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Clegg I, Notebaert L, Richardson C. Negative attention bias and attentional control as mechanisms in the association between insomnia and depression in young people. Behav Res Ther 2024; 179:104569. [PMID: 38761556 DOI: 10.1016/j.brat.2024.104569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/20/2024]
Abstract
Evidence supports a causal role of insomnia in the development and maintenance of depression, yet mechanisms underlying this association in young people are not well established. Attention biases have been implicated separately in the sleep and depression fields and represents an important candidate mechanism. Poor sleep may lead to a negative attention bias (characteristic of depression) by impacting attentional control. This study assessed the hypothesis that attentional control and negative attention bias would sequentially mediate the relationship between insomnia and depressive symptoms in an unselected sample of young people (17-24 years). Concerns have been raised regarding the psychometric properties of tasks used to measure attention bias, and a Dual-Probe Task is emerging as a more reliable measure. Participants (N = 275, Male = 59, Mage = 19.40) completed the Dual-Probe Task, a behavioural measure of attentional control, and self-report measures of insomnia and depression. Participants completed a one-week sleep diary. Results were consistent with negative attention bias, but not attentional control, as a mechanism which partially accounts for the relationship between sleep (i.e., insomnia severity, sleep duration, sleep efficiency, sleep latency) and depression. This study highlights sleep and negative attention bias as potentially modifiable risk factors to reduce depressive symptoms in young people.
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Affiliation(s)
- Isabel Clegg
- Center for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia; Center for Sleep Science, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia.
| | - Lies Notebaert
- Center for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia.
| | - Cele Richardson
- Center for Sleep Science, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia.
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2
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Kravitz HM, Ruppert K, Lian P, Neal-Perry G, Swanson LM. Sleep Health and Anxiety Symptoms in Midlife Women: The Study of Women's Health Across the Nation (SWAN). Int J Womens Health 2024; 16:1079-1091. [PMID: 38884052 PMCID: PMC11178082 DOI: 10.2147/ijwh.s455834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/23/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose To investigate the associations between anxiety symptoms in midlife women and sleep features later in life, the aim is to test the hypothesis that poor sleep, as measured by each of six individual dimensions (4 objective actigraphy measures, 2 self-reports) of sleep health, is associated with higher levels of anxiety symptoms in midlife women. Participants and Methods The participants in this longitudinal analysis included women from the SWAN Sleep I Study, a subcohort of the community-dwelling midlife women participating in the core Study of Women's Health Across the Nation (SWAN), which was initiated in 1996. Of the 370 participants enrolled in the Sleep Study, 270 were included in the analytic sample, and 100 who did not meet the inclusion criteria were excluded. Baseline measures of six dimensions of multidimensional sleep health (actigraphy measures: efficiency, duration, mid-sleep timing, regularity; self-report measures: alertness, satisfaction) were obtained between 2003 and 2005, corresponding to SWAN core annual/biennial assessments 5-8. Associations of each dimension with self-reported anxiety symptoms (Generalized Anxiety Disorder - 7-item scale; GAD-7), collected during visits 12 (2009-2011), 13 (2011-2013), and 15 (2015-2017), were examined using mixed models. The GAD-7 outcome was measured both continuously and as a categorical variable due to its skewed distribution. Results No statistically significant associations were found between any of the six baseline sleep health dimensions and the GAD-7 score after adjustment for covariates. Conclusion The reasons for the lack of support for our hypothesis, despite previous evidence supporting an association between sleep and anxiety, are unclear. There is considerable overlap between anxiety and sleep symptoms, which may complicate the interpretation of our the findings. Thus, the failure to identify associations is likely multifactorial, and more studies with shorter follow-up intervals are warranted to better understand these relationships.
