Effect of Psychological Inflexibility on Depressive Symptoms and Sleep Disturbance among Japanese Young Women with Chronic Pain

Abstract

Background: Psychological inflexibility based on an acceptance and commitment therapy model is theoretically well-established as a process to exacerbate psychological distress, such as depressive symptoms and sleep disturbance. This study aimed to examine the associations of psychological inflexibility with depressive symptoms and sleep distribution. We hypothesized that psychological inflexibility would be associated with higher levels of depressive symptoms and sleep disturbance in women with chronic pain. Methods: Female college students in Japan answered a questionnaire on pain status, treatment, and psychological inflexibility as measured by the Acceptance and Action Questionnaire-Ⅱ before answering questionnaires on depressive symptoms and sleep disturbance eight months after. Results: Women with chronic pain (n = 320) reported more severe depressive symptoms and sleep disturbances compared to women without chronic pain (n = 90). Hierarchical multiple regressions revealed that psychological inflexibility predicted higher levels of depressive symptoms and sleep disturbance, independent of the pain intensity, whether they consulted a doctor or used pain medication. Conclusion: Based on our findings self-management interventions aimed at reducing psychological inflexibility should be developed for individuals who are experiencing chronic pain.

Cognitive and psychological factors associated with severe insomnia in Brazilian women: a cross-sectional study

“…Logistic regression analysis showed that each additional point on the AAQ-II increased the chances of women having severe insomnia. Therefore, our findings are in line with those of previous studies that have reported an association between psychological inflexibility and sleep problems (Daly-Eichenhardt et al, 2016;Kato, 2016Kato, , 2020McCracken et al, 2011).…”

“…Recent studies have demonstrated the association between psychological inflexibility and the severity of insomnia and sleep problems (Kato, 2016;Kato, 2020;McCracken et al, 2021). For instance, the study conducted by Kato (2020) among 320 women with chronic pain revealed that psychological inflexibility predicted higher levels of depressive symptoms and sleep disturbance. McCracken et al (2021) obtained similar findings with 1102 participants in the context of COVID-19.…”

Perceived social support and sleep quality in patients with arteriosclerotic obliterans: The mediating roles of psychological flexibility

“…The reason for this if patients receive less understanding and support from their society, family and friends, they are more likely to deal with this disease negatively, which reduces their confidence in disease recovery (Fivecoat et al, 2018 ; Liu et al, 2021 ) It also amplifies their negative emotions during the disease progression, which reduces their sleep quality (Grey et al, 2020 ). The results of this study indicate that the sleep quality of ASO patients was usually worse when their PF was lower, and these two factors were positively correlated ( r = .553, p < .01), which is consistent with the results of previous studies (Daly‐Eichenhardt et al, 2016 ; Kato, 2020 ). Avoidance behaviour is a natural human reaction, but excessive avoidance leads to psychological rigidity (Dawson & Golijani‐Moghaddam, 2020 ).…”

The Psychological Flexibility in Epilepsy Questionnaire (PFEQ): Psychometric properties of the Persian version

“…In general, the results in the current study are in line with previous studies that have shown PF can predict the levels of psychological health problems, such as depressive symptoms, anxiety as well as sleep disturbance and PF is related to the quality of life outcomes [49][50][51]. In that, implementing an ACT intervention might improve quality of life and reduce mental health problems by increasing PF [52][53][54].…”