Digital Platform for the Prevention of Suicidal Behaviour and Non-Suicidal Self-Injuries in Adolescents: The SmartCrisis-Teen Study Protocol
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Design
2.2. Sample
2.2.1. Cohort 1: Clinical Setting
- Being between 13 and 17 years old.
- Presenting a suicide attempt or an NSSI in the month previous to recruitment.
- Being able to understand the project and being interested in participating.
- Having parents or legal guardians capable of signing the informed consent.
- Being fluent in Spanish.
- Owning a smartphone with internet access and iOS or Android operating system.
- Refusal to install the mobile application.
- Any circumstance or indication that discourages the regular use of a mobile phone (e.g., addiction to new technologies).
2.2.2. Cohort 2: High School
- Being between 13 and 17 years old.
- Testing positive in the screening that will be carried out at the centers (explained below).
- Being able to understand the project and being interested in participating
- Having parents or legal guardians capable of signing the informed consent.
- Being fluent in Spanish
- Owning a smartphone with internet access and iOS or Android operating system.
- Refusal to install the mobile application.
- Any circumstance or indication that discourages the regular use of a mobile phone (e.g., addiction to new technologies).
2.2.3. Cohort 3: University Setting
- Testing positive in the screening that will be carried out at the center (explained below).
- Being able to understand the project and being interested in participating.
- Being capable of signing the informed consent.
- Being fluent in Spanish.
- Owning a smartphone with internet access and iOS or Android operating system.
- Refusal to install the mobile application.
- Any circumstance or indication that discourages the regular use of a mobile phone (e.g., addiction to new technologies).
2.3. Sample Size Calculation
2.4. General Procedure:
2.5. Procedure: Clinical Setting
2.6. Procedure: High School and University Setting
2.7. Randomization and Follow-Up
2.8. Psychometric Assessment
2.9. Implicit Association Test
2.10. Ecological Momentary Assessment
- Suicidality: 4 questions;
- Non-suicidal self-injury: 2 questions;
- Affect: 9 questions;
- Interpersonal experiences: 11 questions;
- Sleep: 4 questions;
- Apetite and eating: 3 questions.
2.11. Assessments: Questionnaires
- Sociodemographic data including gender, age, family socioeconomic status, grade repetition, sexual orientation, number of siblings (including the participant) and child adoption.
- The Columbia Suicide Severity Rating Scale (CSSRS) [34] will be administered to measure suicide ideation and behavior. This scale will be employed both in the basal and the follow-up appointments.
- In addition, we will verify suicide attempts and suicide deaths through the digital medical record (clinical events).
- The Inventory for Depressive Symptomatology—Clinical (IDSC-30) scale [49] will be administered in order to measure depressive signs and symptoms.
- MacLean Screening Instrument for Borderline Personality Disorder [50].
- The Spanish version of the Death/Suicide Implicit Association Test (D/S-IAT) [38]
- Satisfaction surveys (one qualitative and one quantitative satisfaction survey).
2.12. Assessment Criteria
- The occurrence of suicidal behavior as a clinical event (completed suicide, attempted suicide, ED visit for suicidal ideation, ED visit for self-harm),
- Predictive validity of the D/S IAT and SI IAT tests to clinical events recorded during follow-up.
- Acceptability of the project through user-perceived satisfaction.
- Project feasibility measured by participation and retention.
Treatment as Usual (TAU)
2.13. Statistical Analysis
3. Limitations
4. Expected Results
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Ecological Momentary Assessment (EMA) Questionnaire
Category | Variable | Question | Minimum Value | Maximum Value | Scoring |
Suicidality (4 questions) | Pasive SI | My wish to live is | No wish to live | Maximum wish lo live | 1–7 |
My wish to die is | No wish to die | Maximum wish to die | 1–7 | ||
Do you have thoughts of hurting yourself in some way? | Not at all | Nearly every day | 0–3 | ||
Active SI | Are you able to keep yourself safe right now? | I definitely can keep myself safe | I definitely cannot keep myself safe | 1–5 | |
Non-Suicidal Self-Injuries (2 questions) | NSSIs | At any point in the last 24 h, did you harm yourself on purpose? | Yes | No | Yes/No |
Since the last prompt, have you felt an urge or wanted to harm or injure yourself on purpose? | Not at all | Extremely | 1–5 | ||
