A scoping review of photovoice studies concerning greenspaces and their impacts on health: Protocol.

Suicidal ideation (SI) is a significant clinical and public health concern and a potential precursor to suicidal behavior, with 9.2% of the global population experiencing some form of SI during their lifetime []. Understanding the mechanisms that underlie SI is crucial for the development of effective interventions. The Integrated Motivational-Volitional Model (IMVM) of suicidal behavior, proposed by O’Connor, and O’Connor and Kirtley [,], offers a comprehensive framework that proposes feelings of entrapment to be the central predictor of SI. Entrapment can be thought of as a psychological state in which individuals perceive themselves as trapped in a negative situation or set of circumstances that they believe cannot be escaped from []. The model suggests that when individuals experience entrapment, they are more likely to engage in SI as a way of escaping from this perceived inescapability, followed by increased intent, which may relate differently to psychological predictors and may exhibit different patterns of fluctuation over time [-]. Entrapment can be divided into two subdimensions, internal entrapment (IE) and external entrapment (EE). While EE refers to the perception of being trapped by external circumstances (eg, situational constraints and interpersonal demands), IE captures the experience of being unable to escape from one’s own thoughts, emotions, or mental states []. Recent clinical and psychometric findings based on the often-used Entrapment Scale (ES) [] increasingly support a 2D structure. This indicates that IE and EE represent distinct yet related psychological phenomena with potentially different implications for SI [-]. Importantly, to date, this differentiation has not been systematically examined in real-time using ecological momentary assessment (EMA). EMA enables repeated assessments of participants within their everyday surroundings [,]. It allows for the recording of moment-to-moment fluctuations in psychological and behavioral variables and facilitates the analysis of relationships between these constructs both within and across different sampling points. In recent years, this approach has attracted considerable attention in the field of suicidology [,]. Although there is empirical support for the IMVM in various studies (eg, in other studies [,]), much of this research has been conducted with data from general population samples or in cross-sectional research designs. Few studies have explored the real-time dynamics of entrapment and its covariability with SI, especially in clinical samples. Longitudinal as well as real-time data are particularly valuable, as they allow for an examination of how these relationships evolve over time and under changing circumstances. In the past, it has been shown that both SI fluctuates over time [] and that entrapment is a risk factor that is not stable over time, but fluctuates in its severity []. Accordingly, it might be assumed that these predictors also fluctuate in association with SI over time. Understanding whether entrapment leads to an increase in SI over time is an important step toward refining suicide prevention strategies. van Ballegooijen et al [] examined the temporal relationships between defeat, entrapment, and SI in a clinical sample of individuals with SI and/or suicidal behaviors in the past month and the experience of at least one major depressive episode. Over seven days, participants reported their level of defeat, entrapment, and SI up to six times per day. Using multilevel vector autoregressive models, analyses revealed that higher momentary levels of entrapment predicted increased SI at subsequent time points across intervals of approximately 3, 6, 9, and 12 hours, with the association being particularly pronounced at shorter intervals around three hours, suggesting short-term dynamic processes. Furthermore, this study identified bidirectional associations between entrapment and SI. Entrapment appeared to function as a bridging variable linking defeat with SI, as stated in the IMVM. Overall, the findings underscore the role of entrapment as a central, temporally fluctuating risk factor in the suicidal process.