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Affiliation(s)
- Howard M Kravitz
- Department of Psychiatry and Behavioral Sciences, and Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kristine Ruppert
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pam Lian
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Leslie M Swanson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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3
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Costa-López B, Lavigne-Cerván R, Collado-Valero JA, Juárez-Ruiz de Mier R, Navarro-Soria I. The Influence of Emotional Regulation and Cognitive Flexibility on Sleep Habits in Spanish Children and Adolescents through the Lens of Parents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1390. [PMID: 37628389 PMCID: PMC10453574 DOI: 10.3390/children10081390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/04/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Previous research studies have suggested the importance of studying the relationship between emotional regulation and sleep habits. Some investigations have especially focused on how emotional regulation could impact sleep habits in children and adolescents. Therefore, these researchers have stated there exists a two-way direction in this relationship. OBJECTIVE This study aimed to analyze the influence of emotional regulation on sleep habits in Spanish children and adolescents and the mediating role of anxiety in this relationship. METHOD Participants were 953 Spanish parents who completed the assessment protocol according to their children and adolescents' information. RESULTS The results revealed moderate-strong correlations between emotional regulation problems and sleep habit disturbances (r = 0.375, p < 0.001), trait (r = 0.488, p < 0.001) anxiety, and state (r = 0.589, p < 0.001) anxiety. Additionally, emotional regulation showed a direct impact on sleep habits (β = 0.011, p = 0.005). Trait and state anxiety demonstrated a significant mediating role in the relationship between emotional regulation and sleep habits. CONCLUSIONS Emotional regulation may have an impact on sleep habits during childhood and adolescence, suggesting the importance of early intervention focused on the emotions management and the prevention of sleep habit disturbances.
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Affiliation(s)
- Borja Costa-López
- Department of Health Psychology, University of Alicante, 03690 Alicante, Spain;
| | - Rocío Lavigne-Cerván
- Department of Developmental and Educational Psychology, University of Malaga, 29016 Málaga, Spain; (R.L.-C.); (J.A.C.-V.); (R.J.-R.d.M.)
| | - Joshua A. Collado-Valero
- Department of Developmental and Educational Psychology, University of Malaga, 29016 Málaga, Spain; (R.L.-C.); (J.A.C.-V.); (R.J.-R.d.M.)
| | - Rocío Juárez-Ruiz de Mier
- Department of Developmental and Educational Psychology, University of Malaga, 29016 Málaga, Spain; (R.L.-C.); (J.A.C.-V.); (R.J.-R.d.M.)
| | - Ignasi Navarro-Soria
- Department of Developmental and Educational Psychology, University of Alicante, 03690 Alicante, Spain
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Almeida F, Marques DR, Gomes AA. A preliminary study on the association between social media at night and sleep quality: The relevance of FOMO, cognitive pre-sleep arousal, and maladaptive cognitive emotion regulation. Scand J Psychol 2023; 64:123-132. [PMID: 36256468 DOI: 10.1111/sjop.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/14/2022] [Accepted: 09/22/2022] [Indexed: 12/01/2022]
Abstract
Research shows that nighttime social media is negatively associated with sleep quality and that it might be utilized to cope with aversive psychological states related to cognitive pre-sleep arousal (i.e., transdiagnostic psychopathology variables, referring to maladaptive repetitive thought), namely Fear of Missing Out (FoMO). The use of nighttime social media to cope with other aversive cognitive states (i.e., worry/rumination), their relationship with FoMO, and these variables' association with sleep are not fully understood. This study explored the relationships between nighttime social media, sleep quality, FoMO, cognitive pre-sleep arousal, and maladaptive cognitive emotion regulation (i.e., worry/rumination). The present correlational study followed a cross-sectional design. Participants were 525 university students, ranging in age from 18 to 64 (M = 22.39, SD = 5.62). Measures of sleep quality, morningness/eveningness, cognitive pre-sleep arousal, worry, rumination, FoMO, nighttime screen, and social media use were collected online or in pencil-paper format. Multiple linear regression analyses were performed. Nighttime social media and FoMO were associated with rumination, worry (H1) and cognitive pre-sleep arousal. Both FoMO and worry predicted higher levels of cognitive pre-sleep arousal (H2) and nighttime social media use (H3). Nighttime social media use independently predicted poor sleep quality (H4). These results suggest that worry and FoMO may potentially affect sleep quality by increasing cognitive pre-sleep arousal and nighttime social media. A possible explanation for these findings is that nighttime social media might be used as a strategy to cope with aversive cognitive states. These conclusions may contribute to improving sleep intervention in this population.
