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Desjardins E, Gaber L, Larkin E, Benoit A, Boafo A, De Koninck J. The Dream Experience and Its Relationship with Morning Mood in Adolescents Hospitalized after a Suicide Attempt. Brain Sci 2024; 14:804. [PMID: 39199496 PMCID: PMC11353029 DOI: 10.3390/brainsci14080804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 09/01/2024] Open
Abstract
Suicidality in adolescents has been associated with emotional distress, stressful life events, relationship issues, and nightmares to name a few. This study explored the actual dream content and the mood at pre-sleep, during a reported dream, and in the morning in 33 adolescents admitted to the hospital on account of a suicide attempt. In all aspects, hospitalized adolescents were compared to 33 matched adolescents who had followed the same protocol. In accordance with the Continuity and the Threat Simulation theories of dream formation, it was hypothesized that the waking-life experiences of suicidal adolescents would transpire in both dream mood and content as well as in the frequency of nightmares. Dreams were analyzed by independent judges using traditional dream content scales, including for the presence of negative and destructive themes and types of interpersonal relationships. As predicted, more suicidal adolescents experienced frequent nightmares, which was significant. A higher negative mood at pre-sleep, within dreams, and at post-sleep was also observed. Furthermore, their dreams contained a higher prevalence of destructive themes and failures, as well as self-directed and death-resulting aggressions. Regression analyses indicated that morning mood was most accurately predicted by positive and negative dream mood in the normative adolescents, whereas only negative dream mood appeared to predict subsequent waking affect in suicidal participants. Our results underline the valuable potential of implementing nightmare-reducing therapies in the presence of suicidal adolescents who suffer from frequent nightmares.
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Affiliation(s)
- Emma Desjardins
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; (E.D.); (L.G.); (E.L.); (A.B.)
| | - Lina Gaber
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; (E.D.); (L.G.); (E.L.); (A.B.)
| | - Emily Larkin
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; (E.D.); (L.G.); (E.L.); (A.B.)
| | - Antoine Benoit
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; (E.D.); (L.G.); (E.L.); (A.B.)
| | - Addo Boafo
- Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada;
| | - Joseph De Koninck
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; (E.D.); (L.G.); (E.L.); (A.B.)
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Ratzon R, Reiter J, Goltser-Dubner T, Segman R, Weisstub EG, Benarroch F, Ran SRZ, Kianski E, Giesser R, Weinberg PB, Ben-Ari A, Sela Y, Nitsan MB, Lotan A, Shalev A. Sleep measures as a predictor of suicidal ideation among high-risk adolescents. Eur Child Adolesc Psychiatry 2024; 33:2781-2790. [PMID: 38225414 DOI: 10.1007/s00787-023-02358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
Suicide is the second leading cause of death among youth aged 15-24 years. Identifying modifiable risk factors relevant to adolescents is crucial for suicide prevention. Sleep patterns have been linked to suicidality in adults, but lack sufficient study in youth. This ecological momentary assessment (EMA) study aimed to explore the relationship between objectively and subjectively measured sleep characteristics and next-day suicidal ideation in high-risk youth. We included 29 adolescents (12-18 years old) admitted to the inpatient psychiatric ward post-suicide attempt or due to suicidal intent within the previous month. We conducted objective (actigraphy) and subjective (sleep diary) sleep pattern assessments over ten consecutive days. Daily suicidal ideation was evaluated using a questionnaire based on the validated C-SSRS interview. A significant positive association was observed between sleep onset latency (SOL) and expressing a "death wish" the following day (OR = 1.06, 95% CI [1-1.11], p = .04), with each minute of longer SOL increased the risk for a death wish the following day by 6%. In addition, a marginally significant negative association was observed between total sleep time (TST) and expressing a "death wish" the following day (OR = 0.57, 95% CI [0.3-1.11], p = 0.1), with each one-hour decrease in objectively measured TST increasing the odds of a death wish by 43%. Our study highlights the interplay between sleep patterns and suicidal ideation, with SOL and TST playing a significant role that may function as proximal risk factors for suicidality and as a target for intervention while treating suicidal youth.
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Affiliation(s)
- Roy Ratzon
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Joel Reiter
- Pediatric Pulmonary and Sleep Unit, Department of Pediatrics, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tanya Goltser-Dubner
- Molecular Psychiatry Laboratory, The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ronen Segman
- Molecular Psychiatry Laboratory, The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Esti Galili Weisstub
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Fortunato Benarroch
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Shlomo Rahmani Zwi Ran
- Adult Inpatient Unit, The Biological Psychiatry Laboratory, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ella Kianski
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Ruth Giesser
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Pnina Blum Weinberg
- The Donald Cohen Child and Adolescent Psychiatry Department, Eitanim Psychiatric Hospital, The Jerusalem Mental Health Center, Jerusalem, Israel
| | - Amichai Ben-Ari
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Yaron Sela
- The Research Center for Internet Psychology (CIP), Sammy Ofer School of Communication, Reichman University, Herzliya, Israel
| | - Moriah Bar Nitsan
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Amit Lotan
- Adult Inpatient Unit, The Biological Psychiatry Laboratory, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Amit Shalev
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel.
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