Affective lability and pre-sleep social-media use in relation to adolescent suicide attempts

This study aimed to examine the relationship between affective lability, pre-sleep social-media engagement, and suicide-attempt vulnerability among adolescents.

This cross-sectional study included 159 adolescents aged 10-17 years, of whom 66 had a suicide-attempt history, and 93 controls. Affective lability was measured using the Children's Affective Lability Scale, and pre-sleep social-media engagement was assessed with two investigator-developed items on duration of social-media use and difficulty disengaging before sleep. Mann-Whitney U tests and binary logistic regression models adjusted for age, sex, and sexual-minority status were used to identify group differences and predictors of suicide-attempt history.

Adolescents with a suicide-attempt history showed higher affective lability (median = 36.5 vs. 12) and greater pre-sleep social-media engagement, reflected in both longer time spent on social media before sleep (median = 60 vs. 30 min, p = .016) and greater difficulty disengaging at bedtime (median = 5 vs. 4, p = .004). In regression analyses adjusting for age, sex, and sexual-minority status, both affective lability (OR = 1.05, 95% CI [1.03-1.08], p < .001) and pre-sleep social-media engagement (OR = 1.71, 95% CI [1.06-2.76], p = .029) independently predicted suicide-attempt history. Sexual-minority status further elevated risk (OR = 9.33, 95% CI [3.95-22.01], p < .001). The full model demonstrated strong discrimination (AUC = 0.861, 95% CI [0.802-0.920]) and good calibration.

Findings indicate that affective lability and pre-sleep social-media engagement each uniquely predict suicide-attempt vulnerability among adolescents, underscoring their relevance as potential markers of suicide risk.