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Oh SY, Meaklim H, Nicholas CL, Cunnington D, Schenker M, Patrick CJ, Windred D, Phillips LJ. Perfect Enough to Sleep? Perfectionism and Actigraphy-Determined Markers of Insomnia. Behav Sleep Med 2024; 22:709-724. [PMID: 38785108 DOI: 10.1080/15402002.2024.2355476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVES Perfectionism is an important factor in insomnia development and maintenance. Previous studies exploring the relationship between perfectionism and insomnia have predominantly relied on self-reported sleep measures. Therefore, this study sought to assess whether actigraphy-measured sleep parameters were associated with perfectionism. METHODS Sixty adults (85% females, mean age 30.18 ± 11.01 years) were sampled from the Australian general population. Actigraphy-derived objective sleep measures, subjective sleep diary measures, the Frost Multidimensional Perfectionism Scale (FMPS), Hewitt-Flett Multidimensional Perfectionism Scale (HFMPS) and Depression, Anxiety and Stress Scale 21 (DASS-21) were collected. RESULTS High perfectionism levels were associated with poor sleep, but these relationships differed between objective and subjective measures. Perfectionism via FMPS total score and subscales of Concern over Mistakes, Doubts about Actions, Personal Standards and Self-oriented Perfectionism correlated with subjective sleep onset latency and sleep efficiency with moderate effects (r = .26 to .88). In contrast, perfectionism via HFMPS total score and subscales of Socially Prescribed Perfectionism and Parental Expectations predicted objective sleep onset latency and sleep efficiency. Additionally, stress mediated the relationships between objective sleep efficiency and Concern over Mistakes and Doubts about Actions. CONCLUSIONS Perfectionism demonstrated stronger associations with subjective than objective sleep measures. Higher Parental Expectations and Socially Prescribed Perfectionism may increase one's vulnerability to objectively measured poor sleep. Therefore, perfectionism may be important in preventing and treating insomnia.
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Affiliation(s)
- Susie Y Oh
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
- Turner Institute for Brain and Mental Health, Monash University Healthy Sleep Clinic, Monash University, Clayton, Australia
| | - Hailey Meaklim
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
- Institute for Breathing and Sleep, Austin Health, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | | | - Maya Schenker
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Cameron J Patrick
- Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
| | - Daniel Windred
- Turner Institute for Brain and Mental Health, Monash University Healthy Sleep Clinic, Monash University, Clayton, Australia
| | - Lisa J Phillips
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
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Küskens A, Stricker J, Hertrampf LS, Pietrowsky R, Gieselmann A. Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study. J Clin Sleep Med 2024; 20:433-443. [PMID: 37942932 PMCID: PMC11019203 DOI: 10.5664/jcsm.10910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/10/2023]
Abstract
STUDY OBJECTIVES Perfectionism is considered a predisposing and maintaining factor for insomnia disorder. However, previous studies were predominantly based on retrospective self-reports of sleep and have yielded mixed results. Here, we investigated associations between perfectionism, daily stress levels, pre-sleep arousal, and actigraphic and sleep diary-derived sleep in insomnia using an experience sampling design. METHODS Individuals with insomnia (n = 63) reported their trait perfectionism levels and completed assessments on seven consecutive days. Momentary stress levels were reported on mobile phones at three semirandom time points each day. Presleep arousal levels were rated each morning for the previous night. Sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency were assessed prospectively using actigraphic watches and sleep diaries. RESULTS Perfectionism dimensions and daily stress levels did not predict self-reported or actigraphic sleep parameters. Higher levels of somatic and cognitive presleep arousal were robustly associated with indicators of poorer same-night sleep. The concern over mistakes and doubts dimension of perfectionism interacted with cognitive presleep arousal in predicting self-reported sleep parameters. In the presence of higher presleep arousal, participants with high concern over mistakes and doubts experienced shorter self-reported total sleep time and lower sleep efficiency (both Ps < .01) than on days with lower cognitive arousal. CONCLUSIONS Taken together, our results did not indicate an impact of heightened perfectionism levels on sleep in individuals with insomnia, based on prospective sleep assessments. However, our findings provide further evidence for the role of somatic and cognitive presleep arousal, potentially interacting with perfectionism, in the perpetuation of insomnia symptoms. CITATION Küskens A, Stricker J, Hertrampf LS, Pietrowsky R, Gieselmann A. Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study. J Clin Sleep Med. 2024;20(3):433-443.
