Insomnia and emotion dysregulation: Independent and interactive associations with posttraumatic stress symptoms among trauma-exposed smokers

Introduction: Traumatic event exposure is common among cigarette smokers, and elevated posttraumatic stress symptoms (PTSS) are associated with increased smoking levels. As such, the current study exainined factors that may contribute to elevated PTSS among trauma-exposed smokers. Insomnia and emotion dysregulation may be particularly relevant among smokers, and are each associated with PTSS. However, it remains unclear whether these factors are associated with PTSS after accounting for the effects of dispositional factors and each other, and whether they may interact to predict PTSS. Thus, the current study sought to test whether insomnia and emotion dysregulation are independently associated with PTSS after accounting for negative affectivity and number of traumas experienced, and to investigate the potential interactive influence of these factors on PTSS. Method: Hypotheses were tested cross-sectionally among a community sample of trauma-exposed individuals who presented for smoking cessation treatment (n=349). Results: Results demonstrated that insomnia and emotion dysregulation each predicted elevated PTSS after controlling for the other, negative affectivity and number of traumas experienced. In addition, the interaction between insomnia and emotion dysregulation was significant, such that higher levels of insomnia and emotion dysregulation were associated with the most severe PTSS. Limitations: Future research should examine these factors among a clinical-sample of individuals with PTSD, as well as utilize prospective designs. Conclusions: Findings highlight the roles of insomnia and emotion dysregulation in contributing to elevated PTSS among trauma-exposed smokers, and the potential importance of targeting these factors in the context of PTSD treatment. (C) 2014 Elsevier B.V. All rights reserved.