A penny for your thoughts: Patterns of sleep-related beliefs, insomnia symptoms and treatment outcome

The aim of this study was to determine how distinctive patterns of unhelpful beliefs about sleep endorsed by insomnia patients relate to their presenting symptoms and treatment responses. A sample of 281 primary insomnia sufferers completed items comprising the Dysfunctional Beliefs About Sleep scale (DBAS-16). Their resultant scores on the four DBAS-16 subscales were then subjected to a cluster analysis, which resulted in the identification of four distinctive age-matched subgroups. Two subgroups were characterized by pathologically elevated scores on at least two of the DBAS-16 subscales, whereas the other two subgroups had subscale scores that closely resembled those of a normative sample. Subsequent comparisons showed the insomnia subgroups differed in regard to their insomnia severity, use of prescribed medication for sleep, depression and anxiety symptoms, and daytime sleepiness. Furthermore, comparisons of treatment outcomes (i.e. analysis of change scores and normative comparisons) across clusters showed that the subgroups did not benefit equally from a standardized form of Cognitive-Behavioral Therapy (CBT) for insomnia. Findings demonstrate the contribution of specific sleep-related beliefs on presenting insomnia symptoms and suggest the potential usefulness of tailoring CBT protocols to match the needs of distinctive insomnia subtypes.     

Distinguishing rumination from worry in clinical insomnia

Research has found that repetitive thought processes, such as worry and rumination, play an important role in several disorders; however, these cognitive processes have not yet been examined in insomnia. This study explores rumination and worry in insomnia by examining: 1) whether those high and low on rumination and worry differ on subjective sleep measures, and 2) whether rumination and worry are distinct processes in insomnia. Participants (N = 242) were diagnosed with an insomnia disorder by sleep experts. Participants completed measures of worry and rumination and maintained a 2-week daily sleep log. Results of a multivariate analysis of variance found no main effect of worry; although high and low ruminators differed on several sleep log indices, including sleep efficiency, wakefulness after sleep onset and sleep quality. Factor analysis supported the idea that rumination and worry are separate constructs. Whereas previous research has focused on worry in insomnia, these findings suggest that rumination is important for understanding sleep disturbance. Further, although rumination and worry are both repetitive thought processes, these results indicate that they are distinct processes within insomnia and should be treated as such. The results are discussed with respect to treatment implications for Cognitive Behavioural Therapy for Insomnia.     

An abac for determining the mean deviation of a class from the general mean

The abac is presented with instructions for use.     

Predicting Suicide Ideation in the Military: The Independent Role of Aggression

The purpose of this study was to examine the longitudinal relationship between aggression and suicide ideation when controlling for other externalizing (i.e., alcohol misuse and risk‐taking) and internalizing (i.e., depression and sleep problems) risk factors in an active duty, military sample. Preexisting data from a longitudinal study were analyzed to assess the wellness of service members across the deployment cycle. Participants were 944 active duty service members (95% male, 48% between 18 and 24 years old) who completed surveys upon initial return from deployment and approximately 3 months later. After controlling for other externalizing (alcohol misuse, risk‐taking) and internalizing (depression, sleep problems) risk factors, service members reporting aggression were significantly more likely to report suicide ideation than those reporting no aggression (OR = 3.19; OR 95% CI: 1.16–8.80). The independent nature of the relationship between anger and suicidality suggests aggression may be an important indicator of suicidality for service members. Understanding the role of aggression in suicidality may improve the ability to identify at‐risk service members and to develop effective interventions to reduce suicide risk.