Sleep and next-day negative affect and suicidal ideation in borderline personality disorder
Open accessAbstract
Sleep disturbance is associated with elevated suicidal ideation and negative affect. To date, however, no study has investigated the temporal relationship between sleep and suicidality among those diagnosed with borderline personality disorder (BPD). This preregistered (https://osf.io/4vugk) study tested whether nightly sleep (self-reported sleep duration, sleep onset latency, and subjective leep quality) represents a (within-person) short-term risk factor for affective dysregulation and increases in suicide risk from day-to-day, as well as whether between-person differences in sleep, negative affect, and suicidality were associated. We used a 21-day ecological momentary assessment protocol in a sample of 142 people diagnosed with BPD, 98 of which had a history of serious suicide attempts, and 52 healthy controls. We found a within-person association between better subjective sleep quality and greater next day negative affect. At the between-person level, we found positive relationships between sleep latency and suicidal ideation, and a negative association between subjective sleep quality and negative affect. BPD severity did not significantly moderate the strength of any within-person associations, although BPD was positively associated with average levels of suicidal ideation, sleep latency, and negative affect, and negatively related to subjective sleep quality. These findings suggest that the association of sleep with suicidal ideation and BPD exists largely at the between-persons rather than the within-person level. Disturbed sleep, therefore, seems to largely coincide, rather than specifically contribute to the exacerbation of suicidal crises in BPD.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Most reports failed to establish independent temporal predictors of suicidal ideation severity: of twelve articles fitting temporal prediction models, four failed to establish significant predictors after accounting for ideation at the previous time point, and five did not control for prior ideation.
“Most reports failed to establish independent temporal predictors of suicidal ideation severity: of twelve articles fitting temporal prediction models (47, 51, 52, 55–57, 60, 73, 74, 76, 77), four failed to establish significant predictors after accounting for ideation at the previous time point (47, 52, 55), and five did not control for prior ideation (51, 60, 73, 74, 76).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [74]
Between days, short sleep duration (both objective and subjective), poor subjective sleep quality and increased sleep latency predicted mean next-day suicidal ideation.
“Between days, short sleep duration (both objective and subjective), poor subjective sleep quality and increased sleep latency (i.e., time to fall asleep) predicted (mean) next-day suicidal ideation (51, 74).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [74]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Sleep Health: Can We Define It? Does It Matter?
Buysse, D. J. (2014) · SLEEP · doi:10.5665/sleep.3298 · Cited by 2,607 · see citing works
Intensive Longitudinal Methods: An Introduction to Diary and Experience Sampling Research
Bolger, N. P., & Laurenceau, J. (2013) · Cited by 2,029 · see citing works
Kleiman, E. M., Turner, B. J., Fedor, S., Beale, E. E., Huffman, J. C., & Nock, M. K. (2017) · Journal of Abnormal Psychology · doi:10.1037/abn0000273 · Cited by 831 · see citing works
Sleep and emotions: Bidirectional links and underlying mechanisms
Kahn, M., Sheppes, G., & Sadeh, A. (2013) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2013.05.010 · Cited by 550 · cited 1× · see citing works
“Overall, these findings generally replicate findings that sleep and negative affect are linked at both the within-and between-person level (Kahn et al., 2013; Palmer & Alfano, 2017).”
