Daily Diary Reports of Social Connection, Objective Sleep, and the Cortisol Awakening Response During Adolescents’ First Year of College

Social determinants of health at multiple socio-ecological levels and sleep health in adolescents: A scoping review

Heightened sleep disturbances occur in adolescence, yet existing research has predominantly focused on individual factors linked to poor sleep and a limited set of sleep outcomes, such as sleep duration and timing. This scoping review aimed to identify the multilevel social determinants of adolescent sleep health across domains, including regularity, satisfaction/quality, alertness/sleepiness, timing, efficiency/continuity, duration, and behavior. Social determinants of health (SDoH) were categorized through a socio-ecological lens, while sleep health domains were aligned with the RU-SATED and Peds B-SATED sleep health frameworks. A systematic database search resulted in 57 studies of non-clinical adolescent and young adult populations (age 10-24 y) in North America, published between 2014 and 2022. Research gaps include 1) absence of other sleep health domains other than duration which is predicated on the included studies using a limited set of sleep outcome measures rather than a more comprehensive measurement strategy that align with the multifaceted domains of sleep health, and 2) inconsistent terminology and/or absent conceptual and operational definitions of subjective sleep reports. The findings highlight the multilevel SDoH that influence adolescent sleep health, underscoring the need for more comprehensive research. Such efforts will facilitate the development of interventions focused on fostering optimal adolescent sleep health this populations.

Examining bi-directional links between loneliness, social connectedness and sleep from a trait and state perspective

Greater loneliness as well as a lack of social connectedness have often been associated with poorer sleep. However, the temporal dynamics and direction of these associations remain unclear. Aim of the current study was to examine bi-directional associations between loneliness/social connectedness and sleep in 48 stress-exposed medical students during their first medical internship, considered a period of heightened stress. We obtained trait-level questionnaire data on loneliness and global sleep completed before and during the internship as well as state-level diary- and wearable-based data on daily changes in social connectedness and sleep collected twice over the period of seven consecutive days, once before and once during the internship. Bi-directional associations among greater loneliness and higher daytime dysfunction on trait-level were identified. In addition, several uni-directional associations between loneliness/social connectedness and sleep were found on trait- and state-level. In sum, findings of this study point at a bi-directional relation among loneliness/social connectedness and sleep, in which variables seem to reciprocally influence each other across longer-term periods as well as on a day-to-day basis.

Hormone physiology and sleep dynamics among BaYaka foragers of the Congo Basin: Gendered associations between nighttime activity, testosterone, and cortisol

Sleep quality is an important contributor to health disparities and affects the physiological function of the immune and endocrine systems, shaping how resources are allocated to life history demands. Past work in industrial and post-industrial societies has shown that lower total sleep time (TST) or more disrupted nighttime sleep are linked to flatter diurnal slopes for cortisol and lower testosterone production. There has been little focus on these physiological links in other socio-ecological settings where routine sleep conditions and nighttime activity demands differ. We collected salivary hormone (testosterone, cortisol) and actigraphy-based sleep data from Congolese BaYaka foragers (N = 39), who have relatively short and fragmented nighttime sleep, on average, in part due to their typical social sleep conditions and nighttime activity. The hormone and sleep data collections were separated by an average of 11.23 days (testosterone) and 2.84 days (cortisol). We found gendered links between nighttime activity and adults' hormone profiles. Contrary to past findings in Euro-American contexts, BaYaka men who were more active at night, on average, had higher evening testosterone than those with lower nighttime activity, with a relatively flat slope relating nighttime activity and evening testosterone in women. Women had steeper diurnal cortisol curves with less disrupted sleep. Men had steeper cortisol diurnal curves if they were more active at night. BaYaka men often hunt and socialize when active at night, which may help explain these patterns. Overall, our findings indicate that the nature of nighttime activities, including their possible social and subsistence contexts, are potentially important modifiers of sleep quality-physiology links, meriting further research across contexts.

A randomized controlled trial of a behavioral intervention for decreasing bedtime procrastination using a wait-list control group in a non-clinical sample of young adults

STUDY OBJECTIVES

Bedtime Procrastination (BP) is defined as the behavior of going to bed later than intended, without external reasons. This study is a randomized controlled trial aiming to establish efficacy of a behavioral intervention to decrease BP in a non-clinical sample.

METHOD

This was an open-label trial that was conducted in sixty participants (mean age 21.33 ± 2.35 years, 86.7% females) without insomnia or psychopathology who endorsed frequent BP. They were randomized to either the treatment group (n = 32) or wait-list control group (n = 28). Participants completed the Bedtime Procrastination Scale (BPS), the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI), Center for Epidemiologic Studies Depression Scale (CES-D), Morningness-Eveningness Questionnaire (MEQ), and a weekly sleep diary. Functional analysis was conducted to investigate the function of BP. Linear mixed models were used for analyses.

RESULT

The treatment group showed significant improvement on the BPS (35.56% decrease, d = 2.19, bedtime procrastination duration based on the sleep diary (-46.29 min, d = 1.22), and sleep efficiency (5.70% increase, d = 1.25) compared to the wait-list control group following the intervention. There were also significant reductions in time spent from bedtime to lights out, and wake time to time out of bed, in addition to improvements in ISI and ESS scores in the treatment group compared to the control group. Functional analysis results indicated emotional regulation (31.3%), compensation (26.5%), and social interaction and belongingness (18.1%) as the most frequent functions of bedtime procrastination.

