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Worry-related sleep problems and suicidal thoughts and behaviors among adolescents in 88 low-, middle-, and high-income countries: an examination of individual- and country-level factors

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Abstract

A strong association between sleep problems and suicidal thoughts and behaviors (STBs) has been demonstrated in high-income countries. The sleep-STB relationship, however, is minimally understood among youth in low and middle-incomes countries. There also is a limited understanding of how individual- (i.e., age, sex) and country-level (i.e., economic inequality, economic quality) factors may moderate the magnitude of the sleep-STB association among youth. Data were analyzed from the cross-national Global School-based Health Survey 2003–2017, which assessed a range of health behaviors among school-enrolled adolescents aged 11–18 years from 88 low-, lower-middle, upper-middle, and high-income countries. Multilevel models were used to examine the influence of individual- and country-level factors on the association between past-year worry-related sleep problems and past-year suicide ideation, suicide plans, and suicide attempts. Worry-related sleep problems were significantly associated with suicide ideation, plans, and attempts. Adolescent sex, country economic quality (income group designation), and country economic inequality moderated the sleep-STB association, but age did not. The sleep-STB relationship was stronger for males and across macroeconomic indices, the relationship was generally strongest among upper-middle income countries (economic quality) and countries with a big income gap (economic inequality). When examining how individual-level factors differentially affected the sleep-STB relationship within economic quality (income group designation), the effects were driven by older adolescents in high-income countries for suicide ideation and suicide plans. Study findings suggest an important role for global macroeconomic factors, for males, and older adolescents in high-income countries in the sleep-STB relationship. Future directions include expanding worldwide coverage of countries, assessing a wider range of sleep problems, and longitudinal work to understand potential mechanisms in the sleep-STB relationship.

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Availability of data and material

The GSHS datasets publicly available via the World Health Organization.

Code availability

Analyses were performed in SAS 9.4.

Notes

  1. Consistent with prior GSHS work (e.g., Dema et al. [36], Uddin et al. [3]), all currently available GSHS datasets were used to maximize the coverage of LMICs. This approach was selected so as not to decrease the representation of countries, particularly those in the African Region (e.g., Tunisia, Uganda), where data would otherwise be unavailable.

  2. The GSHS provided a range of age responses, depending on the survey year. For example, more recent surveys provided the following age options: 11 years old or younger, 12 years old, 13 years old, 14 years old, 15 years old, 16 years old, 17 years old, 18 years old or older while older surveys provided the following age options: 11 years old or younger, 12 years old, 13 years old, 14 years old, 15 years old, 16 years old or older. It is highly unlikely that children younger than age 11 or older than age 18 were included in the study, however, these are the age options that GSHS provided respondents. Due to these differing age response options across the 2003–2017 GSHS, ages 15 to 18 years old or older were collapsed into one bin (i.e., 15 years old or older) to aid in cross-national comparison. The GSHS collapsed 11 years or younger into one bin by default.

  3. Due to the small size of some WHO regions (e.g., European Region has two countries), we elected not to examine our results by region. Instead, we chose to examine cross-national indices of economic quality and inequality as opposed to WHO region. The sleep-STB relationship is reported by country in Figs. 1–3.

  4. Relative equality and adequate equality countries did not significantly differ on SI (χ2 = 3.75, p = 0.053, φ = 0.046), SP (χ2 = .16, p = 0.692, φ = 0.046) or worry-related sleep problems (t = −0.20, p = 0.842). These countries did differ on SA (χ2 = 31.93, p < 0.0001), but the effect size was small (φ = 0.014) and weighted percentages were similar (16.1% in countries with relative equality vs. 10.4% in countries with adequate equality). Despite this difference, we retained the combined relative/adequate equality group as we did not want to extrapolate study results from a group with only three countries (relative equality).

