一项关于心理因素在青年人群中失眠症状与自杀意念关系间的中介作用的纵向研究。
A Longitudinal Study of Psychological Factors as Mediators of the Relationship Between Insomnia Symptoms and Suicidal Ideation Among Young Adults.
机构信息
Florida State University, Tallahassee, Florida.
Harvard University, Cambridge, Massachusetts.
出版信息
J Clin Sleep Med. 2019 Jan 15;15(1):55-63. doi: 10.5664/jcsm.7570.
STUDY OBJECTIVES
Prior cross-sectional studies indicate that psychological factors (eg, perceived burdensomeness, thwarted belongingness) may explain the relationship between insomnia and suicidal ideation. Longitudinal studies are needed, however, to examine how these variables may relate to one another over time. Using data collected at three time points, this study aimed to evaluate various psychological factors as mediators of the longitudinal relationship between insomnia symptoms and suicidal ideation.
METHODS
Young adults (n = 226) completed self-report measures of insomnia symptoms, suicidal ideation, and psychological factors (ie, disgust with self, others, and the world; perceived burdensomeness; thwarted belongingness; and loneliness) at baseline (T1), 1-month follow-up (T2), and 2-month follow-up (T3). Bias-corrected bootstrap mediation models were utilized to evaluate each T2 psychological factor as a mediator of the relationship between T1 insomnia symptoms and T3 suicidal ideation severity, controlling for the corresponding T1 psychological factor and T1 suicidal ideation severity.
RESULTS
Only T2 disgust with others and T2 disgust with the world significantly mediated the relationship between T1 insomnia symptoms and T3 suicidal ideation severity. When both mediators were included in the same model, only T2 disgust with the world emerged as a significant mediator.
CONCLUSIONS
Findings indicate that disgust with others, and particularly disgust with the world, may explain the longitudinal relationship between insomnia symptoms and suicidal ideation among young adults. These factors may serve as useful therapeutic targets in thwarting the trajectory from insomnia to suicidal ideation. Research is needed, however, to replicate these findings in higher risk samples.
研究目的
先前的横断面研究表明,心理因素(例如,自我感知的累赘感、归属感受挫)可能可以解释失眠与自杀意念之间的关系。然而,需要进行纵向研究,以检验这些变量如何随时间相互关联。本研究使用在三个时间点收集的数据,旨在评估各种心理因素作为失眠症状和自杀意念之间纵向关系的中介。
方法
青年成年人(n=226)在基线(T1)、1 个月随访(T2)和 2 个月随访(T3)时完成了自我报告的失眠症状、自杀意念和心理因素(即,对自己、他人和世界的厌恶感;自我感知的累赘感;归属感受挫;孤独感)的测量。采用偏置校正的自举中介模型来评估每个 T2 心理因素作为 T1 失眠症状与 T3 自杀意念严重程度之间关系的中介,同时控制相应的 T1 心理因素和 T1 自杀意念严重程度。
结果
只有 T2 对他人的厌恶感和 T2 对世界的厌恶感显著中介了 T1 失眠症状与 T3 自杀意念严重程度之间的关系。当两个中介因素都包含在同一个模型中时,只有 T2 对世界的厌恶感才成为显著的中介因素。
结论
研究结果表明,对他人的厌恶感,尤其是对世界的厌恶感,可能可以解释失眠症状和自杀意念之间在青年成年人中的纵向关系。这些因素可能作为阻止从失眠到自杀意念轨迹的有用治疗靶点。然而,需要进一步的研究来在高风险样本中复制这些发现。