ArticleJournal of behavior therapy and experimental psychiatry2024
Influences of sleep, cortisol reactivity, and risk/reward-based decision-making on suicide.
Article in Journal of behavior therapy and experimental psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Psychological burden as the primary determinant of suicidal ideation in patients with temporomandibular disorders.Journal of oral & facial pain and headache · 2026Article
- Hair stress hormones in individuals with a recent suicide attempt experiencing a depressive episode.Neurobiology of stress · 2026Article
- Applying the Research Domain Criteria to Social Determinants of Community Mental Health in Low-Resource Settings: A Contextualized Framework with Insights from the TOPOWA Study.Community mental health journal · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
BACKGROUND AND
objectivesPoor sleep quality is a known contributor to suicidal thoughts and behaviors. This study examines whether sleep quality modulates the effect of an individual's stress response and risk/reward-based decision making on suicide risk.
methodsParticipants were 160 adults at a residential substance use treatment facility with lifetime exposure to trauma who completed a clinician-administered measure of suicide risk, the Iowa Gambling Task (IGT), and a self-report measure of sleep. Cortisol reactivity (i.e., changes in cortisol before and after a personalized trauma script) was used to measure stress response. We used quantile regression to examine the effects of sleep, cortisol, and risk/reward decision-making on suicide risk.
resultsWe found poor sleep quality to be increasingly salient in individuals at greater risk for suicide than those at lower risk for suicide. Furthermore, individuals with moderate to moderate-high levels of suicide risk seem to have greater cortisol reactivity. In the low-moderate quantile, we found suicide risk to be associated with both high stress reactivity and low-risk, high-reward decision-making, as well as low stress reactivity and high-risk/low-reward decision-making. LIMITATIONS: These findings should be interpreted considering several methodological constraints, such as the use of a pre-determined sample and instruments not tailored for our hypotheses, the MINI 'Suicide' Module's limited differentiation between suicidal ideation and behavior, and variably timed cortisol sampling.
conclusionsDespite these limitations, the findings from this study support the use of evidence-based interventions focused on improving sleep quality and managing emotional reactivity to decrease suicide risk.
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