Personality and severity of primary insomnia

Abstract

Introduction Primary Insomnia is difficulty in initiating, or maintaining sleep, waking up too early, or sleep that is chronically nonrestorative or of poor quality (AASM, 2005) that can not be explained by another mental disorder, medical illness or substance abuse disorder. Psychological factors, such as depression, anxiety and excessive worry, can strongly influence insomnia (Kales and Vgontzas, 1992). Moreover, the personality profiles of insomniacs may differ from those of normal controls (de Saint Hilaire et al., 2005), suggesting that personality traits may also influence the severity of insomnia. Both depression and anxiety have been suggested to be the underlying link between personality and insomnia (Harvey and Greenall, 2003; Ongur et al., 2005; Carney et al., 2010), though the precise mechanism of this influence is unclear at the moment. Traditional studies using the MMPI and found higher scores in patients insomniacs: Traits of neuroticism, anxiety, worry (Freedman and Sattler, 1982), Personality styles aimed at internalizing the concerns and increased psychological and physiological activation (Kales, Caldwell, Preston, Healey and Kales, 1976). According to these results, it is found more anxiety, both psychic and somatic, in patients suffering from insomnia (Lundh, Broman and Hetta, 1995). Studies applying the Temperament and Character Inventory (TCI-R) Clonninger consistently show higher Harm Avoidance in insomniac patients than in control and less self- direction (De Saint Hilaire, Straub & Pelissolo, 2005). Severity of insomnia correlates (Park, An, Jang and Chung, 2012): Positively with Harm Avoidance; Negatively with Novelty Seeking, Cooperation and Reward Dependence Objectives: Analyze temperamental and characterological features of a group of patients diagnosed with primary insomnia To study the relationship between the severity of insomnia and anxiety and depression symptoms. Materials and methods Sample: 25 patients diagnosed with primary insomnia Instruments: Beck Depression Inventory (BDI), Hamilton Anxiety Scale, Temperament and Character Inventory- Revised (TCI-R), Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Horne and Ostberg morning/evening questionnaire (MEQ), and actigraphy. Statistical Analysis: Raw scores on TCI-R were standardized and transformed into Z scores following normative data (Gutierrez- Zotes et al., 2003), compared with population mean using a Student t test for one sample (comparison value=0 ). We used Pearson correlation between BDI, Hamilton and ISI. Results The scores on the Harm Avoidance scale are significantly above average in patients with primary insomnia ( t =4.51, p t =−2.51, p =0.02) The measures of anxiety and depression correlated with each other ( r =0.71, p r =0.22 and r =0.02, respectively). Conclusion The results are consistent with the literature reviewed in a greater tendency to harm avoidance and lower self-direction in patients with insomnia The present study found no relationship between the severity of insomnia and anxiety and depression symptoms In light of the results are proposed therapeutic interventions aimed at increasing active coping and improving emotional regulation. Acknowledgement Sara Izquierdo and Ana Alcon, clinical psychological trainees, who also collaborated in the studio and of course patients.