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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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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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3
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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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4
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Akram U, Stevenson JC. The joy of repetition: Perfectionism and poor sleep Comment on "Multidimensional perfectionism and poor sleep: A meta-analysis of bivariate associations". Sleep Health 2023; 9:236-237. [PMID: 36858836 DOI: 10.1016/j.sleh.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/03/2023] [Indexed: 03/02/2023]
Affiliation(s)
- Umair Akram
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
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5
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Stricker J, Kröger L, Küskens A, Gieselmann A, Pietrowsky R. The importance of cumulative science and the perils of perfectionistic strivings: A reply to Akram and Stevenson (2023). Sleep Health 2023; 9:238-239. [PMID: 36849282 DOI: 10.1016/j.sleh.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 02/27/2023]
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 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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6
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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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Fabbri M, Beracci A, Martoni M. Insomnia, Time Perspective, and Personality Traits: A Cross-Sectional Study in a Non-Clinical Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11018. [PMID: 36078734 PMCID: PMC9517905 DOI: 10.3390/ijerph191711018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Insomnia disorder is considered a public health problem and additional studies should investigate predisposing and perpetuating factors. This study examined the relationship between Big Five personality traits, time perspective, and insomnia. In a cross-sectional study, 400 participants (227 women; age range 18-74 years) were administered the Big Five Inventory-10 items, the Zimbardo Time Perspective Inventory, and the Insomnia Severity Index (ISI). A measure of chronotype was also included for control purposes. The results show that insomniacs reported lower scores for conscientiousness and extraversion, and for past-positive (PP) and future (F) perspectives, whereas they obtained higher scores for past-negative (PN) perspectives and deviation from a balanced time perspective. The correlations confirmed these findings, but negative correlations between present-hedonistic (PH) perspective and ISI score, and between emotional stability and ISI score, were also found. The mediation analyses showed that F played an indirect role in the relationship between consciousness and ISI score, PN had an indirect effect on the relationship between emotional stability and ISI or between extraversion and insomnia, and PH had an indirect effect on the relationship between extraversion and ISI score. The current outcomes shed light on the mechanisms which serve to mediate the relationship between insomnia and personality traits.
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Affiliation(s)
- Marco Fabbri
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Alessia Beracci
- Department of Psychology, University of Granada, 18011 Granada, Spain
| | - Monica Martoni
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
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Pentagna Á, Castro LHM, Conway BA. What's new in insomnia? Diagnosis and treatment. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:307-312. [PMID: 35976314 PMCID: PMC9491430 DOI: 10.1590/0004-282x-anp-2022-s124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/29/2022] [Indexed: 06/12/2023]
Abstract
Although, insomnia is one of the most common diseases that health professionals face in their practice, it receives little attention in medical training. Diagnosis is based on a careful history taking, and physicians must be aware of the diagnostic criteria. Insomnia should not be considered a symptom, but a comorbid condition. Although cognitive behavioral therapy (CBT) has been the mainstay treatment for insomnia for many years, it is usually regarded as a novel therapeutic strategy, both because of scarcity of qualified psychologists and of limited knowledge about insomnia among physicians. GABA receptor acting drugs are being abandoned in the treatment of insomnia because of abuse and dependence potential and accident risk. Two main current therapeutic options with the best scientific evidence are the tricyclic antidepressant, doxepin, and a new melatoninergic receptor agonist, ramelteon. Newer drugs to treat insomnia are in the pipeline. Hypocretine blocking agents will be marketed in the near future.
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Affiliation(s)
- Álvaro Pentagna
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Clínica Neurológica, Ambulatório de Medicina do Sono, São Paulo, SP, Brazil
| | - Luiz Henrique Martins Castro
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Clínica Neurológica, Ambulatório de Medicina do Sono, São Paulo, SP, Brazil
| | - Bárbara Araújo Conway
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Clínica Neurológica, Ambulatório de Medicina do Sono, São Paulo, SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Curso de Pós-Graduação, Departamento de Psiquiatria, São Paulo, SP, Brazil
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9
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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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Sakib AS, Mukta MSH, Huda FR, Islam AKMN, Islam T, Ali ME. Identifying Insomnia From Social Media Posts: Psycholinguistic Analyses of User Tweets. J Med Internet Res 2021; 23:e27613. [PMID: 34889758 PMCID: PMC8704110 DOI: 10.2196/27613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/12/2021] [Accepted: 10/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background Many people suffer from insomnia, a sleep disorder characterized by difficulty falling and staying asleep during the night. As social media have become a ubiquitous platform to share users’ thoughts, opinions, activities, and preferences with their friends and acquaintances, the shared content across these platforms can be used to diagnose different health problems, including insomnia. Only a few recent studies have examined the prediction of insomnia from Twitter data, and we found research gaps in predicting insomnia from word usage patterns and correlations between users’ insomnia and their Big 5 personality traits as derived from social media interactions. Objective The purpose of this study is to build an insomnia prediction model from users’ psycholinguistic patterns, including the elements of word usage, semantics, and their Big 5 personality traits as derived from tweets. Methods In this paper, we exploited both psycholinguistic and personality traits derived from tweets to identify insomnia patients. First, we built psycholinguistic profiles of the users from their word choices and the semantic relationships between the words of their tweets. We then determined the relationship between a users’ personality traits and insomnia. Finally, we built a double-weighted ensemble classification model to predict insomnia from both psycholinguistic and personality traits as derived from user tweets. Results Our classification model showed strong prediction potential (78.8%) to predict insomnia from tweets. As insomniacs are generally ill-tempered and feel more stress and mental exhaustion, we observed significant correlations of certain word usage patterns among them. They tend to use negative words (eg, “no,” “not,” “never”). Some people frequently use swear words (eg, “damn,” “piss,” “fuck”) with strong temperament. They also use anxious (eg, “worried,” “fearful,” “nervous”) and sad (eg, “crying,” “grief,” “sad”) words in their tweets. We also found that the users with high neuroticism and conscientiousness scores for the Big 5 personality traits likely have strong correlations with insomnia. Additionally, we observed that users with high conscientiousness scores have strong correlations with insomnia patterns, while negative correlation between extraversion and insomnia was also found. Conclusions Our model can help predict insomnia from users’ social media interactions. Thus, incorporating our model into a software system can help family members detect insomnia problems in individuals before they become worse. The software system can also help doctors to diagnose possible insomnia in patients.
