DOI
https://doi.org/10.25772/HB34-WA96
Author ORCID Identifier
https://orcid.org/0000-0002-5246-6297
Defense Date
2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Psychology
First Advisor
Bruce Rybarczyk
Second Advisor
Taylor Crouch
Third Advisor
Natalie Dautovich
Fourth Advisor
Jared Keeley
Fifth Advisor
Paul Perrin
Abstract
Among individuals with chronic illness, sleep difficulties and chronic pain are prevalent and interrelated. Sleep- and pain-related cognitions are known contributors to insomnia severity and sleep quality. Yet, no one has explored to what extent two social-cognitive constructs known to influence pain and pain perceptions, illness invalidation and perceived injustice, may influence sleep quality in the context of chronic illness broadly and chronic insomnia with and without chronic pain, specifically. The purpose of the present study was to elucidate the relationships among illness invalidation, perceived injustice, sleep, and pain in a sample of adults, to add to the literature on psychosocial factors influencing chronic health outcomes. A subsample of 639 adults was taken from a larger cross-sectional sample of 999 individuals who completed a series of questionnaires via Amazon Mechanical Turk. Analysis of variance was used to assess the levels of illness invalidation and perceived injustice in those with and without insomnia and chronic pain. Subsequently, a path analysis examined the theoretical relationships among two illness invalidation subscales (discounting and lack of understanding), perceived injustice, and sleep quality. Results revealed that both invalidation subscales and perceived injustice were higher in participants with insomnia than in participants without insomnia. Illness invalidation— discounting and perceived injustice, but not illness invalidation—lack of understanding, were xi higher in those with chronic pain than in those without chronic pain. Path analysis revealed that perceived injustice partially mediated the relationship between illness invalidation—discounting and sleep quality. This pattern was stable across individuals with and without insomnia and chronic pain. The theoretical implications of these novel findings are discussed in the context of study limitations. Directions for future research and clinical implications are also explored.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
5-19-2023