PhD Studentship: The Role of Sleep Disturbances and Psychological Processes in Self-injury: Implications for Suicide Prevention

There has been considerable growth in research seeking to understand the role of non-suicidal self-injury (NSSI) in predicting future suicidal behaviour (Grandclerc et al., 2016) given NSSI and suicidal behaviour frequently co-occur (O’Connor et al., 2018), though it is acknowledged that establishing temporal relationships between constructs is necessary as it is not yet understood. It is estimated that 6% of the population engage in NSSI (Plener et al., 2016). However, given the often-covert nature of such behaviours (Peel-Wainwright et al., 2021), and recognition that many individuals who self-harm do not contact medical or social services afterwards (McManus et al., 2019), it is accepted that prevalence rates are likely to be considerably higher; particularly as recent reports indicate a ‘major rise’ in NSSI in England (Mayor, 2019). There are, however, groups of individuals who are considered to experience significantly higher risk of engaging in NSSI. Thus, research seeking to identify those at higher risk of engaging in NSSI and understand the psychological processes involved with such behaviours is imperative to contribute to reducing inequalities in self-harm and suicidal behaviour.

Sleep disturbances have received growing attention as a salient risk factor for suicide, with both cross-sectional (Harris et al., 2020), and longitudinal associations evidenced (Liu et all., 2021). A small body of research suggests that sleep disturbances are associated with, and prospectively predict NSSI (Khazaie et al., 2021). However, the degree to which sleep disturbances may predict or influence short-term NSSI risk is less clear. Clinical assessments of suicide risk are often focused on determining risk in the near future, thus, greater precision in determining the immediacy of the risk conferred from sleep disturbances is crucial. Currently, our understanding of the specific sleep parameters contributing to the sleep-suicide relationship and the psychological processes underpinning it, require further exploration. E.g., recent research has indicated that sleep irregularity may play a role in subsequent NSSI (Burke et al., 2022). Alike sleep, suicide may reflect a ‘circadian pattern’ (Perlis et al., 2022), in that the temporal pattern of suicide shows that although the frequency of suicides is reduced at night, the risk (given the proportion of people expected to be awake) is considerably higher. The research in this area is currently developing, thus, this project proposes exploration of sleep disturbances and NSSI in the general population to broadly understand these proposed relationships and processes.

This project proposes the use of a multiple/mixed methods design, and will involve i) conducting a systematic/scoping review of sleep disturbances as proximal and distal predictors of NSSI; ii) observational association-based study of sleep-suicidality measures; iii) exploratory qualitative study exploring lived experience perspectives and underpinning psychological processes involved in the sleep-suicidality relationship; and iv) use Ecological Momentary Assessment (EMA) methods (including actigraphy and psychometrics) to assess associations at multiple time points in a 24-hour period over a number of days.

Entry requirements

Applicants should have, or expect to achieve, at least a 2:1 Honours degree (or equivalent) in Psychology or other relevant Allied Health Professional subject. A relevant Master’s degree, and/or relevant research experience, will be an advantage. The candidate should hold strong communication skills within complex environments and have an interest in psychological understandings of clinical presentations in mental health.

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