CONCLUSION

This study shows promising results for a behavioral intervention targeting BP and sleep. In addition, this study demonstrated various functions of BP as a sleep-interfering behavior. We expect that these findings could be used in future studies and clinical settings to decrease BP.

Impact of COVID-19 pandemic on sleep of undergraduate students: A systematic literature review

The 2019 coronavirus pandemic forced the shift to distance education aggravating mental and physical vulnerabilities of undergraduate students, including sleep. This review aims to describe sleep problem rates and prevalence, sleep pattern disruption, sleep duration, sleep quality, insomnia symptoms, psychological and socio-economic factors affecting sleep of undergraduates in 22 countries. A systematic search for articles published from 2020 to 2021 using 'COVID-19,' 'Coronavirus,' 'Pandemic,' 'Sleep,' 'Mental Health,' and 'Students' from PubMed, Scopus, and Cochrane yielded 2550 articles, where 72 were included. Selection criteria were: English full-text available articles, undergraduates and not postgraduates, reported sleep outcomes, and participants not from allied health courses. Risk of bias was assessed using various Joanna Briggs Institute checklists and outcomes were descriptively synthesized. Prevalence of sleep problems was notable, while longitudinal studies showed increased rates. There was significantly increased sleep duration, and sleep pattern disruption during lockdowns. Several psychological, behavioural, environmental, demographic, and socio-economic factors were found to be associated with sleep changes. These highlight the pandemic's impact on sleep of undergraduate students and reveal opportunities for institutions to intervene with policies and programs to promote the well-being of undergraduates. Limitations include recall bias and underrepresentation of other countries. This study is self-funded with registration number RGAO-2021-0071.

The Social Side of Sleep: A Systematic Review of the Longitudinal Associations between Peer Relationships and Sleep Quality

In adolescence, peer relationships become crucial since youths start to rely on their peers for support. Thus, multiple facets of adolescents' well-being are affected by their peer relationships. In this vein, one of the central well-being aspects that could be affected by the peer relationships of adolescents is sleep quality. Nevertheless, it is still unclear how multiple peer relationship factors (i.e., positive, negative, emotional, and behavioral issues related to peer relationships) are intertwined with adolescents' sleep quality. For this reason, this systematic review with meta-analysis aims to summarize longitudinal studies to uncover how the interplay between peer relationship factors and adolescents' sleep quality unfolds over time. Nineteen longitudinal studies involving a total of 21,232 adolescents were included. Overall, findings from this review showed that (a) positive peer relationships and sleep quality were not associated over time; (b) negative peer relationships and sleep quality were bidirectionally associated over time; (c) few studies evaluated the bidirectional relations between emotional and behavioral issues and sleep quality, showing links with sleep schedule and duration, but not with sleep quality. Meta-analytic results were discussed, considering their implications.

Daily associations between family interaction quality, stress, and objective sleep in adolescents

OBJECTIVE

To better understand the short-term impact of family interactions on adolescent sleep, this study examined daily associations between family interaction quality and sleep duration, sleep maintenance efficiency, and subjective sleep quality.

METHODS

Participants were 517 diverse youth (M_age = 15.4 years, Range = 15-18) in the Fragile Families and Child Wellbeing Study who completed daily reports of family interaction quality, mood and subjective sleep quality and provided actigraphy-based estimates of sleep duration and sleep maintenance efficiency.

RESULTS

Following days when youth reported that they got along with their parents, they slept 26 minutes (95% CI [2.93, 49.88]) longer. Youth who reported greater quality interactions with other family members on average had longer sleep duration, and youth who reported higher levels of family stress perceived lower sleep quality.

CONCLUSIONS

Findings highlight the importance of considering daily family life, including the quality of brief family interactions, as an entry point for future sleep interventions for adolescents.

Prior night sleep moderates the daily spillover between conflict with peers and family and diurnal cortisol

We investigated whether daily experiences of conflict with family and peers were associated with fluctuations in diurnal cortisol, and whether sleep buffers the associations between conflict and diurnal cortisol. A racially diverse sample of 370 adolescents (ages 11-18; 57.3% female) provided daily diaries for 5 days and saliva samples for 4 days. Hierarchical linear models tested how peer and family conflict were associated with diurnal cortisol (i.e., total cortisol output, cortisol slope, and cortisol awakening response) the next day, and whether these associations were moderated by sleep duration the previous night. When adolescents experienced peer conflict, they showed higher area under the curve (AUC) the next day if they had slept less the night prior to conflict, but relatively lower cortisol awakening response (CAR) and flatter cortisol slope the next day if they had slept more the night prior to conflict. When adolescents experienced family conflict, they also showed higher AUC the next day if they had slept less the night prior to conflict, but higher CAR the next day if they had slept more the night prior to conflict. Family conflict and sleep were not directly or interactively related to cortisol slope.

