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PERSPECTIVE article

Front. Psychiatry
Sec. Public Mental Health
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1434499
This article is part of the Research Topic Psychiatric Illness Across the Menstrual Cycle View all 8 articles

RUNNING HEAD: JITAI for Premenstrual Exacerbation of Suicide

Provisionally accepted
Hafsah A Tauseef Hafsah A Tauseef 1*Daniel Coppersmith Daniel Coppersmith 2Azure J Reid-Russell Azure J Reid-Russell 2Anisha Nagpal Anisha Nagpal 1Jaclyn M Ross Jaclyn M Ross 1Matthew Nock Matthew Nock 2Tory Anne Eisenlohr-Moul Tory Anne Eisenlohr-Moul 1
  • 1 University of Illinois Chicago, Chicago, United States
  • 2 Harvard University, Cambridge, Massachusetts, United States

The final, formatted version of the article will be published soon.

    This paper discusses the scientific rationale and methodological considerations for incorporating the menstrual cycle as a time-varying intra-individual factor in personalized medicine models, such as Just-In-Time Adaptive Interventions (JITAIs). Among patients, accumulating evidence suggests that the normal hormone fluctuations of the menstrual cycle represent a time-varying factor that can trigger or exacerbate psychiatric symptoms, including but not limited to affective dysregulation, suicidality, and irritability. While only a minority of the general female population experiences significant cyclical changes, this hormone-sensitive response appears to be greater among patients with psychiatric disorders, with studies demonstrating that a majority of patients recruited for past-month suicidal ideation demonstrate worsening of their suicidality around menses. However, no interventions target suicidality during this monthly period of elevated risk despite evidence of a clear recurring biological trigger. This unique and recurrent "biotype" of suicidality is well-suited for JITAIs. In addition to providing a rationale for the inclusion of the cycle in JITAI, we provide illustrative options and examples regarding the measurement and implementation of cycle variables in JITAIs. We discuss how JITAIs might be leveraged to use menstrual cycle data to identify states of vulnerability within people and strategically select and deploy interventions based upon their receptivity at various phases in the cycle. Furthermore, we discuss how to integrate passive measures for tracking the menstrual cycle. Although much research is needed before implementation, we maintain that the menstrual cycle represents a critically understudied time-varying feature that may markedly improve the accuracy of JITAI models for predicting suicidality.

    Keywords: just-in-time adaptative intervention, Menstrual Cycle, Suicide, idiographic modeling, and mobile health

    Received: 17 May 2024; Accepted: 23 Sep 2024.

    Copyright: © 2024 Tauseef, Coppersmith, Reid-Russell, Nagpal, Ross, Nock and Eisenlohr-Moul. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hafsah A Tauseef, University of Illinois Chicago, Chicago, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.