2020 Volume 60 Issue 3 Pages 241-248
Objective : Positive and negative metacognitive belief is considered to effect sleep-onset insomnia mediated by cognitive arousal. In previous studies on relationships between sleep-onset insomnia and metacognitive beliefs indicate that positive metacognitive belief rather than negative metacognitive belief is correlated with sleep-onset insomnia. However, these studies have two major problems : (a) Do not include “uncontrollability of worry” when evaluating negative metacognitive belief, (b) Lack investigation on the indirect effect of each metacognitive belief on sleep-onset insomnia and cognitive arousal as mediation role. Therefore, it is unclear whether for treatment of sleep-onset insomnia to target negative metacognitive belief or positive metacognitive belief. From these considerations, the present study aimed to evaluate the association between metacognitive belief and sleep-onset insomnia, mediated by cognitive arousal.
Methods : A cross-sectional survey was conducted on 414 undergraduate students. The questionnaire included Pittsburgh Sleep Quality Index (evaluating sleep-onset insomnia), Pre-sleep Cognitive Activity Scale (evaluating cognitive arousal), and Metacognitive Beliefs about Worry Questionnaire (evaluating negative metacognitive belief including “uncontrollability of worry” and positive metacognitive belief). Three hundred seventy-nine valid responses (male : 155, female : 224, mean age : 20.21, SD : 1.88) were analyzed.
Results : The mediation analysis indicated that negative metacognitive belief was significantly correlated with sleep-onset insomnia indirectly [β=0.18, 95%Confidence interval (CI) : 0.12, 0.25, p<0.01]. On the other hand, no significant correlation was demonstrated between positive metacognitive belief and sleep-onset insomnia (β=−0.02, 95%CI : −0.12, 0.08, p=0.66).
Conclusions : The present study indicates that negative metacognitive belief correlated with sleep-onset insomnia was mediated by cognitive arousal. It is important to target negative metacognitive belief rather than positive metacognitive belief for sleep-onset insomnia treatments. Moreover, there is need to evaluate the “uncontrollability of worry” when assessing negative metacognitive belief.
