Nightmares and Dysfunctional Beliefs about Sleep Mediate the Effect of Insomnia Symptoms on Suicidal Ideation

McCall, W. Vaughn; Batson, Nicholas; Webster, Megan; Case, L. Douglas; Joshi, Indu; Derreberry, Todd; McDonough, Adam; Farris, Suzan R.

doi:10.5664/jcsm.2408

Cited by 80 publications

(75 citation statements)

References 18 publications

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“…Although we were unable to test whether nightmares mediated the relation between alcohol use and suicide risk, the present study adds to the literature regarding nightmares and suicidality. Previous studies have demonstrated that nightmares are associated with suicide risk and behavior independent of many forms of psychopathology, 3,5,9,10,[38][39][40][41] as well as Joiner's Interpersonal-Psychological Theory of Suicide. 8,42,43 Further, research has shown that among suicide attempters, nightmares are associated with suicide risk and suicide attempts independent of alcohol use.…”

Section: Discussionmentioning

confidence: 99%

Explaining Alcohol Use and Suicide Risk: A Moderated Mediation Model Involving Insomnia Symptoms and Gender

Nadorff

Salem

Winer

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: The purpose of the study was to examine whether insomnia symptoms and nightmares mediated the relation between alcohol use and suicide risk. Further, we examined whether this mediation was moderated by gender. Design: The study consisted of questionnaires administered online examining insomnia symptoms, nightmares, alcohol use, and suicide risk. Setting: University. Patients or Participants: 375 undergraduate students at a large, public university in the southeastern United States. Interventions: N/A. Measurements and Results: Results indicated that insomnia symptoms signifi cantly mediated the relation between alcohol use and suicide risk; however, this mediation was moderated by gender. For women, there was both a direct effect of alcohol use on suicide risk as well as an indirect effect of alcohol use through insomnia symptoms increasing suicide risk. For men, there was no direct effect of alcohol use on suicide risk, but there was a signifi cant indirect effect of alcohol use increasing suicide risk through insomnia symptoms. Nightmares were not related to alcohol use, and the association between nightmares and suicide risk was found to be independent of alcohol use Conclusions: Insomnia symptoms are an important factor in explaining the mechanism by which alcohol use increases suicide risk. Keywords: insomnia symptoms, suicide risk, alcohol use, gender Citation: Nadorff MR, Salem T, Winer ES, Lamis DA, Nazem S, Berman ME. Explaining alcohol use and suicide risk: a moderated mediation model involving insomnia symptoms and gender. J Clin Sleep Med 2014;10(12):1317-1323.pii: jc-00186-14 http://dx.doi.org/10.5664/jcsm.4288 S C I E N T I F I C I N V E S T I G A T I O N SS uicide is a serious and growing public health concern in the United States (U.S.). In 2010 alone, 38,364 Americans died by suicide, making suicide the tenth leading cause of death in the U.S.; among 15-24 year olds it was the third leading cause of death, and was the second leading cause of death among college-age students.1 Moreover, 2010 marked the fi fth consecutive year that suicide rates in the U.S. increased.1 Thus, it is crucial for clinicians and researchers to gain a better understanding of suicide risk and protective factors. Insomnia and Suicide RiskNumerous empirical studies have demonstrated a relation between insomnia symptoms and suicide risk, 2-7 including several that have found an association above and beyond other psychopathology. In a longitudinal study of 6,504 adolescents, Wong and Brower found that sleep problems signifi cantly predicted future suicidal ideation and attempts. 7 Additionally, among young adults in the military, insomnia symptoms were positively related to suicidal ideation. 6 Insomnia symptoms are also associated with death by suicide. In a chart review of U.S. Veterans who died by suicide, Pigeon and colleagues found that Veterans who had documented insomnia symptoms died within a shorter time span following their last VA appointment than did Veterans who had not reported insomnia sympto...

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Section: Discussionmentioning

confidence: 99%

Explaining Alcohol Use and Suicide Risk: A Moderated Mediation Model Involving Insomnia Symptoms and Gender

Nadorff

Salem

Winer

et al. 2014

Journal of Clinical Sleep Medicine

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“…As nightmares are discussed as a potential risk factor for suicide [22][23][24] and their negative effect on daytime functioning 8 , it would be desirable to study in more detail the reasons why nightmare sufferers do not seek professional help. One might speculate that adults who suffered from nightmares since childhood -a high percentage of adult nightmare sufferers state that nightmares started in childhood 25 perceive them as "normal" despite the burden of the disorder.…”

Section: Discussionmentioning

confidence: 99%

Seeking professional help for nightmares: a representative study

Schredl

2013

Eur. J. Psychiat.

