TY - JOUR
T1 - Sleep in youth with repeated self-harm and high suicidality
T2 - Does sleep predict self-harm risk?
AU - Asarnow, Joan Rosenbaum
AU - Bai, Sunhye
AU - Babeva, Kalina N.
AU - Adrian, Molly
AU - Berk, Michele S.
AU - Asarnow, Lauren D.
AU - Senturk, Damla
AU - Linehan, Marsha M.
AU - McCauley, Elizabeth
N1 - Funding Information:
AFSP LSRG-0-008-13; NIMH R01MH090159; R01MH93898; T32MH073517; K23 MH116520; UCLA Cousins Center for Psychoneuroimmunology, Seed Grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funding agencies. The authors thank the children, families, and many colleagues who made this project possible. We thank Michael Irwin, Dana McMakin, and Allison Harvey who consulted during project development, and Olivia Fitzpatrick, Nicholas Anderson, Michelle Rozenman, Benjamin Rolon-Arroyo, Kathryn Korslund, and Nicole Starace who supported project implementation.
Publisher Copyright:
© 2020 The American Association of Suicidology
PY - 2020/12
Y1 - 2020/12
N2 - Objective: To elucidate processes contributing to continuing self-harm in youth at very high risk for suicide, focusing on sleep disturbance, a putative warning sign of imminent suicide risk. Method: 101 youth (ages 12–18) selected for high risk of suicide/suicide attempts based on suicidal episodes plus repeated self-harm (suicide attempts and/or nonsuicidal self-injury [NSSI]). Youth were assessed at baseline, 6-, and 12-month follow-ups on measures of self-harm, suicidality, sleep, and depression. Results: Youth showed high rates of baseline sleep disturbance: 81.2% scored in the clinical range on the Pittsburgh Sleep Quality Index (PSQI); 81.2% reported an evening (night owl) circadian preference. PSQI score was associated with elevated levels of self-harm (suicide attempts and NSSI) contemporaneously and predicted future self-harm within 30 days. Rates of self-harm were high during follow-up: 45.0% and 33.7% at 6 and 12 months, respectively. Conclusions: Results underscore the need to move beyond an acute treatment model to prevent recurrent and potentially deadly self-harm, the importance of clarifying mechanisms contributing to elevated suicide/self-harm risk, and the potential promise of engaging sleep as a therapeutic target for optimizing treatment and elucidating mechanistic processes.
AB - Objective: To elucidate processes contributing to continuing self-harm in youth at very high risk for suicide, focusing on sleep disturbance, a putative warning sign of imminent suicide risk. Method: 101 youth (ages 12–18) selected for high risk of suicide/suicide attempts based on suicidal episodes plus repeated self-harm (suicide attempts and/or nonsuicidal self-injury [NSSI]). Youth were assessed at baseline, 6-, and 12-month follow-ups on measures of self-harm, suicidality, sleep, and depression. Results: Youth showed high rates of baseline sleep disturbance: 81.2% scored in the clinical range on the Pittsburgh Sleep Quality Index (PSQI); 81.2% reported an evening (night owl) circadian preference. PSQI score was associated with elevated levels of self-harm (suicide attempts and NSSI) contemporaneously and predicted future self-harm within 30 days. Rates of self-harm were high during follow-up: 45.0% and 33.7% at 6 and 12 months, respectively. Conclusions: Results underscore the need to move beyond an acute treatment model to prevent recurrent and potentially deadly self-harm, the importance of clarifying mechanisms contributing to elevated suicide/self-harm risk, and the potential promise of engaging sleep as a therapeutic target for optimizing treatment and elucidating mechanistic processes.
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U2 - 10.1111/sltb.12658
DO - 10.1111/sltb.12658
M3 - Article
C2 - 32706147
AN - SCOPUS:85088401612
VL - 50
SP - 1189
EP - 1197
JO - Suicide and Life-Threatening Behavior
JF - Suicide and Life-Threatening Behavior
SN - 0363-0234
IS - 6
ER -