title: Relationships between adult attachment style ratings and sleep disturbances in a nationally representative sample.
abstract: OBJECTIVE
  Recent research with small non-clinical and clinical samples suggests a positive association between attachment insecurity and sleep disturbances. The present study extends this line of research by exploring this relationship in a large sample of the U.S. population and by statistically adjusting for health conditions and psychiatric disorders as potential confounds.
  
  
  METHODS
  The data used were from the National Comorbidity Survey Replication (N=5692). The main interview consisted of the Composite International Diagnostic Interview used to assess psychiatric diagnoses. Ratings of three adult attachment styles (viz., secure, avoidant, and anxious) were obtained along with self-reports of health conditions and four sleep disturbances (viz., difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and daytime sleepiness).
  
  
  RESULTS
  Bivariate logistic regression analyses indicated that ratings of secure attachment were negatively associated with each sleep disturbance and ratings of insecure attachment were positively associated with each sleep disturbance. Multivariate logistic regression analyses were used to examine associations between the attachment ratings and sleep disturbances while statistically controlling for sociodemographic variables, the presence of a health condition, and psychiatric disorders (viz., depressive disorders, bipolar disorders, anxiety disorders, alcohol/substance disorders, and attention deficit disorder). With one exception, the insecure attachment ratings continued to be positively associated with sleep disturbances.
  
  
  CONCLUSIONS
  The findings demonstrate that attachment insecurity is related to sleep disturbances independent of health conditions and concurrent psychiatric disorders. Research aimed at delineating the mechanisms responsible for these associations is warranted.
authors.affiliation: Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada.
authors.forename: G Camelia
authors.initials: GC
authors.lastname: Adams
authors.affiliation: Department of Psychology, University of Saskatchewan, Saskatoon, Canada. Electronic address: lachlan.mcwilliams@usask.ca.
authors.forename: Lachlan A
authors.initials: LA
authors.lastname: McWilliams
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology; D001714:Bipolar Disorder / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D012893:Sleep Wake Disorders / Q000523:psychology*; D014481:United States
keywords: Adult attachment; Attachment style; National Comorbidity Survey Replication; Sleep disturbances