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Al-Beltagi M, Saeed NK, Bediwy AS, Elbeltagi R. Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders. World J Clin Pediatr 2025; 14:103323. [PMID: 40491742 PMCID: PMC11947882 DOI: 10.5409/wjcp.v14.i2.103323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 12/14/2024] [Accepted: 01/02/2025] [Indexed: 03/18/2025] Open
Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health. AIM To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions. METHODS A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts. RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children's vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress. CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Paediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Nermin K Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Governmental Hospitals, Manama 26671, Bahrain
- Medical Microbiology Section, Department of Pathology, The Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel S Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
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Aji M, Xu X, McDermott EA, Metz M, Songco A, O'Gradey-Lee M, Lim CYS, Sicouri G, Parrish L, Hudson JL. Measures of Sleep-Related Fears in Children: A Systematic Review of Psychometric Properties Using COSMIN. Clin Child Fam Psychol Rev 2025; 28:439-457. [PMID: 40397330 PMCID: PMC12162706 DOI: 10.1007/s10567-025-00526-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2025] [Indexed: 05/22/2025]
Abstract
Sleep-related fears (i.e. fears related to sleep, nighttime and/or occurring before sleep) are linked to the development of anxiety and sleep problems in children. Parent- and child-report measurement tools are key to increasing understanding and facilitating better identification for treatment to prevent disorder development. We conducted a systematic review with the aim of identifying the breadth of parent- and child-report measures that include an assessment of sleep-related fears in children from 7 to 12 years old (stage 1) and reviewing the psychometric properties of measures that more comprehensively assess sleep-related fears (i.e. 3 or more items) using the COSMIN checklist (stage 2) to provide recommendations for measures (stage 3). A systematic search was performed using MEDLINE, EMBASE, ERIC and PsycINFO in accordance with PRISMA guidelines. At stage 1, we retrieved 14,495 records. Of these, 66 papers met eligibility and included 43 distinct measures. At stage 2, 11 out of the 43 measures met criteria for more comprehensive measurement of sleep-related fears. Findings demonstrated mixed and incomplete data and very little high-quality evidence. No measures met criteria for recommendation and the majority of measures require further validation studies.
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Affiliation(s)
- Melissa Aji
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia.
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Xiaomin Xu
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Emma A McDermott
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
| | - Madeline Metz
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Annabel Songco
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Maddison O'Gradey-Lee
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Chloe Y S Lim
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Gemma Sicouri
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Laura Parrish
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
| | - Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Hospital Rd, Randwick NSW 2031, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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Carcelén-Fraile MDC, Ruiz-Ariza A, Rusillo-Magdaleno A, Aibar-Almazán A. Effects of Active Gamification on Sleep and Anxiety Reduction in Spanish Primary School Children. Healthcare (Basel) 2025; 13:623. [PMID: 40150473 PMCID: PMC11942101 DOI: 10.3390/healthcare13060623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Revised: 03/09/2025] [Accepted: 03/11/2025] [Indexed: 03/29/2025] Open
Abstract
Background/Objectives: Active gamification, which incorporates game elements with physical interaction, is presented as an innovative strategy to address anxiety problems and sleep quality in children. This study aimed to evaluate the impact of an active gamification program on the aforementioned variables in children in primary education. Methods: This study utilized a randomized, controlled trial with 120 children between 8 and 11 years of age, divided into an experimental group, which participated in a 12-week gamified program, and a control group, which continued with traditional physical education classes. Results: The main findings indicate that the intervention had a significant impact on reducing anxiety, with improvements in most of the subscales evaluated except for the obsessive-compulsive disorder subscale. Significant improvements were also found in sleep quality, with reductions in bedtime resistance, nighttime awakenings, parasomnias, and sleep-disordered breathing, although no significant changes were noted in sleep-onset delay, sleep duration, sleep anxiety, and daytime sleepiness. Conclusions: The gamification intervention in physical exercise showed positive effects in reducing anxiety and improving sleep quality in primary school children, highlighting its potential as an intervention strategy in primary education classrooms.
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Affiliation(s)
- María del Carmen Carcelén-Fraile
- Department of Educational Sciences, Faculty of Social Sciences, University of Atlántico Medio, 35017 Las Palmas de Gran Canaria, Spain;
| | | | | | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain;
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Chen TY, Lai HC, Ho YT, Chen CW, Chang HA, Li LA, Kuo TBJ, Yang CCH. Impact of comorbid sleep-disordered breathing on escitalopram treatment in patients newly diagnosed with generalized anxiety disorder: A 12-week prospective observational study. J Psychiatr Res 2024; 180:274-280. [PMID: 39471716 DOI: 10.1016/j.jpsychires.2024.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 07/01/2024] [Accepted: 10/20/2024] [Indexed: 11/01/2024]
Abstract
We aimed to evaluate the presence of sleep-disordered breathing (SDB) in generalized anxiety disorder (GAD) patients and its impacts after 12-week of escitalopram treatment. In this prospective observational study, GAD patients were followed up to determine whether comorbid SDB affects their treatment response. They underwent a home sleep apnea test (HSAT), and oxygen desaturation index ≥5 was considered indicative of SDB. All participants were treated with escitalopram 5 mg in the first 2 weeks and 10 mg in the remaining 10 weeks. They underwent assessments of heart rate variability and completed questionnaires for sleep, mood, attention, and daytime sleepiness on the day of enrollment, and 2 weeks, 4 weeks, and 12 weeks later. A total of 45 GAD participants (mean age, 56.2 years) were included in the study. Of these, 53.3% had comorbid SDB. Participants with GAD and SDB had higher baseline Beck Anxiety Inventory (BAI) and STOP-BANG scores. Both groups of participants with GAD showed overall improvement in anxiety, depression, and insomnia symptoms after 12 weeks of escitalopram treatment. Additionally, there were no statistically significant differences in the changes in BAI, Beck Depression Inventory, and Epworth Sleepiness Scale scores between the two groups at the Week 2, Week 4, and Week 12 assessments compared to baseline. However, the GAD group with comorbid SDB seemed to have a lower tendency for improvement in depressive symptoms than the group with non-comorbid SDB. Compared with the GAD group without comorbid SDB, the GAD group with comorbid SDB exhibited more severe anxiety symptoms at baseline and tended to show less improvement in depressive symptoms after 12 weeks of escitalopram treatment.
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Affiliation(s)
- Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan
| | - Hsiao-Ching Lai
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Human Nutrition and Food-Related Behaviour, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
| | - Yu-Ting Ho
- Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Chieh-Wen Chen
- Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Li-Ang Li
- Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Center, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Tsoutun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan.
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Gittins Stone DI, Elkins RM, Gardner M, Boger K, Sperling J. Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis. Child Psychiatry Hum Dev 2024; 55:1398-1412. [PMID: 36749490 PMCID: PMC9902833 DOI: 10.1007/s10578-023-01500-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.
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Affiliation(s)
| | - R Meredith Elkins
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | | | - Kathryn Boger
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Jacqueline Sperling
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
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Wang F, Syed Ali SKB. Health benefits of short Taichi Qigong exercise (STQE) to University Students' core strength, lower limb explosive force, cardiopulmonary endurance, and anxiety: A Quasi experiment research. Medicine (Baltimore) 2024; 103:e37566. [PMID: 38552100 PMCID: PMC10977524 DOI: 10.1097/md.0000000000037566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/20/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND College students' physical fitness has declined over the past decades. Taichi Qigong exercise offers numerous health benefits and could serve as a suitable option for them. Traditional programs, however, are time-consuming and necessitate long-term commitments. Therefore, a more cost-effective intervention is needed. METHODS The study enrolled a total of 31 students who actively participated in a 5-week STQE program, consisting of three 60-minute sessions per week. Physical and mental health assessments included the Plank test, vital capacity measurement, 1000/800 m run test, standing jump, and the Zung Self-Rating Scale. Data analysis was performed using SPSS. RESULTS Following the STQE intervention, participants showed improvement in core strength (28.1 seconds in the Plank test, P = .025) and lower limb explosive force (6.52 cm in the standing jump test, P = .011), accompanied by a decrease in anxiety levels (a reduction of 3.41 in the Zung Self-Rating Scale, P = .039). However, no significant improvements were observed in cardiopulmonary endurance, as evidenced by a non-significant increase of 237.84 mL in vital capacity (P = .134) and a non-significant reduction of 1.6 seconds in the 1000/800 m run test (P = .764). CONCLUSION The study suggests that the STQE program effectively improves core strength, lower limb explosive force, and reduces anxiety levels among university students.
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Affiliation(s)
- Feng Wang
- Department of Education Foundations and Humanities, Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
| | - Syed Kamaruzaman Bin Syed Ali
- Department of Education Foundations and Humanities, Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
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7
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Patriarca GC, Rey Y, Yeguez CE, Buitron V, McMakin DL, Pettit JW. Attentional Control Accounts for the Association Between Anxiety Sensitivity and Sleep Efficiency in Clinic-Referred Youth. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01631-9. [PMID: 38036742 PMCID: PMC11143078 DOI: 10.1007/s10578-023-01631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023]
Abstract
Youth with anxiety disorders report difficulty falling asleep and returning to sleep after sleep onset (i.e., poor sleep efficiency). Anxiety sensitivity, the excessive attention to physical symptoms of anxiety and their threatening interpretations, has been linked to poor sleep efficiency. We tested a conceptual model wherein attentional control, attentional focusing and attentional shifting would account for the relationship between anxiety sensitivity and poor sleep efficiency. 255 youths (6-17 years old, 78% Hispanic/Latino) who presented to a university-based research clinic completed measures on anxiety sensitivity, sleep, and attentional control. Poorer sleep efficiency was significantly correlated with higher anxiety sensitivity and lower attentional control, attentional focusing, and attentional shifting. Higher anxiety sensitivity was significantly correlated with lower attentional control and attentional focusing. Attentional control and attentional focusing, not attentional shifting, accounted for the relationship between anxiety sensitivity and poor sleep efficiency. These findings identify attentional control and attentional focusing as variables that may explain the association between anxiety sensitivity and sleep efficiency in youth.