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Affiliation(s)
- Filipa Almeida
- University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Daniel R Marques
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
- University of Aveiro, Department of Education and Psychology, Aveiro, Portugal
| | - Ana A Gomes
- University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
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Alvarenga MAS, Bandeira PFR, Guilhermino CS, de Azevedo TG, Olímpio KF, Mansur-Alves M, Buchanan T. Cross-cultural adaptation of the web-based executive functioning questionnaire for Brazilian sample (Webexec-BR). APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-11. [PMID: 36706078 DOI: 10.1080/23279095.2023.2170799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The Web-based Executive Functioning Questionnaire (Webexec) is a brief scale developed to assess executive functions via online format. It has been used in different contexts, but its adaptation to other cultures is still restricted. This study aimed to perform a cross-cultural adaptation of the Webexec for a Brazilian sample considering the psychometric properties of the scale. This study used a sample of 295 Brazilian participants, with a mean age equal to 20.69 (SD = 6.030). This is a longitudinal study with reapplication of the scale six weeks after the test phase. Classical and contemporary methods were applied to analyze the psychometric properties of the Webexec. The results showed that the scale presented excellent psychometric properties for the Brazilian version, considering validity evidence based on the content and internal structure of Webexec, as well as reliability and precision. However, it is considered that other relational and experimental studies should be carried out with a larger sample size and for different population groups.
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Affiliation(s)
| | | | | | - Tiago Geraldo de Azevedo
- Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil
| | - Kelly Fernandes Olímpio
- Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil
| | - Marcela Mansur-Alves
- Department of Psychology, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Tom Buchanan
- Centre for Psychological Sciences, University of Westminster, London, UK
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Salguero JM, Ramos-Cejudo J, García-Sancho E, Arbulu I, Zaccagnini JL, Bjureberg J, Gross JJ. Testing the impaired disengagement hypothesis: The role of attentional control and positive metacognitive beliefs in depression. Behav Res Ther 2021; 146:103961. [PMID: 34543923 DOI: 10.1016/j.brat.2021.103961] [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: 11/26/2020] [Revised: 07/01/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
The impaired disengagement hypothesis holds that people ruminate - and thus increase their risk for depression - due to impaired attentional control and conflict signaling. We tested this hypothesis by examining the role of attentional control and conflict signaling (operationalized as positive metacognitive beliefs) in rumination and depressive symptoms. We expected that attentional control and positive metacognitive beliefs would be associated with depressive symptoms and that these associations would be cross-sectionally mediated by rumination. We tested two community samples (Study 1, N = 289; Study 2, N = 292), assessing attentional control, positive metacognitive beliefs, rumination, and depressive symptoms. In both studies, attentional control and positive metacognitive beliefs were significantly associated with rumination and depression, and path analyses corroborated the proposed mediation model. Our findings support the impaired disengagement hypothesis, and suggest that attentional control and positive metacognitive beliefs may be informative in the personalization of depression assessment and treatment.
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Affiliation(s)
- José M Salguero
- Department of Personality, Evaluation and Psychological Treatment, University of Malaga, Spain.
| | | | | | - Ilyana Arbulu
- Department of Personality, Evaluation and Psychological Treatment, Complutense University of Madrid, Spain
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7
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Bai S, Chang Q, Yao D, Zhang Y, Wu B, Zhao Y. Anxiety in Residents in China: Prevalence and Risk Factors in a Multicenter Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:718-727. [PMID: 33464742 DOI: 10.1097/acm.0000000000003913] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To explore the prevalence of major anxiety and its associated risk factors in residents in China. METHOD This multicenter, cross-sectional study was conducted from December 2019 to February 2020; 1,343 residents from 8 hospitals in Northeast China were included in the final analysis (effective response rate of 86.48%). Demographic characteristics, dietary habits, life-related factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. This questionnaire measured sleep quality, physical activity, anxiety, perceived organizational support, psychological capital, and burnout. Adjusted odds ratios (ORs) and 95% confidence intervals were determined using binary logistic regression. Cutoff values and the area under the curve were calculated for risk factors using receiver operating characteristic curve analysis. RESULTS Of participants, 441 (32.80%) reported anxiety symptoms and 133 (9.90%) reported major anxiety symptoms. Four independent risk factors for major anxiety were identified: poor sleep quality (OR = 1.282, P < .001) and 3 dimensions of burnout: higher emotional exhaustion (OR = 1.085, P < .001), higher depersonalization (OR = 1.064, P = .002), and reduced personal accomplishment (OR = 0.951, P < .001). The optimal cutoff values for these risk factors were 7, 10, 9, and 22 scores, respectively. CONCLUSIONS This study found a considerable prevalence of major anxiety symptoms in residents in China and identified poor sleep quality and higher levels of burnout as having a close association with major anxiety. These findings enrich the existing literature on anxiety and demonstrate a critical need for additional studies that investigate intervention strategies to improve sleep quality and combat burnout, which could improve the mental health of residents.
