Measuring Adolescents' Self-injurious Thoughts and Behaviors: Comparing Ecological Momentary Assessment to a Traditional Interview

The purpose of this study was to compare adolescents' reports of self-injurious thoughts and behaviors (SITBs) between ecological momentary assessment (EMA) and a traditional, retrospective interview. Adolescents were recruited following recent discharge from acute psychiatric care for a suicidal crisis (as part of a larger study). Participants completed: (1) EMA surveys assessing SITBs multiple times daily over a 28-day follow-up period, and (2) a follow-up phone interview to evaluate SITBs retrospectively at the end of the same 28-day follow-up period. Forty-one adolescents completed the final follow-up interview (M-age = 14.9 years; 78.0% White; 61.0% female). Adolescents' reports of SITB presence (vs. absence) and frequency, collected via EMA and retrospective interview over follow-up, were compared. Preliminary differences in SITB endorsement (presence/absence) were observed between reporting methods with more adolescents endorsing suicide ideation (SI; n = 30) and nonsuicidal self-injury (NSSI; n = 15) in EMA compared to retrospective interview (SI: n = 17; NSSI: n = 10). Reasons for withholding SITBs from EMA reports (gathered during a final qualitative interview) included not wanting to answer additional EMA questions and concerns about EMA-reporting consequences. There were no statistically significant differences in SITB frequency by report method. Further investigation is warranted in a larger sample to elucidate frequency patterns. Given the growing research using this method, these findings are important to help clarify the utility of EMA methods for studying SITBs in youth.

Automated summary

The purpose of this study was to compare the reports of self-injurious thoughts and behaviors (SITBs) among adolescents using ecological momentary assessment (EMA) and retrospective interviews. Preliminary findings showed that more adolescents reported the presence of suicide ideation and non-suicidal self-injury using EMA compared to retrospective interviews. However, no significant differences were found in the frequency of SITBs between the two reporting methods. Some adolescents chose to withhold reporting SITBs in the EMA surveys, citing reasons such as not wanting to answer additional questions and concerns about the consequences of reporting.