Abstract
Purpose
Researchers have proposed that multiple factors such as hyperarousal, conditioning, worrying, or cortical arousal play roles in the predisposition to, initiation, and perpetuation of insomnia disorder. Previously, only a few studies investigated the differential effects of intrusive visual imagery (IVI) and intrusive verbal thoughts (IVT) on pre-sleep arousal or insomnia severity. The aim of the current cross-sectional study was to examine these effects as well as the moderator role of visual imagery ability (VIA) on the relationship between IVI and pre-sleep arousal.
Methods
A path model comprising the variables of IVI, IVT, pre-sleep arousal, and insomnia severity was tested with 166 of 1444 participants (Mage = 25.5, SD = 5.26) who were identified as having insomnia disorder based on a 12-question form corresponding to DSM-5 criteria for insomnia disorder and Insomnia Severity Index scores (≥ 8). The moderator role of VIA on the relationship between IVI and pre-sleep arousal was evaluated with a moderation analysis.
Results
It was found that IVI (β = 0.44, p < .001), but not IVT (β = 0.15, p = .12), significantly predicted pre-sleep arousal and pre-sleep arousal (β = 0.44, p < .001) significantly predicted insomnia severity. In addition, the indirect effect of IVI via pre-sleep arousal (IE = 0.19, p < .001) on insomnia severity was significant. Finally, the moderator role of VIA on the relationship between IVI and pre-sleep arousal (p = .07) was not significant.
Conclusions
IVI may play a more important role in insomnia disorder than IVT. Interventions targeting pre-sleep visual imagery can help poor sleepers alleviate insomnia severity.
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Data Availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Change history
03 February 2024
A Correction to this paper has been published: https://doi.org/10.1007/s10608-024-10464-2
References
Albers, A. M., Kok, P., Toni, I., Dijkerman, H. C., & de Lange, F. P. (2013). Shared Representations for Working Memory and Mental Imagery in early visual cortex. Current Biology, 23(15), 1427–1431. https://doi.org/10.1016/j.cub.2013.05.065.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
Baglioni, C., Spiegelhalder, K., Lombardo, C., & Riemann, D. (2010). Sleep and emotions: A focus on insomnia. Sleep Medicine Reviews, 14(4), 227–238. https://doi.org/10.1016/j.smrv.2009.10.007.
Baker, L. D., Baldwin, D. S., & Garner, M. (2015). Daytime intrusive thoughts and subjective insomnia symptoms. Psychiatry Research, 229(3), 1038–1042. https://doi.org/10.1016/j.psychres.2015.02.022.
Bastien, C. H., Vallières, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297–307. https://doi.org/10.1016/S1389-9457(00)00065-4.
Benbir, G., Demir, A. U., Aksu, M., Ardic, S., Firat, H., Itil, O., Ozgen, F., Yılmaz, H., & Karadeniz, D. (2015). Prevalence of insomnia and its clinical correlates in a general population in Turkey. Psychiatry and Clinical Neurosciences, 69(9), 543–552. https://doi.org/10.1111/pcn.12252.
Benjamin, D. J., Berger, J. O., Johannesson, M., Nosek, B. A., Wagenmakers, E. J., Berk, R., Bollen, K. A., Brembs, B., Brown, L., Camerer, C., Cesarini, D., Chambers, C. D., Clyde, M., Cook, T. D., De Boeck, P., Dienes, Z., Dreber, A., Easwaran, K., Efferson, C., & Johnson, V. E. (2018). Redefine statistical significance. Nature Human Behaviour, 2(1), https://doi.org/10.1038/s41562-017-0189-z.
Blazhenkova, O., & Kozhevnikov, M. (2009). The new object-spatial-verbal cognitive style model: Theory and measurement. Applied Cognitive Psychology, 23(5), 638–663. https://doi.org/10.1002/acp.1473.
Bootzin, R. R. (1972). Stimulus Control Treatment for Insomnia: [Data set]. In Proceedings of the American Psychological Association (Vol. 7, pp. 395–396). https://doi.org/10.1037/e465522008-198.