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Affiliation(s)
| | | | | | | | - Tohedul Islam
- American International University-Bangladesh, Dhaka, Bangladesh
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12
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Dyrberg H, Juel A, Kragh M. Experience of Treatment and Adherence to Cognitive Behavioral Therapy for Insomnia for Patients with Depression: An Interview Study. Behav Sleep Med 2021; 19:481-491. [PMID: 32627595 DOI: 10.1080/15402002.2020.1788033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE/BACKGROUND Research supports the efficacy of Cognitive Behavioral Therapy for Insomnia (CBT-I) for patients suffering from depression and insomnia, but little is known about how they experience treatment and adhere to it. Our objective, therefore, was to explore how patients with depression experience treatment components and how their experiences influence adherence to CBT-I as a full-package treatment. PARTICIPANTS/METHODS Twelve patients with depression and comorbid insomnia were interviewed after six sessions of CBT-I, and a conventional qualitative content analysis was conducted. RESULTS Two themes were found. The theme "I picked what I needed" showed that participants chose among CBT-I methods. Behavioral methods were considered hard but so effective that they reduced the need to learn other methods. Participants had difficulty learning cognitive methods, such as the restructuring of negative thoughts, owing to lack of energy and cognitive problems aggravated by sleep loss. Sleep hygiene education was regarded as common knowledge. The theme "Staying on track" highlighted factors promoting adherence, such as a preference for non-pharmacological treatment, rapid improvement, and support from relatives and therapists. Factors impeding adherence were: a perceived lack of support from the ongoing group setting, side effects of medication, changes in daily routine, and daytime fatigue influencing cognitive and emotional functioning. CONCLUSION The study suggests: focusing on adherence throughout treatment; actively using support from relatives and therapists; preferring individual treatment; and prioritizing behavioral treatment components, with cognitive components introduced later in the treatment course when the negative effects on cognitive functioning due to sleep restriction have diminished.
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Affiliation(s)
- Henny Dyrberg
- Department for Affective Disorders, Aarhus University Hospital, Aarhus N, Denmark
| | - Anette Juel
- Department for Affective Disorders, Aarhus University Hospital, Aarhus N, Denmark.,Centre for Relationships and De-escalation, Mental Health Services Region Zealand
| | - Mette Kragh
- Department for Affective Disorders, Aarhus University Hospital, Aarhus N, Denmark
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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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15
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Akram U, Gardani M, Akram A, Allen S. Anxiety and depression mediate the relationship between insomnia symptoms and the personality traits of conscientiousness and emotional stability. Heliyon 2019; 5:e01939. [PMID: 31245649 PMCID: PMC6581874 DOI: 10.1016/j.heliyon.2019.e01939] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 03/21/2019] [Accepted: 06/06/2019] [Indexed: 11/22/2022] Open
Abstract
This study examined the relationship between the Big Five personality traits and insomnia symptoms in the general population. Additionally, the mediating role of anxiety and depression was examined. Participants (N = 625) completed online measures of the big five personality traits and insomnia severity. Insomnia symptoms were independently related to extroversion, agreeableness, conscientiousness, emotional stability, anxiety and depression in univariate analysis. Linear regression determined conscientiousness and emotional stability to be the only traits predicting insomnia symptoms. However, these relationships were at least partially mediated by anxiety and depression. Whilst reduced levels of conscientiousness and emotional stability has previously associated with poor sleep and insomnia, the current outcomes shed light on the mechanisms which serve to mediate this relationship.
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Affiliation(s)
- Umair Akram
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | | | - Asha Akram
- Department of Psychology, The University of Sheffield, UK
| | - Sarah Allen
- Mental Health and Addiction Research Group, University of York, UK
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