Nightmares Linked to Increased Suicide Risk in PTSD Interview with:
Donna L. Littlewood PhD Student
School of Psychological Sciences
University of Manchester, UK What is the background for this study? What are the main findings?

Response: Every year over 800,000 people die by suicide, and for every individual’s death, it is estimated that another 20 people will make a suicide attempt. Therefore, to be able to prevent suicide, we need to understand the different factors that can combine to make an individual think about ending their own life.

Recent research indicates that nightmares are associated with suicidal thoughts and behaviours, and that this association is independent of other related suicide risk factors, such as, depression and PTSD. However, it is now important for research to examine the mechanisms that underpin this association, as this information will support the development of clinical interventions to prevent subsequent suicide attempts and deaths What should clinicians and patients take away from your report?

Response: Our findings suggest that when people with PTSD experience nightmares, this may act as a stressor. This, in turn, may trigger specific types of negative cognitive appraisals (i.e. defeat, entrapment and hopelessness), which underpin suicidal thoughts and behaviours.  Furthermore, it is noteworthy, that the pathways between nightmares and suicidal behaviours appear to operate independent of comorbid insomnia and depression. What recommendations do you have for future research as a result of this study?

Response: PTSD increases the risk of suicidal thoughts and behaviours, and our study shows that nightmares, a hallmark symptom of PTSD, may be an important treatment target to reduce suicide risk. This study emphasizes the importance of specifically assessing and targeting nightmares within those individuals experiencing PTSD. In addition, monitoring and targeting levels of negative cognitive appraisals such as defeat, entrapment, and hopelessness, may help to reduce suicidal thoughts and behaviours. Is there anything else you would like to add?

Response: Whilst these findings mark a step forward in our understanding of the variables that may account for the nightmares/suicide relationship, it is important for future studies to test these findings within a longitudinal design.  Furthermore, it is notable that the direct relationship between nightmares and suicidal behaviour remained significant. This suggests that there are additional pathways which underpin this relationship, which should be identified through further research. Thank you for your contribution to the community.


Nightmares and Suicide in Posttraumatic Stress Disorder: The Mediating Role of Defeat, Entrapment, and Hopelessness

Donna L. Littlewood, MRes1; Patricia A. Gooding, PhD1; Maria Panagioti, PhD2; Simon D. Kyle, PhD3

1School of Psychological Sciences, University of Manchester, UK; 2Institute of Population Health, University of Manchester, UK; 3Sleep and Circadian Neuroscience Institute, University of Oxford, UK

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Last Updated on March 18, 2016 by Marie Benz MD FAAD