Sleep influences daily suicidal ideation through affective reactivity to interpersonal events among high-risk adolescents and young adults

TY - JOUR

T1 - Sleep influences daily suicidal ideation through affective reactivity to interpersonal events among high-risk adolescents and young adults

AU - Hamilton, Jessica L.

AU - Tsypes, Aliona

AU - Zelazny, Jamie

AU - Sewall, Craig J.R.

AU - Rode, Noelle

AU - Merranko, John

AU - Brent, David A.

AU - Goldstein, Tina R.

AU - Franzen, Peter L.

N1 - Funding Information: This research was supported by grants awarded by the American Foundation for Suicide Prevention (T.R.G.; P.L.F.) (SRG‐0‐056‐16) and University of Pittsburgh Clinical and Translational Science Institute (UL1 TR001857), as well as K01MH121584 (J.L.H.), L30MH117642 (J.L.H.), T32MH018269 (A.T.), T32MH018951 (C.J.R.S.), and R01 MH118312 (P.L.F.). The authors are grateful to the Services for Teens at Risk (STAR) clinic staff, participants, and their families in helping to conduct this study, which is supported in part by an appropriation from the Commonwealth of Pennsylvania. The authors have declared that they have no competing or potential conflicts of interest. Key points Publisher Copyright: © 2022 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

PY - 2023/1

Y1 - 2023/1

N2 - Background: Identifying proximal risk factors for suicidal ideation that are modifiable and relevant for adolescents and young adults is critical for suicide prevention. This study used an intensive monitoring approach to examine whether objectively- and subjectively- measured sleep characteristics predict next-day suicidal ideation occurrence and intensity through affective reactivity to interpersonal events in young people at high risk for suicide. Methods: Participants included 59 (13–23 years; 76% White; 75% female) adolescents and young adults undergoing intensive outpatient program treatment for depression and suicidality. Participants completed daily ratings of suicidal ideation, sleep quality, and affective reactivity to positive and negative interpersonal events for up to 3 months (M = 56 days, SD = 24.13). Actigraphy captured behavioral sleep duration and timing. Multilevel modeling was used to evaluate within-person fluctuations in sleep and affective reactivity as predictors of suicidal ideation, and multilevel mediation tested the indirect effects of sleep on suicidal ideation via affective reactivity to interpersonal events. Results: Results indicate significant indirect effects of objectively measured sleep duration and subjective sleep quality on next-day suicidal ideation via affective reactivity to negative and positive interpersonal events, respectively. Shorter-than-usual sleep predicted the presence and intensity of next-day suicidal ideation via heightened affective reactivity to negative interpersonal events. Worse sleep quality than usual predicted next-day suicidal ideation via reduced affective reactivity to positive interpersonal events. Conclusions: Affectivity reactivity is a proximal mechanism through which sleep indices may influence risk for suicidal thinking on a daily basis. Findings highlight the utility of targeting sleep and emotion regulation in suicide prevention among adolescents and young adults at high-risk for suicide.

AB - Background: Identifying proximal risk factors for suicidal ideation that are modifiable and relevant for adolescents and young adults is critical for suicide prevention. This study used an intensive monitoring approach to examine whether objectively- and subjectively- measured sleep characteristics predict next-day suicidal ideation occurrence and intensity through affective reactivity to interpersonal events in young people at high risk for suicide. Methods: Participants included 59 (13–23 years; 76% White; 75% female) adolescents and young adults undergoing intensive outpatient program treatment for depression and suicidality. Participants completed daily ratings of suicidal ideation, sleep quality, and affective reactivity to positive and negative interpersonal events for up to 3 months (M = 56 days, SD = 24.13). Actigraphy captured behavioral sleep duration and timing. Multilevel modeling was used to evaluate within-person fluctuations in sleep and affective reactivity as predictors of suicidal ideation, and multilevel mediation tested the indirect effects of sleep on suicidal ideation via affective reactivity to interpersonal events. Results: Results indicate significant indirect effects of objectively measured sleep duration and subjective sleep quality on next-day suicidal ideation via affective reactivity to negative and positive interpersonal events, respectively. Shorter-than-usual sleep predicted the presence and intensity of next-day suicidal ideation via heightened affective reactivity to negative interpersonal events. Worse sleep quality than usual predicted next-day suicidal ideation via reduced affective reactivity to positive interpersonal events. Conclusions: Affectivity reactivity is a proximal mechanism through which sleep indices may influence risk for suicidal thinking on a daily basis. Findings highlight the utility of targeting sleep and emotion regulation in suicide prevention among adolescents and young adults at high-risk for suicide.

KW - Adolescence

KW - actigraphy

KW - affective reactivity

KW - intensive monitoring

KW - interpersonal

KW - sleep

KW - suicide

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U2 - https://doi.org/10.1111/jcpp.13651

DO - https://doi.org/10.1111/jcpp.13651

M3 - Article

C2 - 35778912

SN - 0021-9630

VL - 64

SP - 27

EP - 38

JO - Journal of Child Psychology and Psychiatry and Allied Disciplines

JF - Journal of Child Psychology and Psychiatry and Allied Disciplines

IS - 1

ER -