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Unsound sleep, wound-up mind: a longitudinal examination of acute suicidal affective disturbance features among an eating disorder sample

Published online by Cambridge University Press:  05 August 2021

Shruti S. Kinkel-Ram Open the ORCID record for Shruti S. Kinkel-Ram [Opens in a new window] ,
William Grunewald ,
Lindsay P. Bodell Open the ORCID record for Lindsay P. Bodell [Opens in a new window]  and
April R. Smith
Shruti S. Kinkel-Ram
Affiliation:
Department of Psychology, Miami University, Oxford, Ohio, USA
William Grunewald
Affiliation:
Department of Psychology, Auburn University, Auburn, Alabama, USA
Lindsay P. Bodell
Affiliation:
Department of Psychology, Western University, London, Ontario, Canada
April R. Smith*
Affiliation:
Department of Psychology, Auburn University, Auburn, Alabama, USA
*
Author for correspondence: April R. Smith, E-mail: ars0152@auburn.edu
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Abstract

Background

Suicide is one of the most commonly reported causes of death in individuals with eating disorders. However, the mechanisms underlying the suicide and disordered eating link are largely unknown, and current assessments are still unable to accurately predict future suicidal thoughts and behaviors. The purpose of this study is to test the utility of two promising proximal risk factors, sleep quality and agitation, in predicting suicidal ideation in a sample of individuals with elevated suicidal thoughts and behaviors, namely those with eating disorders.

Methods

Women (N = 97) receiving treatment at an eating disorder treatment center completed weekly questionnaires assessing suicidal ideation, agitation, and sleep. General linear mixed models examined whether agitation and/or sleep quality were concurrently or prospectively associated with suicidal ideation across 12 weeks of treatment.

Results

There was a significant interaction between within-person agitation and sleep quality on suicidal ideation [B(s.e.) = −0.02(0.01), p < 0.05], such that on weeks when an individual experienced both higher than their average agitation and lower than their average sleep quality, they also experienced their highest levels of suicidal ideation. However, neither agitation nor sleep quality prospectively predicted suicidal ideation.

Conclusions

This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results suggest that ongoing assessment for overarousal symptoms, such as agitation and poor sleep quality, in individuals with eating disorders may be warranted in order to manage suicidal ideation among this vulnerable population.

Keywords

Agitationeating disorderslongitudinalsleepsuicidal ideation
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 4 , March 2023 , pp. 1518 - 1526
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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