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Affiliation(s)
- Anna Küskens
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Johannes Stricker
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Luca Stefan Hertrampf
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Annika Gieselmann
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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3
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Steinmetz L, Simon L, Feige B, Riemann D, Akram U, Crawford MR, Johann AF, Spiegelhalder K. Adherence to sleep restriction therapy - An evaluation of existing measures. J Sleep Res 2023; 32:e13975. [PMID: 37402605 DOI: 10.1111/jsr.13975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 07/06/2023]
Abstract
Sleep restriction, a key element of cognitive behavioural therapy for insomnia, involves considerable behavioural changes in patients' lives, leading to side-effects like increased daytime sleepiness. Studies on sleep restriction rarely report adherence, and when assessed it is often limited to the average number of therapy sessions attended. This study aims to systematically evaluate different measures of adherence to cognitive behavioural therapy for insomnia and their relationship with treatment outcome. This is a secondary analysis of data from a randomized controlled trial investigating cognitive behavioural therapy for insomnia (Johann et al. (2020) Journal of Sleep Research, 29, e13102). The sample included 23 patients diagnosed with insomnia according to DSM-5 criteria who underwent 8 weeks of cognitive behavioural therapy for insomnia. The following adherence measures based on sleep diary data were used: number of sessions completed; deviations from agreed time in bed; average percentage of patients deviating from bedtime by 15, 30 or 60 min; variability of bedtime and wake-up time; change in time in bed from pre- to post-assessment. Treatment outcome was assessed using the Insomnia Severity Index. Multiple regression models were employed, and insomnia severity was controlled for. Results showed that none of the adherence measures predict insomnia severity. Baseline insomnia severity, dysfunctional thoughts and attitudes about sleep, depression or perfectionism did not predict adherence. The limited variance in the outcome parameter due to most patients benefiting from treatment and the small sample size may explain these findings. Additionally, using objective measures like actigraphy could provide a better understanding of adherence behaviour. Lastly, the presence of perfectionism in patients with insomnia may have mitigated adherence problems in this study.
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Affiliation(s)
- Lisa Steinmetz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Laura Simon
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Center for Basics in NeuroModulation (NeuroModulBasics), University of Freiburg, Freiburg, Germany
| | - Umair Akram
- School of Psychology, University of Lincoln, Lincoln, UK
| | - Megan R Crawford
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Institute of Medical Psychology and Medical Sociology, University of Freiburg, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
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Roy J, Godin R, Gaudreault P, Forest G. The relationship between sleep, perfectionistic strivings, perfectionistic concerns, and academic and sports performance in young athletes. Chronobiol Int 2023; 40:1500-1514. [PMID: 37919967 DOI: 10.1080/07420528.2023.2273828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
Perfectionism is associated with sleep as well as with academic and sports performance. Given the importance of sleep for performance and the sleep changes that occur during adolescence, the present study aimed to explore the relationship between sleep, two dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns), with academic and sports performance in young athletes. The occurrence of perfectionistic strivings was identified as a tendency to set high personal standards for oneself, while the occurrence of perfectionistic concerns was identified as a tendency to feel pressure to be perfect and have concerns about imperfections. A total of 32 athletes aged 13 to 16 years old participated in this study. Perfectionism, sleep, and course grades were measured at the end of the school year. Sleep was measured by actigraphy, and sports performance improvement was obtained by comparing individual performance at the beginning and the end of the school year. The moderating effect of both dimensions of perfectionism on the relationships between sleep and academic and sports performance improvement was measured. First, results showed no significant relationship between sleep and academic/sports performance. Further analyses revealed that perfectionistic strivings moderated the relationship between certain aspects of sleep with academic and sports performance improvement. Delayed and suboptimal sleep habits were associated with lower academic and sports performance improvement when low levels of perfectionistic strivings were present. Results with perfectionistic concerns showed that this dimension did not moderate the relationship between sleep and academic and sports performance improvement. This study supports the notion that high levels of perfectionistic strivings in young athletes may mitigate the adverse effects of poor sleep habits in young athletes.
