چكيده لاتين
Suicide is one of the major global mental health challenges, claiming the lives of more than 700,000 people each year. In Iran, although the rate is lower than the global average, its upward trend—particularly among youth and university students—is alarming. Research grounded in the Interpersonal Theory of Suicide has demonstrated that two key constructs—thwarted belongingness and perceived burdensomeness—play a central role in eliciting suicidal desire. These constructs fluctuate rapidly in daily life and can heighten the risk of suicidal behavior over short periods. However, most existing assessment and intervention methods in the field of suicide remain static, relying on single-time clinical evaluations. In response to this limitation, Ecological Momentary Assessment (EMA) has emerged as an innovative approach for capturing emotional–cognitive fluctuations in real-life contexts, while Ecological Momentary Intervention (EMI) has gained attention as an “in-the-moment” preventive strategy. The present study aimed to integrate these two approaches through a two-phase design: Phase 1 involved intensive longitudinal modeling of concurrent, lagged, and autoregressive associations among thwarted belongingness, perceived burdensomeness, and suicide risk using the GIMME method; Phase 2 tested the effectiveness of a modular self-help intervention package in participants’ daily lives using linear mixed modeling (LMM). The study consisted of two 21-day periods, with four assessments per day. Participants were three undergraduate students from the University of Isfahan (two females aged 19 and 23, and one male aged 20) who met inclusion criteria of suicide risk but no severe psychiatric or comorbid personality disorders. The EMA protocol included three single-item, five-point Likert measures assessing thwarted belongingness, perceived burdensomeness, and suicide risk. In Phase 2, whenever a participant scored 4 or 5 on a construct, the corresponding intervention was activated: cognitive bias modification for perceived burdensomeness, interpersonal problem-solving for thwarted belongingness, and safety planning for suicide risk. Data analyses were performed using R-based coding packages. Findings from Phase 1 indicated that, at the group level, the lagged path from perceived burdensomeness to suicide risk was stronger than that from thwarted belongingness to suicide risk, although individual participants displayed distinct patterns (e.g., a stronger effect of thwarted belongingness on suicide risk). All three constructs exhibited significant autoregressive effects. In Phase 2, group-level LMM results revealed that all three interventions produced significant and meaningful reductions in their target constructs (perceived burdensomeness: β ≈ −0.24; thwarted belongingness: β ≈ −0.21; suicide risk: β ≈ −0.26; p < 0.01). Moreover, higher thwarted belongingness at the previous time point significantly increased suicide risk at the subsequent assessment. Overall, the results suggest that a modular ecological momentary intervention can effectively reduce short-term levels of thwarted belongingness, perceived burdensomeness, and suicide risk among university students. By enabling immediate assessment and intervention, this package may serve as a valuable component within stepped-care systems in universities and related institutions.