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Affiliation(s)
- Guadalupe C Patriarca
- Department of Psychology, Center for Children and Families, Florida International University, AHC 1 Room 140, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Yasmin Rey
- Department of Psychology, Center for Children and Families, Florida International University, AHC 1 Room 140, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Carlos E Yeguez
- Department of Psychology, Center for Children and Families, Florida International University, AHC 1 Room 140, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Victor Buitron
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Dana L McMakin
- Department of Psychology, Center for Children and Families, Florida International University, AHC 1 Room 140, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Jeremy W Pettit
- Department of Psychology, Center for Children and Families, Florida International University, AHC 1 Room 140, 11200 SW 8th Street, Miami, FL, 33199, USA.
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8
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Li Y, Tian W, Liu P, Geng F. A cross-sectional analysis of the relationships between anxiety sensitivity and youth irritability: the mediated roles of insomnia and selective attention for threat. BMC Psychiatry 2023; 23:782. [PMID: 37880675 PMCID: PMC10598902 DOI: 10.1186/s12888-023-05280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Irritability is common in multiple psychiatric disorders and is hallmark of disruptive mood dysregulation disorder. Child irritability is associated with higher risk of suicide and adulthood mental health problems. However, the psychological mechanisms of irritability are understudied. This study examined the relationship between anxiety sensitivity and irritability among youth, and further explored three possible mediated factors: selective attention for threat, delayed reward discounting, and insomnia. METHODS Participants were 1417 students (51.7% male; mean age 13.83 years, SD = 1.48) recruited from one high school in Hunan province, China. Self-report questionnaires were used to measure irritability (The Affective Reactivity Index and The Brief Irritability Test), anxiety sensitivity (The Childhood Anxiety Sensitivity Index), selective attention for threat (The Davos Assessment of Cognitive Biases Scale-attention for threat bias subscale), insomnia (The Youth Self-Rating Insomnia Scale), and delayed reward discounting (The 27-item Monetary Choice Questionnaire). Structural equation modal (SEM) was performed to examine mediated relations. RESULTS Anxiety sensitivity was modestly related to irritability and insomnia (r from 0.25 to 0.54) and slightly correlated with selective attention for threat (r from 0.12 to 0.28). However, there is no significant relationship of delayed rewards discounting with anxiety sensitivity and irritability. The results of SEM showed that selective attention for threat (indirect effect estimate = 0.04) and insomnia (indirect effect estimate = 0.20) partially mediate the relationship between anxiety sensitivity and irritability, which explained 34% variation. CONCLUSIONS Anxiety sensitivity is an important susceptibility factor for irritability. Selective attention for threat and insomnia are two mediated mechanisms to understand the relationship between anxiety sensitivity and irritability.
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Affiliation(s)
- Yalin Li
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, Jiangxi, 330022, China
| | - Wanfu Tian
- Chenzhou Xiangnan Middle School, Chenzhou, China
| | - Ping Liu
- Chenzhou Xiangnan Middle School, Chenzhou, China
| | - Fulei Geng
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, Jiangxi, 330022, China.
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Qiu G. Towards the effects of translators' emotional intelligence and anxiety on their translation quality. Heliyon 2023; 9:e19276. [PMID: 37662783 PMCID: PMC10474425 DOI: 10.1016/j.heliyon.2023.e19276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/12/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
For years, the impact of translators and their emotional characteristics on translation quality have been the main concern of scholars. That is, few studies have evaluated the role of translators' qualities on their professional performance. It is because most translation studies have focused on the linguistic and sociolinguistic determinants of translation quality. To highlight the consequences of translators' emotional characteristics on their professional performance, this study sought to review the role of translators' emotional intelligence and anxiety on their translation quality. As evidenced by previous investigations, both emotional intelligence and anxiety can enormously affect the quality of translations. This review offers some takeaways for educators in translation studies as well as the translation educational system to make them cognizant of the role of emotional intelligence in translation quality. It also recommends some solutions to avoid the adverse effects of anxiety on translation quality.
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Affiliation(s)
- Guanghua Qiu
- Lecturer in English Curriculum and Teaching Theory and Translation, School of College English Teaching and Research, Henan University, No.85, Minglun Street, Shunhe District, Kaifeng, 475000 10260036, People's Republic of China
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10
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Tan WJ, Ng MSL, Poon SH, Lee TS. Treatment Implications of Sleep-Related Problems in Pediatric Anxiety Disorders: A Narrative Review of the Literature. Child Psychiatry Hum Dev 2023; 54:659-664. [PMID: 34724133 DOI: 10.1007/s10578-021-01277-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 10/19/2022]
Abstract
Pediatric anxiety disorders and sleep-related problems (SRPs) are highly prevalent and are associated with serious health or psychopathological consequences. This narrative review aims to provide an overview of the current evidence of the associations between anxiety disorders and SRPs, to examine how this relationship may affect treatment, and to evaluate future directions for the field. Despite their strong bi-directional relationship, SRPs are often neglected in pediatric anxiety literature. There is little consensus on the conceptualization and related measurements of SRPs, which has led to methodological limitations and difficulties. Furthermore, available research suggests that anxiety treatment alone may be inadequate as clinically impairing SRPs were still present post-treatment, which may, in turn, diminish effects of therapy. Understanding the implications of the relationship between anxiety and SRPs on treatment outcomes may be helpful in recognizing opportunities for high impact and enduring interventions.
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Affiliation(s)
- Wan Jie Tan
- Duke-NUS Medical School, Neuroscience and Behavioral Disorders Program, 8 College Rd, Singapore, 169857, Singapore.
| | - Melissa S L Ng
- Duke-NUS Medical School, Neuroscience and Behavioral Disorders Program, 8 College Rd, Singapore, 169857, Singapore
| | - Shi Hui Poon
- Duke-NUS Medical School, Neuroscience and Behavioral Disorders Program, 8 College Rd, Singapore, 169857, Singapore
| | - Tih Shih Lee
- Duke-NUS Medical School, Neuroscience and Behavioral Disorders Program, 8 College Rd, Singapore, 169857, Singapore
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Jemcov A, Olthuis JV, Watt MC, Stewart SH. Do anxiety sensitivity cognitive concerns and/or depression symptoms independently explain sleep disturbances in a high anxiety sensitive treatment-seeking sample? J Anxiety Disord 2023; 97:102731. [PMID: 37236069 DOI: 10.1016/j.janxdis.2023.102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
Cognitive models of insomnia posit a role for anxiety sensitivity (AS) in sleep difficulties. While sleep disturbances have been linked to AS, particularly AS cognitive concerns, prior studies have rarely accounted for the correlated construct of depression. We used pre-treatment intervention trial data from 128 high AS, treatment-seeking adults with a DSM-5 diagnosis of an anxiety, depressive, or posttraumatic stress disorder to determine whether AS cognitive concerns and/or depression are independently associated with sleep impairment domains (e.g., sleep quality, latency, daytime dysfunction). Participants provided data on AS, depressive symptoms, and sleep impairments. AS cognitive concerns (but not other AS dimensions) were correlated with four of five sleep impairment domains; depression was correlated with all five. Multiple regressions revealed four of five sleep impairment domains were predicted by depression with no independent contribution of AS cognitive concerns. In contrast, AS cognitive concerns and depression were independently associated with daytime dysfunction. Results suggest previous findings linking AS cognitive concerns to sleep impairments may have been largely secondary to the overlap of cognitive concerns with depression. Findings demonstrate the importance of incorporating depression into the cognitive model of insomnia. Both AS cognitive concerns and depression may be useful targets for reducing daytime dysfunction.
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Affiliation(s)
- Anastasija Jemcov
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada
| | - Janine V Olthuis
- Department of Psychology, Faculty of Arts, University of New Brunswick, 38 Dineen Drive, Fredericton, New Brunswick E3B 5A3, Canada
| | - Margo C Watt
- Department of Psychology, Faculty of Science, St. Francis Xavier University, 2323 Notre Dame Ave., Antigonish, Nova Scotia B2G 2W5, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veteran's Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada.
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12
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The Role of Anxiety Sensitivity in the Association Between Childhood Maltreatment and Sleep Disturbance Among Adults in Psychiatric Inpatient Treatment. J Nerv Ment Dis 2023; 211:306-313. [PMID: 36801864 DOI: 10.1097/nmd.0000000000001621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The present investigation examined associations of childhood maltreatment, anxiety sensitivity (AS), and sleep disturbance among a diverse sample of adults in psychiatric inpatient treatment. We hypothesized that childhood maltreatment would be indirectly associated with greater sleep disturbance through elevated AS. Exploratory analyses examined the indirect effect models with three AS subscales (i.e., physical, cognitive, and social concerns) as parallel mediators. A sample of adults in acute-care psychiatric inpatient treatment (N = 88; 62.5% male; Mage = 33.32 years, SD = 11.07; 45.5% White) completed a series of self-report measures. After accounting for theoretically relevant covariates, childhood maltreatment was indirectly associated with sleep disturbance through AS. Parallel mediation analyses revealed that no individual subscale of AS significantly accounted for this association. These findings suggest that heightened levels of AS may explain the association between childhood maltreatment and sleep disturbance among adults in psychiatric inpatient treatment. Interventions targeting AS can be brief and efficacious and have the potential to improve clinical outcomes among psychiatric populations.