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Affiliation(s)
- Jonathan Roy
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Roxanne Godin
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Pascale Gaudreault
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Geneviève Forest
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Canada
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Dikeos D, Wichniak A, Ktonas PY, Mikoteit T, Crönlein T, Eckert A, Kopřivová J, Ntafouli M, Spiegelhalder K, Hatzinger M, Riemann D, Soldatos C. The potential of biomarkers for diagnosing insomnia: Consensus statement of the WFSBP Task Force on Sleep Disorders. World J Biol Psychiatry 2023; 24:614-642. [PMID: 36880792 DOI: 10.1080/15622975.2023.2171479] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/30/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Thus far, the diagnosis of insomnia is based on purely clinical criteria. Although a broad range of altered physiological parameters has been identified in insomniacs, the evidence to establish their diagnostic usefulness is very limited. Purpose of this WFSBP Task Force consensus paper is to systematically evaluate a series of biomarkers as potential diagnostic tools for insomnia. METHODS A newly created grading system was used for assessing the validity of various measurements in establishing the diagnosis of insomnia; these measurements originated from relevant studies selected and reviewed by experts. RESULTS The measurements with the highest diagnostic performance were those derived from psychometric instruments. Biological measurements which emerged as potentially useful diagnostic instruments were polysomnography-derived cyclic alternating pattern, actigraphy, and BDNF levels, followed by heart rate around sleep onset, deficient melatonin rhythm, and certain neuroimaging patterns (mainly for the activity of frontal and pre-frontal cortex, hippocampus and basal ganglia); yet, these findings need replication, as well as establishment of commonly accepted methodology and diagnostic cut-off points. Routine polysomnography, EEG spectral analysis, heart rate variability, skin conductance, thermoregulation, oxygen consumption, HPA axis, and inflammation indices were not shown to be of satisfactory diagnostic value. CONCLUSIONS Apart from psychometric instruments which are confirmed to be the gold standard in diagnosing insomnia, six biomarkers emerge as being potentially useful for this purpose.
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Affiliation(s)
- Dimitris Dikeos
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Adam Wichniak
- Third Department of Psychiatry, Sleep Medicine Center, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Periklis Y Ktonas
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Electrical and Computer Engineering, University of Houston, Houston, TX, USA
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn, Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Tatjana Crönlein
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Anne Eckert
- Neurobiology Lab for Brain Aging and Mental Health, Transfaculty Research Platform Molecular & Cognitive Neuroscience (MCN), University of Basel, Basel, Switzerland
| | - Jana Kopřivová
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Maria Ntafouli
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Martin Hatzinger
- Psychiatric Services Solothurn, Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Constantin Soldatos
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Johann AF, Feige B, Hertenstein E, Nissen C, Benz F, Steinmetz L, Baglioni C, Riemann D, Spiegelhalder K, Akram U. The Effects of Cognitive Behavioral Therapy for Insomnia on Multidimensional Perfectionism. Behav Ther 2023; 54:386-399. [PMID: 36858767 DOI: 10.1016/j.beth.2022.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 11/11/2022]
Abstract
Perfectionism is related to insomnia and objective markers of disturbed sleep. This study examined whether multidimensional perfectionism is related to dysfunctional beliefs about sleep, sleep-effort, pre-sleep arousal, and polysomnography-determined markers of sleep among individuals with insomnia. The effects of cognitive behavioral therapy for insomnia (CBT-I) on perfectionism was also examined. This was a secondary analysis of a randomized controlled trial on CBT-I. Forty-three insomnia patients were randomized to treatment (receiving CBT-I) or waitlist control groups. Sleep was recorded using polysomnography at baseline. Participants completed measures of perfectionism, dysfunctional beliefs about sleep, sleep-effort and pre-sleep arousal at baseline and posttreatment. Total perfectionism scores and doubts about action, concern over mistakes and personal standards were each significantly related to increased sleep effort, pre-sleep arousal and dysfunctional beliefs about sleep at baseline. Patients receiving treatment displayed increased total perfectionism scores posttreatment d = .49. In those receiving treatment, levels of organization d = .49 and parental expectations d = .47 were significantly increased posttreatment, relative to baseline. In line with the literature, our results confirm that perfectionism is related to insomnia. Here, insomnia was related to increased sleep effort, pre-sleep arousal and dysfunctional beliefs about sleep. The propensity to maintain a high standard of order and organization may be elevated following CBT-I, considering the treatment protocol expects patients to strictly adhere to a set of clearly defined rules. Levels of parental expectations may be increased following CBT-I since the patient-therapist-relationship may trigger implicit expectations in patients which are reminiscent of their relationship to their parents.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Umair Akram
- Sheffield Hallam University, University of Lincoln.
