(PS2-A8) An Exploration of Dimensions of Self-care as Mediators of the Relationship Between Rumination and Sleep Quality

Background: Chronic, persistent rumination is associated with numerous adverse physical health outcomes, including increased blood pressure, heart rate, cortisol levels, and sleep disturbances (Clancy et al., 2019). Likewise, rumination often characterizes the cognitive perseveration that occurs within certain forms of psychopathology, including depression, anxiety, and anger (Besharat et al., 2013). Given the often detrimental effects of rumination on physical and psychological well-being, research efforts have explored potential protective factors that mitigate ruminative thinking and the subsequent negative consequences for psychological and physical well-being, such as mindfulness and gratitude (Kristin et al., 2014). However, research has yet to explore facets of self-care as protective factors in this context. The current study explores pertinent domains of self-care as potential mediators of the relationship between rumination and sleep quality, which represents perhaps the first indicator of physical health problems.

Method: Participants included college students from a Northeastern university (N = 103; 57.1% Female; 96.1% White) ages 18-39 (M = 18.47, SD = 3.24) who completed a battery of self-report measures to assess aspects of their physical and mental health. Measures relevant to the current study that were completed included the Ruminative Thought Style Questionnaire (RTSQ), Self-Care Inventory (SCI), and Pittsburgh Sleep Quality Index (PSQI). Separate mediation models were constructed for each of the self-care domains within the SCI (physical, spiritual, emotional, and professional). All mediation models were analyzed with PROCESS Version 4.0 (model 4) for IBM SPSS Statistics Version 29.

Results: Physical, spiritual, and professional domains of self-care were not significant as mediators of the relationship between rumination and sleep quality. The proposed model for emotional self-care was significant [F(2,102) = 14.153, p < .001, adjusted R2 = .22], with rumination and emotional self-care accounting for approximately 22% of the variance in sleep quality. Both rumination (standardized β=0.264, t=2.88, p=.005) and emotional self-care (standardized β=0.324,t=3.54, p< .001) were significant predictors of sleep quality within the model. The observed indirect effect of emotional self-care (ab=0.014, SE=0.007, 95% CI=[0.002, 0.029]) indicated partial mediation of the relationship between rumination and sleep quality (c’=0.041, SE=0.014, t=2.88, p=.005, 95% CI=[0.013, 0.070]).

Discussion: The current results indicate that emotional self-care, above other forms of self-care, may represent an integral coping mechanism for ruminative thinking, with potential additive benefits for sleep quality. This follows the recent identification of the secondary benefits of emotional self-care including attenuated symptoms of anxiety, depression, and anger, each which confers additional risks for adverse physical health outcomes (Lindert et al., 2022). With this knowledge, it is essential to further explore the possible positive effects of emotional self-care on other negative emotional manifestations, particularly within clinical, diverse samples.