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Chen Y, Zhu J. Longitudinal Associations Between Cybervictimization and Adolescent Sleep Problems: The Role of Anxiety and Depressive Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2806-2827. [PMID: 35585655 DOI: 10.1177/08862605221102485] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adolescents who have experienced cybervictimization are at risk for sleep problems. However, there is a gap in knowledge about the mechanism that would explain this link. The study used a longitudinal design to test if cybervictimization predicted adolescents' sleep problems 6 and 12 months later, and whether these patterns could be explained in part by emotional distress in response to the victimization. Participants were 1987 Chinese adolescents (56.1% males) ages 10 to 14 (M = 12.32, SD = 0.53) at baseline. Data were collected over the course of 1 year, in three waves 6 months apart. The adolescents completed questionnaires regarding cybervictimization, sleep problems, depressive symptoms, and anxiety symptoms at all three time points. Autoregressive cross-lagged models showed that cybervictimization predicted later sleep problems after controlling for traditional peer victimization, and anxiety and depressive symptoms mediated this link. Multivariate latent growth models showed that the developmental trajectories of cybervictimization, sleep problems, anxiety symptoms, and depressive symptoms were related in complex ways over time. Measures of study variables were self-reported, and generalizability may be limited by a sample of adolescents from school in China. These results are important because of their implications for prevention and treatment of adolescents' sleep problems evoked by cybervictimization.
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Affiliation(s)
- Yuanyuan Chen
- School of Education, 47875Guangzhou University, Guangzhou, China
| | - Jianjun Zhu
- Department of Psychology, 47875Guangzhou University, Guangzhou, China
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14
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Adcock S, Lang B. Caffeine Motives and Expectancies for Individuals with High Anxiety Sensitivity. Subst Use Misuse 2023; 58:610-617. [PMID: 36798051 DOI: 10.1080/10826084.2023.2177959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Background: Anxiety Sensitivity (AS) is a transdiagnostic risk factor that includes fear of the potential physical and psychological consequences of anxiety-related symptoms. Caffeine consumption in high amounts is associated with symptoms of anxiety. Research on the relationship between AS and caffeine consumption has yielded inconsistent results. Objectives: In this study, we conducted an exploratory analysis to examine whether caffeine motives moderated the relationship between AS and high caffeine consumption. We also examined whether caffeine expectancies moderated the relationship between AS and high caffeine consumption. In addition, we assessed the bivariate relationships between AS and caffeine motives and between AS and caffeine expectancies. N = 317 participants completed an online survey using Amazon Mechanical Turk. Results: Results revealed that neither expectancies nor motives interacted with AS to predict high caffeine consumption. There was also no significant main effect of AS on high caffeine consumption. The only significant main effect in the prediction of high caffeine consumption was the use of caffeine for symptom management motives. In our follow-up analyses, high AS participants in the study expected that caffeine consumption would provoke anxiety. They also reported using caffeine for symptom management, taste, and social reasons. Conclusions: These findings suggest that the utility of AS as a predictor or foundation for higher amounts of substance use is not uniform across substances but rather depends on the type of substance in question.
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Affiliation(s)
- Steal Adcock
- Department of Psychology, University of Houston-Victoria, Victoria, TX, USA
| | - Brent Lang
- Department of Psychology, University of Houston-Victoria, Victoria, TX, USA
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15
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Belmon LS, Van Stralen MM, Harmsen IA, Den Hertog KE, Ruiter RAC, Chinapaw MJM, Busch V. Promoting children's sleep health: Intervention Mapping meets Health in All Policies. Front Public Health 2022; 10:882384. [PMID: 36466483 PMCID: PMC9709501 DOI: 10.3389/fpubh.2022.882384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background To design a comprehensive approach to promote children's sleep health in Amsterdam, the Netherlands, we combined Intervention Mapping (IM) with the Health in All Policies (HiAP) perspective. We aimed to create an approach that fits local infrastructures and policy domains across sectors. Methods First, a needs assessment was conducted, including a systematic review, two concept mapping studies, and one cross-sectional sleep diary study (IM step 1). Subsequently, semi-structured interviews with stakeholders from policy, practice and science provided information on potential assets from all relevant social policy sectors to take into account in the program design (HiAP and IM step 1). Next, program outcomes and objectives were specified (IM step 2), with specific objectives for policy stakeholders (HiAP). This was followed by the program design (IM step 3), where potential program actions were adapted to local policy sectors and stakeholders (HiAP). Lastly, program production (IM step 4) focused on creating a multi-sector program (HiAP). An advisory panel guided the research team by providing tailored advice during all steps throughout the project. Results A blueprint was created for program development to promote children's sleep health, including a logic model of the problem, a logic model of change, an overview of the existing organizational structure of local policy and practice assets, and an overview of policy sectors, and related objectives and opportunities for promoting children's sleep health across these policy sectors. Furthermore, the program production resulted in a policy brief for the local government. Conclusions Combining IM and HiAP proved valuable for designing a blueprint for the development of an integrated multi-sector program to promote children's sleep health. Health promotion professionals focusing on other (health) behaviors can use the blueprint to develop health promotion programs that fit the local public service infrastructures, culture, and incorporate relevant policy sectors outside the public health domain.
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Affiliation(s)
- Laura S. Belmon
- Department of Public and Occupational Health, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands,Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands,Department of Healthy Living, Public Health Service (GGD), Amsterdam, Netherlands,*Correspondence: Laura S. Belmon
| | - Maartje M. Van Stralen
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Irene A. Harmsen
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands
| | - Karen E. Den Hertog
- Department of Healthy Living, Public Health Service (GGD), Amsterdam, Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Vincent Busch
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands,Vincent Busch
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Balaskas A, Schueller SM, Cox AL, Doherty G. Understanding users’ perspectives on mobile apps for anxiety management. Front Digit Health 2022; 4:854263. [PMID: 36120712 PMCID: PMC9474730 DOI: 10.3389/fdgth.2022.854263] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/11/2022] [Indexed: 11/25/2022] Open
Abstract
Anxiety disorders are the most common type of mental health problem. The potential of apps to improve mental health has led to an increase in the number of anxiety apps available. Even though anxiety apps hold the potential to enhance mental health care for individuals, there is relatively little knowledge concerning users’ perspectives. This mixed-methods study aims to understand the nature of user burden and engagement with mental health apps (MHapps) targeting anxiety management, in order to identify ways to improve the design of these apps. Users’ perspectives on these apps were gathered by analyzing 600 reviews from 5 apps on the app stores (Study 1), and conducting 15 interviews with app users (Study 2). The results shed light on several barriers to adoption and sustained use. Users appreciate apps that offer content variation, customizability, and good interface design, and often requested an enhanced, personalized experience to improve engagement. We propose addressing the specific app quality issues identified through human-centered design, more personalized content delivery, and by improving features for social and therapeutic support.
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17
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Duan X, Zheng M, Zhao W, Huang J, Lao L, Li H, Lu J, Chen W, Liu X, Deng H. Associations of Depression, Anxiety, and Life Events With the Risk of Obstructive Sleep Apnea Evaluated by Berlin Questionnaire. Front Med (Lausanne) 2022; 9:799792. [PMID: 35463036 PMCID: PMC9021543 DOI: 10.3389/fmed.2022.799792] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Psychological problems are prevalent in the general population, and their impacts on sleep health deserve more attention. This study was to examine the associations of OSA risk with depression, anxiety, and life events in a Chinese population. Methods A total of 10,287 subjects were selected from the Guangzhou Heart Study. Berlin Questionnaire (BQ) was used to ascertain the OSA. The Center for Epidemiologic Studies Depression Scale (CES-D) and Zung's self-rating anxiety scale (SAS) were used to define depression and anxiety. A self-designed questionnaire was used to assess life events. Odds ratio (OR) with 95% confidence interval (95% CI) was calculated by using the logistic regression model. Results There were 1,366 subjects (13.28%) classified into the OSA group. After adjusting for potential confounders, subjects with anxiety (OR: 2.60, 95% CI: 1.63-4.04) and depression (OR: 1.91, 95% CI: 1.19-2.97) were more likely to have OSA. Subjects suffering from both anxiety and depression were associated with a 3.52-fold (95% CI: 1.88-6.31) risk of OSA. Every 1-unit increment of CES-D score and SAS index score was associated with 13% (95% CI: 1.11-1.15) and 4% (95% CI: 1.03-1.06) increased risk of OSA. Neither positive life events nor adverse life events were associated with OSA. Conclusions The results indicate that depression and anxiety, especially co-occurrence of both greatly, were associated with an increased risk of OSA. Neither adverse life events nor positive life events were associated with any risk of OSA. Screening for interventions to prevent and manage OSA should pay more attention to depression and anxiety.
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Affiliation(s)
- Xueru Duan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Jun Huang
- Department of Geriatrics, Institute of Geriatrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Lixian Lao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Haiyi Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiahai Lu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xudong Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
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18
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Knowland VCP, van Rijn E, Gaskell MG, Henderson L. UK children's sleep and anxiety during the COVID-19 pandemic. BMC Psychol 2022; 10:76. [PMID: 35313993 PMCID: PMC8936042 DOI: 10.1186/s40359-022-00729-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 01/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background Sleep and mental wellbeing are intimately linked. This relationship is particularly important to understand as it emerges over childhood. Here we take the opportunity that the COVID-19 pandemic, and resulting lockdown in the UK, presented to study sleep-related behaviour and anxiety in school-aged children.
Methods Parents and children were asked to complete questionnaires towards the start of the UK lockdown in April-to-May of 2020, then again in August of that year (when many restrictions had been lifted). We explored children’s emotional responses to the pandemic and sleep patterns at both time points, from the perspectives of parents and children themselves.