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Affiliation(s)
- Song Bai
- S. Bai is associate professor, Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Q. Chang is associate director, Department of Graduate Medical Education, Health Service Center of Liaoning Province, Shenyang, China
| | - Da Yao
- D. Yao is a student, Department of Graduate Medical Education, Health Service Center of Liaoning Province, Shenyang, China
| | - Yixiao Zhang
- Y. Zhang is a resident, Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bin Wu
- B. Wu is director, Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Y. Zhao is director, Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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8
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Kaczkurkin AN, Tyler J, Turk-Karan E, Belli G, Asnaani A. The Association between Insomnia and Anxiety Symptoms in a Naturalistic Anxiety Treatment Setting. Behav Sleep Med 2021; 19:110-125. [PMID: 31955594 PMCID: PMC7369215 DOI: 10.1080/15402002.2020.1714624] [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] [Indexed: 10/25/2022]
Abstract
Objective/Background: Few studies have examined the relationship between insomnia and anxiety treatment outcomes in naturalistic settings. Furthermore, prior studies typically examine insomnia within a single anxiety diagnosis without accounting for the high overlap between disorders. Here we investigate the association between insomnia and multiple anxiety disorders over a course of cognitive behavioral treatment (CBT) in a naturalistic treatment setting. Participants: Insomnia was assessed in 326 patients seeking treatment at a clinic specializing in CBT for anxiety. Methods: Multilevel modeling was used to investigate whether insomnia moderated reductions in anxiety symptoms. A cross-lagged analysis tested for bidirectional effects between insomnia and anxiety. Multiple regression was used to investigate the relationship between insomnia and anxiety while controlling for the other anxiety disorders and depression. Results: While there was a significant reduction in insomnia during treatment in all anxiety disorders, the majority of the most severe patients remained in the clinical range at post-treatment. Baseline insomnia did not significantly moderate anxiety outcomes, suggesting that patients with high or low levels of insomnia will do equally well in CBT for anxiety. The bidirectional effect between insomnia and anxiety did not reach significance. Additionally, posttraumatic stress disorder, generalized anxiety disorder, and panic disorder were associated with the greatest endorsement of insomnia, after controlling for the overlap between disorders. Conclusions: Sleep problems may persist after anxiety treatment, suggesting that CBT for insomnia may be warranted during or after a course of CBT for anxiety. Importantly, baseline insomnia does not impede anxiety reduction during CBT.
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Affiliation(s)
| | - Jeremy Tyler
- University of Pennsylvania, Department of Psychiatry, Center for the Treatment and Study of Anxiety, Philadelphia, PA, USA 19104
| | - Elizabeth Turk-Karan
- University of Pennsylvania, Department of Psychiatry, Center for the Treatment and Study of Anxiety, Philadelphia, PA, USA 19104
| | - Gina Belli
- University of Pennsylvania, Department of Psychiatry, Center for the Treatment and Study of Anxiety, Philadelphia, PA, USA 19104
| | - Anu Asnaani
- University of Utah, Department of Psychology, Salt Lake City, UT 84112
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9
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Cox RC, Olatunji BO. Sleep in the anxiety-related disorders: A meta-analysis of subjective and objective research. Sleep Med Rev 2020; 51:101282. [PMID: 32109832 DOI: 10.1016/j.smrv.2020.101282] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 02/04/2023]
Abstract
Although sleep disturbance is implicated in psychopathology, its role in anxiety-related disorders remains unclear. The present meta-analysis characterizes sleep disturbance in anxiety-related disorders collectively and individually. Subjective measures of total sleep time and sleep continuity were included with objective measures. Results indicate a large effect for increased subjective sleep disturbance (g = 2.16), medium effects for decreased total sleep time (g = -.40) and sleep continuity (g = -.49), and a small effect for decreased sleep depth (g = -.20) in anxiety-related disorders compared to healthy controls. Each anxiety-related disorder exhibited a distinct sleep disturbance pattern, suggesting that sleep may facilitate identification of unique biopsychological underpinnings. Effects were not moderated by comorbid depression and were similar in magnitude to those found for depression. Sleep disturbances, particularly decreased sleep continuity, may be a key pathology in the anxiety-related disorders that could highlight novel etiological mechanisms and intervention targets.
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Affiliation(s)
- Rebecca C Cox
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA.
