# A Systematic Review of Ecological Momentary Assessment Procedures of Self-Harm (With and Without Suicidal Intent) Studies in Adolescents and Young Adults

## TL;DR

This paper reviews how real-time data collection methods can help understand self-harm behaviors in teenagers and young adults.

## Contribution

The study provides a systematic review focusing specifically on adolescents using ecological momentary assessment (EMA) for self-harm.

## Key findings

- EMA is well-accepted by adolescents with high compliance rates.
- Self-harm is linked to factors like negative emotions, stress, and sleep issues.
- EMA captures real-time fluctuations in self-harm behaviors and risk factors.

## 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 Five databases, plus pre-print, unpublished and grey literature sources, were searched up to 30 January 2024.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.