Results Children’s bedtime anxiety increased at the start of the lockdown as compared to a typical week; however, by August, bedtime anxiety had ameliorated along with children’s COVID-19 related anxiety. Bedtime anxiety predicted how long it took children to fall asleep at night at both the start and the end of the lockdown. Bedtime and wake-up time shifted at the start of lockdown, but interestingly total sleep time was resilient (likely owing to an absence of early school start times) and was not predicted by child anxiety. Conclusions These findings further support calls for sleep quality (in particular, time taken to fall asleep) to be taken as a key indicator of mental health in children, particularly under usual circumstances when schools are open and sleep duration may be less resilient. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00729-4.
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Affiliation(s)
- Victoria C P Knowland
- Department of Psychology, University of York, York, YO10 5DD, UK. .,Speech and Language Sciences, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
| | - Elaine van Rijn
- Department of Psychology, University of York, York, YO10 5DD, UK
| | - M Gareth Gaskell
- Department of Psychology, University of York, York, YO10 5DD, UK
| | - Lisa Henderson
- Department of Psychology, University of York, York, YO10 5DD, UK
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19
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Comer JS, Conroy K, Cornacchio D, Furr JM, Norman SB, Stein MB. Psychometric evaluation of a caregiver-report adaptation of the Overall Anxiety Severity and Impairment Scale (OASIS) for use with youth populations. J Affect Disord 2022; 300:341-348. [PMID: 34979182 PMCID: PMC8828693 DOI: 10.1016/j.jad.2021.12.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/24/2021] [Accepted: 12/30/2021] [Indexed: 01/09/2023]
Abstract
Background Despite progress in youth anxiety assessment, there is need for a measure that is simultaneously (a) free, (b) brief, (c) focused broadly on anxiety and avoidance severity, frequency, and interference, and (d) concerned with the past week. The adult overall anxiety severity and impairment scale (OASIS) was adapted to yield a caregiver-report of past week youth anxiety and interference (OASIS-Y). Methods In a sample of diverse youth seeking anxiety services (N = 132; 67% racial/ethnic minority) and their caregivers, analyses examined the OASIS-Y factor structure, internal consistency, and convergent and divergent validity. Hierarchical linear modeling in a participant subset examined OASIS-Y sensitivity to treatment-related change. Results OASIS-Y internal consistency was high and confirmatory factor analysis supported a single-factor structure similar to that found in adults. OASIS-Y convergent validity was supported by a medium-sized association with an established, commercially available measure of youth anxiety, and divergent validity was supported by the absence of unique associations with measures of youth attention and externalizing problems. In a sample subset, session-by-session OASIS-Y scores significantly declined across treatment, and declined at a steeper rate among treatment "responders" versus "non-responders," providing evidence of OASIS-Y sensitivity to treatment-related change. Limitations This study focused on a clinical sample and cannot speak to OASIS-Y performance in community settings. Shared method-variance may have also influenced findings. Conclusions This study offers the first psychometric evaluation of the OASIS-Y, and underscores the promising clinical utility of the measure for assessing past week youth anxiety and impairment and for supporting routine outcome monitoring.
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Affiliation(s)
- Jonathan S. Comer
- Center for Children and Families, Department of Psychology, Florida International University
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University
| | | | - Jami M. Furr
- Center for Children and Families, Department of Psychology, Florida International University
| | - Sonya B. Norman
- Department of Psychiatry, University of California, San Diego
| | - Murray B. Stein
- Department of Psychiatry, University of California, San Diego
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20
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Denche-Zamorano Á, Franco-García JM, Carlos-Vivas J, Mendoza-Muñoz M, Pereira-Payo D, Pastor-Cisneros R, Merellano-Navarro E, Adsuar JC. Increased Risks of Mental Disorders: Youth with Inactive Physical Activity. Healthcare (Basel) 2022; 10:237. [PMID: 35206852 PMCID: PMC8872491 DOI: 10.3390/healthcare10020237] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 01/14/2023] Open
Abstract
Before COVID-19, one of the most dangerous pandemics of the 21st century was physical inactivity (PI). Sedentary habits had increased in the last decades, reducing physical condition and increasing non-communicable diseases and mental disorders in the population. This study aimed to analyse the relationships between physical activity level (PAL) and the prevalence of anxiety, depression, and other mental disorders in Spanish young aged 15-35 years and to calculate the odd ratio (OR) of developing from these mental disorders in inactive young people, based on PAL. METHODS A cross-sectional study based on data from the Spanish National Health Survey 2017 with 4195 participants was conducted. A descriptive analysis was performed. Possible differences between groups were analysed using the non-parametric statistical tests. OR and relative risks for mental disorders in inactive versus others PAL were calculated. RESULTS Dependence relationships were found between PAL and the prevalence of anxiety, depression, and other mental disorders (p < 0.001). In addition, the risk of developing: anxiety (OR: 6.14. 95% CI: 3.28-11.50), depression (OR: 5.35. 95% CI: 2.40-11.96), and other mental disorders (OR: 8.52. 95% CI: 2.90-25.06) was higher in inactive young people. CONCLUSIONS PI is associated to high risk of mental disorders in Spanish young people.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society (PHeSO) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (Á.D.-Z.); (J.C.-V.); (M.M.-M.); (R.P.-C.); (J.C.A.)
| | - Juan Manuel Franco-García
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society (PHeSO) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (Á.D.-Z.); (J.C.-V.); (M.M.-M.); (R.P.-C.); (J.C.A.)
| | - María Mendoza-Muñoz
- Promoting a Healthy Society (PHeSO) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (Á.D.-Z.); (J.C.-V.); (M.M.-M.); (R.P.-C.); (J.C.A.)
| | - Damián Pereira-Payo
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Raquel Pastor-Cisneros
- Promoting a Healthy Society (PHeSO) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (Á.D.-Z.); (J.C.-V.); (M.M.-M.); (R.P.-C.); (J.C.A.)
| | | | - José Carmelo Adsuar
- Promoting a Healthy Society (PHeSO) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (Á.D.-Z.); (J.C.-V.); (M.M.-M.); (R.P.-C.); (J.C.A.)
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21
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Fujimura Y, Sekine M, Yamada M. Short-term and long-term associations with sleep onset latency in school children in Japan. Pediatr Int 2022; 64:e15161. [PMID: 35616116 DOI: 10.1111/ped.15161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/27/2021] [Accepted: 01/28/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aims to examine the relationships between sleep onset latency and multiple sleep-related factors of seventh and tenth graders during the transition from childhood to adolescence. METHODS Regarding sleep onset latency, we examined the short-term associations in Phase IV (2002) and long-term associations in Phase V (2005) of the Toyama Birth Cohort Study. In total, 4,673 boys and 4,694 girls in Phase IV and 2,969 boys and 3,108 girls in Phase V answered the questionnaire items regarding sleep, physical and mental health, lifestyle, socioeconomic status, and family and school factors. Considering sleep onset latency as the outcome and 13 sleep-related factors as independent variables, we calculated the odds ratio using binary logistic regression. The longitudinal study was conducted with 1,703 boys and 1,919 girls whose sleep onset latency was within 30 min in Phase IV. RESULTS The following factors were found to be related to longer sleep onset latency in the short term: sleep duration, physical activity, game time, and self-esteem in boys and sleep duration, bedroom environment, game time, abdominal pain, long-standing illness, onset of puberty, mental health difficulties, and school avoidance feelings in girls. Regarding its long-term effects, having a single parent and self-esteem in boys and breakfast, game time, long-standing illness, obesity, onset of puberty, and school avoidance feelings in girls were associated with longer sleep onset latency. CONCLUSIONS Education of adolescent health and sleep hygiene at home and school should include both short-term and long-term associations between sleep and a healthy lifestyle by gender.
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Affiliation(s)
- Yuko Fujimura
- Community Medicine & Health Support Division, Organization for Promotion of Regional Collaboration, University of Toyama, Toyama, Japan
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan
| | - Masaaki Yamada
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan
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22
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El Refay AS, Hashem SA, Mostafa HH, Kamel IH, Sherif LS. Sleep quality and anxiety symptoms in Egyptian children and adolescents during COVID-19 pandemic lockdown. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2021; 45:134. [PMID: 34335015 PMCID: PMC8300984 DOI: 10.1186/s42269-021-00590-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Coronavirus Disease Pandemic 2019 has a pervasive effect on all health aspects include psychological and mental health. This study aimed to assess the hidden stressful impact of COVID-19 pandemic on Egyptian children and adolescents' lifestyles 2 months after lockdown in Egypt by detecting symptoms of anxiety and sleep disorders. Online questionnaire was used by snowball sampling approach 2 months after lockdown targeting children and adolescents. RESULTS The overall mean Sleep Disturbance Scale for Children score (SDSC) in participated groups was 44.6 ± 11.72. Of 765 participants 502 (65.6%) showed the symptoms suggestive of sleep disorder. Disorders of initiating and maintaining sleep were the most common among participants as 168 (33.4%) of them were suffering from it while 79 (15.7%) children were suffering from excessive somnolence. Linear stepwise regression revealed that anxiety score, understanding safety measures, and following strict quarantine measures significantly predicted SDSC (p = 0.001, 0.009, 0.046). Significant positive correlations were found between SDSC and extra screen usage, understanding safety and quarantine measures, anxiety signs, and change in child lifestyle with (p = 0.029, 0.010, 0.001 and 0.001) sequentially. Significant positive correlation was found between family income affection, SDSC, and anxiety with p value (00.001, 00.4). CONCLUSION Child deprived of his or her normal lifestyle is vulnerable to develop anxiety symptoms and sleep disturbances. Low income, extra screen time, and restricted quarantine measures are all contributing factors that influence children and adolescent's mental health.