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA
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10
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Xu S, Ouyang X, Shi X, Li Y, Chen D, Lai Y, Fan F. Emotional exhaustion and sleep-related worry as serial mediators between sleep disturbance and depressive symptoms in student nurses: A longitudinal analysis. J Psychosom Res 2020; 129:109870. [PMID: 31862630 DOI: 10.1016/j.jpsychores.2019.109870] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The multi-wave longitudinal study was to explore the underlying mechanisms between sleep disturbance and depressive symptoms for up to 9.5 months among student nurses and to examine whether emotional exhaustion and sleep-related worry could be the mediators. METHODS 856 student nurses aged 15-24 years (mean age = 17.8 years; all female) were recruited from a nursing school. Participants reported demographic variables (age, sibling, location, health condition, family monthly income and parents' marital quality) at baseline (Time1), Body Mass Index, weekly exercise, sleep disturbance and depressive symptoms at 3-month into internship (Time2), emotional exhaustion and sleep-related worry at 6-month into internship (Time3), and depressive symptoms at 9.5-month follow-up (Time4). Mediation analyses with bootstrapping were conducted to investigate the mediating role of emotional exhaustion and sleep-related worry in the relationship between sleep disturbance and depressive symptoms. RESULTS Adjusted analyses suggested that the direct effect of sleep disturbance on depressive symptoms was not significant (β = 0.026, SE = 0.069, p = .71). Mediation analyses revealed two significant indirect effects between Time2 sleep disturbance and Time4 depressive symptoms with the mediating effect of emotional exhaustion (β = 0.019, SE = 0.009, BC95%CI [0.0036,0.0405]) and sleep-related worry (β = 0.016, SE = 0.008, BC95%CI [0.0026,0.0337]) respectively. When testing serial multiple mediation, the specific indirect effect of sleep disturbance on depressive symptoms through both emotional exhaustion and sleep-related worry was significant (β = 0.005, SE = 0.003, BC95%CI [0.0004,0.0123]). CONCLUSIONS Emotional exhaustion and sleep-related worry were positively associated with sleep disturbance and depressive symptoms.
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Affiliation(s)
- Shuling Xu
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Xi Ouyang
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Xuliang Shi
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China; College of Education, Hebei University, Hebei, China
| | - Yuanyuan Li
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Dingxuan Chen
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Yuan Lai
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China.
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11
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Clancy F, Prestwich A, Caperon L, Tsipa A, O’Connor DB. The association between worry and rumination with sleep in non-clinical populations: a systematic review and meta-analysis. Health Psychol Rev 2020; 14:427-448. [DOI: 10.1080/17437199.2019.1700819] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F. Clancy
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - A. Prestwich
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - L. Caperon
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - A. Tsipa
- School of Psychology, Faculty of Medicine, The University of Leeds, Leeds, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Camden and Islington Foundation Trust, London, UK
| | - D. B. O’Connor
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
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12
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Marcusson-Clavertz D, West M, Kjell ONE, Somer E. A daily diary study on maladaptive daydreaming, mind wandering, and sleep disturbances: Examining within-person and between-persons relations. PLoS One 2019; 14:e0225529. [PMID: 31774836 PMCID: PMC6880993 DOI: 10.1371/journal.pone.0225529] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/06/2019] [Indexed: 12/31/2022] Open
Abstract
Cross-sectional and experimental research have shown that task-unrelated thoughts (i.e., mind wandering) relate to sleep disturbances, but there is little research on whether this association generalizes to the day-level and other kinds of task-unrelated mentation. We employed a longitudinal daily diary design to examine the within-person and between-person associations between three self-report instruments measuring mind wandering, maladaptive daydreaming (a condition characterized by having elaborate fantasy daydreams so insistent that they interfere with daily functioning) and sleep disturbances. A final sample of 126 participants self-identified as experiencing maladaptive daydreaming completed up to 8 consecutive daily reports (in total 869 daily observations). The scales showed acceptable-to-excellent within-person reliability (i.e., systematic day-to-day change) and excellent between-person reliability. The proportion of between-person variance was 36% for sleep disturbances, 57% for mind wandering, and 75% for maladaptive daydreaming, respectively (the remaining being stochastic and systematic within-person variance). Contrary to our pre-registered hypothesis, maladaptive daydreaming did not significantly predict sleep disturbances the following night, B = -0.00 (SE = 0.04), p = .956. Exploratory analyses indicated that while nightly sleep disturbances predicted mind wandering the following day, B = 0.20 (SE = 0.04), p < .001, it did not significantly predict maladaptive daydreaming the following day, B = -0.04 (SE = 0.05), p = .452. Moreover, daily mind wandering did not significantly predict sleep disturbances the following night, B = 0.02 (SE = 0.05), p = .731. All variables correlated at the between-person level. We discuss the implications concerning the differences between maladaptive daydreaming and mind wandering and the possibility of targeting sleep for mind wandering interventions.
