Degree Name

MA (Master of Arts)



Date of Award


Committee Chair or Co-Chairs

Jameson Hirsch

Committee Members

Julia Dodd, Ginette Blackhart


Sleep disturbances are prevalent in primary care patients and can be exacerbated by interpersonal dysfunction and depression. As well, thwarted interpersonal needs (TIN), including thwarted belongingness and perceived burdensomeness, contribute to depression. However, the presence of gratitude, a cognitive-emotional protective factor, may improve symptoms. We longitudinally examined the mediating role of depressive symptoms on the relation between TIN and sleep disturbances, and the moderating role of gratitude on the TIN-sleep disturbances and depression-sleep disturbances linkages. Our primary care patient sample (N = 223) completed self-report surveys at baseline (T1) and at a one-year follow-up (T2; n = 97). Patients with greater TIN reported more depressive symptoms (T1) and, in turn, increased sleep disturbances (T2). Gratitude did not moderate the belongingness model but, in the burdensomeness model, buffered the linkage between burdensomeness and sleep disturbances and strengthened the relation between depressive symptoms and sleep disturbances. Clinical implications and future research directions are discussed.

Document Type

Thesis - unrestricted


Copyright by Heather Renee Altier.