A systematic review of ecological momentary assessment procedures of self-harm (with and without suicidal intent) studies in adolescents and young adults

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Martin, Bethany and Rasmussen, Susan and Russell, Kirsten and Crawford, Megan and Whittaker, Spence and Thomson, Scott and Greenwood, Abbie (2026) A systematic review of ecological momentary assessment procedures of self-harm (with and without suicidal intent) studies in adolescents and young adults. International Journal of Environmental Research and Public Health, 23 (1). 84. ISSN 1660-4601 (https://doi.org/10.3390/ijerph23010084)

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Abstract

Ecological momentary assessment (EMA) captures real-time data on thoughts, emotions, and behaviours within individuals’ natural environments. Although EMA has been increasingly used to examine self-harm, existing reviews have not focused specifically on adolescents. This systematic review examines EMA research on adolescent self-harm, focusing on methodological considerations and key risk and protective factors for self-harm. Five databases, plus pre-print, unpublished and grey literature sources, were searched up to 30 January 2024. Studies were included if published in English, used EMA methodology, included adolescents aged 10–24 years and measured suicidal ideation, suicidal behaviours, or self-harm. The review included 79 studies, published from 2009 to the present. Self-harm was associated with numerous risk factors, including negative affect, stress, interpersonal influences and sleep. EMA was generally well-accepted by adolescent participants, with high compliance rates. The findings highlight the value of EMA in capturing real-time fluctuations in self-harm and associated risk factors among adolescents. EMA demonstrates strong potential for improving understanding and prediction of self-harm; yet challenges remain, including variability in study designs and a lack of clear reporting of the methodologies. Future research should focus on standardising methodologies, increasing participant diversity, and exploring the clinical utility of EMA in early intervention and prevention strategies.

ORCID iDs

Martin, Bethany, Rasmussen, Susan ORCID logoORCID: https://orcid.org/0000-0001-6408-0028, Russell, Kirsten ORCID logoORCID: https://orcid.org/0000-0002-7034-2749, Crawford, Megan ORCID logoORCID: https://orcid.org/0000-0002-3167-1398, Whittaker, Spence ORCID logoORCID: https://orcid.org/0009-0001-3645-7497, Thomson, Scott and Greenwood, Abbie;
CORE (COnnecting REpositories)