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Affiliation(s)
- David Marcusson-Clavertz
- Department of Psychology, Lund University, Lund, Sweden
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
- * E-mail:
| | - Melina West
- Department of Psychological Sciences, University of Connecticut, Connecticut, United States of America
| | | | - Eli Somer
- School of Social Work, University of Haifa, Israel
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Jakobsson M, Josefsson K, Högberg K. Reasons for sleeping difficulties as perceived by adolescents: a content analysis. Scand J Caring Sci 2019; 34:464-473. [PMID: 31487078 PMCID: PMC7328685 DOI: 10.1111/scs.12750] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/09/2019] [Indexed: 01/10/2023]
Abstract
Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for adolescent health and education. The aim of this study was to describe the reasons for sleeping difficulties as perceived by adolescents. Sleeping difficulties include insufficient sleep, trouble falling asleep, waking up at night or sleep that does not leave an individual rested. Data were collected in 2015 using an open‐ended question. The sample consisted of n = 475 adolescents from a city in Sweden, aged 15–16 years, with self‐assessed sleeping difficulties. The results described the reasons for the adolescents’ sleeping difficulties, at a general, thematic level, as an imbalance between requirements and preconditions, distributed to stress, technology use, poor sleep habits, existential thoughts, needs and suffering. To find a balance in their daily lives, adolescents may need support from parents, school nurses and school health services to deal with their sleeping difficulties.
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Affiliation(s)
- Malin Jakobsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Karin Josefsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Karin Högberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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14
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Executive Dysfunction and Emotion Dysregulation Explain the Effects of Insomnia Symptoms on Repetitive Negative Thinking. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10033-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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15
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Kechter A, Leventhal AM. Longitudinal Association of Sleep Problems and Distress Tolerance During Adolescence. Behav Med 2019; 45:240-248. [PMID: 30358501 PMCID: PMC6483882 DOI: 10.1080/08964289.2018.1514362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/05/2018] [Accepted: 08/13/2018] [Indexed: 02/04/2023]
Abstract
The mechanism by which sleep problems adversely impacts adolescent health is poorly understood. Distress tolerance-a multifactorial trait indicative of one's ability to withstand negative emotions and persist toward long-term goals-is implicated in numerous emotional psychopathologies and an important target for research and practice. We hypothesized that the adverse psychobiological effects of sleep problems could disrupt the development of distress tolerance during adolescence. This longitudinal study examined whether sleep problems predicted changes in four facets of distress tolerance during adolescence: (1) absorption-feeling attention is captured by negative emotions, (2) appraisal-experiencing distress as unacceptable, (3) regulation-engaging in behaviors to terminate distress, and (4) tolerance-low perceived ability to tolerate distress. High school students (M baseline age = 15.5 years, N = 2,309, 56.1% female), completed self-report measures of sleep problems and distress tolerance at baseline and 1-year follow-up. In linear regression models adjusting for baseline distress tolerance, sleep problems predicted poorer distress tolerance at 1-year follow-up for each distress tolerance facet (βs = -0.10 to -0.24, ps ≤ 0.02). After additionally controlling for sociodemographics and emotional psychopathology, sleep problems were associated with poorer distress tolerance for absorption (β = -0.13, p = 0.004) and appraisal (β = -0.09, p = 0.049) facets, but not regulation or tolerance (ps ≥ 0.35) facets. Interventions targeting healthy sleep habits warrant consideration for improving adolescent development of certain facets of distress tolerance, and in turn various positive health outcomes improved by distress tolerance.
