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. 2019 Sep 5;16(18):3253.
doi: 10.3390/ijerph16183253.

A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms

Marco Lauriola  1 , R Nicholas Carleton  2 , Daniela Tempesta  3 , Pierpaolo Calanna  4 , Valentina Socci  5 , Oriana Mosca  6 , Federico Salfi  7 , Luigi De Gennaro  8 , Michele Ferrara  9
Affiliations

A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms

Marco Lauriola et al. Int J Environ Res Public Health. .

Abstract

In this study, we used structural equation modeling to investigate the interplay among Intolerance of Uncertainty (IU), Anxiety Sensitivity (AS), and sleep problems. Three hundred undergraduate students completed the Intolerance of Uncertainty Scale, the Intolerance of Uncertainty Inventory, the Anxiety Sensitivity Index, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. 68% and 40% of the students reported poor sleep quality or sub-threshold insomnia problems, respectively. Depression and anxiety levels were above the cut-off for about one-fourth of the participants. Structural equation modeling revealed that IU was strongly associated with AS, in turn influencing both insomnia severity and sleep quality via depression and anxiety. Significant indirect effects revealed that an anxious pathway was more strongly associated with insomnia severity, while a depression pathway was more relevant for worsening the quality of sleep. We discussed the results in the frameworks of cognitive models of insomnia. Viewing AS and IU as antecedents of sleep problems and assigning to AS a pivotal role, our study suggested indications for clinical interventions on a population at risk for sleep disorders.

Keywords: anxiety; anxiety sensitivity; depression; insomnia severity; intolerance of uncertainty; mediation analyses; sleep quality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of six alternative structural equation models of sleep quality and insomnia severity. IU = Intolerance of Uncertainty; AS = Anxiety Sensitivity; DEP = Depression; ANX = Anxiety; IS = Insomnia Severity; SQ = Sleep Quality.
Figure 2
Figure 2
Structural equation model of insomnia severity and sleep quality. IU = Intolerance of Uncertainty; AS = Anxiety Sensitivity; DEP = Depression; ANX = Anxiety; IS = Insomnia Severity; SQ = Sleep Quality. The solid lines represent statistically significant paths (p < 0.05). The dashed lines represent not significant paths. The thickness of the lines representing structural relationships is proportional to the effect size of the path coefficient.
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