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 (beta=0.20, p<.001) significantly predicted psychiatric symptoms directly and via worry and rumination (beta=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.