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The detection of acute risk of self-injury project: Protocol for an ecological momentary assessment study among individuals seeking treatment
Kiekens,Glenn Claes,Laurence Schoefs,Steffie Kemme,Nian D. F. Luyckx,Koen Kleiman,Evan M. Nock,Matthew K. Myin-Germeys,Inez
Kiekens,Glenn
Claes,Laurence
Schoefs,Steffie
Kemme,Nian D. F.
Luyckx,Koen
Kleiman,Evan M.
Nock,Matthew K.
Myin-Germeys,Inez
Abstract
Background: Nonsuicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence and severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-damaging behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The DAILY (Detection of Acute rIsk of seLf-injurY) project will address these gaps among individuals seeking treatment. Objective: This protocol paper presents the DAILY project's aims, design, and materials used. The primary objectives are to advance understanding of (1) the short-term course and contexts of elevated risk for NSSI thoughts, urges, and behavior; (2) the transition from NSSI thoughts and urges to NSSI behavior; and (3) the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of individuals seeking treatment and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life. Methods: The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves 3 phases: a baseline assessment (phase 1), 28 days of ecological momentary assessment (EMA) followed by a clinical session and feedback survey (phase 2), and 2 follow-up surveys and an optional interview (phase 3). The EMA protocol consists of regular EMA surveys (6 times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (3 surveys within 30 minutes), and event registrations of NSSI behavior. The primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, and purging), substance use (binge drinking and smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. The assessed predictors include emotions, cognitions, contextual information, and social appraisals. Results: We will recruit approximately 120 individuals seeking treatment aged 15 to 39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and data collection is anticipated to conclude in August 2023. Conclusions: The findings of the DAILY project will provide a detailed characterization of the short-term course and patterns of risk for NSSI and advance understanding of how, why, and when NSSI and other self-damaging behaviors unfold among individuals seeking treatment. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside of the therapy room that support people who self-injure in real time.
Description
Funding Information: The authors wish to thank all patients and mental health professionals for their participation and the following individuals for their assistance in the setup and execution of the DAILY (Detection of Acute rIsk of seLf-injurY) project: Silke Apers, Kristina Eggermont, Elise van Laere, Louise Staring, Daphne Tuyaerts, and Martien Wampers. The involvement of Kristina Eggermont was funded by the Internal Funds of the KU Leuven Research Council (C14/21/052; principal investigator: KL) and Research Foundation Flanders (Belgium; G070620N; principal investigator: KL). The involvement of NDFK, SS, Louise Staring, and Daphne Tuyaerts was funded by the FWO Odysseus program (G0F8416N; principal investigator: IM-G). The authors also gratefully acknowledge all mental health services for their collaboration and contributions: Alexianen Zorggroep Tienen, Bethanië Zoersel, Karus (JOVO) Gent, Openbaar Psychiatrisch Zorgcentrum Rekem, Psychiatrisch Centrum Sint-Hiëronymus Sint-Niklaas, People Development Leuven, Psychotherapiepraktijk Katrien Oosterlynck Aalst, Psychiatrisch Ziekenhuis Asster Sint-Truiden, Psychiatrisch Ziekenhuis Onze-Lieve-Vrouw Brugge, Universitair Psychiatrisch Centrum KU Leuven, Stuvo KU Leuven, Universitair Psychiatrisch Centrum Duffel, and Universitair Ziekenhuis Gent. Funding Information: The study is funded by a postdoctoral fellowship from the Research Foundation Flanders (Belgium) awarded to the first author (June 2020: 12ZZM21N; Multimedia Appendix 1). The recruitment of participants began in June 2021 and data collection is anticipated to conclude in August 2023. Funding Information: Edited by T Leung; The proposal for this study was peer-reviewed by: Fonds voor Wetenschappelijk Onderzoek – Vlaanderen (FWO) / Research Foundation Flanders (Belgium). See the Multimedia Appendix for the peer-review report. Submitted 10.03.23; accepted 24.04.23; published 15.06.23. Publisher Copyright: ©Glenn Kiekens, Laurence Claes, Steffie Schoefs, Nian D F Kemme, Koen Luyckx, Evan M Kleiman, Matthew K Nock, Inez Myin-Germeys.
Date
2023
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Publisher
Research Projects
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Keywords
Digital interventions, Ecological momentary assessment, Experience sampling, Mobile phone, Nonsuicidal self-injury, Real-time, Suicidal thoughts and behaviors, SDG 3 - Good Health and Well-being
Citation
Kiekens, G, Claes, L, Schoefs, S, Kemme, N D F, Luyckx, K, Kleiman, E M, Nock, M K & Myin-Germeys, I 2023, 'The detection of acute risk of self-injury project : Protocol for an ecological momentary assessment study among individuals seeking treatment', JMIR Research Protocols, vol. 12, e46244. https://doi.org/10.2196/46244