(PS11-16) Associations Between Childhood Adversity, Sleep Disturbances, and Suicidal Ideation Among Peripubertal Youth Receiving Intensive Psychiatric Services

Background: In the past few years, there has been an increase in suicide rates in adolescents and children younger than 14. Despite evidence for risk factors for suicidal ideation (SI), the mechanisms are not well established in peripuberty. This is an important developmental period, as it is vital to examine how stress (e.g., adversity) may affect physiology and neural development and, in turn, maladaptive health outcomes. Two established risk factors for SI are childhood adversity and sleep disturbances. The current study aims to examine these two risk factors as predictors of SI in peripubertal youth with severe psychopathology, a population in which these mechanisms, as they relate to SI, have been understudied.

Methods: Participants were admitted to a children’s partial hospitalization program with severe psychopathology. The final n = 548, with participants predominantly identifying as White (75%) and male (51%) with a mean age of 10.30 (SD = 1.57). Approximately half of youth (48.7%) endorsed experiencing active or passive SI. Sleep disturbances (e.g., difficulty falling asleep, staying asleep) were assessed by youth report on the PROMIS Pediatric Sleep Disturbance scale. Parent reports on the CYW Adverse Childhood Experiences questionnaire measured childhood adversity. SI was measured by youth report on the Children’s Depression Inventory (CDI) with one item with the following options: 1) “I do not think about killing myself”, 2) “I think about killing myself but would not do it”, and 3) “I want to kill myself”. Endorsement of option 2 or 3 was coded as overall SI.

Results: A binomial logistic regression analysis was used to examine the interaction between sleep disturbances (perceived sleep quality), childhood adversity, and age to predict SI probability. Results showed an interaction between youth age and perceived sleep disturbances (OR = 1.03, 95% CI = 1.00, 1.06) such that older youth were the most impacted by low sleep quality. The probability of youth SI increased from .31 at high sleep quality to .72 at low sleep quality whereas the probability was similar at high and low sleep quality for younger children (age 8). No significant interactions or main effects were found for childhood adversity predicting SI.

Discussion: These findings suggest that peripubertal youth are more likely to experience SI if they perceive their sleep quality to be low. Specifically, children are more likely to experience SI as they get closer to adolescence. These are important findings, as past research has already shown sleep quality to be predictive of SI in adolescence and young adults. Identifying methods to improve sleep quality may reduce the likelihood of developing SI in peripuberty, which may then decrease the chance of these youth experiencing SI and even engaging in suicidal behavior later in life. While no interactions were found for overall childhood adversity, future research may examine specific types of adversity in relation to SI in peripubertal youth.