Development of An Ecological Momentary Assessment of the Impact of Social Media Use Among Suicidal Adolescents

Abstract

Objective

We aimed to develop an ecological momentary assessment (EMA) measure and sampling protocol to assess the near-term impact of experiences with social media use (SMU) that are associated with risk and protective factors for adolescent suicide.

Methods

To develop the EMA measure, we consulted literature reviews and conducted focus groups with the target population, adolescents at risk for suicide. Subsequently, we refined the measure through interviews with experts and cognitive interviews with adolescents, through which we explored adolescents’ thought processes as they considered questions and response options. Data were recorded, transcribed, and analyzed using thematic analysis.

Results

The initial measure had 37 items assessing a range of harmful and beneficial aspects of SMU. Through expert and cognitive interviews, we refined the measure to 4 pathways assessing positive and negative experiences with SMU as well as positive and negative in-person interactions. Each pathway included a maximum of 11 items, as well as 2 items pertaining to SMU at nighttime to be assessed once daily. Acceptable targets the EMA measure’s sampling protocol included a 10-day data collection window with text message-based prompts to complete the measure triggered 2–4 times daily.

Conclusions

By assessing a range of risk and protective factors for youth suicide, while using methods to reduce participant burden, we established content validity for the EMA measure and acceptability for the sampling protocol among youth at high risk of suicide.

HIGHLIGHTS

• Development of an ecological momentary assessment measure and sampling protocol

• Exploring brief momentary assessment of social media’s impact on adolescent suicidal risk

• Multi-phase approach to establishing content validity and an acceptable sampling protocol

Keywords:

• Adolescents
• ecological momentary assessment
• measure development
• social media
• suicide

ACKNOWLEDGEMENTS

The authors are grateful to Isha Yemula for her assistance with transcription. We are also thankful for the adolescents and content and measurement experts who participated in this study.

DISCLOSURE STATEMENT

Drs. Biernesser, Bear, Mair, Zelazny, and Trauth have no disclosures to report. Dr. Brent receives research support from NIMH, AFSP, the Once Upon a Time Foundation, and the Beckwith Foundation, receives royalties from Guilford Press, from the electronic self-rated version of the C-SSRS from eRT, Inc., and from performing duties as an UptoDate Psychiatry Section Editor, receives consulting fees from Healthwise, and receives Honoraria from the Klingenstein Third Generation Foundation for scientific board membership and grant review.

AUTHOR NOTES

Candice Biernesser, PhD, Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Todd Bear, PhD, Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. David Brent, MD, Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Christina Mair, PhD, Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. Jamie Zelazny, PhD, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. Jeanette Trauth, PhD, Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.

Additional information

Funding

This work was supported by the National Institute of Mental Health under Grants T32 MH018951 and P50 MH115838.