Chronic Insomnia and Healthcare Utilization in Young Adults Page: 32
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and need to be conducted by trained individuals. In large epidemiology studies, this is not
always possible hence the use of self-report and well-validated measures such as the Quick
Inventory of Depressive Symptomatology (QIDS; Rush et al., 2003) and the State-Trait Anxiety
Inventory (STAI; Spielberger et al., 1983).
Another limitation was that personality factors were not measured. Neuroticism has been
found to be associated with increased primary care and mental health utilization (van Hemert,
Bakkar, Vandenbroucke, & Valkenburg, 1993; ten Have, Oldehinkel, Vollebergh, & Ormel,
2005). Additionally, a recent review found that traits like neuroticism, internalizing, and
perfectionism were associated with insomnia (van de Laar, Verbeek, Pevernagie, Aldenkamp, &
Overeem, 2010). Personality factors may be another moderator between insomnia and HCU and
should be included in future research.
While this study is not meant to be generalizable to an adult population, the sample may
also not be generalizable to all young adults. College students represent a large percentage (i.e.,
69%) of high school graduates (Bureau of Labor Statistics, 2009) but those who do not attend
college may have different rates of insomnia, comorbid medical/mental health problems, and
HCU. Reasons for potential differences among the non-student young adults may include more
consistent work hours and lack of access to affordable healthcare (e.g., a student health center).
Geographic location may also make a difference in prevalence of insomnia and HCU. This study
was conducted at a large public university in the south central United States. Smaller colleges,
private schools, and schools located in different geographic areas may have different rates of
insomnia and HCU. Because of University of North Texas' (UNT) large enrollment
(approximately 35,000) and the large sample size of the study (> 1,000), it is unlikely that the32
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Bramoweth, Adam Daniel. Chronic Insomnia and Healthcare Utilization in Young Adults, dissertation, August 2011; Denton, Texas. (https://digital.library.unt.edu/ark:/67531/metadc84179/m1/38/: accessed July 17, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; .