BackgroundClassification of suicidal behaviors: I. Quantifying intent and medical lethality
(1975) · American Journal of Psychiatry · doi:10.1176/ajp.132.3.285 · Cited by 460 · see citing works
Selby, E. A., & Joiner, T. E. (2009) · Review of General Psychology · doi:10.1037/a0015687 · Cited by 452 · see citing works
Sleep disturbances as an evidence-based suicide risk factor
Bernert, R. A., Kim, J. S., Iwata, N. G., & Perlis, M. L. (2015) · Current Psychiatry Reports · doi:10.1007/s11920-015-0554-4 · Cited by 406 · see citing works
Lemola, S., Ledermann, T., & Friedman, E. M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0071292 · Cited by 310 · see citing works
Ribeiro, J. D., Pease, J. L., Gutierrez, P. M., Silva, C., Bernert, R. A., Rudd, M. D., & Joiner, T. E. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.09.049 · Cited by 304 · see citing works
Sleep and suicide: A systematic review and meta-analysis of longitudinal studies
Liu, R. T., Steele, S. J., Hamilton, J. L., Do, Q. B. P., Furbish, K., Burke, T. A., Martinez, A. P., & Gerlus, N. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101895 · Cited by 239 · see citing works
Littlewood, D. L., Kyle, S. D., Carter, L.-A., Peters, S., Pratt, D., & Gooding, P. (2019) · Psychological Medicine · doi:10.1017/s0033291718001009 · Cited by 209 · see citing works
Sleep problems and suicidality in the National Comorbidity Survey Replication
Wojnar, M., Ilgen, M. A., Wojnar, J., McCammon, R. J., Valenstein, M. M., & Brower, K. J. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2008.07.006 · Cited by 168 · see citing works
The nosologic status of borderline personality: clinical and polysomnographic study
Akiskal, H. S., Yerevanian, B. I., Davis, G. C., King, D., & Lemmi, H. (1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.2.192 · Cited by 151 · see citing works
Links, P. S., Eynan, R., Heisel, M. J., Barr, A., Korzekwa, M., McMain, S., & Ball, J. S. (2007) · Journal of Personality Disorders · doi:10.1521/pedi.2007.21.1.72 · Cited by 129 · see citing works
Feasibility and validity of ecological momentary assessment in the investigation of suicide risk
Husky, M., Olié, E., Guillaume, S., Genty, C., Swendsen, J., & Courtet, P. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.08.019 · Cited by 124 · see citing works
Variability and predictability in sleep patterns of chronic insomniacs
Vallières, A., Ivers, H., Bastien, C., Beaulieu‐Bonneau, S., & Morin, C. M. (2005) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2005.00480.x · Cited by 123 · see citing works
Real-time predictors of suicidal ideation: mobile assessment of hospitalized depressed patients
Ben-Zeev, D., Young, M. A., & Depp, C. A. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.11.025 · Cited by 122 · see citing works
EEG sleep evaluation of depression in borderline patients
McNamara, E. A., Reynolds, C. F., Soloff, P. H., et al. (1984) · American Journal of Psychiatry · doi:10.1176/ajp.141.2.182 · Cited by 107 · see citing works
Winsper, C., & Tang, N. K. Y. (2014) · International Review of Psychiatry · doi:10.3109/09540261.2014.881330 · Cited by 88 · see citing works
Zanarini, M., Frankenburg, F., Reich, D. B., & Fitzmaurice, G. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15081045 · Cited by 83 · see citing works
Chronic sleep disturbances and borderline personality disorder symptoms.
Selby, E. A. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0033201 · Cited by 81 · see citing works
Russell, K., Rasmussen, S. A., & Hunter, S. C. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7104 · Cited by 80 · see citing works
The sleep phenotype of Borderline Personality Disorder: A systematic review and meta-analysis
Winsper, C., Tang, N. K. Y., Marwaha, S., Lereya, S. T., Gibbs, M., Thompson, A. D., & Singh, S. P. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.12.008 · Cited by 74 · see citing works
Sleep problems in childhood and borderline personality disorder symptoms in early adolescence
Lereya, S. T., Winsper, C., Tang, N. K. Y., & Wolke, D. (2017) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-016-0158-4 · Cited by 65 · see citing works
Depression in borderline patients: A prospective EEG sleep study
Reynolds, C. F., Soloff, P. H., Kupfer, D. J., Taska, L. S., Restifo, K., Coble, P. A., & McNamara, M. E. (1985) · Psychiatry Research · doi:10.1016/0165-1781(85)90084-8 · Cited by 62 · see citing works
Sleep difficulties are associated with increased symptoms of psychopathology
Tkachenko, O., Olson, E. A., Weber, M., Preer, L. A., Gogel, H., & Killgore, W. D. S. (2014) · Experimental Brain Research · doi:10.1007/s00221-014-3827-y · Cited by 59 · see citing works
Nightmares as predictors of suicide: an extension study including war veterans
Sandman, N., Valli, K., Kronholm, E., Vartiainen, E. A., Laatikainen, T. K., & Paunio, T. (2017) · Scientific Reports · doi:10.1038/srep44756 · Cited by 59 · see citing works
Mou, D., Kleiman, E. M., Fedor, S., Beck, S., Huffman, J. C., & Nock, M. K. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.08.006 · Cited by 54 · see citing works
Circadian Sleep-Wake Cycles, Well-Being, and Light Therapy in Borderline Personality Disorder
Bromundt, V., Wirz-Justice, A., Kyburz, S., Opwis, K., Dammann, G., & Cajochen, C. (2013) · Journal of Personality Disorders · doi:10.1521/pedi_2012_26_057 · Cited by 49 · cited 1× · see citing works
“…a variety of indicators of poor sleep, including insomnia, nightmares, poor subjective sleep quality, short self-reported sleep duration, or low sleep efficiency (Bromundt et al., 2013; Grove et al., 2020; Hafizi, 2013; Oltmanns et al., 2014; Sansone et al., 2010; Selby, 2013; Wall et al., 2020).”
