Daily physical activity associated with suicidal ideation in college students: an ecological momentary assessment study.

Background: Suicidal ideation is common among college students and often fluctuates from day to day. Identifying short-term modifiable correlates is therefore important. Physical activity may be one such correlate, but its day-level association with suicidal ideation, the role of activity type, and the influence of childhood maltreatment remain unclear. Methods: This study used a two-stage design, including a baseline survey and a 14-day ecological momentary assessment (EMA) phase. Undergraduate students completed baseline measures of childhood maltreatment and suicidal ideation. Students with elevated suicidal ideation (BSI > = 6) who passed safety screening entered the EMA phase. During the 14-day period, suicidal ideation was assessed three times daily. Evening surveys assessed whether participants had engaged in at least 20 min of physical activity that day and whether the activity was individual or team-based. Multilevel mixed-effects models were used to examine day-level associations and the moderating role of childhood maltreatment. Results: Of 1,500 students who completed the baseline survey, 312 met the screening criterion for elevated suicidal ideation, 245 entered the EMA phase, and 208 were included in the final analyses. Daily physical activity was statistically associated with lower same-day evening suicidal ideation at the within-person level. When activity type was examined, both individual and team-based physical activity showed negative associations with evening suicidal ideation. Evidence for moderation by childhood maltreatment was strongest in the activity-type model. The overall physical activity × childhood maltreatment interaction reached only the conventional threshold, whereas the team-based physical activity × childhood maltreatment interaction was statistically significant; the inverse association between team-based activity and evening suicidal ideation became stronger as childhood maltreatment increased. Limitations: The study was conducted in a single university sample of Chinese college students with elevated suicidal ideation and relied on self-reported daily physical activity and a single-item EMA measure of suicidal ideation. Conclusion: Daily physical activity may be a relevant short-term behavioral correlate of suicidal ideation in college students with elevated suicidal ideation. Team-based activity may be particularly relevant for students with greater childhood maltreatment exposure.