Borkovec, T. D. (1982). Insomnia. Journal of Consulting and Clinical Psychology, 50(6), 880–895. https://doi.org/10.1037/0022-006X.50.6.880.
Borkovec, T. D., Ray, W. J., & Stöber, J. (1998). Worry: A cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy and Research, 22(6), 561–576. https://doi.org/10.1023/A:1018790003416.
Boysan, M., Güleç, M., Beşiroğlu, L., & Kalafat, T. (2010). Psychometric properties of the Insomnia Severity Index in Turkish sample. Anadolu Psikiyatri Dergisi, 11, 248–252.
Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in Psychological Disorders. Psychological Review, 117(1), 210–232. https://doi.org/10.1037/a0018113.
Broman, J. E., & Hetta, J. (1994). Perceived pre-sleep arousal in patients with persistent psychophysiologic and psychiatric insomnia. Nordic Journal of Psychiatry, 48(3), 203–207.
Brown, T. A. (2015). Confirmatory factor analysis for Applied Research, Second Edition. Guilford Publications.
Buysse, D. J., Germain, A., Hall, M., Monk, T. H., & Nofzinger, E. A. (2011). A neurobiological model of insomnia. Drug Discovery Today: Disease Models, 8(4), 129–137. https://doi.org/10.1016/j.ddmod.2011.07.002.
Cao, X. L., Wang, S. B., Zhong, B. L., Zhang, L., Ungvari, G. S., Ng, C. H., Li, L., Chiu, H. F. K., Lok, G. K. I., Lu, J. P., Jia, F. J., & Xiang, Y. T. (2017). The prevalence of insomnia in the general population in China: A meta-analysis. PLOS ONE, 12(2), e0170772. https://doi.org/10.1371/journal.pone.0170772.
Capellini, I., Preston, B. T., McNamara, P., Barton, R. A., & Nunn, C. L. (2010). Ecological constraints on mammalian sleep architecture. Evolution of sleep: Phylogenetic and functional perspectives (pp. 12–33). Cambridge University Press.
Casement, M. D., & Swanson, L. M. (2012). A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress. Clinical Psychology Review, 32(6), 566–574. https://doi.org/10.1016/j.cpr.2012.06.002.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037//0033-2909.112.1.155
Cui, X., Jeter, C. B., Yang, D., Montague, P. R., & Eagleman, D. M. (2007). Vividness of mental imagery: Individual variability can be measured objectively. Vision Research, 47(4), 474–478. https://doi.org/10.1016/j.visres.2006.11.013.
Cuthbert, B. N., Lang, P. J., Strauss, C., Drobes, D., Patrick, C. J., & Bradley, M. M. (2003). The psychophysiology of anxiety disorder: Fear memory imagery. Psychophysiology, 40(3), 407–422. https://doi.org/10.1111/1469-8986.00043.
Dadds, M. R., Bovbjerg, D. H., Redd, W. H., & Cutmore, T. R. H. (1997). Imagery in human classical conditioning. Psychological Bulletin, 122(1), 89–103. https://doi.org/10.1037/0033-2909.122.1.89.
Dijkstra, N., Bosch, S. E., & van Gerven, M. A. J. (2017). Vividness of visual imagery depends on the neural overlap with perception in visual areas. Journal of Neuroscience, 37(5), 1367–1373. https://doi.org/10.1523/JNEUROSCI.3022-16.2016.
Espie, C. A. (2002). Insomnia: Conceptual issues in the development, persistence, and treatment of sleep disorder in adults. Annual Review of Psychology, 53(1), 215–243. https://doi.org/10.1146/annurev.psych.53.100901.135243.
Ford, E. S., Cunningham, T. J., Giles, W. H., & Croft, J. B. (2015). Trends in insomnia and excessive daytime sleepiness among US adults from 2002 to 2012. Sleep Medicine, 16(3), 372–378. https://doi.org/10.1016/j.sleep.2014.12.008.
Fortier-Brochu, É., Beaulieu-Bonneau, S., Ivers, H., & Morin, C. M. (2012). Insomnia and daytime cognitive performance: A meta-analysis. Sleep Medicine Reviews, 16(1), 83–94. https://doi.org/10.1016/j.smrv.2011.03.008.
