Ecological Assessment of Proximal Risk Factors for Suicide During Care Transitions

Recruit and follow-up with 240 psychiatric inpatients hospitalized for suicidal ideation or behavior over a five-year study period. Participants will complete baseline assessments including clinical interviews, laboratory-based behavioral assessments, and self-reports of distal risk factors. During hospitalization, participants will begin completing ecological momentary assessments (EMAs) of affect, cognition, behavior, and social/environmental context. Following discharge, participants will continue EMA monitoring for 4-weeks at baseline and again for two 3-week EMA “bursts” at 3- and 6-month follow-up assessments. During each EMA monitoring period, digital phenotyping data (e.g., sleep, location, activity level/movement) will be collected using wearables and smartphone sensors. 3- and 6-month follow-up assessments will be conducted in a lab to re-administer lab-based behavioral assessments and collect outcome data including suicidal ideation, suicidal behavior, and re-hospitalization. The study aims to characterize the relationships among affective and contextual proximal risk factors and examine how distal risk factors moderate these relationships.