Domain-specific hopelessness and near-term suicide risk: Evidence from ecological momentary assessment in a high-risk clinical sample

Introduction: Hopelessness is a well-established correlate of suicidal thoughts and behaviors, yet most research conceptualizes it as a global construct. Less is known about how hopelessness within specific life domains relates to near-term suicide risk and whether general hopelessness accounts for these associations. This study examined these relationships using ecological momentary assessment (EMA). Methods: Twenty-six adults (M age = 35.6, SD = 14.36) receiving outpatient therapy who reported suicidal ideation in the past two weeks completed EMA prompts three times daily for 21 days, yielding 1309 observations. At each prompt, participants rated hopelessness across six domains (work, partner, social/friends, home/family, finances, health), general hopelessness, and suicidal urge intensity. Within-person multi-level indirect effect models tested whether general hopelessness accounted for associations between domain-specific hopelessness and concurrent suicidal urges. Results: Hopelessness specific to work, partner, social/friends, home/family, and health were positively concurrently associated with both general hopelessness and suicidal urges. General hopelessness also predicted suicidal urges. After adjusting for general hopelessness, direct effects persisted for social/friends and home/family, whereas effects for work, health, and partner became nonsignificant. Financial hopelessness was not significantly related to concurrent suicidal urges. Conclusion: Findings suggest that domain-specific hopelessness fluctuates proximally with suicidal urges and contributes to general hopelessness in shaping suicide risk. Assessing both general and domain-specific hopelessness may improve short-term risk evaluation and inform targeted interventions for high-risk clinical populations.