Non-Constructive Ruminations, Insomnia and Nightmares: Trio of Vulnerabilities to Suicide Risk

Julie Faccini, Vrutti Joshi, Pierluigi Graziani, Jonathan Del-Monte University of Nîmes, LSP Laboratory, Aix-Marseille University, Marseille, FranceCorrespondence: Julie Faccini, LSP Laboratory, Aix-Marseille University, 5 Rue Château de l’Horloge, Marseille, 13090, Aix-en-Provence, France, Tel +33 4 42 52 40 00, Email faccinijulie@hotmail.frObjective: Nightmare distress, nightmare frequency and anxiety are related to suicidal risk. Ruminations are a factor maximizing the risk of suicide. Research has identified two types of ruminations: constructive ruminations and non-constructive ruminations. As per our knowledge, no study has verified the links between non-constructive ruminations and sleep disorders and their role in the development of suicidal risk. We aimed to highlight the impact of non-constructive ruminations on nightmares, anxiety and insomnia in the development of suicidal risk.Methods: A total of 429 French participants responded to an anonymous online survey using the Qualtrics® software. To assess variables, we used the Mini Cambridge-Exeter Repetitive Thought Scale, the Suicide Behaviors Questionnaire-Revised, the Nightmare Distress Questionnaire, the Beck Anxiety Inventory, and the Sleep Condition Indicator. Nightmare frequency was assessed by subjective evaluation through a question. We tested the possible effects of confounding variables such as age, gender, marital status and depression (Beck Depression Inventory-II).Results: Nightmare frequency was found to mediate the link between anxiety and suicidal risk (32.9%). Nightmare distress (37%) and non-constructive thoughts (48%) were also seen to mediate this link. Additionally, we found a moderating effect of insomnia on the link between non-constructive ruminations and suicidal risk (Z = 7.42, p < 0.001).Conclusion: Our results showed that the frequency of nightmares, distress and non-constructive ruminations are closely related to suicidal risk. The interoperability between these element