Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-22T17:11:09.742Z Has data issue: false hasContentIssue false
  • English
  • Français

A psychological pathway from insomnia to depression among older adults

Published online by Cambridge University Press:  13 May 2013

Paul Sadler ,
Suzanne McLaren  and
Megan Jenkins
Paul Sadler*
Affiliation:
School of Health Sciences, University of Ballarat, Ballarat, Victoria, Australia
Suzanne McLaren
Affiliation:
School of Health Sciences, University of Ballarat, Ballarat, Victoria, Australia
Megan Jenkins
Affiliation:
School of Health Sciences, University of Ballarat, Ballarat, Victoria, Australia
*
Correspondence should be addressed to: Paul Sadler, School of Health Sciences, University of Ballarat, PO Box 663, Ballarat 3353, Victoria, Australia. Phone: +61 (03) 5327 9000; Fax: +61 (03) 5327 9704. Email: [email protected].
Get access

Abstract

Background: Higher levels of insomnia predict greater depression severity among older adults; however, the psychological mechanisms underlying this relationship are unclear. This study tested a path model that explored whether dysfunctional beliefs about sleep and hopelessness mediated the relationship from insomnia to depression. It was hypothesized that insomnia would predict depression, both directly and indirectly, via dysfunctional beliefs about sleep and hopelessness.

Methods: A community sample of 218 independent-living Australian older adults aged from 65 to 96 years completed a self-report questionnaire package. From the initial 218 participants, 171 completed a measure of depression three months later.

Results: Path analysis demonstrated that maladaptive sleep beliefs and hopelessness partly explained how insomnia influenced depression, irrespective of the presence of obstructive sleep apnea and/or restless legs syndrome.

Conclusions: An older adult's beliefs about sleep and sense of hopelessness were important psychological factors that helped explain how insomnia related to depression.

Keywords

insomniadysfunctional beliefs about sleephopelessnessdepressionolder adults
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 8: Elder abuse an international perspective , August 2013 , pp. 1375 - 1383
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abramson, L. Y., Metalsky, G. J. and Alloy, L. B. (1989). Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358–372.CrossRefGoogle Scholar
Allen, R. and Earley, C. (2001). Validation of a diagnostic questionnaire for the restless legs syndrome. Neurology, 58, 3–4.Google Scholar
Alloy, L. B., Abramson, L. Y., Whitehouse, W. G., Hogan, M. F., Panzarella, C. and Rose, D. T. (2006). Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression. Journal of Abnormal Psychology, 115, 145–156.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn., Text Revision. Washington, DC: American Psychiatric Association.Google Scholar
Ancoli-Israel, S. and Ayalon, L. (2006). Diagnosis and treatment of sleep disorders in older adults. American Journal of Geriatric Psychiatry, 14, 95–103.CrossRefGoogle ScholarPubMed
Baron, L. P. and Kenny, D. A. (1986). The moderator–mediator distinction in social psychology research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.CrossRefGoogle ScholarPubMed
Bastien, C. H., Vallieres, A. and Morin, C. M. (2001). Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2, 297–307.CrossRefGoogle ScholarPubMed
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International University Press.Google Scholar
Beck, A. T. and Steer, A. (1988). Manual for Beck Hopelessness Scale. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, A. T., Weissman, A., Lester, D. and Trexler, L. (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861–865.CrossRefGoogle ScholarPubMed
Byrne, B. (1998). Structural Equation Modelling: Basic Applications and Programs. New Jersey: Lawrence Erlbaum.Google Scholar
Carney, C. E. and Edinger, J. D. (2006). Identifying critical beliefs about sleep in primary insomnia. Sleep, 29, 444–453.CrossRefGoogle ScholarPubMed
Chung, K. F.et al. (2008). STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology, 108, 812–821.CrossRefGoogle ScholarPubMed
Crimmins, E. M. (2004). Trends in the health of the elderly. Annual Review of Public Health, 25, 79–98.CrossRefGoogle ScholarPubMed
Edinger, J. D. (2003). Cognitive and behavioural abnormalities among insomnia patients with mixed restless legs and periodic limb movement disorder. Behavioural Sleep Medicine, 1, 37–53.CrossRefGoogle Scholar
Ellis, J., Hampson, S. E. and Cropley, M. (2007). The role of dysfunctional beliefs and attitudes in late-life insomnia. Journal of Psychosomatic Research, 62, 81–84.CrossRefGoogle ScholarPubMed
Espie, C. A., Inglis, S. J., Harvey, L. and Tessier, S. (2000). Insomniacs’ attributions: psychometric properties of the dysfunctional beliefs and attitudes about sleep scale and the sleep disturbance questionnaire. Journal of Psychosomatic Research, 48, 141–148.CrossRefGoogle ScholarPubMed
Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869–893.CrossRefGoogle ScholarPubMed
Hu, L. T. and Bentler, P. M. (1998). Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychological Methods, 3, 424–453.CrossRefGoogle Scholar
Manber, R. and Chambers, A. S. (2009). Insomnia and depression: a multifaceted interplay. Current Psychiatry Reports, 11, 437–442.CrossRefGoogle ScholarPubMed
McCall, W. V., Reboussin, V. and Cohen, W. (2000). Subjective measurement of insomnia and quality of life in depressed inpatients. Journal of Sleep Research, 9, 43–48.CrossRefGoogle ScholarPubMed
Morin, C. M. (1993). Insomnia, Psychological Assessment and Management. New York: Guilford Press.Google Scholar
Morin, C. M., Stone, J., Trinkle, D., Mercer, J. and Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and Ageing, 8, 463–467.CrossRefGoogle ScholarPubMed
Muthén, L. K. and Muthén, B. O. (2007). Mplus User's Guide, 5th edn.Los Angeles, CA: Muthén & Muthén.Google Scholar
Perlis, M. L.et al. (2006). Insomnia as a risk factor for onset of depression in the elderly. Behavioural Sleep Medicine, 4, 104–113.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CESD scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Smith, S., Sullivan, K., Hopkins, W. and Douglas, J. (2004). Frequency of insomnia report in patients with obstructive sleep apnoea hypopnea syndrome (OSAHS). Sleep Medicine, 5, 449–456.CrossRefGoogle ScholarPubMed
Stepanski, E. and Rybarczyk, B. (2006). Emerging research on the treatment and etiology of secondary or comorbid insomnia. Sleep Medicine Review, 10, 7–18.CrossRefGoogle ScholarPubMed
Tabachnick, B. G. and Fidell, L. (2001). Using Multivariate Statistics, 4th edn.Needham Heights, MA: Allyn & Bacon.Google Scholar
Taylor, D. J., Lichstein, K. L. and Durrence, H. H. (2003). Insomnia as a health risk factor. Behavioural Sleep Medicine, 1, 227–247.CrossRefGoogle ScholarPubMed
Walters, A. S. (1995). The international restless legs syndrome study group: toward a better definition of the restless legs syndrome. Movement Disorders, 10, 634–642.CrossRefGoogle Scholar
Yuan, K. H. and Bentler, P. M. (2000). Three likelihood-based methods for mean and covariance structure analysis with non-normal missing data. In Sobel, M. E. and Becker, M. P. (eds.), Sociological Methodology (pp. 165–200). Washington, DC: ASA.Google Scholar