Reactivity to experience sampling among adolescents with and without a lifetime or current history of self-harm thoughts or behaviours

Some ethical committees question whether individuals with a history of self-harm thoughts and behaviours (SHTBs) are “too vulnerable” to take part in Experience Sampling Method (ESM) research and if repeatedly asking about SHTBs could be harmful. Past research has focused on whether participating in ESM research influences SHTBs, and has overlooked participants’ general experience of ESM studies. We explored the relationships between ESM beep disturbance (disruptiveness) and compliance, and lifetime and current SHTBs. N=1507 participants completed baseline questionnaires, including about lifetime history of SHTBs, and N=1788 completed ESM 10x per day for six days, including questions about how much completing the ESM questionnaire disturbed them, and their SHTBs in daily life. There were no significant differences in disturbance or compliance between individuals with no lifetime history of SHTBs, self-harm thoughts, or self-harm behaviours. Individuals reporting self-harm behaviours during the ESM period were more likely to experience the ESM questionnaires as more disturbing. Individuals experienced the ESM questionnaires as more disturbing when more intense self-harm thoughts were reported during the ESM period on average and when their current self-harm thoughts were more intense. Our results indicate that lifetime history of SHTBs does not relate to ESM compliance or beep disturbance. However, ESM may be more taxing for individuals experiencing more intense current SHTBs, and at moments when their self-harm thoughts are more intense. We suggest that a ‘static vulnerability’ approach to ethical evaluation of ESM research based on lifetime history of SHTBs is inappropriate, and that a dynamic approach is preferable.