Fulford, J., Milton, F., Salas, D., Smith, A., Simler, A., Winlove, C., & Zeman, A. (2018). The neural correlates of visual imagery vividness – an fMRI study and literature review. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior, 105, 26–40. https://doi.org/10.1016/j.cortex.2017.09.014.
Ganis, G. (2013). Visual Mental Imagery. In S. Lacey & R. Lawson (Eds.), Multisensory Imagery (pp. 9–28). Springer. https://doi.org/10.1007/978-1-4614-5879-1_2.
Godet-Cayré, V., Pelletier-Fleury, N., Le Vaillant, M., Dinet, J., Massuel, M. A., & Léger, D. (2006). Insomnia and absenteeism at work. Who Pays the Cost? Sleep, 29(2), 179–184. https://doi.org/10.1093/sleep/29.2.179.
Gong, H., Ni, C. X., Liu, Y. Z., Zhang, Y., Su, W. J., Lian, Y. J., Peng, W., & Jiang, C. L. (2016). Mindfulness meditation for insomnia: A meta-analysis of randomized controlled trials. Journal of Psychosomatic Research, 89, 1–6. https://doi.org/10.1016/j.jpsychores.2016.07.016.
Hagenaars, M. A., & Holmes, E. A. (2012). Mental Imagery in psychopathology: Another step; Editorial for the special issue of Journal of experimental psychopathology. Journal of Experimental Psychopathology, 3(2), 121–126. https://doi.org/10.1177/204380871200300201.
Hagenaars, M. A., Brewin, C. R., van Minnen, A., Holmes, E. A., & Hoogduin, K. A. L. (2010). Intrusive images and intrusive thoughts as different phenomena: Two experimental studies. Memory (Hove, England), 18(1), 76–84. https://doi.org/10.1080/09658210903476522.
Haig, D. (2014). Troubled sleepNight waking, breastfeeding and parent–offspring conflict. Evolution Medicine and Public Health, 2014(1), 32–39. https://doi.org/10.1093/emph/eou005.
Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2019). Multivariate data analysis. Cengage Learning.
Hall, C., Pongrac, J., & Buckholz, E. (1985). The measurement of imagery ability. Human Movement Science, 4(2), 107–118.
Hall, M., Buysse, D. J., Nowell, P. D., Nofzinger, E. A., Houck, P., Reynolds, C. F. I., & Kupfer, D. J. (2000). Symptoms of stress and depression as Correlates of Sleep in primary insomnia. Psychosomatic Medicine, 62(2), 227–230.
Harvey, A. G. (2000). Pre-sleep cognitive activity: A comparison of sleep-onset insomniacs and good sleepers. The British Journal of Clinical Psychology, 39(3), 275–286. https://doi.org/10.1348/014466500163284.
Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40(8), 869–893. https://doi.org/10.1016/S0005-7967(01)00061-4.
Harvey, A. G. (2005). Unwanted intrusive thoughts in Insomnia. Intrusive thoughts in clinical disorders: Theory, research, and treatment (pp. 86–118). Guilford Press.
Harvey, A. G., & Farrell, C. (2003). The efficacy of a Pennebaker-Like writing intervention for poor sleepers. Behavioral Sleep Medicine, 1(2), 115–124. https://doi.org/10.1207/S15402010BSM0102_4.
Harvey, A. G., & Payne, S. (2002). The management of unwanted pre-sleep thoughts in insomnia: Distraction with imagery versus general distraction. Behaviour Research and Therapy, 40(3), 267–277.
Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford publications.
Hertenstein, E., Feige, B., Gmeiner, T., Kienzler, C., Spiegelhalder, K., Johann, A., Jansson-Fröjmark, M., Palagini, L., Rücker, G., Riemann, D., & Baglioni, C. (2019). Insomnia as a predictor of mental disorders: A systematic review and meta-analysis. Sleep Medicine Reviews, 43, 96–105. https://doi.org/10.1016/j.smrv.2018.10.006.