Abbreviations

CBT-I:

Cognitive Behavioral Therapy for Insomnia

GSHS:

Global School-based Student Health Survey

HIC:

High-income countries

LMIC:

Low- and middle-income countries

LIC:

Low-income countries

MIC:

Middle-income countries

SI:

Suicide ideation

SP:

Suicide plan

SA:

Suicide attempt

STBs:

Suicidal thoughts and behaviors

UMIC:

Upper-middle income countries

WHO:

World Health Organization

References

  1. World Health Organization (2019) Suicide prevention. https://www.who.int/mental_health/suicide-prevention/en/

  2. Tang JJ, Yu Y, Wilcox HC, Kang C, Wang K, Wang C, Wu Y, Chen R (2020) Global risks of suicidal behaviours and being bullied and their association in adolescents: school-based health survey in 83 countries. EClinicalMedicine 19:100253

    Article  Google Scholar 

  3. Uddin R, Burton NW, Maple M, Khan SR, Khan A (2019) Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study. Lancet Child Adolesc Health 3(4):223–233

    Article  Google Scholar 

  4. Biswas T, Scott JG, Munir K, Renzaho A, Rawal LB, Baxter J, Mamun A (2020) Global variation in the prevalence of suicidal ideation, anxiety and their correlates among adolescents: a population based study of 82 countries. EClinicalMedicine 24:100395

    Article  Google Scholar 

  5. Kraemer HC, Kazdin AE, Offord DR, Kessler RC, Jensen PS, Kupfer DJ (1997) Coming to terms with the terms of risk. Arch Gen Psychiatry 54(4):337–343

    Article  CAS  Google Scholar 

  6. World Health Organization (2019) Suicide in the world: Global health estimates

  7. Carskadon MA, Acebo C, Jenni OG (2004) Regulation of adolescent sleep. Ann N Y Acad Sci 1021:276–291

    Article  Google Scholar 

  8. Winsler A, Deutsch A, Vorona RD, Payne PA, Szklo-Coxe M (2015) Sleepless in Fairfax: the difference one more hour of sleep can make for teen hopelessness, suicidal ideation, and substance use. J Youth Adolesc 44(2):362–378

    Article  Google Scholar 

  9. Wong MM, Brower KJ, Nigg JT, Zucker RA (2010) Childhood sleep problems, response inhibition, and alcohol and drug outcomes in adolescence and young adulthood. Alcohol Clin Exp Res 34(6):1033–1044

    Article  Google Scholar 

  10. McGlinchey EL, Harvey AG (2015) Risk behaviors and negative health outcomes for adolescents with late bedtimes. J Youth Adolesc 44(2):478–488

    Article  Google Scholar 

  11. Kearns JC, Coppersmith DD, Santee AC, Insel C, Pigeon WR, Glenn CR (2020) Sleep problems and suicide risk in youth: a systematic review, developmental framework, and implications for hospital treatment. Gen Hosp Psychiatry 63:141–151

    Article  Google Scholar 

  12. Crowley SJ, Wolfson AR, Tarokh L, Carskadon MA (2018) An update on adolescent sleep: new evidence informing the perfect storm model. J Adolesc 67:55–65

    Article  Google Scholar 

  13. Tarokh L, Saletin JM, Carskadon MA (2016) Sleep in adolescence: physiology, cognition and mental health. Neurosci Biobehav Rev 70:182

    Article  Google Scholar 

  14. Littlewood DL, Kyle SD, Carter L-A, Peters S, Pratt D, Gooding P (2019) Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study. Psychol Med 49(3):403–411

    Article  Google Scholar 

  15. Pigeon WR, Pinquart M, Conner K (2012) Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. J Clin Psychiatry 73(9):e1160–e1167

    Article  Google Scholar 

  16. Wong MM, Brower KJ (2012) The prospective relationship between sleep problems and suicidal behavior in the National Longitudinal Study of Adolescent Health. J Psychiatr Res 46(7):953–959

    Article  Google Scholar 

  17. Ribeiro JD, Pease JL, Gutierrez PM, Silva C, Bernert RA, Rudd MD, Joiner TE Jr (2012) Sleep problems outperform depression and hopelessness as cross-sectional and longitudinal predictors of suicidal ideation and behavior in young adults in the military. J Affect Disord 136(3):743–750

    Article  Google Scholar 

  18. Zuromski KL, Cero I, Witte TK (2017) Insomnia symptoms drive changes in suicide ideation: a latent difference score model of community adults over a brief interval. J Abnorm Psychol 126(6):739