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Affiliation(s)
- Amira Sayed El Refay
- Medical Research Division, Department of Child Health, National Research Centre, El-Bohouth Street, P.O. 12622, Dokki, Cairo, Egypt
| | - Shaimaa A. Hashem
- Medical Research Division, Department of Child Health, National Research Centre, El-Bohouth Street, P.O. 12622, Dokki, Cairo, Egypt
| | - Hend H. Mostafa
- Medical Research Division, Department of Child Health, National Research Centre, El-Bohouth Street, P.O. 12622, Dokki, Cairo, Egypt
| | - Iman H. Kamel
- Medical Research Division, Department of Child Health, National Research Centre, El-Bohouth Street, P.O. 12622, Dokki, Cairo, Egypt
| | - Lobna S. Sherif
- Medical Research Division, Department of Child Health, National Research Centre, El-Bohouth Street, P.O. 12622, Dokki, Cairo, Egypt
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23
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Earl RK, Ward T, Gerdts J, Eichler EE, Bernier RA, Hudac CM. Sleep Problems in Children with ASD and Gene Disrupting Mutations. The Journal of Genetic Psychology 2021; 182:317-334. [PMID: 33998396 DOI: 10.1080/00221325.2021.1922869] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sleep difficulties are pervasive in autism spectrum disorder (ASD), yet how sleep problems relate to underlying biological mechanisms such as genetic etiology is unclear, despite recent reports of profound sleep problems in children with ASD-associated de novo likely gene disrupting (dnLGD) mutations, CHD8, DYRK1A, and ADNP. We aimed to inform etiological contributions to ASD and sleep by characterizing sleep problems in individuals with dnLGD mutations. Participants (N = 2886) were families who completed dichotomous questions about sleep problems within a medical history interview for their child with ASD (age 3-28 years). Confirmatory factor analyses compared between those with ASD and a dnLGD mutation and those with idiopathic ASD (i.e., no known genetic event, NON) highlighted four domains (sleep onset, breathing issues, nighttime awakenings, and daytime tiredness) with sleep onset as a strong factor for both groups. Overall, participant predictors indicated that internalizing behavioral problems and lower cognitive scores were related to increased sleep problems. Internalizing problems were also related to increase nighttime awakenings in the dnLGD group. As an exploratory aim, patterns of sleep issues are described for genetic subgroups with unique patterns including more overall sleep issues in ADNP (n = 19), problems falling asleep in CHD8 (n = 22), and increased daytime naps in DYRK1A (n = 23). Implications for considering genetically defined subgroups when approaching sleep problems in children with ASD are discussed.
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Affiliation(s)
- Rachel K Earl
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Tracey Ward
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Jennifer Gerdts
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Evan E Eichler
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA.,Howard Hughes Medical Institute, Seattle, Washington, USA
| | - Raphael A Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Caitlin M Hudac
- Center for Youth Development and Intervention and Department of Psychology, University of Alabama, Tuscaloosa, Alabama, USA
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Cheng M, Lei X, Zhu C, Hou Y, Lu M, Wang X, Wu Q. The association between poor sleep quality and anxiety and depression symptoms in Chinese patients with coronary heart disease. PSYCHOL HEALTH MED 2021; 27:1347-1356. [PMID: 33506709 DOI: 10.1080/13548506.2021.1874440] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Poor sleep quality might be a potentially modifiable predictor of prognosis in patients with coronary heart disease (CHD). Anxiety and depression symptoms are highly prevalent in these patients. Whether anxiety and depression symptoms are risk factors for poor sleep quality in Chinese patients with CHD is unclear. This study is intended to examine the prevalence of poor sleep quality in Chinese patients with CHD and its associations with anxiety and depression symptoms, and to explore whether sex, obesity and CHD type modify these associations. Three hundred and forty-eight participants were included. The Pittsburgh Sleep Quality Index (PSQI, >7 was defined as poor sleep quality) and Hospital Anxiety and Depression Scale (HADS) were used to assess sleep quality and psychological symptoms. 47.1% of the participants had poor sleep quality. Logistic regression analysis showed that poor sleep quality was independently associated with anxiety and depression symptoms adjusting for demographic and clinical factors. However, adjusted for anxiety symptoms, poor sleep quality was no longer associated with depression symptoms. Subgroup and interaction analysis showed that poor sleep quality was associated with markedly higher HADS anxiety and depression scores among patients with stable angina than those with acute coronary syndrome (ACS). These findings suggest that poor sleep quality was associated with both anxiety and depression symptoms in Chinese patients with CHD. However, in the case of concurrent anxiety and depression, anxiety was the main related factor of a high prevalence of poor sleep quality. The association between poor sleep quality and psychological symptoms was influenced by CHD type.
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Affiliation(s)
| | | | | | | | - Minxia Lu
- Division of Cardiology, Suzhou, China
| | | | - Qing Wu
- Division of Cardiology, Suzhou, China
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25
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Vidal Bustamante CM, Rodman AM, Dennison MJ, Flournoy JC, Mair P, McLaughlin KA. Within-person fluctuations in stressful life events, sleep, and anxiety and depression symptoms during adolescence: a multiwave prospective study. J Child Psychol Psychiatry 2020; 61:1116-1125. [PMID: 32185808 PMCID: PMC7494581 DOI: 10.1111/jcpp.13234] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/25/2020] [Accepted: 02/13/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Adolescence is characterized by substantial changes in sleep behavior, heightened exposure to stressful life events (SLEs), and elevated risk for internalizing problems like anxiety and depression. Although SLEs are consistently associated with the onset of internalizing psychopathology, the mechanisms underlying this relationship remain poorly understood, especially at the within-person level. Here, we leverage a high-frequency longitudinal design to examine sleep as a potential mechanism linking SLEs to increases in anxiety and depression symptoms over a one-year period. METHODS Thirty female adolescents aged 15-17 years completed 12 monthly in-laboratory assessments of exposure to SLEs and symptoms of anxiety and depression (n = 355 monthly assessments), and wore an actigraphy wristband for continuous monitoring of sleep for the duration of the study (n = 6,824 sleep days). Multilevel models examined concurrent and lagged within-person associations between SLEs, sleep duration and timing regularity, and anxiety and depression symptoms. RESULTS Within-person fluctuations in SLEs were associated with variability in sleep duration both concurrently and prospectively, such that when adolescents experienced greater SLEs than was typical for them, they exhibited more variable sleep duration that same month as well as the following month. In turn, within-person increases in sleep duration variability predicted greater anxiety symptoms in the same month and mediated the association between SLEs and anxiety. CONCLUSIONS These findings highlight sleep disruptions as a mechanism underlying the longitudinal associations between SLEs and anxiety symptoms, and suggest that interventions promoting sleep schedule consistency may help mitigate risk for stress-related psychopathology in adolescence.
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Affiliation(s)
| | | | | | - John C. Flournoy
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
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26
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Bilsky SA, Friedman HP, Karlovich A, Smith M, Leen-Feldner EW. The interaction between sleep disturbances and anxiety sensitivity in relation to adolescent anger responses to parent adolescent conflict. J Adolesc 2020; 84:69-77. [PMID: 32871495 DOI: 10.1016/j.adolescence.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/09/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Sleep disturbances are common among adolescents and are associated with elevated anxiety, and difficulties managing affect. Familial conflict is associated with both anxiety sensitivity and adolescent sleep disturbances. No work to date has examined how adolescent sleep disturbances may interact with anxiety sensitivity in relation to adolescent affective responding to parent-adolescent conflict. The current study was designed to address this gap in the literature by examining how adolescent sleep disturbances, anxiety sensitivity, conflict elicited anger, and conflict avoidance are associated. METHOD Seventy-two American adolescents (n = 39 males) between the ages of 12 and 16 years (Mage = 13.84, SD = 1.38) completed a baseline assessment as well as a well-validated mother-adolescent laboratory-based conflict task. RESULTS For youth low in anxiety sensitivity, greater sleep disturbance related positively to conflict-elicited anger, which in turn predicted higher conflict avoidance. In contrast, this indirect effect was not significant for adolescents relatively higher in anxiety sensitivity. Instead, for these adolescents, increased sleep disturbances were associated with lower levels of conflict elicited anger. CONCLUSIONS Results suggest that the effects of sleep disturbances on conflict elicited anger may vary as a function of adolescent anxiety vulnerability. These findings highlight the importance of considering the unique effects of sleep disturbances on adolescent affect as a function of adolescent anxiety vulnerability.
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Affiliation(s)
- Sarah A Bilsky
- Department of Psychology, University of Mississippi, Oxford, MS, USA.
| | - Hannah P Friedman
- Department of Psychology, University of Mississippi, Oxford, MS, USA
| | - Ashley Karlovich
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Madeleine Smith
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Ellen W Leen-Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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27
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Lorenzo NE, Cornacchio D, Chou T, Kurtz SM, Furr JM, Comer JS. Expanding Treatment Options for Children With Selective Mutism: Rationale, Principles, and Procedures for an Intensive Group Behavioral Treatment. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Saeidi M, Soroush A, Golafroozi P, Zakiei A, Faridmarandi B, Komasi S. Risk Factors and Psychosocial Correlates of Emotionally Negative Dreams in Patients Referred to a Cardiac Rehabilitation Centre. Malays J Med Sci 2020; 27:97-105. [PMID: 32158349 PMCID: PMC7053550 DOI: 10.21315/mjms2020.27.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/08/2020] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Dream, as a kind of mental activity, includes various functions such as mood regulation, adjustment and integration of new information with the available memory system. The study was done for assessing the relationship between physiological and psychological components of cardiac diseases with emotionally negative dreams in cardiac rehabilitation. METHODS At the baseline of this cross-sectional study, 156 patients from Western Iran participated during April-November 2016. People 20 years-80 years able to recall the emotional content of dreams after cardiac surgery entered the study. The Beck depression inventory (BDI), Beck anxiety inventory (BAI), Buss and Perry's aggression questionnaire (BPAQ) and Schredl's dream emotions manual were used for collecting data. A binary logistic regression analysis used for the study of the relationship between risk factors and emotionally negative dreams. RESULTS The mean age of participants was 59 (SD = 9) years (men: 64.1%). The results showed that 25% of patients have negative emotional content. After adjustment for demographic variables, the results showed that increased anxiety [adjusted odds ratio (adj OR) = 1.08 [1.01-1.16], P = 0.020] and anger (adj OR = 1.03 [1.00-1.06], P = 0.024) and hypertension (adj OR = 2.71 [1.10-6.68], P = 0.030) can predict the dreams with negative content significantly. CONCLUSION The increasing rates of anxiety and anger and history of hypertension are related to increasing dreams with the negative emotional load. The control of risk factors of dreams with negative emotional load can be the target of future interventions.
