Chu Carol, Hom Melanie A, Rogers Megan L, Stanley Ian H, Ringer-Moberg Fallon B, Podlogar Matthew C, Hirsch Jameson K, Joiner Thomas E
Florida State University, Department of Psychology, 1107 West Call St., Tallahassee, FL 32306, USA.
Florida State University, Department of Psychology, 1107 West Call St., Tallahassee, FL 32306, USA.
J Affect Disord. 2017 Jan 15;208:153-162. doi: 10.1016/j.jad.2016.08.065. Epub 2016 Oct 11.
Insomnia is a robust correlate of suicidal ideation and behavior. Preliminary research has identified thwarted belongingness (c.f. social disconnection) as an explanatory link between insomnia and suicidal ideation.
This study replicates and extends previous findings using both cross-sectional and longitudinal designs in four demographically diverse samples. Additionally, the specificity of thwarted belongingness was evaluated by testing anxiety as a rival mediator.
Self-report measures of insomnia symptoms, thwarted belongingness, suicidal ideation and behavior, and anxiety were administered in four adult samples: 469 undergraduate students, 352 psychiatric outpatients, 858 firefighters, and 217 primary care patients.
More severe insomnia was associated with more severe thwarted belongingness and suicidality. Thwarted belongingness significantly accounted for the association between insomnia and suicidality, cross-sectionally and longitudinally, beyond anxiety. Notably, findings supported the specificity of thwarted belongingness: anxiety did not significantly mediate the association between insomnia and suicidality, and insomnia did not mediate the relation between thwarted belongingness and suicidality.
This study relied solely on self-report measures. Future studies incorporating objective sleep measurements are needed.
Findings underscore the utility of assessing and addressing sleep disturbances and social disconnection to reduce suicide risk.
失眠与自杀意念及行为密切相关。初步研究已将归属感受挫（如社交脱节）确定为失眠与自杀意念之间的一种解释性联系。
本研究采用横断面和纵向设计，在四个不同人口统计学特征的样本中重复并扩展先前的研究结果。此外，通过将焦虑作为竞争中介变量进行检验，评估了归属感受挫的特异性。
对四个成年样本进行了关于失眠症状、归属感受挫、自杀意念及行为以及焦虑的自我报告测量：469名本科生、352名精神科门诊患者、858名消防员和217名初级保健患者。
更严重的失眠与更严重的归属感受挫及自杀倾向相关。归属感受挫在横断面和纵向层面上均显著解释了失眠与自杀倾向之间的关联，且超出了焦虑的影响。值得注意的是，研究结果支持了归属感受挫的特异性：焦虑并未显著介导失眠与自杀倾向之间的关联，失眠也未介导归属感受挫与自杀倾向之间的关系。
本研究仅依赖自我报告测量。未来需要纳入客观睡眠测量的研究。
研究结果强调了评估和解决睡眠障碍及社交脱节以降低自杀风险的作用。