    Article  Google Scholar 

  19. Sudak H, Maxim K, Carpenter M (2008) Suicide and stigma: a review of the literature and personal reflections. Acad Psychiatry 32(2):136–142

    Article  Google Scholar 

  20. Blake MJ, Sheeber LB, Youssef GJ, Raniti MB, Allen NB (2017) Systematic review and meta-analysis of adolescent cognitive–behavioral sleep interventions. Clin Child Fam Psychol Rev 20(3):227–249

    Article  Google Scholar 

  21. Werner-Seidler A, Johnston L, Christensen H (2018) Digitally-delivered cognitive-behavioural therapy for youth insomnia: a systematic review. Internet Interv 11:71–78

    Article  Google Scholar 

  22. Espie CA (2002) Insomnia: conceptual issues in the development, persistence, and treatment of sleep disorder in adults. Annu Rev Psychol 53(1):215–243

    Article  Google Scholar 

  23. Espie CA, Broomfield NM, MacMahon KM, Macphee LM, Taylor LM (2006) The attention–intention–effort pathway in the development of psychophysiologic insomnia: a theoretical review. Sleep Med Rev 10(4):215–245

    Article  Google Scholar 

  24. Harvey AG (2002) A cognitive model of insomnia. Behav Res Ther 40(8):869–893

    Article  CAS  Google Scholar 

  25. Edinger JD, Carney CE (2014) Overcoming insomnia: A cognitive-behavioral therapy approach, therapist guide. Oxford University Press, Oxford

    Book  Google Scholar 

  26. Dregan A, Lallukka T, Armstrong D (2013) Potential pathways from biopsychosocial risk factors to sleep loss due to worry: a population-based investigation. J Public Ment Health 12(1):43–50

    Article  Google Scholar 

  27. Harvey AG (2000) Pre-sleep cognitive activity: a comparison of sleep-onset insomniacs and good sleepers. Br J Clin Psychol 39(3):275–286

    Article  CAS  Google Scholar 

  28. Lund HG, Reider BD, Whiting AB, Prichard JR (2010) Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health 46(2):124–132

    Article  Google Scholar 

  29. Watts FN, Coyle K, East MP (1994) The contribution of worry to insomnia. Br J Clin Psychol 33(2):211–220

    Article  CAS  Google Scholar 

  30. Lallukka T, Dregan A, Armstrong D (2011) Comparison of a sleep item from the General Health Questionnaire-12 with the Jenkins Sleep Questionnaire as measures of sleep disturbance. J Epidemiol 21(6):474–480

    Article  Google Scholar 

  31. Liu X (2004) Sleep and adolescent suicidal behavior. Sleep 27(7):1351–1358

    Article  Google Scholar 

  32. Pengpid S, Peltzer K (2018) Vigorous physical activity, perceived stress, sleep and mental health among university students from 23 low-and middle-income countries. Int J Adolesc Med Health 32(2)

  33. Stranges S, Tigbe W, Gómez-Olivé FX, Thorogood M, Kandala N-B (2012) Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia. Sleep 35(8):1173–1181

    Article  Google Scholar 

  34. Kim HH-s, Chun J, (2020) Bullying victimization, school environment, and suicide ideation and plan: focusing on youth in low-and middle-income countries. J Adolesc Health 66(1):115–122

    Article  Google Scholar 

  35. Page RM, West JH (2011) Suicide ideation and psychosocial distress in sub-Saharan African youth. Am J Health Behav 35(2):129–141

    Article  Google Scholar 

  36. Dema T, Tripathy JP, Thinley S, Rani M, Dhendup T, Laxmeshwar C, Tenzin K, Gurung MS, Tshering T, Penjore T (2019) Suicidal ideation and attempt among school going adolescents in Bhutan–a secondary analysis of a global school-based student health survey in Bhutan 2016. BMC Public Health 19(1):1605

    Article  Google Scholar 

  37. Almansour AM, Siziya S (2017) Suicidal ideation and associated factors among school going adolescents in Swaziland. Afr Health Sci 17(4):1172–1177