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Affiliation(s)
- Mozhgan Saeidi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Soroush
- Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parvin Golafroozi
- Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Saeid Komasi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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29
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Murata E, Kato-Nishimura K, Taniike M, Mohri I. Evaluation of the validity of psychological preparation for children undergoing polysomnography. J Clin Sleep Med 2020; 16:167-174. [PMID: 31992404 DOI: 10.5664/jcsm.8158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
STUDY OBJECTIVES Nocturnal polysomnography (PSG) is an essential diagnostic technique to assess sleep abnormalities, including sleep-disordered breathing (SDB). Although low in invasiveness, it is extremely difficult to conduct PSG with children who are not cooperative with wearing electrodes and sensors. Particularly, it is difficult to conduct PSG on children with autism spectrum disorder (ASD) because they have poor predictive ability, exhibit extreme anxiety about novel and unfamiliar things, and have difficulty understanding verbal instructions. Recently, the usefulness of psychological preparation was reported. The primary aim of this study was to assess the usefulness of psychological preparation for PSG. METHODS The goal of our study was to assess the usefulness of psychological preparation for PSG. A total of 253 children were enrolled in the study: 131 in the control group (19 with ASD) and 122 selected for psychological preparation (51 with ASD). RESULTS In the preparation group, 110 of 122 (90.2%) could undergo regular PSG, a significantly higher percentage than the control group at 104 of 131 (79.4%), P = .018. Regarding hypnotic drugs, in the preparation group 111 of 122 (91.0%) underwent PSG without hypnotic drugs, which was a significantly higher percentage than in the control group at 107 of 131 (81.7%), P = .032. Additionally, 45 of 51 children with ASD in the preparation group (88.2%) could undergo PSG without hypnotic drugs. CONCLUSIONS This study indicated that psychological preparation was effective in facilitating PSG without hypnotic drugs in children who have difficulty cooperating with PSG, including those with ASD.
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Affiliation(s)
- Emi Murata
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
| | - Kumi Kato-Nishimura
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ikuko Mohri
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
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30
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Madrid-Valero JJ, Ronald A, Shakeshaft N, Schofield K, Malanchini M, Gregory AM. Sleep quality, insomnia, and internalizing difficulties in adolescents: insights from a twin study. Sleep 2019; 43:5573767. [DOI: 10.1093/sleep/zsz229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/11/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
There is a well-established association between poor sleep quality and internalizing traits. This relationship has previously been studied using a twin design. However, when it comes to adolescence, there is a paucity of twin studies that have investigated this relationship, despite the importance of this developmental stage for both the development of poor sleep quality and internalizing symptoms. Additionally, anxiety sensitivity, which is commonly associated with poor sleep quality, has not been studied in this context. Our objective was to estimate genetic and environmental influences on the relationships between insomnia, poor sleep quality, and internalizing symptoms in adolescence.
Methods
Insomnia, poor sleep quality, depression, anxiety, and anxiety sensitivity traits were measured in a sample of 5111 twin pairs from the Twins Early Development Study, born between 1994 and 1996 (mean age 16.32 years [SD = 0.68]).
Results
A moderate proportion of the variance for the different variables (.29–.42) was explained by genetic factors. Associations between sleep and internalizing variables were moderate (r = .34–.46) and there was a large genetic overlap between these variables (rA= .51–.73).
Conclusion
This study adds novel information by showing that there are large genetic correlations between sleep disturbances and internalizing symptoms in adolescence.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain
- Murcia Institute of Biomedical Research, IMIB-Arrixaca, Murcia, Spain
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - Nicholas Shakeshaft
- MRC Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Kerry Schofield
- MRC Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Margherita Malanchini
- MRC Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
- Department of Psychology, Queen Mary University of London, London, UK
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain
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31
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Wilson C, Carpenter J, Hickie I. The Role of the Sleep-Wake Cycle in Adolescent Mental Illness. CURRENT SLEEP MEDICINE REPORTS 2019. [DOI: 10.1007/s40675-019-00145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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32
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Alfano CA. (Re)Conceptualizing Sleep Among Children with Anxiety Disorders: Where to Next? Clin Child Fam Psychol Rev 2019; 21:482-499. [PMID: 30136070 DOI: 10.1007/s10567-018-0267-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Children with anxiety disorders (AD) characteristically complain of sleep problems and the extent to which cognitive behavioral treatments (CBT) for childhood anxiety produce sleep-based improvements is a topic of increasing interest. The current paper reviews available evidence for subjective sleep complaints and objective sleep alterations in children and adolescents with AD, including investigations of potential changes in sleep following anxiety-focused CBT. Despite pervasive complaints of poor sleep, the empirical literature provides minimal evidence for actual sleep-wake alterations in this population of youth and evidence for sleep-based changes following treatment for anxiety is minimal. In line with calls for more comprehensive models of the role of sleep in developmental psychopathology, several fundamental gaps in understanding are described and highlighted as essential avenues for clarifying the nature and consequences of poor quality sleep among youth with clinical levels of anxiety. In a second section of the paper, an emerging body of novel, translational research investigating more intricate sleep-anxiety relationships is introduced with potential implications for both etiological models and treatment design and delivery.
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Affiliation(s)
- Candice A Alfano
- Sleep and Anxiety Center of Houston (SACH), Department of Psychology, University of Houston, 126 Heyne Bldg, Houston, TX, 77204, USA.
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33
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Carpenter AL, Pincus DB, Furr JM, Comer JS. Working From Home: An Initial Pilot Examination of Videoconferencing-Based Cognitive Behavioral Therapy for Anxious Youth Delivered to the Home Setting. Behav Ther 2018; 49:917-930. [PMID: 30316490 PMCID: PMC6190606 DOI: 10.1016/j.beth.2018.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/07/2018] [Accepted: 01/20/2018] [Indexed: 12/17/2022]
Abstract
Progress in evidence-based treatments for child anxiety has been hampered by limited accessibility of quality care. This study utilized a multiple baseline design to evaluate the pilot feasibility, acceptability, and preliminary efficacy of real-time, Internet-delivered, family-based cognitive-behavioral therapy for child anxiety delivered to the home setting via videoconferencing. Participants included 13 anxious youth (mean age = 9.85) with a primary/co-primary anxiety disorder diagnosis. Eleven participants (84.6%) completed treatment and all study procedures. Consistent with hypotheses, the intervention was feasible and acceptable to families (i.e., high treatment retention, high client satisfaction, strong therapeutic alliance, and low barriers to participation). Moreover, the novel videoconferencing treatment format showed preliminary efficacy: 76.9% of the intention-to-treat (ITT) sample and 90.9% of treatment completers were treatment responders (i.e., Clinical Global Impressions-Improvement Scale = 1 or 2 at posttreatment), and 69.2% of the ITT sample and 81.8% of treatment completers were diagnostic responders (as per the Anxiety Disorders Interview for Children). Gains were largely maintained at 3-month follow-up evaluation. Outcome patterns within and across subjects are discussed, as well as limitations and the need for further controlled evaluations. With continued support, videoconferencing treatment formats may serve to meaningfully broaden the reach of quality care for youth anxiety disorders.
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Affiliation(s)
| | - Donna B Pincus
- Center for Anxiety and Related Disorders, Boston University
| | - Jami M Furr
- Center for Children and Families, Florida International University
| | - Jonathan S Comer
- Center for Children and Families, Florida International University
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34
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Geng F, Liu X, Liang Y, Shi X, Chen S, Fan F. Prospective associations between sleep problems and subtypes of anxiety symptoms among disaster-exposed adolescents. Sleep Med 2018; 50:7-13. [PMID: 29966810 DOI: 10.1016/j.sleep.2018.05.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 10/14/2022]
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35
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Zuj DV, Palmer MA, Malhi GS, Bryant RA, Felmingham KL. Greater sleep disturbance and longer sleep onset latency facilitate SCR-specific fear reinstatement in PTSD. Behav Res Ther 2018; 110:1-10. [PMID: 30145363 DOI: 10.1016/j.brat.2018.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/31/2018] [Accepted: 08/16/2018] [Indexed: 12/15/2022]
Abstract
Fear reinstatement is one of several paradigms designed to measure fear return following extinction, as a laboratory model for the relapse of Posttraumatic Stress Disorder (PTSD) symptoms. Sleep is a key factor in emotional memory consolidation, and here we examined the relationship between sleep quality and fear reinstatement in PTSD, relative to trauma-exposed and non-exposed controls. The Pittsburgh Sleep Quality Index (PSQI) was used as a subjective measure of sleep quality, and skin conductance responses (SCR) and unconditioned stimulus (US)-expectancy ratings were used to index threat responses during a differential fear conditioning, extinction, and reinstatement paradigm. There were no significant between-group differences in the reinstatement of conditioned responding. Sleep disturbance and sleep onset latency were significant moderators between reinstatement of fear and PTSD symptom severity, such that there was a positive relationship between PTSD symptoms and fear reinstatement for higher levels - but not lower levels - of sleep disturbance and sleep onset latency. To our knowledge, this is the first study to investigate PTSD-specific reinstatement patterns and sleep as a boundary condition of reinstatement. Future research using polysomnographic measures of sleep-wave architecture may further clarify the relationship between fear reinstatement and sleep quality in clinical samples with PTSD relative to controls.
