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Insomnia symptoms and non-suicidal self-injury in adolescence: understanding temporal relations and mechanisms
Örebro University, School of Law, Psychology and Social Work. Center for Lifespan Developmental Research, Örebro University, Örebro, Sweden; Department of Child and Adolescents Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.ORCID iD: 0000-0003-3913-1721
Örebro University, School of Law, Psychology and Social Work. Center for Health and Medical Psychology.ORCID iD: 0000-0002-1485-8564
Örebro University, School of Law, Psychology and Social Work.ORCID iD: 0000-0002-6879-3022
2021 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 30, no 1, article id e13190Article in journal (Refereed) Published
Abstract [en]

We propose a theoretical model of insomnia symptoms and non-suicidal self-injury (NSSI) that posits bidirectional linkages. We hypothesised that heightened depressive symptoms and impulsivity that result from insomnia increase NSSI. We also posit that the shame associated with NSSI triggers repetitive negative thinking, in turn increasing insomnia. Using three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1,457; Mage = 13.2, SD = 0.43; 52.7% boys), we assessed the mediating role of depressive symptoms, impulsivity, rumination, and worry on the link between insomnia and NSSI. After controlling for depressive symptoms, we found that insomnia was related to increases in NSSI from the second to the third time point (ß23 = 0.09, p = .01). NSSI was consistently related to increased insomnia (ß12 = 0.09, p = .01; ß23 = 0.11, p < .001). In addition, depressive symptoms (ßind = 0.01, p = .02), but not impulsivity (ßind = 0.01, p = .09), mediated the path from insomnia to increased NSSI. Neither worry (ßind = 0.00, p = .59) nor rumination (ßind = 0.00, p = .96) mediated the link between NSSI and increased insomnia. We conclude that NSSI and insomnia maintain each other over time. Thus, screening adolescents for insomnia symptoms may help identify those at risk of NSSI. Although depression seems to explain why insomnia is a risk factor for NSSI, further studies should investigate why NSSI plays a role in the maintenance of insomnia. This understanding will lay the foundation for intervention.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2021. Vol. 30, no 1, article id e13190
Keywords [en]
adolescence, bidirectional, insomnia, mechanisms, NSSI
National Category
Psychology
Identifiers
URN: urn:nbn:se:oru:diva-85797DOI: 10.1111/jsr.13190ISI: 000566399600001PubMedID: 32893426Scopus ID: 2-s2.0-85090307806OAI: oai:DiVA.org:oru-85797DiVA, id: diva2:1467661
Funder
Swedish Research Council FormasForte, Swedish Research Council for Health, Working Life and WelfareVinnovaSwedish Research Council, 2012-65Available from: 2020-09-16 Created: 2020-09-16 Last updated: 2024-04-22Bibliographically approved

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Latina, DeliaBauducco, SerenaTilton-Weaver, Lauree

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