The Mediating Role of Sleep Quality and Feeling of Loneliness in the Relationship Between Childhood Trauma and Suicidal Ideation Among Adolescents

Abstract

Background: Research has indicated that childhood trauma can negatively impact sleep quality and intensify feelings of loneliness among adolescents. While connections between childhood trauma and suicidal ideation (SI) have been well-documented, the specific roles of loneliness and sleep quality as mediators in this relationship have not been thoroughly explored. Objectives: The goal of this study was to examine the correlational patterns and the potential mediating roles of loneliness and sleep quality in predicting SI in adolescents in relation to childhood trauma. Patients and Methods: This cross-sectional study involved 540 students aged 12 to 18 from Tehran, Iran, selected through multistage cluster random sampling. Participants completed four validated self-administered questionnaires: the Bernstein Childhood Trauma Questionnaire (CTQ) to assess childhood trauma, the Beck Scale for Suicide Ideation (BSSI) to assess SI, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, and the UCLA Loneliness Scale to assess feelings of loneliness. Data were analyzed using SPSS, applying descriptive statistics, chi-square tests, correlation coefficients, and structural modeling tests (P ≤ 0.05). Results: The findings revealed a positive and significant correlation between childhood trauma and SI (R = 0.29, P < 0.001). The model demonstrated that childhood trauma has a direct effect on suicidal thoughts (β = 0.195, P = 0.001), as well as effects on feelings of loneliness (β = 0.126, P = 0.005) and sleep quality (β = 0.185, P = 0.001). Additionally, feelings of loneliness (β = 0.108, P = 0.186) and sleep quality (β = -0.464, P = 0.001) directly impacted SI. The model accounted for a significant portion of the variance in suicidal thoughts (R² = 0.316). Crucially, the mediation effect of loneliness in the relationship between trauma and SI was not statistically significant (β = 0.108, P = 0.186). Conclusions: The results suggest that poor sleep quality may exacerbate the negative effects of childhood trauma, thereby increasing the risk of suicidal thoughts in adolescents. In contrast, feelings of loneliness did not significantly mediate this relationship, contrary to expectation. Given the cross-sectional design, these findings reflect correlational and predictive relationships only and cannot establish a definitive causal relationship between the variables. This non-significant finding necessitates deeper discussion considering the study’s limitations, including the sampling method.