0409 INSOMNIA PREDICTS MULTIPLE DIMENSIONS OF SUICIDAL IDEATION AMONG ARMY SERVICEMEMBERS

Abstract Introduction: Previous research has demonstrated a link between insomnia and suicidal ideation. Most of these studies, however, have treated suicidal ideation as a single construct. Recently, it has been suggested that ideation be considered dimensionally (i.e., in terms of passivity, intent, plan, and willingness to communicate intent and plan). In the present study, the association of insomnia with suicidality was assessed in terms of five different measures of ideation. Methods: An archival analysis was conducted using a national database of army service members (Army STARRS), 2,617 of whom had been assessed for insomnia and suicidality. Insomnia was defined as difficulties initiating and/or maintaining sleep within the last 30 days. Depression was assessed by whether or not the participant met criteria for a depressive episode during the past 30 days. Suicidal ideation was assessed for the last 30 days in terms of: thoughts of death (i.e., wishing one was dead), thoughts of suicide (i.e., thoughts of killing self), suicidal plan (i.e., thoughts of how to kill self), suicidal intent (i.e., intention to kill self), and suicidal communication (i.e., telling someone about the suicidal thoughts). Stepwise logistic regressions were used to determine the association of insomnia with the dimensional measures of suicidality. Results: When controlling for depression, insomnia emerged as a significant predictor for suicidal communication [OR = 2.59, p < .01], thoughts of death [OR = 2.36, p < .001], suicidal plan [OR = 1.88, p < .01], and thoughts of suicide [OR = 1.66, p < .01]. Suicidal intent was not found to be significantly associated with insomnia. Conclusion: The present findings suggest that insomnia may be differentially associated with dimensional aspects of suicidal ideation. A more refined delineation of suicidality may serve to clarify the nature of the association between insomnia and suicidal ideation, and potentially offer some clues as to the mechanisms behind this association. Support (If Any): Army STARRS was funded by the US Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health (NIH/NIMH; U01MH087981).