Abstract
This study investigated the relationship between bedtime counterfactual thoughts,depressive symptoms, nocturnal counterproductive thought-control strategies andinsomnia disorder. Six hundred and fifty adults from the general population wererecruited and provided data on their counterfactual thoughts' frequency at bedtime,depressive symptoms and use of nocturnal maladaptive strategies of thought control.In addition, all participants followed a face-to-face clinical interview for the diagnosisof insomnia disorder. A model positing moderated mediation was tested using conditionalprocess modelling. Overall, 19% of participants met diagnostic criteria fora chronic insomnia diagnosis. Bootstrapped mediation analyses indicated that theassociation of bedtime counterfactual processing and insomnia diagnosis is mediatedby depressive symptoms (B = 0.035, SE = 0.007, bootstrapped 95% CI = 0.023, 0.051).Furthermore, the effects of such a mediation model were significantly larger amongindividuals with high levels of aggressive suppression than those with low levels ofaggressive suppression (B = 0.002, SE = 0.001, bootstrapped 95% CI = 0.001, 0.004).A second model in which a worry strategy moderates the relationship between bedtimecounterfactual processing and depressive symptoms was not statistically significant(B = 0.0036, SE = 0.013, p = .78). The present study adds to the literature on theimportance of self-attacking thoughts and negative affects at bedtime. We recommendthe evaluation of the impact of adding self-attacks management strategies tocognitive behavior therapy for individuals with an insomnia disorder