Hill, T. D., Trinh, H. N., Wen, M., & Hale, L. (2016). Perceived neighborhood safety and sleep quality: A global analysis of six countries. Sleep Medicine, 18, 56–60. https://doi.org/10.1016/j.sleep.2014.12.003.
Holmes, E. A., & Mathews, A. (2005). Mental imagery and emotion: A special relationship? Emotion (Washington D C), 5(4), 489–497. https://doi.org/10.1037/1528-3542.5.4.489.
Holmes, E. A., Mathews, A., Mackintosh, B., & Dalgleish, T. (2008). The causal effect of mental imagery on emotion assessed using picture-word cues. Emotion, 8(3), 395–409. https://doi.org/10.1037/1528-3542.8.3.395.
Hoppe, J. M., Holmes, E. A., & Agren, T. (2022). Imaginal extinction and the vividness of mental imagery: Exploring the reduction of fear within the mind’s eye. Behavioural Brain Research, 418, 113632. https://doi.org/10.1016/j.bbr.2021.113632.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118.
Hurlburt, R. T., Alderson-Day, B., Kühn, S., & Fernyhough, C. (2016). Exploring the ecological validity of thinking on demand: Neural correlates of elicited vs. spontaneously occurring Inner Speech. PLOS ONE, 11(2), e0147932. https://doi.org/10.1371/journal.pone.0147932.
Jansson-Fröjmark, M., & Norell-Clarke, A. (2012). Psychometric properties of the pre-sleep Arousal Scale in a large community sample. Journal of Psychosomatic Research, 72(2), 103–110. https://doi.org/10.1016/j.jpsychores.2011.10.005.
Ji, J. L., Heyes, S. B., MacLeod, C., & Holmes, E. A. (2016). Emotional Mental Imagery as Simulation of reality: Fear and Beyond—A tribute to Peter Lang. Behavior Therapy, 47(5), 702–719. https://doi.org/10.1016/j.beth.2015.11.004.
Joos, E., Vansteenwegen, D., & Hermans, D. (2012). Post-acquisition repetitive thought in fear conditioning: An experimental investigation of the effect of CS-US-rehearsal. Journal of Behavior Therapy and Experimental Psychiatry, 43(2), 737–744. https://doi.org/10.1016/j.jbtep.2011.10.011.
Kelly, W. E. (2002). Worry and sleep length revisited: Worry, sleep length, and sleep disturbance ascribed to worry. The Journal of Genetic Psychology, 163(3), 296–304.
Kline, R. B. (2015). Principles and practice of structural equation modeling, Fourth Edition. Guilford Publications.
Kosslyn, S. M., Thompson, W. L., & Alpert, N. M. (1997). Neural Systems Shared by Visual Imagery and Visual Perception: A Positron Emission Tomography Study. Neuroimage, 6(4), 320–334. https://doi.org/10.1006/nimg.1997.0295.
Krypotos, A. M., Mertens, G., Leer, A., & Engelhard, I. (2019). Imagine avoidance: Induction of conditioned avoidance via mental imagery. PsyArXiv. https://doi.org/10.31234/osf.io/ad2gf.
Kühn, S., Schmiedek, F., Brose, A., Schott, B. H., Lindenberger, U., & Lövden, M. (2013). The neural representation of intrusive thoughts. Social Cognitive and Affective Neuroscience, 8(6), 688–693. https://doi.org/10.1093/scan/nss047.
Lack, L. C., Gradisar, M., Van Someren, E. J. W., Wright, H. R., & Lushington, K. (2008). The relationship between insomnia and body temperatures. Sleep Medicine Reviews, 12(4), 307–317. https://doi.org/10.1016/j.smrv.2008.02.003.
Lang, P. J. (1979). A bio-informational theory of emotional imagery. Psychophysiology, 16(6), 495–512. https://doi.org/10.1111/j.1469-8986.1979.tb01511.x.
Lantz, B. (2013). The large sample size fallacy. Scandinavian Journal of Caring Sciences, 27(2), 487–492. https://doi.org/10.1111/j.1471-6712.2012.01052.x.
