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. 2018 Aug 15:236:6-13.
doi: 10.1016/j.jad.2018.04.087. Epub 2018 Apr 21.

Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality?

Alex S Holdaway  1 , Aaron M Luebbe  2 , Stephen P Becker  3
Affiliations

Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality?

Alex S Holdaway et al. J Affect Disord. .

Abstract

Background: Rumination, particularly brooding rumination, is associated with suicide risk, ideation and attempts; however, findings are inconsistent with respect to reflective rumination. Recent research suggests reflective rumination might be associated with increased suicide risk specifically among vulnerable individuals. Poor sleep quality is related to both suicide risk and rumination, yet no research has examined whether reflective rumination and sleep quality interact in relation to suicidal risk. This study, therefore, examined whether sleep quality moderates the link between ruminative subtypes and (a) suicide risk overall, and (b) suicidal ideation and (c) history of suicide attempts, specifically.

Methods: Participants were 1696 college students (ages 18-29 years; 65% female) who completed measures assessing rumination, sleep, and suicidal ideation and behavior. Hierarchical linear and logistic regressions were performed regressing overall suicide risk (linear), suicidal ideation (linear) and history of attempts (logistic) on ruminative subtypes controlling for demographics. Sleep quality was examined as a moderator of the rumination-suicide risk/ideation/attempts link.

Results: Brooding rumination was significantly associated with increased suicide risk, ideation, and attempts but these associations were not moderated by sleep quality. Sleep quality exacerbated the association of reflective rumination with overall suicide risk and suicidal ideation specifically. Reflective rumination was not itself, or in interaction with sleep quality, significantly associated with a history of suicide attempts.

Limitations: The study is cross-sectional and utilizes a college student sample.

Conclusions: This study adds to the literature that suggests reflective rumination is associated with suicide risk and ideation in certain cases, such as in individuals with lower sleep quality. In addition, the study adds continued support for an association between brooding rumination and suicidal behaviors. More studies that examine the relations between ruminative subtypes and attempts are needed. Interventions that target sleep problems and rumination may be beneficial for suicide prevention and intervention.

Keywords: College; Depression; Rumination; SBQ-R; Sleep; Suicide; University students.

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Conflict of interest statement

Declarations of interest: Stephen Becker is currently supported by award number K23MH108603 from the National Institute of Mental Health (NIMH). Drs. Holdaway and Luebbe have no interests to declare. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH).

Figures

Figure 1
Figure 1
Sleep Quality Moderates the Relation between Reflection Rumination and Suicide Risk.
Figure 2
Figure 2
Sleep Quality Moderates the Relation between Reflection Rumination and Suicidal Ideation.
See this image and copyright information in PMC

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