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7
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Habibi Asgarabad M, Doos Ali Vand H, Salehi Yegaei P, Hooman F, Ahmadi R, Baglioni C, Moradi S. The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia. Front Psychiatry 2023; 14:1162729. [PMID: 37077275 PMCID: PMC10106755 DOI: 10.3389/fpsyt.2023.1162729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023] Open
Abstract
Introduction Various transdiagnostic factors have been associated with insomnia severity. The current study aimed to predict insomnia severity based on a group of transdiagnostic factors including neuroticism, emotion regulation, perfectionism, psychological inflexibility, anxiety sensitivity, and repetitive negative thinking after controlling for depression/anxiety symptoms and demographic characteristics. Methods Two hundred patients with chronic insomnia disorder were recruited from a sleep disorder clinic. Participants completed the Insomnia Severity Index (ISI), Clinical Perfectionism Questionnaire (CPQ), Acceptance and Action Questionnaire-II (AAQ-II), Anxiety Sensitivity Index-3 (ASI-3), Repetitive Thinking Questionnaire (RTQ-10), Big Five Inventory (BFI-10), Emotion Regulation Questionnaire (ERQ), and Depression Anxiety Stress Scale (DASS-21). Results After controlling for the confounding variables (depression/anxiety symptoms and demographic characteristics), hierarchical multiple linear regression suggested the significant association of neuroticism (BFI), cognitive reappraisal (ERQ), personal standards (CPQ), evaluative concerns (CPQ), physical concerns (ASI), cognitive concerns (ASI), and repetitive negative thinking (RTQ) with insomnia severity. Discussion The findings support the role of transdiagnostic factors, especially physical concerns, repetitive negative thinking, and neuroticism in chronic insomnia. Future research using longitudinal designs is required to verify the causal status of transdiagnostic variables.
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Affiliation(s)
- Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Positive Youth Development Lab, Human Development & Family Sciences, Texas Tech University, Texas, TX, United States
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hoda Doos Ali Vand
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Salehi Yegaei
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
| | - Farzaneh Hooman
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Reza Ahmadi
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Shahram Moradi
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway
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Stricker J, Kröger L, Johann AF, Küskens A, Gieselmann A, Pietrowsky R. Multidimensional perfectionism and poor sleep: A meta-analysis of bivariate associations. Sleep Health 2022; 9:228-235. [PMID: 36400679 DOI: 10.1016/j.sleh.2022.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022]
Abstract
The link between perfectionism and poor sleep has been intensively debated, and previous studies on perfectionism-sleep associations have yielded mixed results. Recent research suggests that the two-dimensional perfectionism model, differentiating perfectionistic concerns (centered around concerns over imperfections) and perfectionistic strivings (centered around excessively high personal standards), may reconcile previously inconclusive findings, as both dimensions might be differentially related to sleep. Thus, to clarify the perfectionism-sleep link, this meta-analysis investigated relations of perfectionistic concerns and strivings with two well-established self-report measures of poor sleep. A systematic literature search yielded 55 effect sizes from 15 studies (N = 10,275) for inclusion in this meta-analysis. Perfectionistic concerns correlated positively with the Insomnia Severity Index (r+ = 0.221, 95% CI [0.102, 0.333], p = .004) and the Pittsburgh Sleep Quality Index (r+ = 0.248, 95% CI [0.172, 0.321], p < .001). Perfectionistic strivings correlated positively, albeit less strongly, with the Insomnia Severity Index (r+ = 0.114, 95% CI [0.039, 0.189], p = .010), but not significantly with the Pittsburgh Sleep Quality Index (r+ = 0.028, 95% CI [-0.026, 0.082], p = .247). These meta-analytic findings indicate that perfectionistic concerns are substantially linked to poor sleep, whereas the relation of perfectionistic strivings with sleep is less evident. Although the identified associations were less robust for perfectionistic strivings than for perfectionistic concerns, previously used labels like "positive" or "adaptive" appear inappropriate for perfectionistic strivings in the context of sleep.
