Project Details
Projekt
APOS: Acute risk factors for post-discharge suicidal behaviour
Subject Area
Personality Psychology, Clinical and Medical Psychology, Methodology
Term
since 2021
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 460438176
Background:The risk for non-lethal and lethal suicide attempts is substantially increased after discharge from inpatient treatment due to acute suicidality. Yet, empirical evidence regarding proximal risk factors predicting suicidal ideation or behavior in the short-term is limited. Such evidence is needed to develop clinical monitoring concepts or interventions. The Interpersonal Theory of Suicide (IPTS, Joiner 2005), the Integrated Motivational-Volitional Model of Suicidal Behavior (IMV model, O’Connor 2011), and the Narrative-Crisis Model of Suicide (NCM, Galynker 2017) postulate several variables that might serve as proximal risk factors (e.g., perceived burdensomeness, entrapment, hyperarousal). Central assumptions of these theories have been supported by empirical studies. However, prospective and fine-grained studies in high-risk samples accounting for the temporal dynamics and the interactions of these variables and analyzing the predictive power with regards to suicidal ideation and behavior directly after discharge are lacking to date.Aim:The present study aims at empirically validating assumptions of the IPTS, the IMV-model, and the NCM. To this end, it will be investigated whether central concepts of these theories are predictors of suicidal ideation in real-time and suicidal behavior during a 6-months follow-up after discharge from inpatient psychiatric treatment (accounting for distal risk factors such as sex, previous suicide attempts, heart-rate variability). Individual trajectories of suicidal ideation will be further examined (digital phenotyping) and their predictive validity will be investigated. In addition, the specific role of heart-rate variability and heart-rate in real-time will be analyzed.Methods:In Essen and Leipzig, N=344 inpatients receiving treatment after acute suicidality or suicide attempt will be recruited over 18 months. After an extensive baseline assessment (central constructs of suicide theories, heart-rate variability, and control variables) and briefing, all participating patients will get a smartphone. Psychometrically reliable and valid items covering suicidal ideation and other variables of interest will be rated four times a day by the patients starting 1–3 days before discharge and 21 days following discharge, and two times a week for another 26 weeks in real-time. Additionally, the heart-rate will be assessed using a wearable. After six months, all participants will undergo a telephone follow-up on the occurrence of suicide ideation and attempts. Data will be analyzed using cox regression, multi-level models and latent profile analysis.RelevanceThis is the first study that investigates the prediction of suicidal ideation and behavior by variables of the IPTS, the IMV-model and the NCM applying a prospective and fine-grained study design in a high-risk population. We expect results derived from the project to improve the prediction of suicidal ideation and attempts.
DFG Programme
Research Grants