School commute time, chronotype, and altered HPA axis functioning during adolescence

Hypothalamic pituitary adrenal gland (HPA) axis functioning has been linked with daily demands during adolescence. A ubiquitous, yet understudied daily demand in the lives of youth is the commute to school, which may be associated with the diurnal rhythm of cortisol as demonstrated in prior research among adults. The current study hypothesized that longer school commute times would be associated with altered HPA axis functioning as demonstrated by a heightened cortisol awakening response (CAR) and flatter diurnal slope. Additionally, given that the HPA axis follows a diurnal rhythm and adolescence is marked by changes in the circadian rhythm, adolescents with a more evening chronotype were hypothesized to evince even more altered HPA axis functioning in the face of long school commute times. A total of 269 adolescents (M = 16.38 years, SD = 0.74) provided saliva samples at wake, 15-min. post-wake, and 30-min. post-wake for the calculation of CAR and at dinnertime and bedtime for the calculation of diurnal slope, completed up to 8 nights of sleep actigraphy, and self-reported school commute time. Results suggest that more evening chronotype youth with longer school commute times evince a higher CAR, but not an altered diurnal slope. The present findings may have implications for adolescent mental health as higher CAR has been associated poor mental health and heightened stress.

Stress and Sleep Across the Onset of the COVID-19 Pandemic: Impact of Distance Learning on U.S. College Students' Health Trajectories

Study Objectives

This study examined associations between average and intraindividual trajectories of stress, sleep duration, and sleep quality in college students before, during, and after transitioning to online learning due to the COVID-19 pandemic.

Methods

One hundred and sixty-four first-year college students answered twice-weekly questionnaires assessing stress exposure and perception, sleep duration, and sleep quality from January until May, 2020 (N=4,269 unique observations).

Results

Multilevel growth modeling revealed that prior to distance learning, student stress was increasing and sleep duration and quality were decreasing. After transitioning online, students’ stress exposure and perception trajectories immediately and continuously decreased; sleep quality initially increased but decreased over time; and sleep duration increased but then plateaued for the remainder of the semester. Days with higher stress exposure than typical for that student were associated with lower sleep quality, and both higher stress exposure and perception at the transition were linked with simultaneous lower sleep quality. Specific groups (e.g., females) were identified as at-risk for stress and sleep problems.

Conclusion

Although transitioning to remote learning initially alleviated college students’ stress and improved sleep, these effects plateaued, and greater exposure to academic, financial, and interpersonal stressors predicted worse sleep quality on both daily and average levels. Environmental stressors may particularly dictate sleep quality during times of transition, but adaptations in learning modalities may help mitigate short-term detrimental health outcomes during global emergencies, even during a developmental period with considerable stress vulnerability. Future studies should examine longer-term implications of these trajectories on mental and physical health.

Covariation of psychobiological stress regulation with valence and quantity of social interactions in everyday life: disentangling intra- and interindividual sources of variation

While the overall effects of social relationships on stress and health have extensively been described, it remains unclear how the experience of social interactions covaries with the activity of psychobiological stress in everyday life. We hypothesized that the valence as well as quantitative characteristics of social interactions in everyday life would attenuate psychobiological stress. Sixty healthy participants provided data for the analyses. Using an ecological momentary assessment design, participants received 6 prompts on their smartphone for 4 days. At each prompt, they reported on social interactions since the last prompt (any occurrence, frequency, duration, quality, and perceived social support), current subjective stress, and provided one saliva sample for the analyses of cortisol (sCort) and alpha-amylase (sAA). Experiencing any contact within days as well as higher daily levels of contact quality and perceived social support were associated with reduced levels of sCort. Furthermore, on a daily level, experiencing at least one contact in-between prompts more often as well as having more contacts on average attenuated the sAA output. Perceived social support and contact quality as well as higher daily contact durations were associated with lower subjective stress. For sCort, daily levels of stress moderated the effects of experiencing any contact within days while daily perceived social support moderated the effects of subjective stress. For sAA, experiencing at least one contact in-between prompts more often on a daily level moderated the effects of subjective stress. There were no between-person effects throughout all analyses. The results show ecologically valid evidence for direct attenuating effects of social interactions on psychobiological stress as well as for the stress-buffering hypothesis in everyday life. Increasing the quantity and improving the valence of social interactions on an intrapersonal level can possibly reduce psychobiological stress and prevent its consequences.

Daily provision of instrumental and emotional support to friends is associated with diurnal cortisol during adolescence

This study investigates how adolescents' daily prosocial behaviors to friends are related to diurnal cortisol using between- and within-subject analyses. Further, we examine whether role fulfillment (i.e., feeling like a good friend) moderates links between prosocial behaviors and cortisol. Ethnically diverse adolescents (N = 370; ages 11-18) reported whether they provided instrumental and emotional support to friends for 5 days, and provided four saliva samples/day for 4 days. On the daily level, providing emotional support predicted lower cortisol awakening response the next day, and providing instrumental assistance to friends was associated with a flatter cortisol slope the same day (a cardiovascular risk factor). Adolescents also provided more emotional support on days they had lower CAR and steeper cortisol slopes. On the average level, providing more instrumental support was associated with steeper cortisol slopes among adolescents who felt high levels of role fulfillment, but not among adolescents who felt low levels of role fulfillment. Providing instrumental support may be physiologically taxing from day to day but, across the long term, linked to lower cardiovascular risk for adolescents who experience helping as highly fulfilling.