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Affiliation(s)
- Daniel V Zuj
- Division of Psychology, School of Medicine, University of Tasmania, TAS, Australia; Department of Psychology, Swansea University, Wales, United Kingdom.
| | - Matthew A Palmer
- Division of Psychology, School of Medicine, University of Tasmania, TAS, Australia
| | - Gin S Malhi
- Department of Psychiatry, Royal North Shore Hospital, St Leonards, NSW, Australia; Sydney Medical School, University of Sydney, NSW, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, NSW, Australia
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, VIC, Australia
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36
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Feinberg L, Kerns C, Pincus DB, Comer JS. A Preliminary Examination of the Link Between Maternal Experiential Avoidance and Parental Accommodation in Anxious and Non-anxious Children. Child Psychiatry Hum Dev 2018; 49:652-658. [PMID: 29352362 PMCID: PMC6029431 DOI: 10.1007/s10578-018-0781-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Studies point to parental experiential avoidance (EA) as a potential correlate of maladaptive parenting behaviors associated with child anxiety. However, research has not examined the relationship between EA and parental accommodation of child anxiety, nor the extent to which parental negative beliefs about child anxiety help explain such a relationship. In a sample of mothers (N = 45) of anxious and non-anxious children, the present study investigated the potential link between maternal EA and accommodation of child anxiety and whether this link may be indirectly accounted for via maternal negative beliefs about child anxiety. EA was significantly and positively associated with accommodation of child anxiety, but when negative beliefs about child anxiety were incorporated into the model this direct effect was no longer significant. Findings highlight the contribution of parental emotions and cognitions to behaviors that may exacerbate child anxiety, and may inform treatment and prevention efforts with families of anxious youth.
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Affiliation(s)
- Leah Feinberg
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Caroline Kerns
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Donna B Pincus
- Department of Psychology, Boston University, Boston, MA, USA
| | - Jonathan S Comer
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA.
- Mental Health Interventions and Technology (MINT) Program, Department of Psychology, Center for Children and Families, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
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37
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Poznanski B, Cornacchio D, Coxe S, Pincus DB, McMakin DL, Comer JS. The Link Between Anxiety Severity and Irritability Among Anxious Youth: Evaluating the Mediating Role of Sleep Problems. Child Psychiatry Hum Dev 2018; 49:352-359. [PMID: 29222620 DOI: 10.1007/s10578-017-0769-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although recent studies have linked pediatric anxiety to irritability, research has yet to examine the mechanisms through which youth anxiety may be associated with irritability. Importantly, sleep related problems (SRPs) have been associated with both child anxiety and irritability, but research has not considered whether the link between youth anxiety and irritability may be accounted for by SRPs. The present study investigated whether SRPs mediated the relationship between anxiety severity and irritability in a large sample of treatment-seeking anxious youth (N = 435; ages 7-19 years, M = 12.7; 55.1% female). Anxiety severity, SRPs and irritability showed significant pairwise associations, and the indirect effect of youth anxiety severity on irritability, via SRPs, was positive and significant. The present analysis is the first to examine youth anxiety, irritability, and SPRs in a single model in a sample of anxious youth, and provides preliminary evidence that SRPs partially mediate links between child anxiety and irritability.
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Affiliation(s)
- Bridget Poznanski
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Danielle Cornacchio
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Stefany Coxe
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Donna B Pincus
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Studies, Boston University, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA
| | - Dana L McMakin
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA. .,Department of Psychology, The Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
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38
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Bry LJ, Chou T, Miguel E, Comer JS. Consumer Smartphone Apps Marketed for Child and Adolescent Anxiety: A Systematic Review and Content Analysis. Behav Ther 2018; 49. [PMID: 29530263 PMCID: PMC6082393 DOI: 10.1016/j.beth.2017.07.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Anxiety disorders are collectively the most prevalent mental health problems affecting youth. To increase the reach of mental health care, recent years have seen increasing enthusiasm surrounding mobile platforms for expanding treatment delivery options. Apps developed in academia and supported in clinical trials are slow to reach the consumer marketplace. Meanwhile, proliferation of industry-developed apps on consumer marketplaces has been high. The present study analyzed content within mobile products prominently marketed toward consumers for anxiety in youth. Systematic inventory of the Google Play Store and Apple Store using keyword searches for child and adolescent anxiety yielded 121 apps, which were evaluated on the basis of their descriptive characteristics, mobile functionalities, and adherence to evidence-based treatment principles. Findings revealed that evidence-based treatment content within the sample is scant and few comprehensive anxiety self-management apps were identified. Advanced features that leverage the broader functionalities of smartphone capabilities (e.g., sensors, ecological momentary assessments) were rarely present. Findings underscore the need to increase the prominence and accessibility of quality child anxiety intervention products for consumers. Strategies for improving marketing of supported apps to better penetrate consumer markets are discussed.
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Affiliation(s)
- Laura Jane Bry
- Mental Health Interventions and Technology (MINT) Program, Florida International University
| | - Tommy Chou
- Mental Health Interventions and Technology (MINT) Program, Florida International University
| | - Elizabeth Miguel
- Mental Health Interventions and Technology (MINT) Program, Florida International University
| | - Jonathan S. Comer
- Mental Health Interventions and Technology (MINT) Program, Florida International University
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39
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Morse AM, Garner DR. Traumatic Brain Injury, Sleep Disorders, and Psychiatric Disorders: An Underrecognized Relationship. Med Sci (Basel) 2018; 6:E15. [PMID: 29462866 PMCID: PMC5872172 DOI: 10.3390/medsci6010015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/04/2018] [Accepted: 02/05/2018] [Indexed: 12/28/2022] Open
Abstract
Traumatic brain injury (TBI) is commonplace among pediatric patients and has a complex, but intimate relationship with psychiatric disease and disordered sleep. Understanding the factors that influence the risk for the development of TBI in pediatrics is a critical component of beginning to address the consequences of TBI. Features that may increase risk for experiencing TBI sometimes overlap with factors that influence the development of post-concussive syndrome (PCS) and recovery course. Post-concussive syndrome includes physical, psychological, cognitive and sleep-wake dysfunction. The comorbid presence of sleep-wake dysfunction and psychiatric symptoms can lead to a more protracted recovery and deleterious outcomes. Therefore, a multidisciplinary evaluation following TBI is necessary. Treatment is generally symptom specific and mainly based on adult studies. Further research is necessary to enhance diagnostic and therapeutic approaches, as well as improve the understanding of contributing pathophysiology for the shared development of psychiatric disease and sleep-wake dysfunction following TBI.
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Affiliation(s)
- Anne M Morse
- Janet Weis Children's Hospital, Department of Pediatric Neurology and Sleep Medicine, Geisinger Medical Center, MC 14-12, 100 N Academy Blvd, Danville, PA 17822, USA.
| | - David R Garner
- Department of Pediatrics, Geisinger Medical Center, Danville, PA 17822, USA.
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Dixon LJ, Lee AA, Gratz KL, Tull MT. Anxiety sensitivity and sleep disturbance: Investigating associations among patients with co-occurring anxiety and substance use disorders. J Anxiety Disord 2018; 53:9-15. [PMID: 29127882 DOI: 10.1016/j.janxdis.2017.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/26/2017] [Accepted: 10/31/2017] [Indexed: 01/04/2023]
Abstract
Sleep disturbance is a common problem among individuals with anxiety and substance use disorders (SUD). Anxiety sensitivity (AS) is elevated in patients with anxiety disorders and SUD and has been linked to sleep-related problems, including insomnia and somnolence (i.e., daytime sleepiness). We examined the unique roles of AS cognitive, physical, and social concerns in sleep disturbance among a sample of 99 residential SUD patients with anxiety disorders. Clinical levels of insomnia or somnolence were evidenced by 53.5% of the sample. Consistent with predictions, AS physical concerns was significantly associated with insomnia, and AS cognitive concerns was significantly related to insomnia and somnolence. Hierarchical linear regression models were conducted to test the association of AS cognitive and physical concerns with insomnia and somnolence symptoms while controlling for relevant factors. AS cognitive concerns accounted for unique variance, above and beyond withdrawal symptoms, anxiety, and depressive symptoms, in the model examining insomnia symptoms (B=0.30, SE=0.13, p=0.023). Results suggest that AS cognitive concerns may represent an important transdiagnostic mechanism underlying sleep disturbance among individuals with dual diagnosis.
