Forgan, Grant S.
Psychophysiological insomnia and idiopathic insomnia: the role of self-regulatory behaviour systems.
D Clin Psy thesis, University of Glasgow.
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Further research into identifying the mechanisms that underlie the development and maintenance of insomnia and its different subtypes is required. Neurobiological motivational systems are thought to mediate our experiences of negative and positive affect and are implicated in the etiology of psychiatric disorders, but their role in insomnia is unknown. The present study aimed to compare self-reported sensitivity to these systems across Psychophysiological Insomnia (PI) and Idiopathic Insomnia (IdI). Sixty one adults with PI (n = 20) and IdI (n = 20), and Good Sleepers (n = 21), completed measures of sleep characteristics, Behavioural Inhibition Sensitivity (BIS), Behavioural Activation Sensitivity (BAS), Sleep Effort, Depression and Anxiety. As predicted the PI group reported significantly greater BIS sensitivity compared with the IdI and GS groups. However, no significant differences were found between groups on BAS sensitivity. Post-hoc analysis revealed significant differences between the insomnia groups on sleep effort when age was included as a covariate. Depression and anxiety did not moderate the relationships between the other outcome variables. The findings support the notion that PI is associated with a specific tendency toward threat sensitivity, a tendency absent in IdI. This is consistent with contemporary thinking on PI that this group exhibits greater vulnerability to stress-related sleep disturbance, whereas IdI is a more stable insomnia subtype that may be less reactive to circumstances. Accordingly, this suggests that different psychological treatment approaches are indicated for these subtypes with PI requiring re-conditioning forms of CBT and IdI requiring a more acceptance based approach.
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