BackgroundSuicidal Behavior and Psychosocial Outcome in Borderline Personality Disorder at 8-Year Follow-Up
Soloff, P. H., & Chiappetta, L. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2017_31_280 · Cited by 45 · see citing works
Morales‐Muñoz, I., Broome, M. R., & Marwaha, S. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.1875 · Cited by 43 · see citing works
Zuromski, K. L., Cero, I., & Witte, T. K. (2017) · Journal of Abnormal Psychology · doi:10.1037/abn0000282 · Cited by 37 · see citing works
Lifetime rhythmicity and mania as correlates of suicidal ideation and attempts in mood disorders
Balestrieri, M., Rucci, P., Sbrana, A., Ravani, L., Benvenuti, A., Gonnelli, C., Dell’Osso, L., & Cassano, G. B. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2006.01.004 · Cited by 34 · see citing works
Simor, P., & Horváth, K. (2013) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12048 · Cited by 28 · see citing works
Adolescent Sleep Disturbance, Emotion Regulation and Borderline Features in an Inpatient Setting
Wall, K., Vanwoerden, S., Penner, F., Patriquin, M. A., Alfano, C. A., & Sharp, C. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2020.1772081 · Cited by 16 · see citing works
Suicidal Urges and Attempted Suicide at Multiple Time Scales in Borderline Personality DisorderPreprint
Kaurin, A., Dombrovski, A. Y., Hallquist, M. N., & Wright, A. G. C. (2020) · doi:10.31234/osf.io/hswea · Cited by 5 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 20
- DeShong, H.L., & Tucker, R.P. (2019). Borderline personality disorder traits and suicide risk: The mediating role of insomnia and nightmares. Journal of Affective Disorders, 244, 85- 91.
- Fekedulegn, D., Andrew, M.E., Shi, M., Violanti, J.M., Knox, S., & Innes, K.E. (2020). Actigraphy-Based Assessment of Sleep Parameters. Annals of Work Exposures and Health, 64(4), 350-367.
- Fleischer, M., Schäfer, M., Coogan, A., Häßler, F., & Thome, J. (2012). Sleep disturbances and circadian CLOCK genes in borderline personality disorder. Journal of Neural Transmission, 119(10), 1105-1110.
- Grove, J.L., Smith, T.W., Carlson, S.E., Bryan, C.J., Crowell, S.E., Czajkowski, L., ... & Parkhurst, K. (2020). Prospective association between suicide cognitions and emotional responses to a laboratory stressor: The mediating role of nightly subjective sleep quality. Journal of Affective Disorders, 265, 77-84.
- Grove, J.L., Smith, T.W., Crowell, S.E., & Ellis, J.H. (2017). Preliminary evidence for emotion dysregulation as a mechanism underlying poor sleep quality in borderline personality disorder. Journal of Personality Disorders, 31(4), 542-552.
- Hafizi, S. (2013). Sleep and borderline personality disorder: A review. Asian Journal of Psychiatry, 6(6), 452-459.
