Abstract

Rationale: The severity of insomnia symptoms, including difficulty falling asleep and returning to sleep when awakened in the night, are major risk factors for more severe suicidality including suicidal ideation, suicide attempts, and death by suicide. As a modifiable risk factor, insomnia is a potential target for suicide prevention. There are several commonly observed gaps in the literature studying the association between insomnia and suicidality including little exploration of potential mediators, limited assessments of insomnia and suicidality, and a lack of sample diversity and representativeness. As such, the models that explain the association between insomnia and suicidality remain unclear and understudied. The purpose of this study is to investigate potential mediators that are associated with both insomnia severity and suicidality severity including emotion dysregulation, thwarted belongingness, and perceived burdensomeness with the use of validated measures in a nationally representative sample. Background: Evidence suggests that insomnia severity is related to suicidality severity, even when accounting for common risk factors of suicidality such as depression. Several models have been developed to explain the association between insomnia and suicidality severity. Neurocognitive models propose that insomnia prevents natural recuperative functions of sleep, thereby contributing to daytime impairment such as emotion dysregulation. Joinerâ€™s suicide risk model may also outline potential psychosocial components that facilitate the association between insomnia and suicidality severity including thwarted belongingness and perceived burdensomeness. Emotion dysregulation, thwarted belongingness, and perceived burdensomeness have been individually associated with both insomnia and suicidality severity. Methods: We collected data on demographics, insomnia severity, depression, anxiety, suicidality severity, emotional regulation, thwarted belongingness, and perceived burdensomeness from 428 participants through an online survey. Our first aim was to replicate previous findings of the insomnia-suicidality severity association through regression analyses between self-reported insomnia and suicidality severity whilst controlling demographic variables, self-reported depression severity, and self-reported anxiety severity. Our second aim is to understand the role emotion dysregulation, thwarted belongingness, and perceived burdensomeness play in the insomnia and suicidal severity association, even when accounting for depression, through testing our proposed mediation models using structural equation modeling. Results: Insomnia severity was related to greater suicidality, but not when accounting for depression severity. Emotion dysregulation and perceived burdensomeness partially mediated the association between insomnia severity and suicidality severity. When accounting for depression severity, emotion dysregulation and perceived burdensomeness fully mediated the association between insomnia severity and suicidality severity. Conclusions: Depression, perceived burdensomeness, and emotion dysregulation may explain the association between insomnia and suicidality severity. These difficulties may serve as potent markers for suicide risk and potential targets for treatment and suicide prevention.

Degree

PhD

College and Department

Family, Home, and Social Sciences; Psychology

Rights

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