'Let me draw your attention to sleep'

Psychophysiologic insomnia (PI) is a disorder of somatized tension and learned sleep-preventing associations (ICSD-R). Numerous authors contend that PI is the result of numerous psychological factors. Accumulated evidence supports the notion that PI are preoccupied with sleep, and the impact of not sleeping, and that this drives various behaviours, e.g. selective attention (SA) and monitoring, that result in worrisome thoughts and excessive anxiousness. SA, more commonly termed Attention Bias (AB), can be measured objectively using computerised cognitive probe tasks where information processing speed is taken as a proxy for biases in attention. These tasks use salient and neutral word or picture stimuli within an experimental test paradigm, and most identified AB effects have been attributed to perceived threat. Direct assessment of AB in PI is limited. At the outset of this PhD, namely Experiment 1 and 2, novel AB paradigms were used to confirm the existence of AB in PI to sleep related stimuli. Indeed, AB effects in PI do not appear to be an idiosyncratic finding. Experiment 3 attempts to underpin the components of attention, i.e. engagement or disengagement processes, which are responsible for the AB data of PI, through the use of a Modified Posner Paradigm. The data suggest that delayed disengagement away from salient stimuli are responsible for the AB effects captured. Finally, Experiment 4 differentiates the experimental stimuli in terms of emotional salience, i.e. positive or negative, to assess whether all stimulus valences generate the AB effect in PI. Here the data suggest that negative sleep-related stimuli are most salient to PI in capturing attention