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Affiliation(s)
- Johannes Stricker
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Lasse Kröger
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Küskens
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Annika Gieselmann
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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9
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Zhaoyang H, Feng C, Mei F, Jingjing L, Jiyang P. Negative perfectionism and sleep quality in Chinese international students under COVID-19 epidemic: A moderated mediation. Front Psychol 2022; 13:937816. [PMID: 35978773 PMCID: PMC9377220 DOI: 10.3389/fpsyg.2022.937816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study used a moderated mediation model to test the mediating effect of anxiety on the relationship between negative perfectionism and sleep quality and the moderating effect of COVID-19 epidemic risk perception during the COVID-19 pandemic in Chinese international students. Materials and methods A sample of 239 Chinese international students from the south of China, was surveyed with the Negative and Positive Perfectionism Scale, the Pittsburgh Sleep Quality Index, the General Anxiety Disorder Scale, and the COVID-19 Epidemic Risk Perception Inventory. Version 23.0 of SPSS and version 3.4 of PROCESS were used to perform the correlation analyses, mediation analysis, and moderated mediation analysis. Results (1) Negative perfectionism was significantly correlated with anxiety (r = 0.371, p < 0.01) and poor sleep quality (r = 0.291, p < 0.01). Anxiety was significantly correlated with poor sleep quality (r = 0.594, p < 0.01). (2) The mediating effect test showed that anxiety had a mediating effect between negative perfectionism and poor sleep quality (β = 0.157, p < 0.01). (3) Epidemic risk perception moderated the mediating effect of anxiety between negative perfectionism and poor sleep quality (β = 0.070, p < 0.01). Conclusion Negative perfectionism affected sleep quality indirectly through anxiety. In particular, COVID-19 epidemic risk perception moderated the relationship between anxiety and sleep quality, such that the association was stronger when the COVID-19 epidemic risk perception was high. These results provide a more comprehensive understanding of the negative link between negative perfectionism and poor sleep quality.
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Affiliation(s)
- Huang Zhaoyang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
- School of Management, Jinan University, Guangzhou, China
| | - Chen Feng
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Fan Mei
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lin Jingjing
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Pan Jiyang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
- *Correspondence: Pan Jiyang,
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Lindsay JAB, McGowan NM, King N, Rivera D, Li M, Byun J, Cunningham S, Saunders KEA, Duffy A. Psychological predictors of insomnia, anxiety and depression in university students: potential prevention targets. BJPsych Open 2022; 8:e86. [PMID: 35438069 PMCID: PMC9059737 DOI: 10.1192/bjo.2022.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/18/2022] [Accepted: 03/11/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Perfectionism, low self-esteem and external locus of control are psychological constructs linked to insomnia, anxiety and depression. Examining how these constructs impact mental health and serve as risk factors for the development of clinically significant symptoms may help direct psychological support resources and preventative measures for university students. AIMS To longitudinally examine associations between the aforementioned psychological constructs and symptoms of insomnia, anxiety and depression in a large representative sample of first-year university students. METHOD Electronic surveys including validated measures of the predictors and outcomes were emailed to all first-year undergraduate students at entry to a major Canadian university, and followed up on at conclusion of the academic year. RESULTS Compared with healthy sleepers, students screening positive for insomnia had lower self-esteem, higher self-evaluative perfectionism and increased external locus of control (all P < 0.001). Self-evaluative perfectionism (standardised β = 0.13, P < 0.01), self-esteem (β = -0.30, P < 0.001) and external locus of control (β = 0.07, P = 0.02) measured at entry were significantly associated with insomnia symptoms at follow-up. Insomnia symptoms at entry were strong predictors of symptoms of depression (β = 0.15, P < 0.001) and anxiety (β = 0.16, P < 0.001) at follow-up, even after controlling for baseline symptoms of those disorders. CONCLUSIONS Perfectionism, low self-esteem and external locus of control may predispose the development of insomnia symptoms in university students. In turn, insomnia symptoms appear to be robust predictors for depressive and anxiety symptoms. Sleep may be an important prevention target in university students.