Sleep and social relationships in healthy populations: A systematic review

Over the past decade, research linking sleep and social relationships has burgeoned. Researchers across the globe are trying to understand whether the quality and quantity of our social relationships matter for sleep, and vice versa. We conducted a systematic review of the literature, identifying over 200 relevant articles examining sleep and social relationships in healthy populations. Here, we summarize our findings by reviewing 1) links between sleep and broad social ties across the lifespan, and 2) links between sleep and specific social relationships identified in the literature search, including romantic relationships, family relationships, and work relationships. Taken together, the literature provides evidence that the quality and presence of social relationships, especially our closest relationships, play a role in how we sleep. Likewise, sleep appears to influence our social bonds. However, the majority of work is correlational, limiting conclusions about the directionality of these effects. We conclude by synthesizing the findings, considering the limitations of the present literature, and identifying key future directions for this emerging area of research.

Classification of loneliness using the T-ILS: Is it as simple as it seems?

Student well-being is a growing issue in higher education, and assessment of the prevalence of conditions as loneliness is therefore important. In higher education and population surveys the Three-Item Loneliness Scale (T-ILS) is used increasingly. The T-ILS is attractive for large multi-subject surveys, as it consists of only three items (derived from the UCLA Loneliness Scale). Several ways of classifying persons as lonely based on T-ILS scores exist: dichotomous and trichotomous classification schemes and use of sum scores with rising levels indicating more loneliness. The question remains whether T-ILS scores are comparable across the different population groups where they are used or across groups of students in the higher education system. The aim was to investigate whether the T-ILS suffers from differential item functioning (DIF) that might change the loneliness classification among higher education students, using a large sample just admitted to 22 different academy profession degree programs in Denmark (N = 3,757). DIF was tested relative to degree program, age groups and gender. The framework of graphical loglinear Rasch models was applied, as this allows for adjustment of sum scores for uniform DIF, and thus for assessment of whether DIF might change the classification. Two items showed DIF relative to degree program and gender, and adjusting for this DIF changed the classification for some subgroups. The consequences were negligible when using a dichotomous classification and larger when using a trichotomous classification. Therefore, trichotomous classification should be used with caution unless suitable adjustments for DIF are done prior to classification.

The Cost of Academic Focus: Daily School Problems and Biopsychological Adjustment in Chinese American Families

Stress from daily school problems may accumulate and eventually lead to mental health issues in both youth and their parents. With a strong cultural emphasis on school performance, Chinese American families may be particularly vulnerable to such stress. In the current research, Chinese American adolescents (N = 95; Mean age = 13.7 years; 51% girls) and their parents completed daily diary reports of school problems and emotional well-being for 14 continuous days. Adolescents also provided four saliva samples per day for 4 consecutive days. Multilevel modeling analyses showed that youth's daily school problems predicted their lower happiness, higher distress, and higher total cortisol output above and beyond their emotional well-being and cortisol output the prior day. Moreover, there was a spillover effect such that youth's school problems also negatively predicted their parents' emotional well-being. Notably, the negative influence from school problems was moderated by children's cultural orientation, such that youth who were more oriented toward Chinese (vs. American) culture were more vulnerable to the school problems. Taken together, our results highlight the costs on biopsychological adjustment accompanying the academic focus in Chinese American youth and their parents.

Role Fulfillment Mediates the Association Between Daily Family Assistance and Cortisol Awakening Response in Adolescents

Family assistance (helping the family) is associated with both positive and negative psychological and biological outcomes during adolescence. However, the association between family assistance and the hypothalamic-pituitary-adrenal (HPA) axis remains unstudied. Thus, we assess how helping the family relates to adolescents' diurnal cortisol, an index of HPA activity, and psychological outcomes. Three hundred and seventy ethnically diverse adolescents (ages 11-18) reported daily helping behaviors and psychological experiences for 14 days and provided four saliva samples per day for 4 days. Multilevel modeling revealed that cortisol awakening response was lower the day after adolescents helped their families more. This association was explained, in part, by perceived role fulfillment (feeling like a good son, daughter, and sibling). Results highlight a possible psychological and biological benefit of assisting the family during adolescence.

Latino adolescents' daily bicultural stress and sleep: Gender and school context moderation

OBJECTIVE

Bicultural stress (i.e., challenge arising from navigating 2 cultural contexts) has significant consequences for Latino youth's health, but researchers have yet to examine the implications of bicultural stress for adolescents' sleep. The goals of this study were to examine whether individual and day-to-day (within-person) differences in bicultural stress were associated with Latino adolescents' sleep onset latency (i.e., time to fall asleep), sleep midpoint (i.e., sleep schedule), sleep duration (i.e., time asleep), and subjective sleep quality.

METHOD

Participants were 209 Latino late adolescents (Mage = 18.10 years; 64.4% female) attending over 90 different high schools who completed 7 daily diary surveys while wearing actigraph wristwatches (N = 1,320 daily observations). Participants also reported sleep problems in a standard survey. Statistical interactions were tested to assess moderation by gender and coethnic school composition.

