Sleep-related monitoring on awakening mediates the relationship between insomnia-related interpretive bias and insomnia symptoms using the insomnia ambiguity paradigm.

A number of studies have examined and confirmed the presence of a sleep-related interpretive bias amongst poor sleepers and individuals with insomnia using an insomnia ambiguity task. This study explored possible mechanisms underlying the relationship between interpretive bias and insomnia using the insomnia ambiguity task. More importantly, the possible mediating role of sleep-associated monitoring, sleep preoccupation, sleep anticipatory anxiety and generalized anxiety was also examined. A total of N = 176 participants were stratified into normal sleepers and those displaying insomnia symptoms. Participants completed an online version of the insomnia ambiguity task and questionnaire measures pertaining to sleep and anxiety. Data concerning task response time and time of testing were also collected. Individuals in the insomnia symptom group presented significantly higher sleep-related interpretive bias scores compared to normal sleepers. When sleepiness, sleep-associated monitoring, sleep preoccupation, sleep anticipatory anxiety and generalized anxiety were controlled for, only monitoring on awakening predicted sleep-related interpretive bias. Multiple mediation modelling demonstrated that sleep-associated monitoring on awakening mediated the relationship between interpretive bias and insomnia symptoms. The current outcomes are consistent with previous research, supporting the notion that insomnia is characterized by a disorder-consistent interpretive bias. Furthermore, monitoring for insomnia-consistent cues on awakening appears to mediate group differences in interpretive bias.

The effects of social anxiety on emotional face discrimination and its modulation by mouth salience.

People high in social anxiety experience fear of social situations due to the likelihood of social evaluation. Whereas happy faces are generally processed very quickly, this effect is impaired by high social anxiety. Mouth regions are implicated during emotional face processing, therefore differences in mouth salience might affect how social anxiety relates to emotional face discrimination. We designed an emotional facial expression recognition task to reveal how varying levels of sub-clinical social anxiety (measured by questionnaire) related to the discrimination of happy and fearful faces, and of happy and angry faces. We also categorised the facial expressions by the salience of the mouth region (i.e. high [open mouth] vs. low [closed mouth]). In a sample of 90 participants higher social anxiety (relative to lower social anxiety) was associated with a reduced happy face reaction time advantage. However, this effect was mainly driven by the faces with less salient closed mouths. Our results are consistent with theories of anxiety that incorporate an oversensitive valence evaluation system.