title: Hopelessness mediates the relation between insomnia and suicidal ideation.
abstract: BACKGROUND
  A growing body of literature indicates that insomnia is related to suicidality. However, the mechanism through which insomnia correlates with suicide risk is unclear. The goal of the present research was to determine whether hopelessness, a robust predictor of suicidality, mediates the relation between insomnia and suicidal ideation (SI).
  
  
  METHODS
  The present study used archival data from community-dwelling adults. Participants (n = 766) completed a Health Survey, two weeks of daily sleep diaries, and five measures of daytime functioning, including the Beck Depression Inventory (BDI). BDI item 2 was used to assess hopelessness, and BDI item 9 was used to assess SI. Criteria from the DSM-5 as well as quantitative criteria were used to identify participants with insomnia (n = 135).
  
  
  RESULTS
  The analyses revealed that hopelessness is a significant mediator of the relation between insomnia and SI. After adding depression as an additional mediator, hopelessness remained a significant predictor of SI.
  
  
  CONCLUSIONS
  The present research suggests the need for clinicians to routinely screen clients who have insomnia for hopelessness and SI, and to treat hopelessness when it is present. Further research should address the limitations in this sample and should also consider other potential mediators of the insomnia-SI link.
authors.affiliation: The University of Alabama, Tuscaloosa, AL.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Woosley
authors.affiliation: The University of Alabama, Tuscaloosa, AL.
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Lichstein
authors.affiliation: University of North Texas, Denton, TX.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Taylor
authors.affiliation: University of Memphis, Memphis, TN.
authors.forename: Brant W
authors.initials: BW
authors.lastname: Riedel
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bush
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016001:Confidence Intervals; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005639:Frustration; D006306:Health Surveys; D065026:Hope; D006801:Humans; D015994:Incidence; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000379:methods; D018570:Risk Assessment; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: hopelessness; insomnia; mediation; suicidal ideation