(PS6-B45) The Potential Role of Shame and Rumination in Sleep Disturbances

Introduction: Insufficient sleep is associated with increased stress, impaired concentration, and memory; heightened risk for a range of diseases; and mental health problems like depression and anxiety (Bos and Macedo, 2018; Knutson et al., 2017; Li et al., 2016). Shame has also been associated with core symptoms of psychopathology like depression and anxiety (Callow et al., 2020). However, little is known about the association between shame and sleep, despite the acknowledged the role of repetitive negative thinking and reactivity to shame experiences in sleep disturbances (e.g., Amaral et al., 2018; Wassing et al., 2019). The current study examined the association between shame and sleep duration and subjective sleep quality in young adults, as well as the associations between depression and rumination on sleep-related variables. Further, we explored whether rumination moderated these relationships. 

Methods: A total of 210 young adults were recruited online using the Sona Systems platform and answered surveys on sleep duration and quality, rumination, shame, and depression. Specifically, participants completed the Internalized Shame Scale, the Pittsburgh Sleep Quality Index, the Ruminative Response Questionnaire, and the Center for Epidemiologic Studies Depression Scale. The sample was primarily female (68.1%, n=143), Asian (48.1%, n=101), and non-Hispanic (86.2%, n=181). Age was not collected; however, all participants were undergraduate students, with the majority in their first year of college (45.2%, n=95). Two participants were excluded from analysis due to incomplete data on sleep measures.

Results: First, simple linear regressions were used to evaluate the associations between shame, depression, and rumination with sleep-related variables: sleep duration and subjective sleep quality. Results showed that higher shame was associated with shorter sleep duration (p=.025) and worse subjective sleep quality (p< .000). Greater depressive symptoms and higher rumination were each associated with shorter sleep duration and worse subjective sleep quality (all p values < .009). Further, a moderation analysis for each sleep related variable was conducted using the PROCESS macro in SPSS (Hayes, 2012) to evaluate whether rumination moderates the relationship between shame and sleep when controlling for depression. Results showed that rumination did not significantly moderate the relationship between shame and sleep duration (p=.352) or subjective sleep quality (p=.120) when controlling for depression.

Conclusion: Overall, higher shame, worse depression, and heightened rumination were all significantly associated with shorter sleep duration and poor subjective sleep quality. Rumination did not significantly moderate the relationship between shame and sleep when controlling for depression. Shame and rumination are transdiagnostic measures associated with the presence of psychopathology and therefore could be a modifiable with CBT interventions (e.g., Watkins & Roberts, 2020). Our findings encourage additional research on shame and rumination as potential mechanistic targets for intervening with sleep disturbances.