Effects of childhood trauma on indicators of daily suicide risk: The role of stress and sleep

BACKGROUND: Despite growing attention of the effects of childhood trauma on suicidality, its links to day-to-day fluctuations in suicide risk indicators (defeat, entrapment) and the mediating roles of daily sleep and hassle appraisals remain unclear. This study (1) tests associations between childhood trauma and daily sleep, hassles, and suicide risk indicators; (2) examines mediation by daily sleep and hassle appraisals; and (3) assesses whether trauma moderates daily sleep/hassle-suicide risk relationships. METHODS: A total of 168 participants with a recent history of suicide ideation or attempt completed a 7-day daily-diary protocol with two surveys per day. Each morning, participants reported on the previous night's sleep; each evening, they reported on that day's hassles and suicide risk indicators (defeat, entrapment, reasons for living). RESULTS: Multilevel models showed that childhood trauma was associated with higher pre-sleep arousal, more negative appraisals of daily hassles, and higher daily defeat and entrapment. Indirect pathways were identified whereby childhood trauma affected daily suicide risk via heightened pre-sleep arousal and more negative hassle appraisals. Finally, both daily pre-sleep arousal and hassle appraisals were linked to same-day suicide risk. CONCLUSION: These findings underscore the disruptive impact of childhood trauma on everyday stress-health processes and the complex mechanisms through which sleep dynamics and cognitive appraisals of hassles contribute to suicide risk. The results have implications for refining interventions by attenuating pre-sleep arousal and appraisal processes in individuals with a history of childhood trauma.