RESULTS

On average, more bicultural stressors across the week were associated with lower average sleep duration and more sleep problems for male (compared to female) adolescents and youth attending schools with higher (compared to lower) Latino student enrollment. Regarding day-to-day differences, more daily bicultural stressors than usual predicted longer sleep onset latency that night for male adolescents, earlier sleep midpoint that night, and less sleep duration that night for youth attending higher Latino-enrollment schools.

CONCLUSIONS

Latino adolescents' everyday experiences of bicultural stress relate to differences in sleep duration, timing, and quality, with important variation by gender and school context. Results advance existing theory regarding social position factors that differentiate the health implications of bicultural stress for Latino youth. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Daily rumination about stress, sleep, and diurnal cortisol activity

Rumination is an involuntary cognitive process theorized to prolong arousal and inhibit proper emotion regulation. Most available research has examined individual differences in cognitive dispositions to ruminate about stress as a risk marker for psychopathology and other health problems. This intensive longitudinal study extended previous research by examining day-to-day associations of rumination about stress with objectively-measured actigraph-based sleep and diurnal salivary cortisol activity. Sixty-one healthy participants (Mage = 20.91) completed up to five ecological momentary assessments (EMA) each day and wore actigraph wristwatches for eight days (N = 488). On three of these days, participants provided five saliva samples assayed for cortisol (N = 910). On average, greater daily stress levels were associated with shorter sleep duration and higher waking cortisol levels. In day-to-day analyses, greater daily stress levels, when combined with ruminating about daily stress more than usual, was associated with higher waking cortisol levels the following morning. Ruminating more than usual about daily stress, in the context of low-stress days, was also associated with flatter diurnal cortisol slopes the next day. These findings highlight the potential influences of daily stress, and rumination about stress, on sleep and diurnal cortisol activity - two important markers of health and well-being.

The Stability and Change of Loneliness Across the Life Span: A Meta-Analysis of Longitudinal Studies

Individuals experience loneliness when they perceive a deficiency in the quality or quantity of their social relationships. In the present meta-analysis, we compiled data from 75 longitudinal studies conducted in Asia, Australia, Europe, and North America (N = 83, 679) to examine the rank-order and mean-level development of loneliness across the life span. Data were analyzed using two- and three-level meta-analyses and generalized additive mixed models. The results indicate that the rank order of loneliness is as stable as the rank order of personality traits and follows an inverted U-shaped trajectory across the life span. Regarding mean-level development, loneliness was found to decrease throughout childhood and to remain essentially stable from adolescence to oldest old age. Thus, in contrast to other personality characteristics, changes in loneliness are not generally related to age. Implications for theory are discussed.

Day-to-day friends' victimization, aggression perpetration, and morning cortisol activity in late adolescents

This study investigates bidirectional associations between adolescents' daily experiences of victimization and aggression perpetration within friendships. We investigated (a) across-day associations between victimization and aggression perpetration; (b) morning cortisol activity as a moderator of cross-day victimization and aggression links; and (c) potential sex differences in these patterns. For 4 consecutive days, 99 adolescents (Mage  = 18.06, SD = 1.09, 46 females) reported whether they were victimized by or aggressive toward their friends. On three of these days, adolescents provided three morning saliva samples. Multilevel path analyses showed that across days, victimization and aggression were bidirectionally linked, but only for male adolescents. Additionally, for male adolescents, morning cortisol output (but not morning cortisol increase) moderated the association between victimization and next-day aggression; victimization predicted greater next-day aggression for boys with low, but not high, morning cortisol output. Findings implicate a physiological factor that may modify daily links between victimization and aggression in male adolescent friendships.

Associations between Health Behaviors and Factors on Markers of Healthy Psychological and Physiological Functioning: a Daily Diary Study

Background

Cross-sectional and experimental knowledge highlight the contribution of various health-promoting behaviors, such as physical activity, regular sleep, and healthy nutrition to mental and physical health. Beyond these well-studied lifestyle behaviors, music listening and perceived respect in social interactions are just recently proposed everyday life experiences, which may act as health-promoting factors.

Purpose

This study tested the simultaneous contribution of several health-promoting behaviors and factors and examined listening to music and positive social interaction by means of perceived respect as new potentially preventive and health-promoting behaviors and factors using an ambulatory assessment design.

Methods

Seventy-seven young healthy adults (38 women, 23.9 ± 4.5 years) completed surveys on their psychological state (i.e., mood, stress, and fatigue) five times a day for four consecutive days. A saliva sample was collected with each data entry to explore the physiological stress markers salivary cortisol, alpha-amylase, and flow rate as further outcome variables. As predictors, perceived respect, self-reported physical activity, the sleep’s restfulness, daily coffee, alcohol, vegetable/fruit consumption, and music listening behavior were recorded.

Results

Overall, restful sleep, mean daily perceived respect, and listening to music were most clearly associated with more positive psychological states, that is, better mood and lower fatigue and perceived stress. Associations with daily alcohol, coffee, and vegetable/fruit consumption appeared rather minor. While perceived respect scores were associated with lower daily cortisol output, coffee consumption was positively related to daily cortisol and alpha-amylase. Self-reported physical activity was unrelated to either outcome measure.

