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Objectively-Assessed Sleep Disturbances as a Unique Suicide Risk Factor

Title: Objectively-Assessed Sleep Disturbances as a Unique Suicide Risk Factor.
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Name(s): Bernert, Rebecca A. (Rebecca Ann), 1978-, author
Joiner, Thomas, professor directing dissertation
Jumonville, Neil, university representative
Schmidt, Brad, committee member
Maner, Jon, committee member
Sachs-Ericsson, Natalie, committee member
Department of Psychology, degree granting department
Florida State University, degree granting institution
Type of Resource: text
Genre: Text
Issuance: monographic
Date Issued: 2009
Publisher: Florida State University
Place of Publication: Tallahassee, Florida
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Introduction: Evidence suggests that disturbed sleep may constitute an important and modifiable vulnerability factor for acute suicidal risk and completed suicide. Sleep complaints are closely coupled with mood problems, and depression is considered the single best predictor of suicide. A paucity of research has investigated how specific indices of sleep may predict suicide risk, beyond depressive symptoms, using an objective measurement of sleep and a prospective study design. Methods: Data were collected among 49 men and women across three study time points: baseline (T1), 1 week (T2), and 3 weeks (T3). Using wrist actigraphy, objective indices of sleep were hypothesized to predict increases in suicidal symptoms over time, even after controlling for depression. The Beck Depression Inventory (BDI) and Beck Scale for Suicide (BSS) were used as primary symptom measures. We furthermore hypothesized that mood lability, versus depressed mood per se, would account for the relationship between sleep and suicidality. Results: Hypotheses were partially supported. Regression 1 indicated that, as a set, actigraphy sleep variables, significantly predicted T2 residual changes scores, controlling for BDI (P .05). Regression 2 results also indicated that actigraphy sleep variables together predicted T3 BSS change scores, controlling for BDI (P .05) did not significantly contribute to the variance beyond that contributed by sleep variability. A Sobel test revealed that depression scores significantly mediated the relationship between sleep variability and BSS T2 change scores (Z = 2.03, P = .04); this finding was partially replicated as a nonsignificant trend for BSS T3 change scores (Z = 1.28, P = .19). In contrast, a mood lability mediation model was not supported according to standard tests of mediation (P > .05 for BSS T2 and T3 residual change scores, respectively). Conclusions: Actigraphically-assessed sleep variability was uniquely associated with greater levels of suicidal ideation, an effect that was independent of depression. Low mood, versus increased mood lability, mediated the relationship between sleep and increases in suicide risk. Clinical implications are discussed. .05 for BSS T2 and T3 residual change scores, respectively). Conclusions: Actigraphically-assessed sleep variability was uniquely associated with greater levels of suicidal ideation, an effect that was independent of depression. Low mood, versus increased mood lability, mediated the relationship between sleep and increases in suicide risk. Clinical implications are discussed.
Identifier: FSU_migr_etd-1371 (IID)
Submitted Note: A Dissertation Submitted to the Department of Psychology in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy.
Degree Awarded: Fall Semester, 2009.
Date of Defense: August 25, 2009.
Keywords: Sleep Disturbances, Insomnia, Suicide, Suicidology
Bibliography Note: Includes bibliographical references.
Advisory committee: Thomas Joiner, Professor Directing Dissertation; Neil Jumonville, University Representative; Brad Schmidt, Committee Member; Jon Maner, Committee Member; Natalie Sachs-Ericsson, Committee Member.
Subject(s): Psychology
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_migr_etd-1371
Owner Institution: FSU

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Bernert, R. A. (R. A. ). (2009). Objectively-Assessed Sleep Disturbances as a Unique Suicide Risk Factor. Retrieved from http://purl.flvc.org/fsu/fd/FSU_migr_etd-1371