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Affiliation(s)
- Laura J Dixon
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS 38677, United States.
| | - Aaron A Lee
- VA Center for Clinical Management Research, Ann Arbor, MI, United States
| | - Kim L Gratz
- Department of Psychology, University of Toledo, 2801 W. Bancroft, Toledo, OH 43606, United States
| | - Matthew T Tull
- Department of Psychology, University of Toledo, 2801 W. Bancroft, Toledo, OH 43606, United States
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Albano AM, Comer JS, Compton SN, Piacentini J, Kendall PC, Birmaher B, Walkup JT, Ginsburg GS, Rynn MA, McCracken J, Keeton C, Sakolsky DJ, Sherrill JT. Secondary Outcomes From the Child/Adolescent Anxiety Multimodal Study: Implications for Clinical Practice. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2017; 3:30-41. [PMID: 30906874 PMCID: PMC6425733 DOI: 10.1080/23794925.2017.1399485] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Controlled evaluations comparing medication, cognitive-behavioral therapy (CBT), and their combination in the treatment of youth anxiety have predominantly focused on global ratings by independent evaluators. Such ratings are resource-intensive, may be of limited generalizability, and do not directly inform our understanding of treatment responses from the perspective of treated families. We examined outcomes from the perspective of treated youth and parents in the Child/Adolescent Anxiety Multimodal Study (CAMS). METHODS Participants (N=488; ages 7-17 years) who had a primary diagnosis of separation, social, and/or generalized anxiety disorder were randomly assigned to a treatment condition in the CAMS trial. Linear mixed-effects and ANCOVA models examined parent- and youth-reported anxiety symptoms, impact of anxiety, broader internalizing and externalizing psychopathology, depressive symptoms, and family burden throughout the 12-week acute treatment phase and 6-month follow-up. RESULTS At week 12, combination treatment showed superiority over placebo, sertraline, and CBT with regard to parent-reported youth anxiety symptoms, and sertraline and CBT as monotherapies showed superiority over placebo with regard to parent-reported youth anxiety. Combination therapy and sertraline also showed week 12 superiority over placebo with regard to parent-reported internalizing psychopathology, and superiority over placebo and CBT with regard to parent-reported impact of anxiety, family burden, and youth depressive symptoms. By week 36, parent reports of many youth outcomes were comparable across active conditions. Youth measures tracked parent measures on many outcomes. CONCLUSIONS Findings were drawn on brief, readily available questionnaires that in conjunction with clinician measures can inform patient-centered care and collaborative decision-making.Trial Registry Name: Child and Adolescent Anxiety Disorders (CAMS)Registry identification number: NCT00052078Registry URL: https://www.clinicaltrials.gov/ct2/show/NCT00052078.
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Affiliation(s)
- Anne Marie Albano
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University Medical Center, New York, NY
| | - Jonathan S Comer
- Departments of Psychology and Psychiatry, Center for Children and Families, Florida International University, Miami, FL
| | - Scott N Compton
- Department of Psychiatry and Biobehavioral Sciences, Duke University, Durham, North Carolina
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | | | - Boris Birmaher
- Western Psychiatric Institute and Clinic-University of Pittsburgh Medical Center, Pittsburgh, PA
| | - John T Walkup
- Department of Psychiatry, Weill Cornell Medical College and New York Presbyterian Hospital, New York, NY
| | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - Moira A Rynn
- Department of Psychiatry and Biobehavioral Sciences, Duke University, Durham, North Carolina
| | - James McCracken
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Courtney Keeton
- Department of Psychiatry, Johns Hopkins Medical Institutions
| | - Dara J Sakolsky
- Western Psychiatric Institute and Clinic-University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Joel T Sherrill
- Division of Services and Interventions Research, National Institute of Mental Health, Bethesda, MD
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Modafferi S, Stornelli M, Chiarotti F, Cardona F, Bruni O. Sleep, anxiety and psychiatric symptoms in children with Tourette syndrome and tic disorders. Eur J Paediatr Neurol 2016; 20:696-703. [PMID: 27228790 DOI: 10.1016/j.ejpn.2016.05.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 04/25/2016] [Accepted: 05/08/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The current study evaluated the relationship between tic, sleep disorders and specific psychiatric symptoms (anxiety, depression, obsessive compulsive symptoms). METHODS Assessment of 36 consecutive children and adolescents with tic disorders included: the Yale Global Tic Severity Scale (YGTSS) to assess the severity of tic symptoms; the Self-administered scale for children and adolescents (SAFA) to evaluate the psychopathological profile; a specific sleep questionnaire consisting of 45 items to assess the presence of sleep disorders. An age and sex-matched control group was used for comparisons. RESULTS Sleep was significantly more disturbed in patients with tic disorders than in controls. Difficulties in initiating sleep and increased motor activity during sleep were the most frequent sleep disturbances found in our sample. Patients showed also symptoms of anxiety (SAFA A), depressed mood (SAFA D) and doubt-indecision (SAFA O). Additionally, difficulties in initiating sleep resulted associated with other SAFA subscales relative to obsessive-compulsive symptoms and depression symptoms. Furthermore, anxiety symptoms (SAFA A) resulted associated with increased motor activity during sleep. CONCLUSIONS Findings confirm literature studies reporting high frequency of sleep problems, anxiety and other psychopathological symptoms in patients with tic disorders, and support the hypothesis that intrusive thoughts and other emotional disturbances might disrupt the sleep onset of these patients. These results suggest the importance of a thorough assessment of sleep and psychiatric disturbances in patients with tic disorders.
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Affiliation(s)
- Sergio Modafferi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
| | - Maddalena Stornelli
- Systems Medicine Department, Child Neurology and Psychiatry Unit, Tor Vergata University Hospital, Rome, Italy.
| | - Flavia Chiarotti
- Department of Cell Biology and Neuroscience, National Institute of Health, Rome, Italy.
| | - Francesco Cardona
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University, Rome, Italy.
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy.
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Bilsky SA, Feldner MT, Knapp AA, Babson KA, Leen-Feldner EW. The interaction between anxiety sensitivity and cigarette smoking level in relation to sleep onset latency among adolescent cigarette smokers. J Adolesc 2016; 51:123-32. [PMID: 27351343 DOI: 10.1016/j.adolescence.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/09/2016] [Accepted: 06/11/2016] [Indexed: 12/23/2022]
Abstract
Cigarette smoking during adolescence is linked to a number of sleep disturbances and has been consistently linked to sleep onset latency among adults. However, little research has examined factors that may influence the relation between cigarette smoking level and sleep onset latency among adolescents. One factor that may be particularly important in this regard is anxiety sensitivity (AS). The current study examined whether cigarette smoking level interacted with AS in its association with sleep onset latency among 94 adolescent (Mage = 15.72) cigarette smokers. As hypothesized, AS interacted with smoking level to relate to sleep onset latency, even after controlling for age and gender. This relation was specific to sleep onset latency as opposed to other types of sleep disturbances, and that adolescents who smoked at higher levels tended to go to sleep later and wake up later than adolescents who smoked at relatively lower levels.
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Affiliation(s)
- Sarah A Bilsky
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
| | - Matthew T Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA; Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Ashley A Knapp
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Kimberly A Babson
- National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Ellen W Leen-Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
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Peterman JS, Carper MM, Elkins RM, Comer JS, Pincus DB, Kendall PC. The effects of cognitive-behavioral therapy for youth anxiety on sleep problems. J Anxiety Disord 2016; 37:78-88. [PMID: 26735330 DOI: 10.1016/j.janxdis.2015.11.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/19/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
Abstract
The present study examined (a) whether sleep related problems (SRPs) improved following cognitive-behavioral therapy (CBT) for youth with anxiety disorders, (b) whether variables that may link anxiety and SRPs (e.g., pre-sleep arousal, family accommodation, sleep hygiene) changed during treatment, and (c) whether such changes predicted SRPs at posttreatment. Youth were diagnosed with anxiety at pretreatment and received weekly CBT that targeted their principal anxiety diagnosis at one of two specialty clinics (N=69 completers, Mage=10.86). Results indicated that parent-reported SRPs improved from pre- to post-treatment and that treatment responders with regard to anxiety yielded greater SRP improvements than nonresponders. Parent report of bedtime resistance and sleep anxiety showed significant improvements. Youth reported lower rates of SRPs compared to their parents and did not demonstrate pre- to post-treatment changes in SRPs. Pre-sleep arousal and family accommodation decreased over treatment but did not predict lower SRPs at posttreatment. Higher accommodation was correlated with greater SRPs. Sleep hygiene evidenced no change and did not mediate links between accommodation and posttreatment SRPs.
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Abstract
PURPOSE OF REVIEW Adolescence is a period of dynamic change in both sleep and emotional systems, with related increases in problems controlling emotion and behavior. Youth with anxiety enter adolescence with pre-existing vulnerabilities in systems of sleep and emotion that may place them at heightened risk. This review summarizes recent research on sleep and anxiety during the transition to adolescence, and highlights emerging themes. RECENT FINDINGS Prospective studies support that sleep predicts anxiety symptoms in early adolescence. Notably, robust evidence for subjective sleep problems in anxious youth is not well corroborated by objective assessments. Longitudinal designs and methodology that carefully examine dimensions of anxiety and sleep may clarify inconsistencies. Preliminary evidence suggests that late childhood to early adolescence may be a sensitive period for escalating problems with sleep and anxiety. Recent advances in the neuroscience of sleep can further refine integrative mechanistic models of developmental psychopathology - the role of sleep in emotional learning and memory is provided as an example. SUMMARY Sleep problems are common and prospectively predict escalating anxiety symptoms. Precision is needed regarding the nature of sleep disruption, and how and when sleep affects various aspects of developmental trajectories. This precision, along with advances in the neuroscience of sleep, may lead to developmentally informed translational interventions.
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Abstract
Anxiety is adaptive and plays an important role in keeping us safe. However, when anxiety becomes too extreme, it can cause significant disruptions and distress. Understanding the mechanisms underlying excessive anxiety and how to best treat it is a priority for researchers and clinicians. There is increasing recognition that disruptions in the amount and timing of sleep are associated with anxiety symptoms and characteristics. In the current paper, we explore the intersections between sleep, circadian rhythms, and anxiety. First, we review accumulating evidence that anxiety is associated with disruptions in sleep and circadian rhythms in both clinical and nonclinical samples and across ages. Next, we discuss the data linking sleep disruptions with anxiety-related traits (anxiety sensitivity, neuroticism, and perfectionism) and patterns of cognition and emotion. Finally, potential treatment implications are highlighted. Overall, these data suggest that delineating the role of disruptions in the amount and timing of sleep holds promise for improving the lives of individuals with heightened anxiety.
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