Rationale: Suicidal ideation and behaviour are notoriously difficult to predict, and most research so far has focused on long-term, chronic predictors.  Research assessing how suicidal thinking fluctuates from day-to-day and hour-to-hour is greatly needed in order to better understand which proximal factors give rise to it in real-time. 

In this study, we use a mobile phone app (ecological momentary assessment; EMA) to assess several factors that can influence fluctuations in suicidal thinking in real time and in natural settings. Furthermore, participants will be wearing a watch (actigraphy) to assess their sleep and activity levels during night and day. This way we collect both objective and subjective daily measures. The aims of our study are

(1) to examine how momentary risk and protective factors (such as sleep, mood, cognitions, stressful events, social interactions, substance use/coping strategies) lead to increases or decreases in suicidal ideation in the short term,

(2) to assess how suicidal ideation changes in the course of one year (through weekly assessments during that year)

(3) to assess the acceptability of electronic symptom self-monitoring (EMA) in individuals with suicidal ideation.

Study design: A longitudinal cohort study

Study population: Participants (N = 150) will be adults (aged 18 years or above) with a history of a suicide attempt of severe suicidal ideation in the past year.

Outcome: By closely examining risk and protective factors in the daily lives of individuals with suicidal tendencies, we hope to understand which factors are likely to increase their suicidal thinking and which factors are likely to keep it low. Participants can also choose to receive a personalized feedback report at the end of their participation in the study, which could be informative for their own understanding of the contextual factors that pose them at risk as well as of the situations that are likely to be protective.