    Article  Google Scholar 

  38. Smith L, Jackson SE, Vancampfort D, Jacob L, Firth J, Grabovac I, McDermott D, Yang L, López-Sánchez GF, Niederkrotenthaler T (2020) Sexual behavior and suicide attempts among adolescents aged 12–15 years from 38 countries: a global perspective. Psychiatry Res 287:112564

    Article  Google Scholar 

  39. Koyanagi A, Stubbs B, Oh H, Veronese N, Smith L, Haro JM, Vancampfort D (2019) Food insecurity (hunger) and suicide attempts among 179,771 adolescents attending school from 9 high-income, 31 middle-income, and 4 low-income countries: a cross-sectional study. J Affect Disord 248:91–98

    Article  Google Scholar 

  40. Adewuya AO, Oladipo EO (2019) Prevalence and associated factors for suicidal behaviours (ideation, planning, and attempt) among high school adolescents in Lagos, Nigeria. Eur Child Adolesc Psychiatry 29(11):1503–1512

    Article  Google Scholar 

  41. Pandey AR, Bista B, Dhungana RR, Aryal KK, Chalise B, Dhimal M (2019) Factors associated with suicidal ideation and suicidal attempts among adolescent students in Nepal: findings from Global School-based Students Health Survey. PLoS ONE 14(4):e0210383

    Article  CAS  Google Scholar 

  42. Brady D, Fullerton AS, Cross JM (2010) More than just nickels and dimes: A cross-national analysis of working poverty in affluent democracies. Soc Probl 57(4):559–585

    Article  Google Scholar 

  43. Bachmann S (2018) Epidemiology of suicide and the psychiatric perspective. Int J Environ Res Public Health 15(7):1425

    Article  Google Scholar 

  44. Kolves K, De Leo D (2014) Suicide rates in children aged 10–14 years worldwide: changes in the past two decades. Br J Psychiatry 205(4):283–285

    Article  Google Scholar 

  45. Cha CB, Franz PJ, Guzmán ME, Glenn CR, Kleiman EM, Nock MK (2018) Annual research review: suicide among youth—epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry 59(4):460–482

    Article  Google Scholar 

  46. Brent DA, Baugher M, Bridge J, Chen T, Chiappetta L (1999) Age-and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatry 38(12):1497–1505

    Article  CAS  Google Scholar 

  47. Bridge JA, Goldstein TR, Brent DA (2006) Adolescent suicide and suicidal behavior. J Child Psychol Psychiatry 47(3–4):372–394

    Article  Google Scholar 

  48. Lewinsohn PM, Rohde P, Seeley JR, Baldwin CL (2001) Gender differences in suicide attempts from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry 40(4):427–434

    Article  CAS  Google Scholar 

  49. Shah A (2012) Suicide rates: age-associated trends and their correlates. J Inj Violence Res 4(2):79

    Article  Google Scholar 

  50. Glenn CR, Kleiman EM, Kellerman J, Pollak O, Cha CB, Esposito EC, Porter AC, Wyman PA, Boatman AE (2020) Annual research review: a meta-analytic review of worldwide suicide rates in adolescents. J Child Psychol Psychiatry 61(3):294–308

    Article  Google Scholar 

  51. Haw C, Hawton K, Gunnell D, Platt S (2015) Economic recession and suicidal behaviour: possible mechanisms and ameliorating factors. Int J Soc Psychiatry 61(1):73–81

    Article  Google Scholar 

  52. Bantjes J, Iemmi V, Coast E, Channer K, Leone T, McDaid D, Palfreyman A, Stephens B, Lund C (2016) Poverty and suicide research in low-and middle-income countries: systematic mapping of literature published in English and a proposed research agenda. Global Mental Health 3:e32

    Article  CAS  Google Scholar 

  53. Iemmi V, Bantjes J, Coast E, Channer K, Leone T, McDaid D, Palfreyman A, Stephens B, Lund C (2016) Suicide and poverty in low-income and middle-income countries: a systematic review. Lancet Psychiatry 3(8):774–783

    Article  Google Scholar 

  54. Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, De Girolamo G, De Graaf R, Demyttenaere K, Hu C, Iwata N (2011) Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 9(1):1–16