Conclusions

These findings provide important insights regarding potential resources of health (i.e., music and respect), their covariation, and which psycho-physiological mechanisms may underlie the links between health factors and well-being. Findings also have implications for the development of interventions aiming to increase resilience and foster health. Here, strategies for improving sleep quality, the use of music, and approaches that emphasize mutual respect and appreciation appear useful additions.

Can an online curriculum improve the daily socio-emotional lives of middle-aged adults exposed to childhood Trauma?

One pathway linking experiences of childhood trauma to poorer mental and physical health in midlife are disruptions in daily socio-emotional regulation. However, there is a dearth of effective and accessible treatments that meet the needs of trauma-exposed individuals and their communities. Through a randomized controlled trial, this research examines whether an online social intelligence training (SIT) program improves social-emotional regulation compared to an attention-control (AC) condition. During the pre- and post-test phases of the study, participants (N = 230) completed online surveys for 14-days that included measures of social connectedness, emotional awareness, and perspective-taking. In the SIT condition, multi-level analyses revealed significant increases in daily levels of "in-tune" social interactions, emotional awareness, and perspective-taking, and attenuated within-person changes in social engagement on stressful and uplifting days. Participants who reported greater childhood trauma exhibited the strongest increases in daily social engagement and emotional awareness, suggesting that program benefits were largest for those reporting greater exposure to trauma in childhood. Our findings shed light on the potential reversibility of socio-emotional mechanisms linking childhood trauma to poorer mental and physical health in midlife, and support the utility of widely accessible, low-cost intervention methods for individuals and communities.

Cultural neurobiology and the family: Evidence from the daily lives of Latino adolescents

Culturally linked family influences during adolescence are important predictors of health and well-being for Latino youth, yet few studies have examined whether these familial influences are associated with indicators of typical physiological stress processes. Following a cultural neurobiology framework, we examined the role of family in the everyday lives of Latino adolescents (N = 209; Mage = 18.10; 85.1% Mexican descent; 64.4% female) by investigating familism values and perceptions of parent support as well as daily family assistance behaviors in relation to hypothalamic-pituitary-adrenal axis diurnal patterns, indexed by salivary cortisol five times a day for 3 weekdays. Three-level growth curve analyses revealed that perceptions of parental support were associated with greater cortisol awakening responses, whereas familism values were not associated with diurnal cortisol patterns. In day-to-day analyses, assisting family during the day (compared to not assisting family) was associated with lower waking cortisol levels and flatter diurnal slopes the next day. Our findings highlight the dynamic associations and multiple time courses between cultural values and behaviors, daily experiences, and physiological stress processes for Latino adolescents. Further, we identified important cultural risk and promotive factors associated with physiological regulation in daily life and potential pathways toward health outcomes in adulthood.

Childhood adversity moderates the influence of proximal episodic stress on the cortisol awakening response and depressive symptoms in adolescents

Childhood adversity (CA) is known to predict sensitization to proximal stressors. Researchers have suggested that disruptions in hypothalamus-pituitary-adrenal axis functioning may be a biological mechanism. If so, CA may predict altered associations between proximal life stress and markers of cortisol secretion. We examined whether CA moderates associations between recent episodic stress and (a) the cortisol awakening response (CAR), and (b) depressive symptoms, in 241 adolescents aged 14-17 years (cortisol n = 196). Salivary cortisol was sampled at 0, 30, and 60 min postawakening for 2 days. The CAR was calculated as the area under the curve with respect to increase and waking cortisol. CA and episodic stress were assessed using contextual-threat-method-coded objective interviews. CA significantly interacted with episodic stress to predict both the CAR and depression. Among those with low CA, episodic stress predicted increased CAR but did not predict depression. For adolescents with high CA, episodic stress predicted lower CAR and higher depression. These interactions were found only for independent (uncontrollable, fateful) events, and not for dependent (self-generated) stress. Increased allostatic load resulting from CA exposure may interfere with adolescents' ability to optimally regulate their CAR in relation to recent stress, contributing to increased depression risk.

People who need people: Trait loneliness influences positive affect as a function of interpersonal context

Trait loneliness is associated with negative health consequences; understanding involved processes may elucidate its contributory role. Evolutionary and reaffiliative models associate loneliness with negative affect and dysregulated cortisol responding, while the social monitoring system model associates loneliness with heightened salience of social cues. We hypothesized that loneliness would be associated with greater negative affect and cortisol reactivity, comparing a negative-evaluative audience Trier Social Stress Test ("audience condition;" n = 55) versus a no-audience control condition (n = 69) in non-depressed young adults. Opposing hypotheses, multilevel growth curve models indicated that loneliness was not associated with negative affect or cortisol reactivity in the audience versus no-audience condition. Loneliness was, however, associated with greater positive affect reactivity in the audience versus no-audience condition. In particular, the positive affect subfacet "Interest" was heightened in the audience condition but blunted in the no-audience condition as a function of loneliness, echoing a social monitoring system model of loneliness.

