Sleep trajectories and frequency of non-suicidal self-injury in adolescents: a person-oriented perspective over two years

Abstract

Adolescent sleep quality and quantity is commonly linked to worse emotion regulation. One maladaptive emotion regulation strategy that is on the rise is non-suicidal self-injury (NSSI), which includes burning, hitting, or scratching one's own body tissue without suicidal intent. The aim of this study was to explore the frequency of NSSI among different longitudinal trajectories of insomnia symptoms and short sleep duration to identify at-risk adolescents. We used questionnaire data collected annually (3 time points over 2 years) from a sample of Swedish adolescents (N = 1,294; M_age = 13.2 [range: 12-15 years], SD = 0.4; 46.8% girls). Adolescents answered questions about their sleep duration, symptoms of insomnia, NSSI, depressive symptoms, and demographics. Adolescents who reported persistent or increasing sleep problems over time also reported more NSSI. A notable pattern was that adolescents whose insomnia symptoms were high and increasing reported the highest frequency of NSSI, also compared to adolescents who started at the same high level of insomnia symptoms but improved over time. Therefore, measuring NSSI may help identify a risk-group for persistent sleep problems and self-injury. Because sleep disturbances, especially insomnia, and NSSI go hand-in-hand for most adolescents, sleep interventions would benefit the treatment and prevention of self-injury.

Keywords: Person-oriented analyses; Self harm; Sleep disturbance; Teenagers.

Fig. 1

NSSI frequency in insomnia symptom trajectories at T1-T2-T3 (with insomnia symptom trajectories for reference). Note. Z-scores were used to show NSSI and ISI scores in the same figure. Lines of the same color refer to the same insomnia trajectory; dotted lines represent the insomnia symptom levels and solid lines represent NSSI levels in each insomnia trajectory, not controlling for confounders. NSSI non-suicidal self-injury, ISI Insomnia Severity Index. This figure was adapted from the figure published in Bauducco et al. under the CC BY 4.0 license.

Fig. 2

NSSI frequency in sleep duration trajectories at T1-T2-T3 (with Sleep duration trajectories for reference). Note. Z-scores were used to show NSSI and sleep duration scores in the same figure. Lines of the same color refer to the same sleep duration trajectory; dotted lines represent average sleep duration and solid lines represent NSSI scores in each sleep duration trajectory, without controlling for confounders. NSSI non-suicidal self-injury, TST total sleep time. This figure was adapted from the figure published in Bauducco et al. under the CC BY 4.0 license.