LeBlanc, M., Beaulieu-Bonneau, S., Mérette, C., Savard, J., Ivers, H., & Morin, C. M. (2007). Psychological and health-related quality of life factors associated with insomnia in a population-based sample. Journal of Psychosomatic Research, 63(2), 157–166. https://doi.org/10.1016/j.jpsychores.2007.03.004.
Lee, S. H., Kravitz, D. J., & Baker, C. I. (2012). Disentangling visual imagery and perception of real-world objects. Neuroimage, 59(4), 4064–4073. https://doi.org/10.1016/j.neuroimage.2011.10.055.
Léger, D., & Bayon, V. (2010). Societal costs of insomnia. Sleep Medicine Reviews, 14(6), 379–389. https://doi.org/10.1016/j.smrv.2010.01.003.
Lesku, J. A., Roth, T. C., Rattenborg, N. C., Amlaner, C. J., & Lima, S. L. (2008). Phylogenetics and the correlates of mammalian sleep: A reappraisal. Sleep Medicine Reviews, 12(3), 229–244. https://doi.org/10.1016/j.smrv.2007.10.003.
Luciano, J. V., Algarabel, S., Tomás, J. M., & Martínez, J. L. (2005). Development and validation of the thought control ability questionnaire. Personality and Individual Differences, 38(5), 997–1008. https://doi.org/10.1016/j.paid.2004.06.020.
Lundh, L. G., & Broman, J. E. (2000). Insomnia as an interaction between sleep-interfering and sleep-interpreting processes. Journal of Psychosomatic Research, 49(5), 299–310. https://doi.org/10.1016/S0022-3999(00)00150-1.
Marques, D. R., Gomes, A., Clemente, A., Santos, V., J. M., & Castelo-Branco, M. (2015). Hyperarousal and failure to inhibit wakefulness in primary insomnia: Birds of a feather? Processes in insomnia. Sleep and Biological Rhythms, 13(3), 219–228. https://doi.org/10.1111/sbr.12115.
Marques, D. R., Gomes, A. A., Ferreira, M. F., & de Azevedo, M. H. P. (2016). Don’t worry, sleep well: Predictors of sleep loss over worry. Sleep and Biological Rhythms, 14(3), 309–318. https://doi.org/10.1007/s41105-016-0060-z.
McCarthy-Jones, S., Knowles, R., & Rowse, G. (2012). More than words? Hypomanic personality traits, visual imagery and verbal thought in young adults. Consciousness and Cognition, 21(3), 1375–1381. https://doi.org/10.1016/j.concog.2012.07.004.
McNamara, P., & Auerbach, S. (2001). Evolutionary medicine of sleep disorders: Toward a science of sleep duration. In P. McNamara, R. A. Barton, & C. L. Nunn (Eds.), Evolution of Sleep (1st ed., pp. 107–122). Cambridge University Press. https://doi.org/10.1017/CBO9780511642074.006.
Mertens, G., Krypotos, A. M., & Engelhard, I. M. (2020). A review on mental imagery in fear conditioning research 100 years since the ‘Little Albert’ study. Behaviour Research and Therapy, 126, 103556. https://doi.org/10.1016/j.brat.2020.103556.
Molen, Y., Santos, G., Carvalho, L., Prado, L., & Prado, G. (2013). Pre-sleep worry decrease by adding reading and guided imagery to insomnia treatment. Sleep Medicine, 14, e210–e211. https://doi.org/10.1016/j.sleep.2013.11.504.
Mooney, P., Espie, C. A., & Broomfield, N. M. (2009). An Experimental Assessment of a Pennebaker writing intervention in primary insomnia. Behavioral Sleep Medicine, 7(2), 99–105. https://doi.org/10.1080/15402000902762386.
Morin, C. M. (1993). Insomnia: Psychological assessment and management (pp. xvii–238). Guilford Press.
Morin, C. M., & Azrin, N. H. (1987). Stimulus control and imagery training in treating sleep-maintenance insomnia. Journal of Consulting and Clinical Psychology, 55(2), 260.
Morin, C. M., Drake, C. L., Harvey, A. G., Krystal, A. D., Manber, R., Riemann, D., & Spiegelhalder, K. (2015). Insomnia disorder. Nature Reviews Disease Primers, 1, 15026. https://doi.org/10.1038/nrdp.2015.26.
