，但在 SSI 上否认过去一周有想法。在 EMA 上报告有 SI 但在 SSI 上没有报告的参与者，其自杀行为史与在两种形式上都报告有 SI 的参与者一样可能不会减少。
结论
EMA 捕捉到了通过回顾性报告未检测到的自杀想法，从而可能帮助我们识别出一个否则会被遗漏的高危亚组。
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