0303 INSECURE ATTACHMENT STYLE IS RELATED TO EMOTION DEREGULATION AND HYPERAROUSAL IN INSOMNIA

• Published in: Sleep (New York, N.Y.) Vol. 40; no. suppl_1; p. A112
• Main Authors: Palagini, L, Petri, E, Bacci, O, Caruso, D, Perugi, G
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 28.04.2017
• Subjects: Attachment; Attachment theory; Insomnia
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleepj/zsx050.302

Abstract Introduction: Cognitive theories provided evidence about the influence of unhelpful cognitive processes in the development and maintenance of insomnia, whereas interpersonal theories, which emphasize the role of interpersonal factors, have been less studied in insomnia. Attachment theory is one of the integrative theories that can be used as a cognitive-interpersonal framework for understanding the development and maintenance of insomnia. Attachment insecurity (vs security) is related to emotion deregulation in psychiatric disorders. Because, emotion and arousal regulation is a key factor in insomnia, the aim was to study the possible association between the attachment style and these factors, using a set of variables. Methods: The study consisted of 51 subjects with Insomnia disorder according to the DSM-5 and 35 good sleepers. Insomnia Severity Index (ISI), Attachment Style Questionnaire (ASQ), Difficulties in Emotion Regulation Scale (DERS), Pre-sleep Arousal Scale (PSAS) were administered while controlling for anxiety and depressive symptoms. Differences in means between groups were assessed using t-test or Mann-Whitney U/Wilcoxon test. Univariate/ multivariate regression analyses and mediation analyses were performed. Results: Subjects with Insomnia (F 26, mean age 48 ± 2.3) presented higher ISI, ASQ, DERS and PSAS scores than good sleepers (F 22, mean age 47.2 ± 1.2) (ISI: 16.1 ± 5.8 vs 5.1 ± 0.6, p<.01; ASQ: 114.2 ± 23.8 vs 56 ± 12, p<.01; DERS: 85.1 ± 3.1 vs 24.1 ± 12.1, p<.01; PSAS Cognitive 22.3 ± 10 vs 10 ± 0.6, p<.01, PSAS Somatic 15.1 ± 7 vs 10.2 ± 1.2, p<.01). After controlling for anxiety/depressive symptoms, insecure anxious-preoccupied attachment style was correlated to emotion deregulation-DERS (B=0.10, p=0.007), especially to non- acceptance of emotional responses (B=0.59, p=0.02), and to difficulties in engaging in goal directed behaviour (B=0.61, p=0.04). It also related to somatic hyperarousal-PSAS Somatic (B=0.37, p=0.04). Emotion deregulation-DERS mediated the relationship between insecure attachment and somatic hyperarousal-PSAS Somatic (Z=2.18, SE=0.07, p=0.02). Conclusion: Subjects with insomnia show insecure attachment style, they seem anxious and preoccupied with relationships. Insecure attachment in subjects with insomnia seems to favor emotion deregulation and pre sleep hyperarousal. Especially, emotion deregulation may intervene in the relationship between insecure attachment and hyperarousal in insomnia. An interpersonal evaluation should be considered when dealing with insomnia; it may be useful for optimizing CBT-Insomnia treatment. Support (If Any): any