@article{ref1,
title="Insomnia and suicide-related behaviors: a multi-study investigation of thwarted belongingness as a distinct explanatory factor",
journal="Journal of affective disorders",
year="2016",
author="Chu, Carol and Hom, Melanie A. and Rogers, Megan L. and Stanley, Ian H. and Ringer-Moberg, Fallon B. and Podlogar, Matthew C. and Hirsch, Jameson K. and Joiner, Thomas E.",
volume="208",
number="",
pages="153-162",
abstract="BACKGROUND: 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. <br><br>OBJECTIVES: 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. <br><br>METHOD: 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. <br><br>RESULTS: 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. LIMITATIONS: This study relied solely on self-report measures. Future studies incorporating objective sleep measurements are needed. <br><br>CONCLUSION: Findings underscore the utility of assessing and addressing sleep disturbances and social disconnection to reduce suicide risk.<br><br>Copyright © 2016 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2016.08.065",
url="http://dx.doi.org/10.1016/j.jad.2016.08.065"
}