Mastin-Purcell Lisa, Richdale Amanda L, Lawson Lauren P, Morris Eric M J
Department of Psychology, Therapy & Counselling, School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.
Olga Tennison Autism Research Centre, School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.
Psychol Psychother. 2025 Sep;98(3):606-623. doi: 10.1111/papt.12584. Epub 2025 Feb 20.
Psychological inflexibility, the model of psychopathology underlying Acceptance and Commitment Therapy (ACT), has been linked to a broad range of psychological problems, but its link with sleep quality is not well understood. This study aimed to identify relationships between psychological inflexibility processes (cognitive fusion, experiential avoidance, limited perspective-taking, lack of present moment awareness and inaction) and sleep quality, investigating pre-sleep arousal and anxiety symptomatology as mechanisms mediating these relationships.
A correlational, cross-sectional design was used to test two statistical models.
Participants (N = 704) from a general population sample completed an online survey, reporting on sleep quality, pre-sleep arousal, anxiety and measures of psychological inflexibility. Data were analysed using correlations and path analyses.
All psychological inflexibility processes were moderate to strongly correlated with sleep quality. Path analysis showed cognitive fusion, lack of present moment awareness and experiential avoidance, mediated by pre-sleep cognitive and somatic arousal, explained 49% of the variance in sleep quality (Model 1). Cognitive fusion via pre-sleep cognitive arousal had the largest effect. Anxiety preceding pre-sleep arousal (Model 2) explained no additional variance, and model fit was poorer than Model 1.
These findings highlight the role of psychological inflexibility processes in disrupting the de-arousal process needed for healthy sleep, supporting evidence for ACT as a treatment for sleep disturbance.
心理灵活性不足是接纳与承诺疗法（ACT）背后的心理病理学模型，它与广泛的心理问题相关，但与睡眠质量的关系尚不清楚。本研究旨在确定心理灵活性不足过程（认知融合、经验性回避、有限的观点采择、缺乏当下觉察和无为）与睡眠质量之间的关系，并研究睡前觉醒和焦虑症状作为介导这些关系的机制。
采用相关性横断面设计来检验两个统计模型。
来自普通人群样本的参与者（N = 704）完成了一项在线调查，报告了睡眠质量、睡前觉醒、焦虑以及心理灵活性不足的测量指标。使用相关性分析和路径分析对数据进行分析。
所有心理灵活性不足过程均与睡眠质量呈中度至高度相关。路径分析表明，由睡前认知和躯体觉醒介导的认知融合、缺乏当下觉察和经验性回避，解释了睡眠质量变异的49%（模型1）。通过睡前认知觉醒的认知融合影响最大。睡前觉醒前的焦虑（模型2）未解释额外的变异，且模型拟合比模型1差。
这些发现突出了心理灵活性不足过程在扰乱健康睡眠所需的觉醒降低过程中的作用，为ACT作为治疗睡眠障碍的方法提供了支持证据。
