The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation

Betts, Kim; Williams, Gail M.; Najman, Jake M.; Alati, Rosa

doi:10.1016/j.janxdis.2013.09.011

Cited by 28 publications

(16 citation statements)

References 37 publications

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“…Other models highlight the role of various cognitive-affective processes as direct or indirect mediators between PTSD and suicidality, including perceptions of defeat and entrapment (e.g., [93]), negative self-appraisals (e.g., [94]), hopelessness (e.g., [91]), and guilt and shame (e.g., [95]). In addition, some models propose that the link between PTSD and suicidal behavior is partially explained and/or compounded by other comorbid problems such as functional impairment [96], depression [97], sleep disturbance [98], and alcohol dependence [99]. Taken together, these models suggest that treating PTSD is likely to reduce suicidality directly by reducing PTSD symptoms and indirectly by reducing established cognitive and affective mediators as well as other compounding problems.…”

Section: Suicidalitymentioning

confidence: 99%

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Minnen

Zoellner

Harned

et al. 2015

Curr Psychiatry Rep

104

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Prolonged exposure (PE) is an effective psychological treatment for patients who suffer from PTSD. The majority of PTSD patients have comorbid psychiatric disorders, and some clinicians are hesitant to use PE with comorbid patients because they believe that comorbid conditions may worsen during PE. In this article, we reviewed the evidence for this question: what are the effects of PE on comorbid symptoms and associated symptomatic features? We reviewed findings from 18 randomized controlled trials of PE that assessed the most common comorbid conditions (major depression, anxiety disorders, substance use disorders, personality disorders, and psychotic disorders) and additional symptomatic features (suicidality, dissociation, negative cognitions, negative emotions, and general health and work/social functioning). Although systematic research is not available for all comorbid populations, the existing research indicates that comorbid disorders and additional symptomatic features either decline along with the PTSD symptoms or do not change as a result of PE. Therefore, among the populations that have been studied to date, there is no empirical basis for excluding PTSD patients from PE due to fear of increases in comorbid conditions or additional symptomatic features. Limitations of the existing research and recommendations for future research are also discussed.

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Section: Suicidalitymentioning

confidence: 99%

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Minnen

Zoellner

Harned

et al. 2015

Curr Psychiatry Rep

104

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show abstract

“…In analyses of PTSD we operationalized trauma exposure in two separate ways. For initial analyses, we created a count of the number of different types of traumas to which an individual had been exposed, known as 'polyvictimization', consistent with an earlier study conducted by our team (Betts et al, 2013). Evidence shows that the polyvictimization profiles of children and adolescents are more strongly associated with related trauma symptoms than are single or multiple exposures to one type of (worst) trauma (Finkelhor et al, 2007).…”

Section: Measurements Of Psychiatric Diagnosismentioning

confidence: 99%

Associations between self-reported symptoms of prenatal maternal infection and post-traumatic stress disorder in offspring: Evidence from a prospective birth cohort study

Betts

Salom

Williams

et al. 2015

Journal of Affective Disorders

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word count is 259 words.Main text word count is 3,448 words.There are 4 tables and 0 figure. infection with a range of DSM-IV anxiety and affective diagnoses, while also testing for gender interactions. Results:In multivariate analyses, self-reported symptoms of prenatal genital infection predicted post-traumatic stress disorders (OR = 2.38, 95% CI: 1.14, 4.95) and social phobias (OR = 1.93, 95% CI: 1.03, 3.61), in addition to evidence for a gender interaction by which males (OR = 6.04, 95% CI: 2.00, 18.30) but not females were at greater risk for PTSD.Further analyses among those with PTSD revealed the relationship to be stronger when excluding those not exposed to trauma (OR = 3.21, 95% CI; 1.53, 6.72). Limitations:We were unable to clinically or serologically verify the presence and the type of prenatal genital infection. Conclusion:This is the first study to show an association between self-reported symptoms of prenatal genital infections and two highly prevalent anxiety disorders. The relationship with PTSD was particularly strong and suggested that the exposure may primarily impact PTSD in males. Further research with the capacity to assess a fuller-range of specific prenatal infections is warranted to evaluate the potential of reducing the prevalence of these disorders.

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“…Previous studies have reported that insomnia mediates the relationship between PTSD and suicidal ideation (Betts, Williams, Najman, & Alati, 2013), and insomnia mediates the association between AUDs and suicidal ideation (Nadorff et al, 2014); however, this is the first study to integrate PTSD symptoms, AUDs, insomnia, and suicidal ideation into a single model. The study results provide a model representing the order of events following trauma exposure in firefighters.…”

Section: Discussionmentioning

confidence: 79%

“…According to our model, we can hypothesize that after an exposure to trauma, PTSD symptoms occur, leading to increased use of alcohol as means of self-medication, which causes increased insomnia and sleep disturbances, ultimately resulting in the development of suicidal ideation. Previous studies have reported that insomnia mediates the relationship between PTSD and suicidal ideation (Betts, Williams, Najman, & Alati, 2013), and insomnia mediates the association between AUDs and suicidal ideation (Nadorff et al, 2014); however, this is the first study to integrate PTSD symptoms, AUDs, insomnia, and suicidal ideation into a single model.…”

Section: Discussionmentioning

confidence: 79%

Alcohol use disorders and insomnia mediate the association between PTSD symptoms and suicidal ideation in Korean firefighters

2018

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The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation

Cited by 28 publications

References 37 publications

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Associations between self-reported symptoms of prenatal maternal infection and post-traumatic stress disorder in offspring: Evidence from a prospective birth cohort study

Alcohol use disorders and insomnia mediate the association between PTSD symptoms and suicidal ideation in Korean firefighters

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