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DEPRESSION MEDIATES THE RELATION OF INSOMNIA SEVERITY WITH SUICIDE RISK IN THREE CLINICAL SAMPLES OF U.S. MILITARY PERSONNEL.
Depress Anxiety. 2015 Sep; 32(9):647-55.DA

Abstract

BACKGROUND

A growing body of empirical research suggests insomnia severity is directly related to suicide ideation, attempts, and death in nonmilitary samples, even when controlling for depression and other suicide risk factors. Few studies have explored this relationship in U.S. military personnel.

METHODS

The present study entailed secondary data analyses examining the associations of insomnia severity with suicide ideation and attempts in three clinical samples: Air Force psychiatric outpatients (n = 158), recently discharged Army psychiatric inpatients (n = 168), and Army psychiatric outpatients (n = 54). Participants completed the Beck Scale for Suicide Ideation, the Beck Depression Inventory-II or Patient Health Questionnaire-9, the Insomnia Severity Index, and the Posttraumatic Stress Disorder Checklist at baseline; two samples also completed these measures during follow-up.

RESULTS

Sleep disturbance was associated with concurrent (β's > 0.21; P's < 0.059) and prospective (β's > 0.39; P's < 0.001) suicide ideation in all three samples. When adjusting for age, gender, depression, and posttraumatic stress, insomnia severity was no longer directly associated with suicide ideation either concurrently (β's < 0.19; P's > 0.200) or prospectively (β's < 0.26; P's > 0.063), but depression was (β's > 0.22; P's < 0.012). Results of a latent difference score mediation model indicated that depression mediated the relation of insomnia severity with suicide ideation.

CONCLUSIONS

Across three clinical samples of military personnel, depression explained the relationship between insomnia severity and suicide risk.

Authors+Show Affiliations

National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah. The University of Utah, Salt Lake City, Utah.National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah. The University of Utah, Salt Lake City, Utah.National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah. The University of Memphis, Memphis, Tennessee.National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah. The University of Utah, Salt Lake City, Utah.National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah. The University of Utah, Salt Lake City, Utah.National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah. The University of Utah, Salt Lake City, Utah.Fort Carson, Colorado Springs, Colorado.Fort Carson, Colorado Springs, Colorado.Lackland Air Force Base, San Antonio, Texas.Hurlburt Field, Mary Esther, Florida.Maxwell AFB, Montgomery, Alabama.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

26047362

Citation

Bryan, Craig J., et al. "DEPRESSION MEDIATES the RELATION of INSOMNIA SEVERITY WITH SUICIDE RISK in THREE CLINICAL SAMPLES of U.S. MILITARY PERSONNEL." Depression and Anxiety, vol. 32, no. 9, 2015, pp. 647-55.
Bryan CJ, Gonzales J, Rudd MD, et al. DEPRESSION MEDIATES THE RELATION OF INSOMNIA SEVERITY WITH SUICIDE RISK IN THREE CLINICAL SAMPLES OF U.S. MILITARY PERSONNEL. Depress Anxiety. 2015;32(9):647-55.
Bryan, C. J., Gonzales, J., Rudd, M. D., Bryan, A. O., Clemans, T. A., Ray-Sannerud, B., Wertenberger, E., Leeson, B., Heron, E. A., Morrow, C. E., & Etienne, N. (2015). DEPRESSION MEDIATES THE RELATION OF INSOMNIA SEVERITY WITH SUICIDE RISK IN THREE CLINICAL SAMPLES OF U.S. MILITARY PERSONNEL. Depression and Anxiety, 32(9), 647-55. https://doi.org/10.1002/da.22383
Bryan CJ, et al. DEPRESSION MEDIATES the RELATION of INSOMNIA SEVERITY WITH SUICIDE RISK in THREE CLINICAL SAMPLES of U.S. MILITARY PERSONNEL. Depress Anxiety. 2015;32(9):647-55. PubMed PMID: 26047362.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - DEPRESSION MEDIATES THE RELATION OF INSOMNIA SEVERITY WITH SUICIDE RISK IN THREE CLINICAL SAMPLES OF U.S. MILITARY PERSONNEL. AU - Bryan,Craig J, AU - Gonzales,Jacqueline, AU - Rudd,M David, AU - Bryan,AnnaBelle O, AU - Clemans,Tracy A, AU - Ray-Sannerud,Bobbie, AU - Wertenberger,Evelyn, AU - Leeson,Bruce, AU - Heron,Elizabeth A, AU - Morrow,Chad E, AU - Etienne,Neysa, Y1 - 2015/06/05/ PY - 2015/01/18/received PY - 2015/04/08/revised PY - 2015/05/01/accepted PY - 2015/6/6/entrez PY - 2015/6/6/pubmed PY - 2016/5/18/medline KW - agitation KW - insomnia KW - military KW - sleep KW - suicide KW - veterans SP - 647 EP - 55 JF - Depression and anxiety JO - Depress Anxiety VL - 32 IS - 9 N2 - BACKGROUND: A growing body of empirical research suggests insomnia severity is directly related to suicide ideation, attempts, and death in nonmilitary samples, even when controlling for depression and other suicide risk factors. Few studies have explored this relationship in U.S. military personnel. METHODS: The present study entailed secondary data analyses examining the associations of insomnia severity with suicide ideation and attempts in three clinical samples: Air Force psychiatric outpatients (n = 158), recently discharged Army psychiatric inpatients (n = 168), and Army psychiatric outpatients (n = 54). Participants completed the Beck Scale for Suicide Ideation, the Beck Depression Inventory-II or Patient Health Questionnaire-9, the Insomnia Severity Index, and the Posttraumatic Stress Disorder Checklist at baseline; two samples also completed these measures during follow-up. RESULTS: Sleep disturbance was associated with concurrent (β's > 0.21; P's < 0.059) and prospective (β's > 0.39; P's < 0.001) suicide ideation in all three samples. When adjusting for age, gender, depression, and posttraumatic stress, insomnia severity was no longer directly associated with suicide ideation either concurrently (β's < 0.19; P's > 0.200) or prospectively (β's < 0.26; P's > 0.063), but depression was (β's > 0.22; P's < 0.012). Results of a latent difference score mediation model indicated that depression mediated the relation of insomnia severity with suicide ideation. CONCLUSIONS: Across three clinical samples of military personnel, depression explained the relationship between insomnia severity and suicide risk. SN - 1520-6394 UR - https://www.unboundmedicine.com/medline/citation/26047362/DEPRESSION_MEDIATES_THE_RELATION_OF_INSOMNIA_SEVERITY_WITH_SUICIDE_RISK_IN_THREE_CLINICAL_SAMPLES_OF_U_S__MILITARY_PERSONNEL_ L2 - https://doi.org/10.1002/da.22383 DB - PRIME DP - Unbound Medicine ER -