Actigraphically Measured Sleep-Wake Behavior After Mild Traumatic Brain Injury: A Case-Control Study

OBJECTIVE

To characterize and compare the sleep-wake behavior of individuals following a mild traumatic brain injury (mTBI) with that of noninjured healthy controls.

SETTING

Community.

PARTICIPANTS

Fourteen participants with a recent mTBI (Mage = 28.07; SD = 10.45; n = 10 females) and 34 noninjured controls (Mage = 23.70; SD = 7.30; n = 31 females).

DESIGN

Cross-sectional.

MAIN MEASURES

Battery of subjective sleep measures and 14 days of sleep-wake monitoring via actigraphy (objective measurement) and concurrent daily sleep diary.

RESULTS

Participants who had sustained an mTBI self-reported significantly higher sleep-related impairment, poorer nightly sleep quality, and more frequently met criteria for clinical insomnia, compared with controls (d = 0.76-1.11, large effects). The only significant between-group difference on objective sleep metrics occurred on sleep timing. On average, people with a recent history of mTBI fell asleep and woke approximately 1 hour earlier than did the controls (d = 0.62-0.92, medium to large effects).

CONCLUSION

Participants with a history of mTBI had several subjective sleep complaints but relatively few objective sleep changes with the exception of earlier sleep timing. Future research is needed to understand the clinical significance of these findings and how these symptoms can be alleviated. Interventions addressing subjective sleep complaints (eg, cognitive behavior therapy for insomnia) should be tested in this population.

Cortisol Awakening Response, Internalizing Symptoms, and Life Satisfaction in Emerging Adults

The cortisol awakening response (CAR) has been associated with depression and a broader range of internalizing problems. Emerging adulthood is characterized by numerous stressful transitional life events. Furthermore, the functioning of the neurobiological stress system changes across development. These considerations underscore the importance of evaluating the physiological stress system in emerging adults in identifying the extent to which cortisol levels vary with risk and protective factors for mental health. The present study evaluated the association between internalizing symptoms and perceived life satisfaction with CAR in 32 young adults. Three saliva samples were collected to measure cortisol levels upon awakening and participants completed the Depression Anxiety Stress Scale (DASS) and Satisfaction with Life Scale (SWLS). Results show a significant positive correlation between area under the curve for CAR with internalizing symptoms (DASS total) and the DASS-depression subscale, but not with life satisfaction. Study limitations, implications, and future directions for these finding were discussed.

Psychosocial functioning and the cortisol awakening response: Meta-analysis, P-curve analysis, and evaluation of the evidential value in existing studies

Cortisol levels rise immediately after awakening and peak approximately 30-45min thereafter. Psychosocial functioning influences this cortisol awakening response (CAR), but there is considerable heterogeneity in the literature. The current study used p-curve and meta-analysis on 709 findings from 212 studies to test the evidential value and estimate effect sizes of four sets of findings: those associating worse psychosocial functioning with higher or lower cortisol increase relative to the waking period (CARi) and to the output of the waking period (AUCw). All four sets of findings demonstrated evidential value. Psychosocial predictors explained 1%-3.6% of variance in CARi and AUCw responses. Based on these effect sizes, cross-sectional studies assessing CAR would need a minimum sample size of 617-783 to detect true effects with 80% power. Depression was linked to higher AUCw and posttraumatic stress to lower AUCw, whereas inconclusive results were obtained for predictor-specific effects on CARi. Suggestions for future CAR research are discussed.

Children's diurnal cortisol responses to negative events at school and home

This study examined the within-and between-person associations between daily negative events - peer problems, academic problems and interparental conflict - and diurnal cortisol in school-age children. Salivary cortisol levels were assessed four times per day (at wakeup, 30min later, just before dinner and at bedtime) on eight days in 47 youths ages 8-13 years old (60% female; M age=11.28, SD=1.50). The relative contributions of within- and between-person variances in each stressor were estimated in models predicting same-day diurnal cortisol slope, same-day bedtime cortisol, and next morning wakeup cortisol. Children who reported more peer problems on average showed flatter slopes of cortisol decline from wakeup to bedtime. However, children secreted more cortisol at wakeup following days when they had reported more peer or academic problems than usual. Interparental conflict was not significantly associated with diurnal cortisol. Findings from this study extend our understanding of short-term cortisol responses to naturally occurring problems in daily life, and help to differentiate these daily processes from the cumulative effects of chronic stress.

Adolescents' technology and face-to-face time use predict objective sleep outcomes

OBJECTIVES

The present study examined both within- and between-person associations between adolescents' time use (technology-based activities and face-to-face interactions with friends and family) and sleep behaviors. We also assessed whether age moderated associations between adolescents' time use with friends and family and sleep.

DESIGN

Adolescents wore an actigraph monitor and completed brief evening surveys daily for 3 consecutive days.

PARTICIPANTS

Adolescents (N=71; mean age=14.50 years old, SD=1.84; 43.7% female) were recruited from 3 public high schools in the Midwest.

MEASURES

We assessed 8 technology-based activities (eg, texting, working on a computer), as well as time spent engaged in face-to-face interactions with friends and family, via questions on adolescents' evening surveys. Actigraph monitors assessed 3 sleep behaviors: sleep latency, sleep hours, and sleep efficiency.

