title: Explaining alcohol use and suicide risk: a moderated mediation model involving insomnia symptoms and gender.
abstract: OBJECTIVE
  The purpose of the study was to examine whether insomnia symptoms and nightmares mediated the relation between alcohol use and suicide risk. Further, we examined whether this mediation was moderated by gender.
  
  
  METHODS
  The study consisted of questionnaires administered online examining insomnia symptoms, nightmares, alcohol use, and suicide risk.
  
  
  METHODS
  University.
  
  
  METHODS
  375 undergraduate students at a large, public university in the southeastern United States.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Results indicated that insomnia symptoms significantly mediated the relation between alcohol use and suicide risk; however, this mediation was moderated by gender. For women, there was both a direct effect of alcohol use on suicide risk as well as an indirect effect of alcohol use through insomnia symptoms increasing suicide risk. For men, there was no direct effect of alcohol use on suicide risk, but there was a significant indirect effect of alcohol use increasing suicide risk through insomnia symptoms. Nightmares were not related to alcohol use, and the association between nightmares and suicide risk was found to be independent of alcohol use.
  
  
  CONCLUSIONS
  Insomnia symptoms are an important factor in explaining the mechanism by which alcohol use increases suicide risk.
authors.affiliation: Mississippi State University, Mississippi State, MS; Baylor College of Medicine, Houston, TX.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Nadorff
authors.affiliation: Mississippi State University, Mississippi State, MS.
authors.forename: Taban
authors.initials: T
authors.lastname: Salem
authors.affiliation: Mississippi State University, Mississippi State, MS.
authors.forename: E Samuel
authors.initials: ES
authors.lastname: Winer
authors.affiliation: Emory School of Medicine, Atlanta, GA.
authors.forename: Dorian A
authors.initials: DA
authors.lastname: Lamis
authors.affiliation: VISN 19 Mental Illness Research, Education and Clinical Center, Denver, CO.
authors.forename: Sarra
authors.initials: S
authors.lastname: Nazem
authors.affiliation: Mississippi State University, Mississippi State, MS.
authors.forename: Mitchell E
authors.initials: ME
authors.lastname: Berman
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D004325:Dreams / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D012307:Risk Factors; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000523:psychology*; D013334:Students / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: alcohol use; gender; insomnia symptoms; suicide risk