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The Roles of Intrusive Visual Imagery and Verbal Thoughts in Pre-Sleep Arousal of Patients with Insomnia Disorder: A Path Model

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A Correction to this article was published on 03 February 2024

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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.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for- profit sectors.

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Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by KKT and DCÇ. The first draft of the manuscript was written by KKT, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kutlu Kağan Türkarslan.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethics Approval

This research meets the ethical guidelines, including adherence to the legal requirements of the study country. Ethical committee approval was sought where necessary and is acknowledged within the text of the submitted manuscript.

Consent to Participate

Informed consent was obtained from all participants included in the study.

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The original online version of this article was revised: There was a mistake in the 3rd affiliation. The 3rd affiliation should read as “Center for Sleep Medicine, Department of Psychiatry, University Hospitals of Geneva, Geneva, Switzerland” instead of “Center for Sleep Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland“. The 3rd affiliation is now corrected.

Authors’ Note

The article was generated from the Ph.D. thesis that the first author produced under the supervision of the second author.

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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

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