RESULTS

Hierarchical linear models indicated that texting and working on the computer were associated with shorter sleep, whereas time spent talking on the phone predicted longer sleep. Time spent with friends predicted shorter sleep latencies, while family time predicted longer sleep latencies. Age moderated the association between time spent with friends and sleep efficiency, as well as between family time and sleep efficiency. Specifically, longer time spent interacting with friends was associated with higher sleep efficiency but only among younger adolescents. Furthermore, longer family time was associated with higher sleep efficiency but only for older adolescents.

CONCLUSION

Findings are discussed in terms of the importance of regulating adolescents' technology use and improving opportunities for face-to-face interactions with friends, particularly for younger adolescents.

The impact of daily and trait loneliness on diurnal cortisol and sleep among children affected by parental HIV/AIDS

Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and disruptions of restorative processes (e.g., sleep) have been proposed as two key mechanisms through which loneliness leads to medical morbidity in adults and late adolescents. Whether loneliness acts through these biological and behavioral intermediaries in children as well remains unexplored. In a sample of 645 children aged 8-15 affected by parental HIV/AIDS in rural China, trait and state (i.e., daily) loneliness were measured in a 3-day diary study, wherein participants also provided cortisol samples and sleep measures. Whereas high levels of trait loneliness were found to predict lower morning cortisol levels, longer time in bed, lower sleep quality, and a higher number of night awakenings, daily loneliness was associated with a flatter diurnal cortisol slope and shorter time in bed. Although the association between trait loneliness and daily loneliness with HPA activity remained significant after controlling for psychological constructs that overlap with loneliness (e.g., depression and daily negative affect), some of the associations between loneliness and sleep measures became non-significant after including these additional covariates. These findings provide the first empirical evidence to our knowledge of associations between trait and state loneliness and health-related outcomes among school-aged children and young adolescents.

The stress-reducing effect of music listening varies depending on the social context

OBJECTIVE

Given that music listening often occurs in a social context, and given that social support can be associated with a stress-reducing effect, it was tested whether the mere presence of others while listening to music enhances the stress-reducing effect of listening to music.

METHODS

A total of 53 participants responded to questions on stress, presence of others, and music listening five times per day (30min after awakening, 1100h, 1400h, 1800h, 2100h) for seven consecutive days. After each assessment, participants were asked to collect a saliva sample for the later analysis of salivary cortisol (as a marker for the hypothalamic-pituitary-adrenal axis) and salivary alpha-amylase (as a marker for the autonomic nervous system).

RESULTS

Hierarchical linear modeling revealed that music listening per se was not associated with a stress-reducing effect. However, listening to music in the presence of others led to decreased subjective stress levels, attenuated secretion of salivary cortisol, and higher activity of salivary alpha-amylase. When listening to music alone, music that was listened to for the reason of relaxation predicted lower subjective stress.

CONCLUSION

The stress-reducing effect of music listening in daily life varies depending on the presence of others. Music listening in the presence of others enhanced the stress-reducing effect of music listening independently of reasons for music listening. Solitary music listening was stress-reducing when relaxation was stated as the reason for music listening. Thus, in daily life, music listening can be used for stress reduction purposes, with the greatest success when it occurs in the presence of others or when it is deliberately listened to for the reason of relaxation.

Prevent the blue, be true to you: Authenticity buffers the negative impact of loneliness on alcohol-related problems, physical symptoms, and depressive and anxiety symptoms

This study investigated authenticity as a moderator of the association between loneliness and depressive symptoms, anxiety, physical symptoms, and alcohol-related problems. It was expected that loneliness and health outcomes would be negatively related and that relationship would be weaker among those higher in authenticity. Significant interactions emerged between authenticity and loneliness for each outcome such that authenticity mitigated the relationship between higher loneliness and negative health outcomes. Results suggest that authenticity may be an underutilized resource for lonely individuals and warrants future investigation. The potential implications are diverse and could be incorporated in college adjustment and health promotion programs.

Advancing a biopsychosocial and contextual model of sleep in adolescence: a review and introduction to the special issue

Sleep problems in adolescence have been identified as an international public health issue. Over the past few decades, notable advances have been made in our understanding of the patterns and consequences of sleep in adolescence. Despite these important gains, there is much about the role of sleep in adolescence that remains to be understood. This Special Issue brings together studies that examine sleep as it specifically pertains to adolescent development and adjustment. In this introductory article, we argue for the importance of grounding the study of sleep and adolescence in developmental science and a developmental psychopathology framework. First, a review of the literature is used to outline a biopsychosocial and contextual model of sleep in adolescence. Second, attention-deficit/hyperactivity disorder (ADHD) is used as an exemplar of the proposed model given the pervasiveness of sleep problems among youth with ADHD and the likelihood that sleep problems and ADHD symptoms are interconnected in complex ways. Finally, a brief introduction to the empirical articles included in the Special Issue is provided, with particular attention given to how these articles fit within the proposed biopsychosocial and contextual model. Along with the framework proposed in this article, the studies included in this Special Issue advance the current literature and point to critical directions for future research.