0993 Impaired Executive Functioning Is Linked to Suicidality in Youth with Insomnia Disorder

Abstract Introduction Suicide, a critical global mental health issue, has been linked to sleep difficulties. Previous studies have also found that psychological distress and negative thinking styles could contribute to a higher risk of suicide. While cognitive deficit is one of the most common complaints among individuals with insomnia, its impact on suicidality in the context of insomnia has seldom been investigated. The current study aimed to investigate the relationship between executive functioning and suicidality among youth with insomnia. Methods Adolescents with DSM-5 insomnia disorder were recruited from local schools, universities, and the community in Hong Kong. Eligible participants completed self-reported measures, including Depressive Symptom Index - Suicidality Subscale (DSISS), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Ruminative Response Scale (RRS), and were administered Wisconsin Card Sorting Test (WCST). The total scores of HADS were used to indicate psychological distress. Failure to maintain set (FMS) from WCST was used to indicate distractibility, an aspect of executive function, with higher scores suggesting greater distractibility. Results A total of 115 adolescents with insomnia disorder (Age: 18.34 ± 1.56, 14-20, female: 65.22%) were recruited. Multivariate regressions revealed that higher HADS (b=0.06, p=.045), RRS (b=0.05, p.001), and FMS (b=0.30, p=.035) scores were all significantly associated with DSISS. The results remained significant after controlling for insomnia severity, gender, and age. Conclusion Our findings showed a link between impaired executive functioning, specifically distractibility, and suicidality. Distractibility may be attributed to the reduced suppression of the default mode network, which is associated with depression and rumination, thereby increasing the risk for suicidality. Future neuroimaging research is needed to further explore the underlying mechanism of such associations. Support (if any) This work was funded by General Research Fund (Ref. 17613820), Research Grants Council, University Grants Committee, Hong Kong SAR, China.