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.

Associations between sleep disturbances, personality, and trait emotional intelligence

“…Sleep deprivation is negatively associated with emotional intelligence and is linked to impairments in interpersonal functioning, stress management, and coping (Killgore, et al, 2008). Additionally, insomnia and emotional dysregulation individually appear to be uniquely associated with psychopathology severity (Fairholme, Nosen, Nillni, Schumacher, Tull & Coffey, 2013). There is concordance between results of this study and past research.…”

Toward a Unified Treatment for Emotional Disorders: Update on the Science and Practice

“…Emotion regulation has been implicated as a transdiagnostic feature common to NAS (Campbell-Sills & Barlow, 2007;Fairholme et al, 2013;Fairholme, Boisseau, Ellard, Ehrenreich, & Barlow, 2010;Werner & Gross, 2010 Sawyer, Fang, & Asnaani, 2012). Despite this growing evidence demonstrating the transdiagnostic nature of emotion dysregulation across disorders, it has been suggested that the next step in this area will be to investigate differential forms and functions of emotion regulation across affective problems (Aldao, 2012).…”

“…Update on Transdiagnostic Science and Practice 8 (Paulus, Vanwoerden, Norton, & Sharp, under review), sleep disturbance/insomnia (Fairholme et al, 2013), and thought-action fusion (Thompson-Hollands, . This list represents an ever-growing list of transdiagnostic factors that are related to one or more disorders under the NAS umbrella.…”

The sleep phenotype of Borderline Personality Disorder: A systematic review and meta-analysis

“…Harty et al (2010) suggest that sleep problems in BPD may represent a more general impairment in self-regulation, and that sleep and impaired psychological self-regulation in BPD are underpinned by a common biological substrate. It has been proposed that sleep disturbances and emotional dysregulation are transdiagnostic processes which are aetiological and maintaining factors for a range of psychopathologies (Fairholme et al, 2013). As hypothesised in the "emotional cascades" theory of BPD, daytime dysregulation may spill over into the night-time increasing risk of sleep disturbance, which in turn may further contribute to dysregulation in a positive feedback loop .…”