    Article  Google Scholar 

  55. Ayuso-Mateos JL, Nuevo R, Verdes E, Naidoo N, Chatterji S (2010) From depressive symptoms to depressive disorders: the relevance of thresholds. Br J Psychiatry 196(5):365–371

    Article  Google Scholar 

  56. Stein DJ, Chiu WT, Hwang I, Kessler RC, Sampson N, Alonso J, Borges G, Bromet E, Bruffaerts R, De Girolamo G (2010) Cross-national analysis of the associations between traumatic events and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS ONE 5(5):e10574

    Article  Google Scholar 

  57. Burns JK, Tomita A, Kapadia AS (2014) Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality. Int J Soc Psychiatry 60(2):185–196

    Article  Google Scholar 

  58. Yu S (2018) Uncovering the hidden impacts of inequality on mental health: a global study. Transl Psychiatry 8(1):1–10

    Article  Google Scholar 

  59. Johnson SL, Wibbels E, Wilkinson R (2015) Economic inequality is related to cross-national prevalence of psychotic symptoms. Soc Psychiatry Psychiatr Epidemiol 50(12):1799–1807

    Article  Google Scholar 

  60. Pickett KE, Wilkinson RG (2015) Income inequality and health: a causal review. Soc Sci Med 128:316–326

    Article  Google Scholar 

  61. Chibanda D, Mesu P, Kajawu L, Cowan F, Araya R, Abas MA (2011) Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC Public Health 11(1):1–10

    Article  Google Scholar 

  62. Youth Risk Behavior Survey Questionnaire (2019) www.cdc.gov/yrbs. Accessed 1 November 2020

  63. Becker AE, Roberts AL, Perloe A, Bainivualiku A, Richards LK, Gilman SE, Striegel-Moore RH (2010) Youth health-risk behavior assessment in Fiji: the reliability of Global School-based Student Health Survey content adapted for ethnic Fijian girls. Ethn Health 15(2):181–197

    Article  Google Scholar 

  64. Wang Q, Liu Y, Mati K (2020) Bully victimization is a correlate of sleep loss over worry (SLOW) among adolescents in four South-East Asian countries. Sleep Med 69:179–188

    Article  Google Scholar 

  65. Harvey AG (2005) Unwanted intrusive thoughts in insomnia. In: Clark DA (ed) Intrusive thoughts in clinical disorders: theory, research, and treatment. Guilford Press, New York, pp 88–118

    Google Scholar 

  66. Harvey AG, Tang NK, Browning L (2005) Cognitive approaches to insomnia. Clin Psychol Rev 25(5):593–611

    Article  Google Scholar 

  67. Miranda-Mendizabal A, Castellví P, Parés-Badell O, Alayo I, Almenara J, Alonso I, Blasco MJ, Cebria A, Gabilondo A, Gili M (2019) Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. Int J Public Health 64(2):265–283

    Article  Google Scholar 

  68. Group WB (2017) New country classifications by income level: 2017–2018. https://blogs.worldbank.org/opendata/new-country-classifications-income-level-2017-2018

  69. World Bank Group (2020) Why use GNI per capita to classify economies into income groupings? https://datahelpdesk.worldbank.org/knowledgebase/articles/378831-why-use-gni-per-capita-to-classify-economies-into. Accessed 10 November 2020

  70. Teng F, He J, Pan X, Zhang C (2011) Metric of carbon equity: Carbon Gini index based on historical cumulative emission per capita. Adv Clim Chang Res 2(3):134–140

    Article  Google Scholar 

  71. SAS S, Guide SUs (2014) SAS Institute, Cary, NC

  72. Salk RH, Hyde JS, Abramson LY (2017) Gender differences in depression in representative national samples: meta-analyses of diagnoses and symptoms. Psychol Bull 143(8):783

    Article  Google Scholar 

  73. Franko DL, Keel PK (2006) Suicidality in eating disorders: occurrence, correlates, and clinical implications. Clin Psychol Rev 26(6):769–782

    Article  Google Scholar 

  74. Vijayakumar L (2015) Suicide in women. Indian J Psychiatry 57(Suppl 2):S233

    Article  Google Scholar 

  75. Cluver L, Orkin M, Boyes ME, Sherr L (2015) Child and adolescent suicide attempts, suicidal behavior, and adverse childhood experiences in South Africa: a prospective study. J Adolesc Health 57(1):52–59

