Insomnia Severity Predicts Psychiatric Symptoms: A Cross-Sectional Study Investigating the Partial Mediations of Worry and Rumination

Abstract

Objective

Insomnia as a disorder on its own or as a symptom of other mental disorders can lead to significant distress and lower quality of life. By exacerbating negative affect and emotion dysregulation, poor sleep and insomnia can contribute to the initiation and maintenance of mental disorders. The aim of this cross-sectional study was to investigate the relationship between insomnia severity and overall psychiatric symptoms (anxiety, depression, obsessive-compulsive symptoms, somatization, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism), and the mediational roles of worry and rumination in this relationship.

Method

The data was collected from a community sample of 1444 participants (females 69.39%, M_age = 27.95, SD = 9.37) who completed self-report measures of insomnia severity, worry, rumination, and psychiatric symptoms. The mediational roles of worry and rumination were tested with mediation analysis using the PROCESS Macro.

Results

It was found that insomnia severity (β = 0.20, p < .001) significantly predicted psychiatric symptoms directly and via worry and rumination (β = 0.33, p < .001), meaning that worry and rumination partially mediated the relationship between insomnia severity and psychiatric symptoms. The findings were similar after controlling for smoking status, daily screen time, coffee consumption in the evening, weekly exercise frequency, and pre-sleep screen time.

Conclusions

Interventions targeting the reduction of insomnia severity and maladaptive emotion regulation strategies (e.g., worry and rumination), as well as the enhancement of adaptive emotion regulation strategies (e.g., positive refocusing and mindfulness), may alleviate the adverse effects of insomnia on psychiatric symptoms.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

ETHICS APPROVAL

This research meets the ethical guidelines, including adherence to the legal requirements of the study country. Ethical committee approval was sought where necessary and is acknowledged within the text of the submitted manuscript.

AVAILABILITY OF DATA AND MATERIAL

The data-sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

AUTHOR CONTRIBUTIONS

Kutlu Kağan Türkarslan: Conceptualization, Data curation, Formal analysis; Investigation, Methodology, Software; Roles/Writing—original draft, Writing—review & editing.

Deniz Canel Çınarbaş: Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Supervision; Roles/Writing—original draft, Writing—review & editing.

SUPPLEMENTARY MATERIAL

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00332747.2024.2347100

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for- profit sectors.

Notes on contributors

Kutlu Kağan Türkarslan

Kutlu Kağan Türkarslan is an assistant professor in the psychology department of Atılım University. Türkarslan does research in insomnia, sleep-related behaviors, evolutionary psychology, and psychoanalysis.

Deniz Canel Çınarbaş

Deniz Canel Çınarbaş is a professor in the psychology department of Middle East Technical University. Canel Çınarbaş does research in cross-cultural psychopathology, cross-cultural equivalence, multicultural psychotherapy, microaggressions, and discrimination.