Affect (9 questions) | Psychological pain | I feel psychological pain | No pain | Maximum pain | 1–7 |
Stress | I feel stressed out today (with pressure, overwhelmed) | No stress | Maximum stress | 1–7 | |
Restlessness | I feel restless (agitates), with the need to keep moving | No restlessness | Maximum restlessness | 1–7 | |
Hopelessness | I feel full of hope | No hope | Maximum hope | 1–7 | |
Self-hatred | I feel hatred or anger towards myself | No hatred | Maximum hatred | 1–7 | |
Hatred of others | I feel hatred or anger towards others | No hatred | Maximum hatred | 1–7 | |
Anxiety | At this moment I feel nervous | Very slightly or not at all | Extremely | 1–5 | |
Sadness | At this moment I feel sad | Very slightly or not at all | Extremely | 1–5 | |
Happiness | At this moment I feel happy | Very slightly or not at all | Extremely | 1–5 | |
Interpersonal experiences (11 questions) | Thwarted belongingness | I wish there was a trusted person with whom I can talk about all my personal issues | Not at all | Absolutely | 1–7 |
I feel like an outsider | Not at all | Absolutely | 1–7 | ||
Lack of recognition | I wish I received more recognition and love from others | Not at all | Absolutely | 1–7 | |
Lack of independence | I have the impression that important people around me want to decide for me what I should think and do | Not at all | Absolutely | 1–7 | |
Criticism | Since the last prompt have you felt insulted or criticized? | Not at all | Extremely | 1–5 | |
Thwarted belongingness | Since the last prompt have you felt rejected, abandoned, excluded or left out? | Not at all | Extremely | 1–5 | |
Perceived burdensomeness | I believe I am contributing to the well-being of my family/friends | Not at all | Absolutely | 1–7 | |
believe I am contributing to the well-being of the people around me | Not at all | Absolutely | 1–7 | ||
I feel disconnected from other people | Not at all | Absolutely | 1–7 | ||
I feel like a burden to others | Not at all true for me | Very true for me | 1–7 | ||
I feel useless | Not at all true for me | Very true for me | 1–7 | ||
Sleep (4 questions) | Sleep maintenance | Last night I had trouble staying sleep | None | Very severe | 0–4 |
Sleep-derived quality of life | Others think that sleep problems affect my quality of life | Not at all | Absolutely | 0–4 | |
Sleep dissatisfaction | Today I am satisfied with my sleep | Very unsatisfied | Very satisfied | 0–4 | |
Sleep-derived interference with daily activity | My sleep problems are interfering with my daily activity | Not at all | Very much | 0–4 | |
Appetite and eating (3 questions) | Appetite | In the last few days, I have been hungry | Never | All the time | 0–4 |
Taste | In the last days when I eat, the food tastes | Very bad | Very good | 0–4 | |
Number of meals | In the last few days, I usually do | Less than one meal a day | More thn three meals a day | 0–4 |
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Abascal-Peiró, S.; Peñuelas-Calvo, I.; Alacreu-Crespo, A.; Sáiz, P.A.; De la Torre-Luque, A.; Ruiz-Veguilla, M.; Barrigón, M.L.; Courtet, P.; López-Castroman, J.; Baca-García, E.; et al. Digital Platform for the Prevention of Suicidal Behaviour and Non-Suicidal Self-Injuries in Adolescents: The SmartCrisis-Teen Study Protocol. Behav. Sci. 2024, 14, 740. https://doi.org/10.3390/bs14090740
Abascal-Peiró S, Peñuelas-Calvo I, Alacreu-Crespo A, Sáiz PA, De la Torre-Luque A, Ruiz-Veguilla M, Barrigón ML, Courtet P, López-Castroman J, Baca-García E, et al. Digital Platform for the Prevention of Suicidal Behaviour and Non-Suicidal Self-Injuries in Adolescents: The SmartCrisis-Teen Study Protocol. Behavioral Sciences. 2024; 14(9):740. https://doi.org/10.3390/bs14090740
Chicago/Turabian StyleAbascal-Peiró, Sofía, Inmaculada Peñuelas-Calvo, Adrian Alacreu-Crespo, Pilar Alejandra Sáiz, Alejandro De la Torre-Luque, Miguel Ruiz-Veguilla, María Luisa Barrigón, Philippe Courtet, Jorge López-Castroman, Enrique Baca-García, and et al. 2024. "Digital Platform for the Prevention of Suicidal Behaviour and Non-Suicidal Self-Injuries in Adolescents: The SmartCrisis-Teen Study Protocol" Behavioral Sciences 14, no. 9: 740. https://doi.org/10.3390/bs14090740
APA StyleAbascal-Peiró, S., Peñuelas-Calvo, I., Alacreu-Crespo, A., Sáiz, P. A., De la Torre-Luque, A., Ruiz-Veguilla, M., Barrigón, M. L., Courtet, P., López-Castroman, J., Baca-García, E., & Porras-Segovia, A. (2024). Digital Platform for the Prevention of Suicidal Behaviour and Non-Suicidal Self-Injuries in Adolescents: The SmartCrisis-Teen Study Protocol. Behavioral Sciences, 14(9), 740. https://doi.org/10.3390/bs14090740