Journal of Medical Internet Research · Published 2026-08-04 · DOI 10.2196/81095
Emmy Wichelhaus, Dajana Schreiber, Inken Höller, Thomas Forkmann
Abstract BackgroundThe Integrated Motivational-Volitional Model posits entrapment as a central driver of suicidal ideation (SI), yet little is known about how internal (IE) vs external entrapment (EE) unfolds in real time. Prior ecological momentary assessment (EMA) studies have generally treated entrapment as unidimensional and used sampling intervals of several hours, potentially obscuring rapid risk processes. ObjectiveThis study examined (1) cross-sectional and longitudinal temporal associations between IE, EE, and SI across lags of 1‐3 prompts; (2) differences in immediacy of IE vs EE effects; and (3) whether the exact time interval (in minutes) between assessments moderates these associations. MethodsA total of 91 (62.2% female; Mage ResultsSI varied primarily within persons (intraclass correlation=0.15). Cross-sectionally, both IE (est=0.16, 95% CI 0.08 to 0.24; PPRPPPPPPP ConclusionsEntrapment is a dynamic correlate of SI, with IE and EE showing distinct temporal patterns. IE has rapid, within-minute effects on SI, whereas EE shows delayed associations. This study is innovative in modeling minute-level dynamics using high-frequency EMA. Unlike prior unidimensional, lower-frequency designs, it captures ultra-short-term risk processes and clarifies temporally distinct pathways within the Integrated Motivational-Volitional Model and enhances theoretical precision regarding proximal vs distal drivers of SI. Clinically, results suggest that interventions may benefit from targeting IE in real time.
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Wichelhaus, E., Schreiber, D., Höller, I., et al. (2026). Temporal Dynamics of Internal vs External Entrapment in Suicidal Ideation in Psychotherapy Outpatients: Prospective Longitudinal Cohort Study Using Ecological Momentary Assessment. Journal of Medical Internet Research. https://doi.org/10.2196/81095