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GERMANYABSTRACT -Background and Objectives: Nightmares are defined as disturbing mental experiences that generally occur during REM sleep and often result in awakening. Even though about 5% of the general population suffers from nightmares, little is known about seeking professional help in this patient group.Methods: A quota sample of 2019 participants representative for the German population was studied.Results: The findings indicate that every eighth person with frequent nightmares (cutoff: every other week or more often) sought at one time of his/her life for professional help for coping with nightmares. Socio-demographic variables did not correlate with helpseeking behavior.Conclusions: Nightmares are an undertreated condition and future studies should aim at a more throughout understanding why nightmare sufferers rarely seek help for their condition.

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“…A recent research study found the relation between insomnia and suicidal ideation to be mediated by nightmares and dysfunctional attitudes about sleep. 16 Additionally, our research team has also found relations between insomnia symptoms and suicide to be mediated by symptoms of psychopathology among young adults 20 and older adults. 13 However, an emerging factor that may help explain this discrepancy in the literature is insomnia duration.…”

mentioning

confidence: 99%

“…[10][11][12][13][14][15][16][17] For instance, in a sample of individuals who suffer from depression and insomnia being treated by hypnotic and selective serotonin reuptake inhibitor (SSRI) medication, insomnia is correlated with suicidal thinking, suggesting a link between insomnia and suicidal ideation in a clinical population. 11 Although research has clearly demonstrated that insomnia symptoms are associated with suicidal behavior, fi ndings regarding whether this association is independent of other psychopathology are mixed.…”

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confidence: 99%

“…1 Further, 2012 marks the fi rst time in history that U.S. deaths by suicide have exceeded 40,000 in a year. 2 Suicide is a particularly large problem for older adults: although older adults only made up about 13.7% of the population in 2012, older adults represented 16.4% of suicides. 1 Suicidal intent, which refers to the degree to which one desires to end his/her life by suicidal behavior, 3 is more common in older adults than in the rest of the population, and attempts made by older adults are more likely to be fatal.…”

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confidence: 99%

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Unpacking Sleep and Suicide in Older Adults in a Combined Online Sample

Golding

Nadorff

Winer

et al. 2015

Journal of Clinical Sleep Medicine

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BRIEF SUMMARYCurrent Knowledge/Study Rationale: Research has shown relations between duration of insomnia symptoms/duration of nightmares and suicide risk in younger adults. However, this relation has not been examined in older adults. Study Impact: The present study found that, in older adults, nightmare duration was related to suicide risk independent of current nightmares, current symptoms of and duration of insomnia, and symptoms of anhedonia and PTSD. Nightmare duration was also related to suicide risk independent of the IPTS. Thus, nightmare duration is an important factor to be assessed when evaluating the level of suicide risk with patients.Objective: Duration of insomnia symptoms and nightmares are related to suicidal risk in young adults independent of current symptoms of insomnia, nightmares, anxiety, depression, and PTSD. However, this relation has yet to be examined among older adults, despite older adults being at higher risk of suicidal behavior. Further, the current study aims to replicate previous research among younger adults showing that insomnia symptoms and nightmares are associated with suicide risk independent of the interpersonal psychological theory of suicide (IPTS). Methods: The present study utilized 167 participants age 55 and older obtained by combining two independent mTurk data collections of adults in the United States. Results: In the current sample, duration of nightmares was associated with suicide risk in older adults independent of symptoms of current insomnia and nightmares, duration of insomnia, and symptoms of PTSD, anhedonia, and the IPTS. Conclusions: Our fi ndings suggest that the duration of nightmares (i.e., how long someone has been experiencing nightmares) predict substantial variance in suicide risk among older adults in addition to the risk factors typically examined. S uicide is a leading cause of death, yet it remains a challenge to predict and prevent. In 2012, suicide was the tenth leading cause of death in the United States, accounting for 40,600 deaths.1 Further, 2012 marks the fi rst time in history that U.S. deaths by suicide have exceeded 40,000 in a year.2 Suicide is a particularly large problem for older adults: although older adults only made up about 13.7% of the population in 2012, older adults represented 16.4% of suicides.1 Suicidal intent, which refers to the degree to which one desires to end his/her life by suicidal behavior, 3 is more common in older adults than in the rest of the population, and attempts made by older adults are more likely to be fatal. 4 To illustrate this, there are 100-200 attempts for every one youth suicide and 4 attempts for every one older adult suicide.5 Thus, older adult suicide attempts are much more likely to be fatal than younger adult suicide attempts. Research has identifi ed many risk factors for older adult suicide including the loss of independence, social isolation, mental illness, and decline in physical health. 4,[6][7][8] However, despite having identifi ed these risk factors, clinicians are still very po...

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Nightmares and Dysfunctional Beliefs about Sleep Mediate the Effect of Insomnia Symptoms on Suicidal Ideation

Cited by 80 publications

References 18 publications

Explaining Alcohol Use and Suicide Risk: A Moderated Mediation Model Involving Insomnia Symptoms and Gender

Explaining Alcohol Use and Suicide Risk: A Moderated Mediation Model Involving Insomnia Symptoms and Gender

Seeking professional help for nightmares: a representative study

Unpacking Sleep and Suicide in Older Adults in a Combined Online Sample

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