Mueller, E. M., Sperl, M. F. J., & Panitz, C. (2019). Aversive imagery causes De Novo Fear Conditioning. Psychological Science, 30(7), 1001–1015. https://doi.org/10.1177/0956797619842261.
Nelson, J., & Harvey, A. G. (2002). The differential functions of imagery and verbal thought in insomnia. Journal of Abnormal Psychology, 111(4), 665–669. https://doi.org/10.1037/0021-843X.111.4.665.
Nelson, J., & Harvey, A. G. (2003a). An exploration of pre-sleep cognitive activity in insomnia: Imagery and verbal thought. British Journal of Clinical Psychology, 42(3), 271–288. https://doi.org/10.1348/01446650360703384.
Nelson, J., & Harvey, A. G. (2003b). Pre-sleep imagery under the microscope: A comparison of patients with insomnia and good sleepers. Behaviour Research and Therapy, 41(3), 273–284. https://doi.org/10.1016/S0005-7967(02)00010-4.
Nicassio, P. M., Mendlowitz, D. R., Fussell, J. J., & Petras, L. (1985). The phenomenology of the pre-sleep state: The development of the pre-sleep arousal scale. Behaviour Research and Therapy, 23(3), 263–271. https://doi.org/10.1016/0005-7967(85)90004-X.
Nota, J. A., & Coles, M. E. (2015). Duration and timing of Sleep are Associated with repetitive negative thinking. Cognitive Therapy and Research, 39(2), 253–261. https://doi.org/10.1007/s10608-014-9651-7.
Nuhoğlu, P., & Akkoyunlu, B. (2012). Nesnesel—Uzamsal İmgeleme Ve Sözel Bilişsel Stil Ölçeği’nin Türkçe’ye Uyarlanma Çalışması. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi, 42, 299–309.
Ohayon, M. M., & Hong, S. C. (2002). Prevalence of insomnia and associated factors in South Korea. Journal of Psychosomatic Research, 53(1), 593–600. https://doi.org/10.1016/S0022-3999(02)00449-X.
Palagini, L., Mauri, M., Dell’Osso, L., Riemann, D., & Drake, C. L. (2016). Trait- and pre-sleep-state-dependent arousal in insomnia disorders: What role may sleep reactivity and sleep-related metacognitions play? A pilot study. Sleep Medicine, 25, 42–48. https://doi.org/10.1016/j.sleep.2016.07.020.
Palagini, L., Moretto, U., Dell’Osso, L., & Carney, C. (2017). Sleep-related cognitive processes, arousal, and emotion dysregulation in insomnia disorder: The role of insomnia-specific rumination. Sleep Medicine, 30, 97–104. https://doi.org/10.1016/j.sleep.2016.11.004.
Pearson, J. (2019). The human imagination: The cognitive neuroscience of visual mental imagery. Nature Reviews Neuroscience, 20(10), 624–634. https://doi.org/10.1038/s41583-019-0202-9.
Perlis, M. L., Giles, D. E., Mendelson, W. B., Bootzin, R. R., & Wyatt, J. K. (1997). Psychophysiological insomnia: The behavioural model and a neurocognitive perspective. Journal of Sleep Research, 6(3), 179–188. https://doi.org/10.1046/j.1365-2869.1997.00045.x.
Perlis, M. L., Ellis, J. G., Kloss, J. D., & Dieter, W. R. (2016). Etiology and pathophysiology of Insomnia. Principles and practice of Sleep Medicine (6th ed., pp. 769–784). Elsevier.
Perlis, M. L., Vargas, I., Ellis, J. G., Grandner, M. A., Morales, K. H., Gencarelli, A., Khader, W., Kloss, J. D., Gooneratne, N. S., & Thase, M. E. (2020). The natural history of Insomnia: The incidence of acute insomnia and subsequent progression to chronic insomnia or recovery in good sleeper subjects. Sleep, 43(6), zsz299. https://doi.org/10.1093/sleep/zsz299.
