TY - JOUR
T1 - Insomnia and the Interpersonal Theory of suicide among civilians, service members, and veterans
AU - Tubbs, Andrew S.
AU - Killgore, William D.S.
AU - Karp, Jordan F.
AU - Fernandez, Fabian Xosé
AU - Grandner, Michael A.
N1 - Funding Information:
This work was in part supported by the Military Suicide Research Consortium (MSRC) , an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs under Award No. ( W81XWH-16-2-0003 ). Opinions, interpretations, conclusions, and recommendations are those of the author and are not endorsed by the MSRC or the Department of Defense.
Funding Information:
Data were acquired from the Common Data Elements (CDE) of the Military Suicide Research Consortium (MSRC), which consists of a truncated set of 57-items taken from multiple questionnaires that have excellent internal consistency and are strongly correlated with their original measures (Ringer et al., 2018). The MSRC was established in 2010 through funding from the Department of Defense to conduct multidisciplinary research on suicide risk and prevention among military Service members and Veterans. The CDE represents 57 common variables collected across all MSRC studies as well as additional variables unique to each study. Because the focus of these studies is identification, characterization, prediction, and prevention of suicidal thoughts and behaviors, the data are not representative of civilian or military populations, but rather civilians, Veterans, and Service members who were specifically recruited to participate in suicide-related research. The MSRC CDEs are maintained at Florida State University, and de-identified data for 6556 individuals were provided for this archival analysis, which was determined exempt from review by the University of Arizona Institutional Review Board (#2104715461). Although the CDE does not identify the origin of its individual records, at least one study previously published on this topic (Hom et al., 2017a) identifies its source as the MSRC, so it is possible that restricted segments of these data have been previously described.This work was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs under Award No. (W81XWH-16-2-0003). Opinions, interpretations, conclusions, and recommendations are those of the author and are not endorsed by the MSRC or the Department of Defense.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/11
Y1 - 2022/11
N2 - Background: Insomnia is associated with suicide risk in civilian and military populations. Thwarted belongingness is proposed as a mediator of this relationship under the Interpersonal Theory of Suicide (IPTS). The present study explored how insomnia relates to suicidal ideation in conjunction with thwarted belongingness among civilians, Service members, and Veterans. Methods. Data from the Military Suicide Research Consortium for N = 6556 individuals (6316 with non-missing suicidal ideation status) were divided into 4 subgroups: civilians, never deployed Service members, previously deployed Service members, and Veterans. Robust Poisson models evaluated the associations between insomnia severity/subtype and current suicidal ideation, with bootstrap mediation models assessing thwarted belongingness as a mediator. Results. A 5-point increase in insomnia severity was associated with a 38% increased risk for current suicidal ideation among civilians, a 56% greater risk among never deployed Service members, an 83% greater risk among previously deployed Service members, and a 37% greater risk among Veterans. Moreover, active Service members showed greater associations between difficulty falling asleep and staying asleep with suicidal ideation than civilians. These associations were independent of covariates and only mediated by thwarted belongingness among Veterans. Conclusions. The relationship between insomnia and suicide is not purely explained by thwarted belongingness except among Veterans. Future research should explore additional psychological and neurobiological mechanisms connecting insomnia and suicidality.
AB - Background: Insomnia is associated with suicide risk in civilian and military populations. Thwarted belongingness is proposed as a mediator of this relationship under the Interpersonal Theory of Suicide (IPTS). The present study explored how insomnia relates to suicidal ideation in conjunction with thwarted belongingness among civilians, Service members, and Veterans. Methods. Data from the Military Suicide Research Consortium for N = 6556 individuals (6316 with non-missing suicidal ideation status) were divided into 4 subgroups: civilians, never deployed Service members, previously deployed Service members, and Veterans. Robust Poisson models evaluated the associations between insomnia severity/subtype and current suicidal ideation, with bootstrap mediation models assessing thwarted belongingness as a mediator. Results. A 5-point increase in insomnia severity was associated with a 38% increased risk for current suicidal ideation among civilians, a 56% greater risk among never deployed Service members, an 83% greater risk among previously deployed Service members, and a 37% greater risk among Veterans. Moreover, active Service members showed greater associations between difficulty falling asleep and staying asleep with suicidal ideation than civilians. These associations were independent of covariates and only mediated by thwarted belongingness among Veterans. Conclusions. The relationship between insomnia and suicide is not purely explained by thwarted belongingness except among Veterans. Future research should explore additional psychological and neurobiological mechanisms connecting insomnia and suicidality.
KW - Insomnia
KW - Interpersonal theory of suicide
KW - MSRC
KW - Suicidal ideation
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U2 - 10.1016/j.jpsychires.2022.09.043
DO - 10.1016/j.jpsychires.2022.09.043
M3 - Article
C2 - 36194991
AN - SCOPUS:85139049252
SN - 0022-3956
VL - 155
SP - 534
EP - 541
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
ER -