The role of sleep disturbance in the associations of borderline personality disorder symptom severity to nonsuicidal self-injury and suicide risk among patients with substance use disorders

This study sought to examine the explanatory role of sleep disturbance in the associations of borderline personality disorder (BPD) symptom severity to nonsuicidal self-injury (NSSI) and suicide risk within an at-risk sample of patients with substance use disorders (SUDs), as well as whether emotion regulation (ER) difficulties account for significant variance in the relations of sleep disturbance to NSSI and suicide risk. Patients in a residential SUD treatment facility (N = 166) completed a diagnostic interview and questionnaires. Results revealed significant indirect relations of BPD symptom severity to both NSSI frequency and suicide risk through sleep disturbance. In addition, ER difficulties accounted for significant variance in the relation of sleep disturbance to NSSI frequency (but not suicide risk). Findings highlight the relevance of sleep disturbance to the association between BPD symptoms and both suicidal and nonsuicidal self-injury and suggest the potential utility of interventions aimed at improving sleep quality among individuals with BPD pathology.