{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:47:02Z","timestamp":1790185622777,"version":"4.1.0"},"reference-count":57,"publisher":"Leibniz Institute for Psychology (ZPID)","issue":"2","content-domain":{"domain":["cpe.psychopen.eu"],"crossmark-restriction":false},"short-container-title":["Clin. Psychol. Eur."],"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Trauma-related sleep disturbances constitute critical symptoms of posttraumatic stress disorder (PTSD), but sleep symptoms often reside even after successful trauma-focused psychotherapy. Therefore, currently unattended factors \u2013 like fear of sleep (FoS) \u2013 might play a crucial role in the development and maintenance of residual sleep disturbances. However, it is unclear whether trauma-exposed individuals exhibit different symptomatic profiles of sleep disturbances that could inform individualized therapeutic approaches and eventually enhance treatment efficacy.<\/jats:p>\n         <\/jats:sec>\n         <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>In a large online study, a two-step cluster analysis and a hierarchical cluster analysis using Ward\u2019s method were performed to explore subgroups among trauma-exposed individuals (N = 471) in terms of FoS, different aspects of trauma-related sleep disturbances (e.g., insomnia symptoms, nightmares, arousal), and PTSD symptoms. These variables were compared between resulting clusters using ANOVAs and Scheff\u00e9\u2019s post-hoc tests.<\/jats:p>\n         <\/jats:sec>\n         <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The hierarchical cluster analysis supported 3- and 4-cluster solutions. The 3-cluster solution consisted of one \u201chealthy\u201d (n = 199), one \u201csubclinical\u201d (n = 223), and one \u201cclinical\u201d (n = 49) cluster, with overall low, medium, and high symptomatology on all used variables. In the 4-cluster solution, the clinical cluster was further divided into two subgroups (n = 38, n = 11), where one cluster was specifically characterized by elevated somatic pre-sleep arousal and high levels of FoS.<\/jats:p>\n         <\/jats:sec>\n         <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>A subgroup of trauma-exposed individuals with PTSD and sleep disturbances suffers from increased pre-sleep arousal and FoS, which has been suggested as one possible explanation for residual sleep disturbances. In these patients, FoS might be a relevant treatment target.<\/jats:p>\n         <\/jats:sec>","DOI":"10.32872\/cpe.v2i2.2699","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T08:33:31Z","timestamp":1593506011000},"update-policy":"https:\/\/doi.org\/10.5964\/psychopen.cmp","source":"Crossref","is-referenced-by-count":14,"title":["Pre-sleep arousal and fear of sleep in trauma-related sleep disturbances: A cluster-analytic approach"],"prefix":"10.32872","volume":"2","author":[{"given":"Gabriela G.","family":"Werner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Danb\u00f6ck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislav","family":"Metodiev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Kunze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1941","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"key":"sp1_r1","unstructured":"WernerG. 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