Nightmares increase the risk of suicide by boosting feelings of hopelessness, according to a new study.
While the finding that nightmares boost suicide risk is nothing new, researchers from The University of Manchester said the latest research is the first to explain the mechanism behind the link.
Lead study author Donna L. Littlewood, a researcher in medical and human sciences at the university, and her team believe that the relationship between bad dreams and suicidal behavior is partially explained by a multi-step pathway that includes defeat, entrapment and hopelessness.
The study involved 91 participants who have experienced traumatic events, with 51 of participants meeting the diagnostic criteria for post-traumatic stress disorder. Participants were asked to complete questionnaires that measured nightmare frequency and intensity as well as their level of suicidal behavior, hopelessness, defeat and entrapment.
Study results revealed that 62 percent of participants who experienced nightmares and 20 percent of those who did not had suicidal thoughts, plans or attempts.
"Suicidal behaviors were higher in those participants who experienced nightmares, in comparison to those who did not. Bootstrapped analyses provided support for the hypothesized multistep mediational model. Specifically, nightmares were both directly and indirectly associated with suicidal behaviors, through perceptions of defeat, entrapment, and hopelessness, independent of comorbid insomnia and depression," researchers wrote in the study.
"For the first time we show that the relationship between nightmares and suicidal behaviors is partially mediated by a multistep pathway via defeat, entrapment, and hopelessness. Clinically, our work highlights the importance of monitoring and targeting nightmares and perceptions of defeat, entrapment, and hopelessness when working with clients who have experienced trauma," researchers added.
"PTSD increases the risk of suicidal thoughts and behavior, and our study shows that nightmares, a hallmark symptom of PTSD, may be an important treatment target to reduce suicide risk," Littlewood said in a university release. "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 reduce suicidal thoughts and behaviors."
The latest findings were published in the Journal of Clinical Sleep Medicine.
