Life stress and suicidality mediated by insomnia and depressive symptoms in adolescents: a three-wave longitudinal study.

IF 5.3 2区 医学 Q1 CLINICAL NEUROLOGY Sleep Pub Date : 2024-03-11 DOI:10.1093/sleep/zsad121
Xianchen Liu, Yanyun Yang, Zhen-Zhen Liu, Cun-Xian Jia
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Abstract

Study objectives: Little empirical work has investigated the associations between life stress (LS), insomnia, depression, and suicidality in multi-wave longitudinal studies. With three 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 6995 adolescents (mean age = 14.86 years, 51.4% male) participated in a three-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 (i.e., ST/SP) 2 years later was significantly mediated by both insomnia and depression. Depression was also a significant mediator between LS and SA.

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

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以青少年失眠和抑郁症状为中介的生活压力和自杀倾向:三波纵向研究。
研究目的:在多波纵向研究中,很少有实证研究调查生活压力(LS)、失眠、抑郁和自杀之间的关联。本纵向研究通过相隔一年的三波数据收集,对大量青少年样本进行了研究,考察了生活压力对一年后和两年后自杀倾向的预测作用,以及失眠和抑郁在生活压力-自杀倾向之间的中介作用:共有6995名青少年(平均年龄=14.86岁,51.4%为男性)参加了在中国山东进行的三波行为与健康纵向研究。研究采用自填式结构化问卷和标准化量表对2015年(T1)、1年后(T2)和2年后(T3)的自杀倾向(包括自杀想法[ST]、自杀计划[SP]和自杀未遂[SA])、LS、失眠和抑郁进行了评估。通过路径模型检验了中介效应:过去一年自杀的总体发生率在T1、T2和T3分别为13.4%、10.0%和9.5%。随着基线 LS、失眠和抑郁水平的升高,T1-T3 期的自杀率显著增加(p 结论:LS 是自杀的重要预测因素:LS是青少年1-2年后出现自杀倾向的重要预测因素。抑郁是LS与自杀意念和自杀未遂之间关系的中介,而失眠似乎是自杀意念而非自杀未遂的中介。
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来源期刊
Sleep
Sleep 医学-临床神经学
CiteScore
10.10
自引率
10.70%
发文量
1134
审稿时长
3 months
期刊介绍: SLEEP® publishes findings from studies conducted at any level of analysis, including: Genes Molecules Cells Physiology Neural systems and circuits Behavior and cognition Self-report SLEEP® publishes articles that use a wide variety of scientific approaches and address a broad range of topics. These may include, but are not limited to: Basic and neuroscience studies of sleep and circadian mechanisms In vitro and animal models of sleep, circadian rhythms, and human disorders Pre-clinical human investigations, including the measurement and manipulation of sleep and circadian rhythms Studies in clinical or population samples. These may address factors influencing sleep and circadian rhythms (e.g., development and aging, and social and environmental influences) and relationships between sleep, circadian rhythms, health, and disease Clinical trials, epidemiology studies, implementation, and dissemination research.
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