The prospective relationship between sleep problems and suicidal behavior in the National Longitudinal Study of Adolescent Health.
The prospective relationship between sleep problems and suicidal behavior in the National Longitudinal Study of Adolescent Health.
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DOI：
10.1016/j.jpsychires.2012.04.008
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发表时间：
2012-07
影响因子：
4.8
通讯作者：
Brower KJ
中科院分区：
文献类型：
--
作者：
Wong MM;Brower KJ
先前的研究发现，在控制了青少年和对照组的高风险样本中的抑郁症和其他重要协变量的同时，睡眠问题和自杀行为之间存在纵向关系。在本文中，我们在一个国家的样本中复制了这种纵向关系，并研究了这种关系是否部分由抑郁症，酒精相关问题和其他药物使用介导。研究参与者是来自国家青少年健康纵向研究（ADD HEALTH）的6504名青少年。在双变量分析中，睡眠问题（即，有入睡困难或保持睡眠）与第1、2和3波（W1、2和3）的自杀想法和自杀企图相关。在多变量分析中，控制抑郁症，酒精问题，非法药物使用和重要的协变量，如性别，年龄和慢性健康问题，前一波的睡眠问题预测了下一波的自杀想法和自杀企图。在中介分析中，W2抑郁显著介导W1睡眠问题对W3自杀想法的影响。此外，W2自杀想法也显著介导W1睡眠问题对W3自杀企图的影响。睡眠问题似乎是青春期和青年期随后自杀想法和企图的有力预测因素。失眠或难以入睡对自杀行为有直接和间接的影响（通过抑郁和自杀念头）。未来的研究可以确定睡眠障碍的早期干预是否会降低青少年和年轻人自杀的风险。
Previous research has found a longitudinal relationship between sleep problems and suicidal behavior while controlling for depression and other important covariates in a high risk sample of adolescents and controls. In this paper, we replicated this longitudinal relationship in a national sample and examined whether the relationship was partially mediated by depression, alcohol-related problems and other drug use. Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH). In bivariate analyses, sleep problems (i.e., having trouble falling asleep or staying asleep) at Wave 1 were associated with suicidal thoughts and suicide attempts at Waves 1, 2, and 3 (W1, 2 and 3). In multivariate analyses, controlling for depression, alcohol problems, illicit drug use, and important covariates such as gender, age, and chronic health problems, sleep problems at a previous wave predicted suicidal thoughts and suicide attempts at a subsequent wave. In mediation analyses, W2 depression significantly mediated the effect of W1 sleep problems on W3 suicide thoughts. Moreover, W2 suicidal thoughts also significantly mediated the effect of W1 sleep problems on W3 suicidal attempts. Sleep problems appear to be a robust predictor of subsequent suicidal thoughts and attempts in adolescence and young adulthood. Having trouble falling sleeping or staying asleep had both direct and indirect effects (via depression and suicidal thoughts) on suicidal behavior. Future research could determine if early intervention with sleep disturbances reduces the risk for suicidality in adolescents and young adults.
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