Citation

Liu X, Yang Y, Liu ZZ, Jia CX. Sleep 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Academy of Sleep Medicine, Publisher Associated Professional Sleep Societies)

DOI

10.1093/sleep/zsad121

PMID

37075813

Abstract

STUDY OBJECTIVES: Little empirical work has investigated the associations between life stress (LS), insomnia, depression, and suicidality in multi-wave longitudinal studies. With 3 waves of data collection 1 year apart, this longitudinal study with a large sample of adolescents examined the predicting effects of LS on suicidality 1 year later and 2 years later and the mediating roles of insomnia and depression in the LS-suicidality link.

METHODS: A total of 6,995 adolescents (mean age=14.86 years, 51.4% male) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. A self-administered structured questionnaire and standardized scales were used to assess suicidality (including suicidal thought (ST), suicide plan (SP), and suicide attempt (SA)), LS, insomnia, and depression in 2015 (T1), 1 year later (T2), and 2 years later (T3). Mediation effects were examined with path models.

RESULTS: The overall prevalence rates of past-year suicidality were 13.4% at T1, 10.0% at T2, and 9.5% at T3, respectively. The prevalence rates of suicidality across T1-T3 significantly increased with elevated levels of baseline LS, insomnia, and depression (p<.001). Path models indicated that the relationship between baseline LS and suicidal ideation (ST/SP) 2 years later was significantly mediated by both insomnia and depression. Depression was also a significant mediator between life stress and SA.

CONCLUSION: Life stress is a significant predictor of suicidality 1-2 years later in adolescents. Depression mediates the association between life stress and suicidal ideation and attempt while insomnia appears to be a mediator for suicidal ideation rather than attempt.

Language: en

Keywords

depression; suicidal behavior; adolescence; insomnia; Life stress