Prior studies have found associations between sleep disturbances and suicide ideation among adolescents. However, there is limited prospective research examining cognitive mechanisms that explain this relationship. This present longitudinal study aimed to examine the mediating role of rumination in the relationship between sleep quality and suicide ideation over time. We hypothesized that low sleep quality would be associated with increased suicide ideation severity over time and that rumination would mediate the relationship. Adolescents (N = 117), ages 12-19, who presented to hospitals or outpatient clinics with suicide ideation or attempt completed self-report measures of sleep quality and suicide ideation severity at baseline, rumination at 3-month follow-up, and depressive symptoms and suicide ideation at 12-month follow-up. There was no statistically significant direct relation between sleep quality and suicide ideation. However, rumination and depressive symptoms serially mediated the relationship between sleep quality and suicide ideation, suggesting an indirect relationship. Interestingly, rumination did not predict later sleep quality. Improving sleep quality may reduce rumination, which, in turn, may reduce depressive symptoms and lower SI severity. Improving sleep quality may ameliorate the impact of cognitive mechanisms - like rumination - that may indirectly exacerbate suicide ideation severity through depressive symptoms.

Abstract Purpose Ecological momentary assessment (EMA) studies converge on the finding that negative affect and psychosis symptoms (e.g., paranoia, hallucinations) are closely linked, with negative affect potentially triggering psychosis symptoms. A deeper understanding of the between-person variability within this affective pathway to psychosis could both benefit case conceptualization in clinical practice and potentially further refine etiological models of psychosis. In this study we re-analysed four EMA-studies and explored whether the associations between negative emotions and concurrent/subsequent paranoia/hallucinations are common across people or vary between individuals. Methods EMA-data of negative emotions and psychosis symptoms from two population and two patient samples (assessment intervals: 20–150 min) were subjected to Group Iterative Multiple Model Estimation network analysis to explore which associations between negative emotions and concurrent/subsequent hallucinations and paranoia are found universally (i.e., in more than 50% of the sample) vs. only in individuals. Results Most associations between hallucinations/paranoia and emotions varied between individuals. Two networks yielded population-wide cross-sectional connections between anxiety and paranoia and shame and paranoia, respectively. Nevertheless, the vast majority of individual networks included one or more associations between negative emotions and symptoms. Conclusion These results have to be interpreted cautiously due to the low number of assessments per individual in most samples, but they tentatively suggest that the affective path to psychosis shows considerable inter-individual variability. Within this diversity of individually different associations, different connections between negative emotions and concurrent/subsequent psychosis symptoms are consistently found, highlighting the potential for combining the individual and global perspective in future research.

Abstract Purpose The transdiagnostic theory of eating disorders (EDs) states that maintenance mechanisms are largely the same across different ED diagnoses. However, different diagnostic groups show different responses to cognitive behavioral therapy with regard to remission rates and reduction of disordered eating behaviors. We investigated the interplay of proposed maintenance mechanisms such as overvaluation of shape and weight and core low self-esteem and ED behaviors in anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED). Methods We analyzed data from 1,023 adult patients ( n = 406 with AN, n = 366 with BN, and n = 251 with BED) and estimated cross-sectional regularized partial correlation networks. For each network, we identified the most central nodes and compared networks by using the network comparison test. Results Consistent with theory, (a) the networks were very similar, (b) core low self-esteem, overvaluation of shape and weight, and dietary restraint were connected to each other, in both AN and BN, and (c) binge eating and self-induced vomiting were closely linked. In contrast with theory, (a) dietary restraint was not linked with binge eating and b) mood intolerance did not show strong associations with ED behaviors. Core low self-esteem consistently had greatest strength centrality. Conclusions Our study adds to the evidence that low self-esteem is a crucial treatment target. However, our findings do not support the notion that dietary restraint leads to binge eating as proposed by the transdiagnostic theory and restraint theory. Overall, our findings partially support the transdiagnostic theory.