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      Do alexithymia and negative affect predict poor sleep quality? The moderating role of interoceptive sensibility

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          Abstract

          Objectives

          Emotion-related hyperarousal is an important core pathology of poor sleep. Studies investigating the interplay of alexithymia and affective experiences in determining sleep quality have yielded mixed results. To disentangle the inconsistency, this study examined the concurrent predictive power of alexithymia, and negative and positive affect, while incorporating interoceptive sensibility (IS) as a possible moderator.

          Methods

          A sample of 224 (70.10% were female) participants completed the Toronto Alexithymia Scale, Positive and Negative Affect Schedule, Pittsburgh Sleep Quality Index, Multidimensional Assessment of Interoceptive Awareness (MAIA), and Marlowe‐Crowne Social Desirability Scale (for controlling response bias) using paper and pencil. A two-stage cluster analysis of the MAIA was used to capture IS characteristics. Stepwise regression was conducted separately for each IS cluster.

          Results

          A three-group structure for IS characteristics was found. Higher alexithymia was predictive of poor sleep quality in the low IS group, while higher negative affect predicted poor sleep quality in the moderate and high IS groups. Additionally, alexithymia and positive affect were significantly different in the three IS groups, while negative affect and sleep quality were not.

          Conclusions

          Emotion and cognitive arousal may impact sleep quality differently in individuals with different levels of internal focusing ability, depending on physiological versus emotional self-conceptualization. The implications on pathological research, clinical intervention, study limitations and future directions are discussed.

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          Most cited references77

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            The twenty-item Toronto Alexithymia scale—I. Item selection and cross-validation of the factor structure

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              Development and validation of brief measures of positive and negative affect: the PANAS scales.

              In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Writing – original draft
                Role: Data curationRole: Project administration
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                3 October 2022
                2022
                : 17
                : 10
                : e0275359
                Affiliations
                [1 ] Department of Psychology, Fo Guang University, Jiaoxi Township, Yilan, Taiwan
                [2 ] Department of Psychology, National Chengchi University, Taipei, Taiwan
                [3 ] Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan
                Hangzhou Normal University, CHINA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-2156-2654
                https://orcid.org/0000-0002-7077-7400
                Article
                PONE-D-21-13329
                10.1371/journal.pone.0275359
                9529110
                36191028
                2cf3d3cc-aafa-4473-96d8-0ee52bb047ff
                © 2022 Huang et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 22 April 2021
                : 15 September 2022
                Page count
                Figures: 0, Tables: 4, Pages: 13
                Funding
                Funded by: Ministry of Education of Taiwan
                Award ID: 108H-121-02
                Award Recipient :
                This work was supported by the Ministry of Education of Taiwan (Award Number 108H-121-02), which was not involved in the actual study. The funders had no role in study design, data collection, and analysis, publication decision, or manuscript preparation.
                Categories
                Research Article
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Sleep
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Perception
                Sensory Perception
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Social Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Biology and Life Sciences
                Neuroscience
                Sensory Perception
                Medicine and Health Sciences
                Medical Conditions
                Sleep Disorders
                Dyssomnias
                Insomnia
                Medicine and Health Sciences
                Neurology
                Sleep Disorders
                Dyssomnias
                Insomnia
                Biology and Life Sciences
                Psychology
                Psychometrics
                Social Sciences
                Psychology
                Psychometrics
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Homeostasis
                Custom metadata
                Data cannot be shared publicly because it is the part of the “Human Project from Mind, Brain and Learning Database.” Data are available from the Research Center for Mind, Brain, and Learning of National Chengchi University (contact via https://rcmbl.nccu.edu.tw/index.php?option=com_content&view=article&id=10&Itemid=106&lang=en-us or rcmbl@ 123456nccu.edu.tw ) for researchers who meet the criteria for access to confidential data.

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