کمال گرایی و بی خوابی مزمن

The relationship between chronic insomnia and perfectionism was investigated using a sample of 32 adults with chronic insomnia and 26 healthy controls. Different aspects of perfectionism were measured using two Multi-Dimensional Perfectionism Scales [Frost RO, Marten P, Lahart C, Rosenblate R. The dimensions of perfectionism. Cognit Ther Res 1990;14(5):449–468; Hewitt PL, Flett GL. The Multidimensional Perfectionism Scale: development and validation. Can Psychol 1989;30:339; Hewitt PL, Flett GL. Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology. J Pers Soc Psychol 1991;60:456–470.]. Using a univariate approach, results indicated that those with chronic insomnia were more likely to endorse features of “maladaptive” perfectionism relative to healthy controls. Further, those with chronic insomnia were more likely to report doubts about action, frequent parental criticism, and concern over mistakes. Although those with chronic insomnia were found to be more perfectionistic in these areas, only perception of heightened parental criticism was associated with the reporting of delayed sleep-onset latency. No other aspect of perfectionism was associated with sleep-onset latency, total sleep time, or sleep quality. Implications for theories of the development of insomnia are discussed.

Perfectionism is a complex, multi-dimensional construct that has generated considerable research interest over the years [4], [5] and [6]. Currently there are differing conceptualizations of this construct. For example, several investigators emphasize that perfectionism entails the setting of and striving for unrealistic personal standards, coupled with a tendency to engage in critical self-evaluation when one falls short of such standards [6] and [7]. Frost et al. [8] suggest that perfectionism is characterized by excessively high standards, excessive concern over mistakes in performance, doubts about the quality of personal performance, perceptions of heightened expectation and evaluation by one's parents, and an exaggerated emphasis on precision, order, and organization. Recently, the interpersonal aspects of perfectionism have been highlighted. Hewitt and Flett [2] and [3] define “socially-prescribed perfectionism” as the need to meet standards and expectations prescribed by significant others, “other-oriented perfectionism” as the expectation that others can and should meet high unrealistic standards, and “self-prescribed perfectionism” as the setting of excessively high standards for oneself. Research shows that “socially-prescribed perfectionism” is associated with elevated fear of negative evaluation, need for approval, and external locus of control, “other-oriented perfectionism” is associated with authoritarianism, dominance, and a tendency to blame others, and “self-oriented perfectionism” is associated with general distress, self-criticism, and self-blame [3]. The aspects of perfectionism measured by Frost et al. [1] and Hewitt and Flett [2] and [3] appear to be inter-related [9]. For example, “socially-prescribed perfectionism” is most strongly related to Frost et al.'s [1] “parental expectations” and “parental criticism” sub-scales, and “other-oriented perfectionism” is most strongly related to Frost et al.'s “concern over mistakes” and “personal standards” sub-scales. It is generally recognized that many of these beliefs and traits can be highly adaptive in the right circumstances and to the appropriate degree. In support of this idea, research has identified an adaptive and maladaptive type of perfectionism. Adaptive perfectionism is associated with good work habits, high need for order and organization, and pleasure gleaned from working towards a goal [5] and [7]. These qualities are associated with the constructive striving for achievement and self-actualization [5]. In contrast, maladaptive perfectionism is associated with the belief that others have unrealistic expectations of you (i.e., socially-prescribed perfectionism), heightened concern about making mistakes, tendency to doubt oneself, and low self-esteem. Maladaptive perfectionism is associated with a variety of health problems such as depression and suicidal ideation [5], [8] and [10], eating disorders [11], panic disorder [12], sexual dysfunction [13], Type A behavior [14], migraines [15], and recently insomnia [16]. Perfectionism and insomnia There has been little research in the area of perfectionism and insomnia (See Lundh et al. [16] for an exception), however, there is some indirect evidence that the two constructs are related. First, perfectionism has been associated with heightened distress and arousal [5] and [6], and heightened arousal has been associated with delayed sleep-onset latency and reduced overall sleep time [17] and [18] (see Chambers and Keller [19] for an alternative view). Second, a relationship between perfectionism and fatigue has been noted in healthy populations [20]. Third, in clinical settings, perfectionistic individuals with insomnia are reported to expect their sleep to be perfect and to become inordinately frustrated/anxious about any deviations from what is desirable [21]. Finally, Lundh et al. [16], in the single study conducted in this area, found that Swedish patients with insomnia were more perfectionistic (i.e., reported more concern about making mistakes, more doubts about personal action, and higher personal standards) than Swedish community controls. Unfortunately, the authors did not indicate the relationship between perfectionism and sleep parameters. The current study aimed to replicate previous findings with a North American sample and to explore the relationship between perfectionism and various aspects of sleep (e.g., sleep latency and sleep quality).