- Harty, L., Forkner, R.D., Thompson, A., Stuewig, J., & Tangney, J.P. (2010). Are inmates' subjective sleep problems associated with borderline personality, psychopathy, and antisocial personality independent of depression and substance dependence?. Journal of Forensic Psychiatry & Psychology, 21(1), 23-38.
- Hochard, K.D., Heym, N., & Townsend, E. (2015). The unidirectional relationship of nightmares on self-harmful thoughts and behaviors. Dreaming, 25(1), 44-58.
- Loranger, A., Sartorius, N., & Janca, A. (1996). Assessment and diagnosis of personality disorders: The International Personality Disorder Examination (IPDE). New York, NY: Cambridge University Press.
- Nutt, D., Wilson, S., & Paterson, L. (2008). Sleep disorders as core symptoms of depression. Dialogues in Clinical Neuroscience, 10(3), 329-336.
- O'Connor, R.C., & Nock, M.K. (2014). The psychology of suicidal behaviour. The Lancet Psychiatry, 1(1), 73-85.
- Oltmanns, J.R. (2019). Personality Disorders, Maladaptive Personality Traits, and Sleep Problems: Findings and Future Directions. In Sleep, Personality, and Social Behavior (pp. 239-254). Springer, Cham.
- Oltmanns, J.R., & Oltmanns, T.F. (2015). Borderline personality pathology, polysomnography, and self-reported sleep problems: a review. Current Sleep Medicine Reports, 1(2), 141- 149.
- Oltmanns, J.R., Weinstein, Y., & Oltmanns, T.F. (2014). Borderline personality pathology and insomnia symptoms in community-dwelling older adults. Personality and Mental Health, 8(3), 178-187.
- Palmer, C.A., & Alfano, C.A. (2017). Sleep and emotion regulation: an organizing, integrative review. Sleep Medicine Reviews, 31, 6-16.
- Pandi-Perumal, S.R., Monti, J.M., Burman, D., Ramanujam, K., BaHammam, A.S., Spence, D.W., Brown, G.M & Narashimhan, M. (2020). Clarifying the role of sleep in depression: A narrative review. Psychiatry Research, 113239.
- Plante, D.T., Frankenburg, F.R., Fitzmaurice, G.M., & Zanarini, M.C. (2013). Relationship between maladaptive cognitions about sleep and recovery in patients with borderline personality disorder. Psychiatry Research, 210(3), 975-979.
- Podsakoff, P.M., MacKenzie, S.B., Lee, J.Y., & Podsakoff, N.P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879-903.
- Sansone, R.A., Edwards, H.C., & Forbis, J.S. (2010). Sleep quality in borderline personality disorder: a cross-sectional study. Primary Care Companion to the Journal of Clinical Psychiatry, 12(5): PCC.09m00919.
- Sjöström, N., Hetta, J., & Waern, M. (2009). Persistent nightmares are associated with repeat suicide attempt: a prospective study. Psychiatry Research, 170(2-3), 208-211.
Cited by
Sorted by citations
Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research
Kivelä, L., van der Does, W. A. J., Riese, H., & Antypa, N. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.876595 · Cited by 163 · see citing works
- Authors
- Kaurin, A., Hisler, G., Dombrovski, A., Hallquist, M., & Wright, A. G. C.
- Affiliations
- University of Pittsburgh (US)
- University of North Carolina at Chapel Hill (US)
- Venue
- Personality Disorders Theory Research and Treatment
- Publisher
- Center for Open Science
- Published
- 2020-08-19
- Volume
- 13
- Issue
- 2
- Pages
- 160-170
- ISSN
- 1949-2715 (ISSN-L)
- PMC
- PMC9815476
- OpenAlex
- W3163218014
- Cited by
- 20
- References
- 36
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 1
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Personality Disorders Theory Research and Treatment (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH100095, R01MH048463)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- borderline personality disorder, sleep disorders, suicidal ideation, negative affect, subjective sleep quality, sleep latency, sleep duration, emotional dysregulation, suicide risk, within-person associations, between-person associations, BPD severity
- MeSH terms
- Ecological Momentary Assessment, Borderline Personality Disorder, Humans, Sleep, Suicide, Attempted, Suicidal Ideation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