    Article  Google Scholar 

  76. Anum A, Adjorlolo S, Kugbey N (2019) Depressive symptomatology in adolescents in Ghana: examination of psychometric properties of the Patient Health Questionnaire-9. J Affect Disord 256:213–218

    Article  Google Scholar 

  77. Salamanca-Buentello F, Seeman MV, Daar AS, Upshur RE (2020) The ethical, social, and cultural dimensions of screening for mental health in children and adolescents of the developing world. PLoS ONE 15(8):e0237853

    Article  CAS  Google Scholar 

  78. Katz C, Bolton SL, Katz LY, Isaak C, Tilston-Jones T, Sareen J, Team SCSP (2013) A systematic review of school-based suicide prevention programs. Depression Anxiety 30(10):1030–1045

    Google Scholar 

  79. Griffiths F, Lindenmeyer A, Powell J, Lowe P, Thorogood M (2006) Why are health care interventions delivered over the internet? A systematic review of the published literature. J Med Internet Res 8(2):e10

    Article  Google Scholar 

  80. Bastien CH, Vallières A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2(4):297–307

    Article  Google Scholar 

  81. Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  Google Scholar 

  82. Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S (2011) The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 168(12):1266–1277

    Article  Google Scholar 

  83. Reynolds WM (1988) SIQ, Suicidal ideation questionnaire: Professional manual. Psychol Assess Resour 10(3)

  84. Wilkinson P, Kelvin R, Roberts C, Dubicka B, Goodyer I (2011) Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Am J Psychiatry 168(5):495–501

    Article  Google Scholar 

  85. King CD, Joyce VW, Nash CC, Buonopane RJ, Black JM, Zuromski KL, Millner AJ (2021) Fear of sleep and sleep quality mediate the relationship between trauma exposure and suicide attempt in adolescents. J Psychiatr Res 135:243–247

    Article  Google Scholar 

  86. Associate Minister of Health (2006) New Zealand suicide prevention strategy 2006–2016. Associate Minister of Health, Wellington, New Zealand

  87. Guzmán E, Cha C, Ribeiro J, Franklin J (2019) Suicide risk around the world: a meta-analysis of longitudinal studies. Soc Psychiatry Psychiatr Epidemiol 54(12):1459–1470

    Article  Google Scholar 

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Acknowledgements

The authors would like to thank the World Health Organization and United States Centers for Disease Control for making the GSHS datasets publicly available for analysis.

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Authors and Affiliations

  1. Department of Psychology, University of Rochester, 180 Meliora Hall, Box 270266, Rochester, NY, 14627, USA

    Jaclyn C. Kearns

  2. Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA

    Julie A. Kittel

  3. Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

    Paige Schlagbaum

  4. VA Center for Excellence for Suicide Prevention, Finger Lakes Healthcare System, Canandaigua, NY, USA

    Wilfred R. Pigeon

  5. Sleep and Neurophysiology Research Lab, University of Rochester Medical Center Rochester, Rochester, NY, USA

    Wilfred R. Pigeon

  6. Department of Psychology, Old Dominion University, Norfolk, VA, USA

    Catherine R. Glenn

  7. Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA

    Catherine R. Glenn

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  1. Jaclyn C. Kearns
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  4. Wilfred R. Pigeon
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Contributions

Jaclyn C. Kearns and Catherine R. Glenn contributed to the manuscript conceptualization. Data preparation, data analysis, and draft of the results were performed by Julie A. Kittel. Paige Schlagbaum assisted with the literature review. Wilfred R. Pigeon provided expert commentary on the conceptualization and interpretation of data. The first draft of the manuscript was written by Jaclyn C. Kearns and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Kearns, J.C., Kittel, J.A., Schlagbaum, P. et al. Worry-related sleep problems and suicidal thoughts and behaviors among adolescents in 88 low-, middle-, and high-income countries: an examination of individual- and country-level factors. Eur Child Adolesc Psychiatry 31, 1995–2011 (2022). https://doi.org/10.1007/s00787-021-01838-y

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