Poor Sleep Associates With Recent Nonsuicidal Self-Injury Engagement in Adolescents

Abstract

Objective/Background: Poor sleep has been shown to have multiple negative outcomes during adolescence, in both academic and mental health domains. Several studies have identified the association between poor sleep and suicide risk in adolescents. However, onset of and engagement in nonsuicidal self-injury (NSSI) is also common in this age group, but this behavior has rarely been studied in association with sleep in adolescent samples. In the current study, it was expected that poorer sleep and more symptoms of insomnia would associate with a greater likelihood of recent NSSI engagement and greater NSSI severity.Participants: Data were collected from 387 community adolescents (mean age = 14.19, SD=1.08), 9% of whom reported NSSI in the past 6 months. The gender breakdown was about even (52% female) and the majority of the sample was White (88.5%).Methods: Adolescent participants were recruited from middle and high schools for a study on mental health and risk behaviors. Researchers visited schools and administered self-report questionnaires to students in large groups. Measures assessed NSSI engagement and severity features, overall sleep quality, and insomnia symptoms.Results: Results indicated that greater insomnia symptoms, but not overall sleep quality, significantly associated with greater likelihood of recent NSSI engagement. Sleep variables were not significantly associated with NSSI severity among adolescents with recent NSSI.Conclusions: Insomnia symptoms seem to be associated with recent engagement in NSSI. Adolescents who report symptoms of insomnia should also be assessed for self-harm behavior.

Insomnia symptoms and non‐suicidal self‐injury in adolescence: understanding temporal relations and mechanisms

“…A handful of longitudinal studies partially supported these findings, where sleep difficulties, and particularly insomnia, predicted later engagement in NSSI (Bandel & Brausch, 2020;Junker, Bjørngaard, Gunnell, & Bjerkeset, 2014;Lundh et al, 2013;Wong et al, 2011). However, this link disappeared when controlling for previous psychopathology (Bandel & Brausch, 2018;Junker et al, 2013). Although informative, these studies have limitations.…”

“…Cross‐sectional studies show that adolescents who self‐injured also reported sleep difficulties, including symptoms of insomnia (Hysing, Sivertsen, Stormark, & O'connor, 2015; Liu, Chen, Bo, Fan, & Jia, 2017; McGlinchey, Courtney‐Seidler, German, & Miller, 2017). A handful of longitudinal studies partially supported these findings, where sleep difficulties, and particularly insomnia, predicted later engagement in NSSI (Bandel & Brausch, 2020; Junker, Bjørngaard, Gunnell, & Bjerkeset, 2014; Lundh et al., 2013; Wong et al., 2011). However, this link disappeared when controlling for previous psychopathology (Bandel & Brausch, 2018; Junker et al, 2013).…”

Insomnia in Patients with Borderline Personality Disorder

“…A positive relationship has been confirmed in adolescents. 89 Sleep disorders have been found to play a causal role in emotional dysfunction problems. In particular, sleep disorders inhibit the function of sleep in processing emotions.…”

“…Notably, most individuals engage with NSSI to regulate intense emotions, and sleep disorders may increase susceptibility to NSSI by contributing to dysregulated emotions. 89 …”

Low-intensity sleep intervention in a youth mental health service: a case series analysis

“…Furthermore, poor sleep in adolescents has been associated with a wide range of negative outcomes including but not restricted to: obesity (Sivertsen et al, 2014b); low mood (Dahl and Harvey, 2007;McGlinchey et al, 2017;Sivertsen et al, 2014a), poor emotional regulation (Baum et al, 2014) and general self-regulation (Owens et al, 2016); anxiety and internalising disorders (Babson et al, 2010;Dahl and Harvey, 2007;McMakin and Alfano, 2015); hopelessness (Winsler et al, 2015); suicidality (Chiu et al, 2018); self-harm (Bandel and Brausch, 2020;Hysing et al, 2015;Liu et al, 2017); and poor concentration and academic performance (Dewald et al, 2010;O'Brien, 2011). Conversely, good sleep has been found to be associated with improved physical and psychological wellbeing (Segura-Jiménez et al, 2015).…”