(PS2-B47) The Role of Insomnia in the Link Between Self-hatred and Suicidal Ideation in Youth

Objectives: Although both sleep problems and self-hatred have been separately linked to suicidal ideation in adolescents, their associations have not been examined simultaneously. Prior studies have shown a link between higher self-disgust and insomnia. Moreover, higher sleep quality served as a buffer against psychopathology in youth, whereas low self-esteem was linked to higher self-harm during the COVID-19 pandemic. Similarly, repetitive thoughts focused on self-hatred might interfere with adolescent sleep quality. In this study, we examined the interplay between self-hatred, insomnia, and suicidal ideation in youth.  

Methods: Participants were 33 children and adolescents aged 12-15 years, primarily recruited from the partial hospitalization settings at a child mental health hospital as part of an ongoing study. The data collection began in April 2020, which coincided with the COVID-19 pandemic. The average age of participants was 13.87 years (SD = 1.02) and the majority (75.8%) were assigned female at birth. 27.3% identified as gender identity minority and 45.5% as a racial or ethnic minority. Self-hatred was assessed via the Hated Self Subscale of the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale. Sleep problems were assessed via the Insomnia Severity Index and suicidal ideation via the Suicidal Ideation Questionnaire-JR.

Results: There was a significant bivariate association between self-hatred and suicidal ideation, r(30) = [.855], p < .001. Second, there was a significant indirect effect of self-hatred on suicidal ideation via insomnia, b = .5433, se = 0.2267, 95% CI [0.1426, 1.0376], tested using PROCESS v4.0 macro (Model 4). The findings were maintained when statistically adjusting for age, minority status in gender, race/ethnic identity, and current depressive symptoms.

Conclusion: These preliminary findings suggest that insomnia might be involved in the link between self-hatred and suicidal ideation. Given that sleep has been shown to have a protective effect on mental health in youth during the COVID-19 pandemic, the results highlight the relevance of assessing and targeting feelings of insomnia and self-hatred in the context of youth suicidal ideation. Further, the findings provide preliminary support for the potential for a dual intervention of self-compassion and sleep hygiene in treating suicidality in youth. Limitations that provide directions for future research include modest sample size and the cross-sectional design of the study.