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Affiliation(s)
| | | | - Nathan King
- Department of Public Health Sciences, Queen's University, Canada
| | - Daniel Rivera
- Department of Pharmacology and Toxicology, University of Toronto, Canada; and Department of Psychiatry, Queen's University, Canada
| | - Melanie Li
- Department of Biology, Queen's University, Canada
| | - Jin Byun
- Faculty of Health Sciences, Queen's University, Canada
| | - Simone Cunningham
- Department of Biomedical and Molecular Sciences, Queen's University, Canada
| | | | - Anne Duffy
- Department of Psychiatry, University of Oxford, UK; and Department of Psychiatry, Queen's University, Canada
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Stricker J, Kröger L, Küskens A, Gieselmann A, Pietrowsky R. No perfect sleep! A systematic review of the link between multidimensional perfectionism and sleep disturbance. J Sleep Res 2022; 31:e13548. [DOI: 10.1111/jsr.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Johannes Stricker
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Lasse Kröger
- Department of Psychology University of Trier Trier Germany
| | - Anna Küskens
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Annika Gieselmann
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
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Dautovich ND, Reid MP, Sabet SM, Ghose SM, Dzierzewski JM. Practice Does Not Make Perfect: The Tireless Pursuit of Achieving Perfect Sleep. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168523. [PMID: 34444273 PMCID: PMC8391445 DOI: 10.3390/ijerph18168523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022]
Abstract
Objective: Perfectionism is consistently identified as a predisposing and perpetuating factor for a wide range of mental health conditions and disorders. Given the unique cognitive, emotional, and physiological characteristics associated with perfectionism, perfection could have serious implications for a critical health behavior—our sleep. The current study examines the links between perfectionism and sleep health with the goal of identifying potential sleep-related beliefs as underlying mechanisms. Methods: Participants were 417 undergraduate students at a large, public university in the mid-Atlantic United States. Participants completed a one-time online survey with the Almost Perfect Scale-Revised, the Dysfunctional Beliefs about Sleep Scale, Perceived Competence Scale about their sleep, and the RU SATED sleep health scale. Results: A two-step structural equation modeling strategy was used. Greater perfectionism discrepancies predicted greater dysfunctional beliefs about sleep (β = 0.45) and worse perceived sleep competence (β = −0.33). Moreover, greater dysfunctional beliefs and worse perceived sleep competence predicted worse sleep health (β = −0.23 and 0.59, respectively). Dysfunctional beliefs and perceived sleep competence significantly mediated the effect of maladaptive perfectionism on sleep health (β = −0.302). Discussion: Dysfunctional beliefs and sleep competence emerged as mechanisms through which maladaptive perfectionism may function as a barrier to healthy sleep. Although prior research positions perfectionism as a primary correlate of poor sleep, the current study identifies the role of beliefs about sleep as the pathway from perfectionism to poorer sleep health. The results highlight the importance of addressing both maladaptive beliefs about sleep as well as beliefs about one’s own sleep competency with undergraduate students with higher maladaptive perfectionism.
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14
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Molnar DS, Janssen WF, Sirois FM. Sleeping perfectly? Trait perfectionism, perceived stress, and sleep quality. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Perfectionism and insomnia in adolescents: The role of vulnerability to stress and gender. J Adolesc 2020; 85:70-79. [PMID: 33069095 DOI: 10.1016/j.adolescence.2020.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/27/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Perfectionism is an often overlooked yet consistent construct related to insomnia in the scientific literature. Perfectionism and insomnia are both highly prevalent in adolescence. However, there is a dearth of research examining mechanisms linking perfectionism with insomnia, particularly in young people. The current study aimed to investigate whether vulnerability to stress, a factor common to both constructs, accounts for the relationship between perfectionism and insomnia symptoms in a sample of adolescents. METHODS 281 Australian participants (Mage = 16.53, SD = 1.91, range = 13-19 years, 78% female) completed questionnaires assessing perfectionism, vulnerability to stress and insomnia on one occasion. RESULTS Vulnerability to stress accounted for the relationship between self-oriented striving perfectionism, self-oriented critical perfectionism and insomnia symptom severity in females, but not males. Females reported higher self-oriented critical perfectionism, vulnerability to stress and insomnia severity, with a stronger relationship between vulnerability to stress and insomnia symptoms observed for females. CONCLUSIONS These results may partly explain the preponderance of insomnia in adolescent females. Possible implications for the prevention and treatment of insomnia in young people are discussed.
