We thank Dr. McCall for his comments1 and support of our work.2 We wish to clarify that when we referred to previous work having “not elucidated the psychological mechanisms which underpin” the relationship between sleep problems and suicide, we did not intend to suggest that no work had been conducted in this area. Rather, our perspective is that a comprehensive and testable account of mediating psychological processes remains to be fully articulated. We are very familiar with the important work of Dr McCall and colleagues3–6 and agree that longitudinal and interventional studies are the next logical steps.
This was not an industry supported study. The authors have indicated no financial conflicts of interest.
Littlewood DL, Gooding PA, Panagioti M, Kyle SD. Investigating psychological mechanisms in relation to sleep problems and suicide. J Clin Sleep Med 2016;12(6):931.
The authors thank the Medical Research Council and the University of Manchester Presidential Scholar Award for funding the PhD research of the first author.
McCall WV, author. Mediators between sleep problems and suicide: response to Littlewood et al. J Clin Sleep Med. 2016;12:929.
Littlewood DL, Gooding PA, Panagioti M, et al., authors. Nightmares and suicide in posttraumatic stress disorder: the mediating role of defeat, entrapment, and hopelessness. J Clin Sleep Med. 2016;12:393–9. [PubMed]
McCall WV, Batson N, Webster M, et al., authors. Nightmares and dysfunctional beliefs about sleep mediate the effect of insomnia symptoms on suicidal ideation. J Clin Sleep Med. 2013;9:135–40. [PubMed Central][PubMed]
McCall WV, Black CG, authors. The link between suicide and insomnia: theoretical mechanisms. Curr Psychiatr Rep. 2013;15:389.
McCall WV, Benca RM, Rosenquist PB, et al., authors. A multi-site randomized clinical trial to reduce suicidal ideation in suicidal adult outpatients with major depressive disorder: development of a methodology to enhance safety. Clin Trials. 2015;12:189–98. [PubMed]
McCall WV, author. Insomnia is a risk factor for suicide - what are the next steps? Sleep. 2011;34:1149–50. [PubMed Central][PubMed]