title: Sleep disturbance and emotion dysregulation as transdiagnostic processes in a comorbid sample.
abstract: Sleep disturbance and emotion dysregulation have been identified as etiologic and maintaining factors for a range of psychopathology and separate literatures support their relationships to anxiety, depression, PTSD, and alcohol dependence (AD) symptom severity. Previous studies have examined these relationships in isolation, failing to account for the high rates of comorbidity among disorders. It is not yet known whether these processes uniquely predict symptom severity in each of these domains. Participants were 220 patients in residential substance abuse treatment, who had experienced a potentially traumatic event and exceeded screening cutoffs for probable PTSD and problematic alcohol use. Controlling for emotion dysregulation and the interrelationships among the outcome variables, insomnia was uniquely associated with anxiety (B = .27, p < .001), depression (B = .25, p < .001), PTSD (B = .22, p < .001), and AD (B = .17, p = .01) symptom severity. Similarly, controlling for insomnia, emotion dysregulation was uniquely associated with anxiety (B = .40, p < .001), depression (B = .47, p < .001), PTSD (B = .38, p < .001), and AD (B = .26, p < .001) symptom severity. Insomnia and emotion dysregulation appear to be transdiagnostic processes uniquely associated with symptom severity across a number of different domains and might be important treatment targets for individuals with PTSD and AD.
authors.affiliation: The University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216, USA. cfairholme@stanford.edu
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Fairholme
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Nosen
authors.forename: Yael I
authors.initials: YI
authors.lastname: Nillni
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schumacher
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Tull
authors.forename: Scott F
authors.initials: SF
authors.lastname: Coffey
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology*; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D056348:Emotional Intelligence; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D016320:Substance Abuse Treatment Centers; D011795:Surveys and Questionnaires
keywords: Alcohol dependence; Difficulties in Emotion Regulation Scale; Emotion regulation; Insomnia; PTSD; Transdiagnostic