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Dysfunctional sleep-related cognition and anxiety mediate the relationship between multidimensional perfectionism and insomnia symptoms. Cogn Process 2019; 21:141-148. [PMID: 31655923 PMCID: PMC7002331 DOI: 10.1007/s10339-019-00937-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/22/2019] [Indexed: 10/27/2022]
Abstract
Perfectionism is one of several personality traits associated with insomnia. Whilst research has examined the relationships between perfectionism and insomnia, the mediating role of dysfunctional sleep-related cognition (i.e. sleep-related worry and dysfunctional beliefs about the biological attribution of and consequences of poor sleep) has yet to be examined. This study aimed to determine whether aspects of multidimensional perfectionism were related to increased reporting of insomnia symptoms. In addition, the potential mediating role of dysfunctional sleep-related cognition and anxiety symptoms was examined. Members of the general population (N = 624) completed the Dysfunctional Beliefs and Attitudes About Sleep Scale, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, and the Multidimensional Perfectionism Scale. The results showed that perfectionism dimensions, anxiety symptoms, and dysfunctional sleep-related cognition were significantly associated with insomnia symptoms. Regression-based mediation analyses further showed that both dysfunctional sleep-related cognition and anxiety significantly mediated the associations between insomnia symptoms and three perfectionism dimensions (i.e. doubts about action, parental expectations, and parental criticism). The experience of perfectionistic tendencies, anxiety, and dysfunctional sleep-related cognition may initiate behavioural strategies (e.g. daytime napping) when faced with an acute sleep problem. However, these strategies may serve to transition insomnia from an acute to a chronic condition.
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17
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Faber J, Schlarb AA. Picture perfect—how seeking perfection influences sleep and romantic relationships. SOMNOLOGIE 2018. [DOI: 10.1007/s11818-018-0172-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Schmidt RE, Courvoisier DS, Cullati S, Kraehenmann R, der Linden MV. Too Imperfect to Fall Asleep: Perfectionism, Pre-sleep Counterfactual Processing, and Insomnia. Front Psychol 2018; 9:1288. [PMID: 30131735 PMCID: PMC6090461 DOI: 10.3389/fpsyg.2018.01288] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 07/05/2018] [Indexed: 11/13/2022] Open
Abstract
Previous research suggests that certain dimensions of perfectionism are associated with insomnia. However, the exact processes whereby perfectionism may influence sleep have as yet remained unexplored. The present study tested the hypothesis that perfectionistic individuals are particularly prone to engage in counterfactual thinking and to experience counterfactual emotions (regret, shame, and guilt) at bedtime, which have been shown to impair sleep. One hundred eighty university students completed questionnaires on perfectionism, counterfactual processing, and insomnia severity. Analyses revealed that three dimensions of perfectionism were significantly related to insomnia severity: Concern over mistakes and doubts about action showed positive correlations, whereas organization showed a negative correlation. Moreover, the frequency of counterfactual thoughts and emotions at bedtime largely mediated the effects of these dimensions of perfectionism on insomnia severity. These findings highlight how personality-related patterns of behavior may translate into affective arousal at bedtime, thereby increasing the risk of insomnia.
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Affiliation(s)
- Ralph E Schmidt
- Cognitive Psychopathology and Neuropsychology Unit, Department of Psychology, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Delphine S Courvoisier
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Stéphane Cullati
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland.,Swiss National Centre of Competence in Research "LIVES - Overcoming Vulnerability: Life Course Perspectives", Institute of Demography and Socioeconomics, University of Geneva, Geneva, Switzerland
| | - Rainer Kraehenmann
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Martial Van der Linden
- Cognitive Psychopathology and Neuropsychology Unit, Department of Psychology, University of Geneva, Geneva, Switzerland
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Akram U. Objective Sleep and Personality. J Clin Sleep Med 2018; 14:485-486. [PMID: 29458706 DOI: 10.5664/jcsm.7010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/07/2017] [Indexed: 11/13/2022]
Affiliation(s)
- Umair Akram
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, United Kingdom
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