Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Master of Science (MS)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Youngmee Kim

Second Committee Member

Charles Carver

Third Committee Member

Maria Llabre

Fourth Committee Member

William Wohlgemuth

Fifth Committee Member

Jamie Zeitzer


Sleep disturbance is an area of functioning that is a prominent concern for cancer patients and has implications for their disease progression, poor prognosis, and mortality. Sleep disturbance can be operationalized by individual differences in difficulty initiating sleep (sleep onset latency, SOL), difficulty maintaining sleep due to extended wakening after sleep onset (WASO), and poor sleep efficiency (SE). These individual differences in sleep disturbance can be examined through a lens of adult attachment theory. This theory posits individual differences in the activated internal working model of one’s attachment system that involves different psychological and physiological restorative processes in response to perceived threat and stress. Sleep disturbance may be a marker of one’s difficulty in the restorative process of stress regulation. Testing this theoretical premise with newly diagnosed colorectal cancer patients, this study examined the extent to which adult attachment orientations are associated with sleep disturbance indices. Data were analyzed from 24 cancer patients who were a subsample of the ongoing parent study. Self-reported adult attachment orientations (security, anxiety, and avoidance) were assessed with the Measure of Attachment Qualities, and sleep disturbance was assessed with the Consensus Sleep Diary over 14 consecutive days. Generalized linear modeling was used to test study hypotheses. Adult attachment orientations were hypothesized to be differentially associated with individuals’ means and variations in SOL, WASO, and SE across days, which were partially supported for attachment security only (B = -22.19, p < .007). Results failed to support hypotheses regarding attachment anxiety and attachment avoidance differentially associating with means and variations of sleep disturbance indices. The current study is an important investigation on cancer patients’ sleep disturbance within an adult attachment conceptual framework. Findings should be replicated with a larger sample. Investigating intra-individual changes of adult attachment, their associations with daily changes in sleep disturbance in the individual and dyadic context, as well as concordance in sleep indices between self-report and actigraph measures is warranted in future research.


adult attachment; cancer; patients; sleep; sleep disturbance