Self-Report Measures and Mobile Applications for Mental Health – Focusing on Suicidality and Bipolar Disorder – Including App Development and Measure Validation

• Author / Creator

  Chan, Eric Christopher

• This thesis describes studies evaluating the predictive validity of suicide risk assessments, assessment and monitoring of bipolar disorder using mobile app-based self-report questionnaires, the feasibility and criterion validity of novel tools for the evaluation of suicidal ideation and behaviours, otherwise known as suicidality, namely the Suicide Ideation and Behavior Assessment Tool (SIBAT) and mobile applications. As suicidality varies over time and is sensitive to a wide range of factors, the accurate assessment of suicide risk remains a challenge in psychiatry. Self-report scales have been developed for the assessment of suicide risk, but their utility has been debated. As such, I have conducted a systematic review of studies examining the predictive validity of self-report scales in the prediction of future suicide attempts and death by suicide. The results of this review suggest that no existing scale has sufficient validity for routine clinical use and all scales studied had particularly low positive predictive value in the prediction of death by suidide. I also conducted a systematic review of studies with Dr. Sudhakar Sivapalan examining the feasibility and validity of assessment and monitoring of bipolar disorder using mobile app-based self-report tools. At the time that this review was conducted, the data suggested that self-report tools were valid in the assessment of symptoms of mania, but their validity in the assessment of depression was unclear. Our findings were limited by the low number of studies identified for inclusion. The development of novel tools to assess suicide risk may improve our ability to assess suicidality and observe its changes over time and in response to different interventions. The SIBAT is a new tool developed for the evaluation of suicidality that encompasses a wide range of factors associated with suicide risk. It was developed for repeat administration with the goal of measuring changes in suicidality over time. Mobile applications have also been developed for management of suicidality, but there are few data on the validity of mobile application-based assessment tools for this purpose. In these studies, I have developed a mobile application for the SIBAT. As an add-on study, participants in an addictions study at the University of Alberta were invited to complete the SIBAT using either the mobile application or the Qualtrics interface (programmed by Dr. Bradley Green). Data collected using the SIBAT via mobile device or Qualtrics were pooled and compared to data collected using the Mini International Neuropsychiatric Interview (MINI). Data collected using the SIBAT showed high internal consistency, and the sum of scores from modules 2 and 3 had good concurrent validity with the scores from the MINI and module 5 of the SIBAT. Participants who completed the SIBAT using the application were divided into two groups, one group completed the SIBAT using a mobile device and the other completed the SIBAT using a personal computer. I compared these two groups to assess the concurrent validity of data collected via mobile device with the data collected via personal computer. Participants completing the scale using a mobile device had a higher proportion of scale completion compared to participants completing the scale using a personal computer. A trend toward an increase in disclosed suicidality was also observed in the mobile device group. This suggests that participants may be more willing to report suicidality using their mobile device, which replicates a small prior study; however, replication of this finding using larger populations is needed. These findings indicate that both mobile applications and the SIBAT show promise as tools for the evaluation of suicidality. Further research assessing the administration of these tools over time may improve our understanding of their potential uses in both research and clinical settings.

• Subjects / Keywords

  • mental health
  • rating scales
  • suicide
  • bipolar disorder
  • cell phone
  • mobile applications
  • smartphone
  • e-mental health

• Graduation date

  Fall 2020

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-tawe-0385

• License

  Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.