Perfectionism & insomnia: The mediating role of anxiety and depression

Introduction: Perfectionism can be considered a predisposing factor in the onset of insomnia. Prior research has demonstrated that individuals with insomnia often exhibit aspects of perfectionism. Further, symptoms of anxiety and depression often appear to be prominent amongst those with insomnia. Despite this, examination of these factors together has been limited. The present study aimed to determine whether individuals with insomnia, compared to normal-sleepers, report increased aspects of perfectionism. In addition, the meditational role of anxiety and depression was examined. Methods: Seventy-eight participants, 39 of whom met the DSM-5 criteria for insomnia disorder (92% female, mean age 22.18 years ± 5.37 years) and 39 normal-sleepers (69% female, mean ages 24 years ± 6.25 years), completed two Multidimensional Perfectionism Scales (F-MPS; HF-MPS) and the Hospital Anxiety and Depression Scale (HADS). Results: Individuals with insomnia reported significantly higher scores of concern over mistakes (t(76) = −2.50, p = 0.02), doubts about action (t(76) = −2.64, p = 0.01) and parental criticism (t(76) = −2.74, p = 0.01) compared to normal-sleepers. In addition, individuals with insomnia also reported greater symptoms of anxiety (t(76) = −4.49, p = 0.01) and depression (t(76) = −2.80, p = 0.01). However, a series of ANCOVA analyses demonstrated that when anxiety and depression were controlled for, none of the previous differences concerning perfectionism remained significant, p > 0.05. Conclusion: The present study indicated that although individuals with insomnia exhibit a greater degree of concern over mistakes (e.g., “people will think less of me if I make a mistake”), doubts about action (e.g., “I have doubts about everyday things I do”) and parental criticism (e.g., “My parents never tried to understand my mistakes”) relative to normal-sleepers, these differences appear to be mediated by anxiety and depression. These results highlight the significance of treating symptoms of anxiety and depression with the prospect of alleviating negative thoughts concerning ones mistakes, doubts about actions, and perception of parental criticism, which may contribute to disturbed sleep.