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Affiliation(s)
- Afton Kechter
- a Department of Preventive Medicine, Keck School of Medicine, University of Southern California , Los Angeles , California , USA
| | - Adam M Leventhal
- a Department of Preventive Medicine, Keck School of Medicine, University of Southern California , Los Angeles , California , USA
- b Department of Psychology, University of Southern California , Los Angeles , California , USA
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16
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DeJong H, Fox E, Stein A. Does rumination mediate the relationship between attentional control and symptoms of depression? J Behav Ther Exp Psychiatry 2019; 63:28-35. [PMID: 30639915 PMCID: PMC6379095 DOI: 10.1016/j.jbtep.2018.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES It has been suggested that impaired attentional control (AC) promotes the use of maladaptive emotional regulation strategies, such as rumination, with subsequent increase in risk of depression. METHOD This study examined this hypothesis in a healthy community sample. Questionnaire measures of depression, anxiety, rumination and self-reported AC (shifting and focusing) were used, as well as an attention performance task (Attention Network Task; ANT). RESULTS While self-report and performance measures of AC were not significantly related, both depression and rumination were associated with reduced self-reported AC. Depression was specifically associated with poorer attentional shifting. Depression and brooding were also associated with better performance on the conflict component of the ANT. Importantly, the relationships of ANT conflict and self-reported AC to depression were mediated by brooding. LIMITATIONS The current study used a community sample, and it is unclear if results would generalise to a clinical population. All measures were taken concurrently and so it is not possible to confidently ascertain causality or direction of effects. CONCLUSIONS These results are consistent with the suggestion that impaired AC, particularly a narrow and inflexible attentional focus, may increase risk of depression by promoting ruminative thinking. The results highlight the importance of considering both self-report and performance measures of AC, as well as different components of attentional performance.
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Affiliation(s)
- Hannah DeJong
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
| | - Elaine Fox
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, 49 Walton Street, OX2 6AE, Oxford, UK.
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
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17
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Woodward E, Sachschal J, Beierl ET, Ehlers A. Night-time rumination in PTSD: development and validation of a brief measure. Eur J Psychotraumatol 2019; 10:1651476. [PMID: 31497260 PMCID: PMC6720014 DOI: 10.1080/20008198.2019.1651476] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/09/2019] [Accepted: 07/25/2019] [Indexed: 11/21/2022] Open
Abstract
Background: Pre-sleep cognitive activity and arousal have long been implicated in the maintenance of insomnia. However, despite high comorbidity between insomnia and posttraumatic stress disorder (PTSD), pre-sleep thoughts in PTSD and their associations with disturbed sleep, have not yet been investigated. Objective: This study presents the development and preliminary validation of a brief self-report measure of the content of trauma-related pre-sleep thoughts: the Trauma Thoughts before Sleep Inventory (TTSI). Methods: Participants (N = 285) were recruited online into five groups: three groups with clinical symptoms, 1) PTSD; 2) depression without PTSD; 3) insomnia without depression or PTSD; and two healthy control groups 4) nontrauma-exposed controls; 5) trauma-exposed controls. The questionnaire was administered at baseline, and for a subsample (n = 157) again one week later to assess test-retest reliability. At baseline, participants also completed questionnaires of sleep quality, PTSD and depression symptoms, and insomnia-related thoughts. Results: The TTSI had good reliability and validity; it discriminated participants with PTSD from those with depression and insomnia, those with depression from insomnia, and correlated with existing measures of pre-sleep thoughts, self-reported pre-sleep arousal and poor sleep. Conclusions: The results support the utility of the TTSI for measuring thoughts that keep people with PTSD awake, although replication in an independent clinical sample is required.
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Affiliation(s)
| | - Juliane Sachschal
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Esther T Beierl
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Anke Ehlers
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
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18
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Holdaway AS, Luebbe AM, Becker SP. Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality? J Affect Disord 2018; 236:6-13. [PMID: 29704657 PMCID: PMC6047760 DOI: 10.1016/j.jad.2018.04.087] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/13/2018] [Accepted: 04/18/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Rumination, particularly brooding rumination, is associated with suicide risk, ideation and attempts; however, findings are inconsistent with respect to reflective rumination. Recent research suggests reflective rumination might be associated with increased suicide risk specifically among vulnerable individuals. Poor sleep quality is related to both suicide risk and rumination, yet no research has examined whether reflective rumination and sleep quality interact in relation to suicidal risk. This study, therefore, examined whether sleep quality moderates the link between ruminative subtypes and (a) suicide risk overall, and (b) suicidal ideation and (c) history of suicide attempts, specifically. METHODS Participants were 1696 college students (ages 18-29 years; 65% female) who completed measures assessing rumination, sleep, and suicidal ideation and behavior. Hierarchical linear and logistic regressions were performed regressing overall suicide risk (linear), suicidal ideation (linear) and history of attempts (logistic) on ruminative subtypes controlling for demographics. Sleep quality was examined as a moderator of the rumination-suicide risk/ideation/attempts link. RESULTS Brooding rumination was significantly associated with increased suicide risk, ideation, and attempts but these associations were not moderated by sleep quality. Sleep quality exacerbated the association of reflective rumination with overall suicide risk and suicidal ideation specifically. Reflective rumination was not itself, or in interaction with sleep quality, significantly associated with a history of suicide attempts. LIMITATIONS The study is cross-sectional and utilizes a college student sample. CONCLUSIONS This study adds to the literature that suggests reflective rumination is associated with suicide risk and ideation in certain cases, such as in individuals with lower sleep quality. In addition, the study adds continued support for an association between brooding rumination and suicidal behaviors. More studies that examine the relations between ruminative subtypes and attempts are needed. Interventions that target sleep problems and rumination may be beneficial for suicide prevention and intervention.
