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Suicide and Self-Injury

A call to researchers to include the menstrual cycle as a salient time-varying factor for personalized medicine: Using premenstrual suicide and just-in-time adaptive Interventions as a framework

(PS11-1) A Call to Researchers to Include the Menstrual Cycle as a Salient Time-varying Factor for Personalized Medicine: Using Premenstrual Suicide and Just-in-time Adaptive Interventions as a Framework

Saturday, November 16, 2024

2:30 PM – 3:30 PM EST

Location: Franklin Hall, Level 4, Marriott Downtown

Author(s)

Hafsah Tauseef, Ph.D.

PhD Student Clinical Psychology
University of Illinois at Chicago
Chicago, Illinois, United States

Co-Author(s)

Tory A. Eisenlohr-Moul, Ph.D.

Associate Professor of Psychiatry
University of Illinois at Chicago
Chicago, Illinois, United States

Abstract Text: Recent applications of ecological momentary assessments (EMA) and idiographic statistical models have demonstrated the dynamic and highly individualized nature of symptoms in various psychological disorders. Consequently, intervention strategies have emerged, such as precision medicine, which emphasizes providing health care specifically tailored to the individual with consideration for predictable, time-varying factors. Among individuals assigned female at birth, accumulating evidence suggests that the menstrual cycle is a time-varying factor that can exacerbate symptoms of psychological disorders, including but not limited to affective disorders, suicidality, substance use disorder, attention deficit hyperactivity disorder (ADHD), and borderline personality disorder. For example, baseline studies demonstrate that a majority, though not all, females with past month suicide ideation demonstrate perimenstrual worsening of emotional symptoms and suicidality. With a particular focus on perimenstrual worsening of suicidal thoughts and behaviors, 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 (JITAI). The unique and recurrent "biotype" response of hormone-sensitive individuals to the menstrual cycle is well-suited for inclusion as a time-varying and predictable variable in JITAI. The research proposal outlines how JITAI can be employed to explore trajectory patterns of suicidal thoughts and behaviors across the menstrual cycle. This work discusses how JITAI can be leveraged to identify individuals for whom the menstrual cycle exerts significant influence and to strategically deploy interventions based on their specific temporal patterns. Furthermore, we discuss how integrating passive measures for tracking the menstrual cycle can enhance the feasibility of including this factor in JITAI models. This low-cost solution minimizes participant burden, as passive tracking methods reliably capture menstrual cycle data. In the pursuit of increased specificity and accuracy within predictive machine learning models and JITAI, this work argues and illustrates how accounting for the menstrual cycle may provide valuable insights and clarify previously unexplained variance of symptoms across time.