Perogamvros, L., Castelnovo, A., Samson, D., & Dang-Vu, T. T. (2020). Failure of fear extinction in insomnia: An evolutionary perspective. Sleep Medicine Reviews, 51, 101277. https://doi.org/10.1016/j.smrv.2020.101277.
Pigeon, W. R., Bishop, T. M., & Krueger, K. M. (2017). Insomnia as a Precipitating factor in New Onset Mental illness: A systematic review of recent findings. Current Psychiatry Reports, 19(8), 44. https://doi.org/10.1007/s11920-017-0802-x.
Pillai, V., & Drake, C. L. (2015). Sleep and Repetitive Thought. In Sleep and Affect (pp. 201–225). Elsevier. https://doi.org/10.1016/B978-0-12-417188-6.00010-4.
Puzino, K., Amatrudo, G., Sullivan, A., Vgontzas, A. N., & Fernandez-Mendoza, J. (2019). Clinical significance and cut-off scores for the pre-sleep Arousal Scale in Chronic Insomnia disorder: A replication in a clinical sample. Behavioral Sleep Medicine, 18(6), 705–718. https://doi.org/10.1080/15402002.2019.1669604.
Rachman, S., & de Silva, P. (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16(4), 233–248. https://doi.org/10.1016/0005-7967(78)90022-0.
Richardson, A. (1994). Individual defferences in imaging: Their measurement, origins, and consequences. Baywood Publishing Company. https://eds.s.ebscohost.com/eds/detail/detail?vid=0&sid=ed9c53fa-b2ce-4df0-a815-7855c50fe3d8%40redis&bdata=JkF1dGhUeXBlPWlwJnNpdGU9ZWRzLWxpdmU%3d#AN=16262959&db=asn.
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Groselj, L. D., Ellis, J. G., Espie, C. A., Garcia-Borreguero, D., Gjerstad, M., Gonçalves, M., Hertenstein, E., Jansson‐Fröjmark, M., Jennum, P. J., Leger, D., Nissen, C., Parrino, L., Paunio, T., Pevernagie, D., Verbraecken, J., & Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675–700. https://doi.org/10.1111/jsr.12594.
Rosekind, M. R., & Gregory, K. B. (2010). Insomnia risks and costs: Health, safety, and quality of life. The American Journal of Managed Care, 16(8), 617–626.
Ruivo Marques, D., Allen Gomes, A., Nicassio, P. M., & Azevedo, M. H. P. (2018). de. Pre-Sleep Arousal Scale (PSAS): Psychometric study of a European Portuguese version. Sleep Medicine, 43, 60–65. https://doi.org/10.1016/j.sleep.2017.10.014.
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23–74.
Schmid, C., & Steil, R. (2019). Cognitive restructuring and imagery modification in insomnia disorder: A feasibility study. Sleep and Hypnosis - International Journal, 233–241. https://doi.org/10.5350/Sleep.Hypn.2019.21.0191.
Schwartz, S., Clerget, A., & Perogamvros, L. (2022). Enhancing imagery rehearsal therapy for nightmares with targeted memory reactivation. Current Biology: CB, 32(22), 4808–4816e4. https://doi.org/10.1016/j.cub.2022.09.032.
Seo, J., Moore, K. N., Gazecki, S., Bottary, R. M., Milad, M. R., Song, H., & Pace-Schott, E. F. (2018). Delayed fear extinction in individuals with insomnia disorder. Sleep, 41(8), https://doi.org/10.1093/sleep/zsy095.
Sharon, S. R., Lauren, B., Daniel, B., Cynthia, D., & Sateia Michael. (2008). Clinical Guideline for the evaluation and management of chronic insomnia in adults. Journal of Clinical Sleep Medicine, 04(05), 487–504. https://doi.org/10.5664/jcsm.27286.
Sheikh, A. A. (1976). Treatment of Insomnia through Eidetic Imagery: A new technique. Perceptual and Motor Skills, 43(3), 994–994. https://doi.org/10.2466/pms.1976.43.3.994.
Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on Insomnia Treatment. Psychiatric Clinics of North America, 10(4), 541–553. https://doi.org/10.1016/S0193-953X(18)30532-X.