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Affiliation(s)
- Alex S Holdaway
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Aaron M Luebbe
- Department of Psychology, Miami University, Oxford, OH, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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19
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Nota JA, Coles ME. Shorter sleep duration and longer sleep onset latency are related to difficulty disengaging attention from negative emotional images in individuals with elevated transdiagnostic repetitive negative thinking. J Behav Ther Exp Psychiatry 2018; 58:114-122. [PMID: 29111422 DOI: 10.1016/j.jbtep.2017.10.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Repetitive negative thinking (RNT) is often associated with disruptions in sleep and circadian rhythms. Disruptions in sleep and circadian rhythms may deal a "second hit" to attentional control deficits. This study evaluated whether sleep and circadian rhythm disruptions are related to the top-down control of attention to negative stimuli in individuals with heightened repetitive negative thinking. METHODS Fifty-two community adults with high levels of transdiagnostic RNT and varying habitual sleep durations and bedtimes participated in a hybrid free-viewing and directed attention task using pairs of emotionally-evocative and neutral images while eye-tracking data were collected. Self-report and clinician-administered interviews regarding sleep were also collected. RESULTS Shorter habitual sleep duration was associated with more time looking at emotionally negative compared to neutral images during a free-viewing attention task and more difficulty disengaging attention from negative compared to neutral images during a directed attention task. In addition, longer sleep onset latencies were also associated with difficulty disengaging attention from negative stimuli. The relations between sleep and attention for positive images were not statistically significant. LIMITATIONS A causal link between sleep and attentional control cannot be inferred from these cross-sectional data. The lack of a healthy control sample means that the relations between sleep disruption, attention, and emotional reactivity may not be unique to individuals with RNT. CONCLUSIONS These findings suggest that sleep disruption may be associated with a specific impact on cognitive resources that are necessary for the top-down inhibitory control of attention to emotionally negative information.
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Affiliation(s)
- Jacob A Nota
- Binghamton University, Department of Psychology, United States.
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20
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Cox RC, Cole DA, Kramer EL, Olatunji BO. Prospective Associations Between Sleep Disturbance and Repetitive Negative Thinking: The Mediating Roles of Focusing and Shifting Attentional Control. Behav Ther 2018; 49:21-31. [PMID: 29405919 DOI: 10.1016/j.beth.2017.08.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/13/2017] [Accepted: 08/08/2017] [Indexed: 10/19/2022]
Abstract
Although considerable evidence has linked sleep disturbance to symptoms of psychopathology, including repetitive negative thinking, few studies have examined how sleep disturbance may predict repetitive negative thinking over time. Further, no study to date has examined specific mechanisms that may account for this relationship. The present study sought to address these gaps in the literature by testing focusing and shifting attentional control as two potential mediators of the relationship between sleep disturbance and repetitive negative thinking over a 6-month period. A final sample of 445 unselected community participants completed measures of sleep disturbance and repetitive negative thinking at Time 1, measures of focusing and shifting attentional control 3 months later, and measures of repetitive negative thinking again 6 months later. Results revealed that focusing, but not shifting, attentional control mediated the relationship between sleep disturbance and repetitive negative thinking, specifically, worry, rumination, and obsessions. These findings provide preliminary evidence for focusing attentional control as a candidate mechanism that may explain the causal role of sleep disturbance in the development of repetitive negative thinking observed in various disorders.
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21
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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: 13] [Impact Index Per Article: 2.2] [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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22
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Cox RC, Olatunji BO. Linking attentional control and PTSD symptom severity: the role of rumination. Cogn Behav Ther 2017. [DOI: 10.1080/16506073.2017.1286517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rebecca C. Cox
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA
| | - Bunmi O. Olatunji
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA
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