Cancer survivors' beliefs about the causes of their insomnia: Associations of causal attributions with survivor characteristics Journal Article


Authors: Shaffer, K. M.; Applebaum, A. J.; DuHamel, K. N.; Garland, S. N.; Gehrman, P.; Mao, J. J.
Article Title: Cancer survivors' beliefs about the causes of their insomnia: Associations of causal attributions with survivor characteristics
Abstract: Objectives: Insomnia is common among cancer survivors, yet survivors’ beliefs about their insomnia following cancer are largely unknown. This study describes cancer survivors’ causal attributions of insomnia and whether these beliefs differ by sociodemographic characteristics. Participants: 160 cancer survivors meeting diagnostic criteria for insomnia disorder. Methods: Survivors endorsed how likely they believed 12 different factors were causally related to their insomnia and self-reported sociodemographics. Multinomial logistic regression tested associations between attribution endorsement and sociodemographics. Latent class analysis (LCA) examined patterns of attribution endorsement and whether sociodemographics were associated. Results: One hundred fifty-four survivors (96%) endorsed that at least 1 causal attribution was likely related to their insomnia. Most survivors endorsed that emotions (77%), thinking patterns (76%), sleep-related emotions (65%), and sleep-related thoughts (57%) were related to their insomnia, similar to data previously published among healthy persons with insomnia. Younger participants were more likely to endorse that biochemical factors related to their insomnia (ps < .02); females were more likely to endorse that hormonal factors related to their insomnia (ps < .001). LCA identified three classes (AIC = 3209.50, BIC = 3485.13). Approximately 40% of survivors endorsed most of the causal attributions were likely related to their insomnia; 13% frequently endorsed attributions were neither likely nor unlikely to be related. Older survivors were more likely to belong to the 47% who reported most attributions were unlikely related to their insomnia (p = .03). Conclusions: Cancer survivors with insomnia commonly endorsed that thoughts and emotions contributed to their sleep disturbance. Survivors’ sociodemographic characteristics did not meaningfully explain individual differences for most causal attribution beliefs. © 2018, © 2018 Taylor & Francis Group, LLC.
Journal Title: Behavioral Sleep Medicine
Volume: 18
Issue: 2
ISSN: 1540-2002
Publisher: Taylor & Francis Group  
Date Published: 2020-01-01
Start Page: 177
End Page: 189
Language: English
DOI: 10.1080/15402002.2018.1546708
PUBMED: 30475651
PROVIDER: scopus
PMCID: PMC6535375
DOI/URL:
Notes: Article -- Export Date: 2 March 2020 -- Source: Scopus
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  1. Katherine N Duhamel
    99 Duhamel
  2. Allison Joyce Applebaum
    191 Applebaum
  3. Jun J Mao
    243 Mao
  4. Kelly M Shaffer
    23 Shaffer