Stoller, M. K. (1994). Economic effects of insomnia. Clinical Therapeutics: The International Peer-Reviewed Journal of Drug Therapy, 16(5), 873–897.
Streiner, D. L. (2005). Finding our way: An introduction to path analysis. Canadian Journal of Psychiatry, 50(2), 8.
Tousignant, O. H., Taylor, N. D., Suvak, M. K., & Fireman, G. D. (2019). Effects of rumination and worry on Sleep. Behavior Therapy, 50(3), 558–570. https://doi.org/10.1016/j.beth.2018.09.005.
Türkarslan, K. K., & Çınarbaş, D. C. (2022). The Examination of Reliability and Validity of the Turkish Intrusive Visual Imagery and Verbal Thought Questionnaires. PsyArXiv. https://doi.org/10.31234/osf.io/6rqmw.
Türkarslan, K. K., Canel Çınarbaş, D., & Nicassio, P. M. (2023). The psychometric properties of the Turkish version of the Pre-sleep Arousal Scale. Sleep and Biological Rhythms. https://doi.org/10.1007/s41105-023-00483-z
Vargas, I., Nguyen, A. M., Muench, A., Bastien, C. H., Ellis, J. G., & Perlis, M. L. (2020). Acute and Chronic Insomnia: What has Time and/or Hyperarousal got to do with it? Brain Sciences, 10(2), 71. https://doi.org/10.3390/brainsci10020071.
Vrana, S. R., Cuthbert, B. N., & Lang, P. J. (1986). Fear imagery and text Processing. Psychophysiology, 23(3), 247–253. https://doi.org/10.1111/j.1469-8986.1986.tb00626.x.
Wassing, R., Schalkwijk, F., Lakbila-Kamal, O., Ramautar, J. R., Stoffers, D., Mutsaerts, H. J. M. M., Talamini, L. M., & Van Someren, E. J. W. (2019). Haunted by the past: Old emotions remain salient in insomnia disorder. Brain, 142(6), 1783–1796. https://doi.org/10.1093/brain/awz089.
Watts, F. N., Coyle, K., & East, M. P. (1994). The contribution of worry to insomnia. British Journal of Clinical Psychology, 33(2), 211–220.
Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62(4), 615–640. https://doi.org/10.1111/j.1467-6494.1994.tb00311.x.
Wicklow, A., & Espie, C. A. (2000). Intrusive thoughts and their relationship to actigraphic measurement of sleep: Towards a cognitive model of insomnia. Behaviour Research and Therapy, 38(7), 679–693. https://doi.org/10.1016/S0005-7967(99)00136-9.
Winlove, C. I. P., Milton, F., Ranson, J., Fulford, J., MacKisack, M., Macpherson, F., & Zeman, A. (2018). The neural correlates of visual imagery: A co-ordinate-based meta-analysis. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior, 105, 4–25. https://doi.org/10.1016/j.cortex.2017.12.014.
Woolfolk, R. L., & McNulty, T. F. (1983). Relaxation treatment for insomnia: A component analysis. Journal of Consulting and Clinical Psychology, 51, 495–503. https://doi.org/10.1037/0022-006X.51.4.495.
Wuyts, J., De Valck, E., Vandekerckhove, M., Pattyn, N., Bulckaert, A., Berckmans, D., Haex, B., Verbraecken, J., & Cluydts, R. (2012). The influence of pre-sleep cognitive arousal on sleep onset processes. International Journal of Psychophysiology, 83(1), 8–15.
Yeh, Z. T., Wung, S. K., & Lin, C. M. (2015). Pre-sleep Arousal as a Mediator of Relationships among worry, rumination, and Sleep Quality. International Journal of Cognitive Therapy, 8(1), 21–34. https://doi.org/10.1521/ijct.2015.8.1.21.
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Türkarslan, K.K., Çınarbaş, D.C. & Perogamvros, L. The Roles of Intrusive Visual Imagery and Verbal Thoughts in Pre-Sleep Arousal of Patients with Insomnia Disorder: A Path Model. Cogn Ther Res (2023). https://doi.org/10.1007/s10608-023-10442-0
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DOI: https://doi.org/10.1007/s10608-023-10442-0