Typologies of individuals vulnerable to insomnia: a two-step cluster analysis

Using Two-Step Cluster Analysis and Latent Class Analysis to Construct a Typology of Internet Users Among Community-Dwelling Older People

This study utilizes data, spanning 2016-2021, from the Belgian Ageing Studies and presents a typology of older internet users based on nine internet activities. Two-step Cluster Analysis and Latent Class Analysis revealed three groups: (1) "Basic users" primarily engage in information search and mailing, (2) "Allrounders" participate in nearly all internet activities and (3) "Selective users" are intermediary, predominantly using the internet for information search, mailing, e-banking and communication with (grand)children. These clusters varied in sociodemographic characteristics, with "Allrounders" being younger, more educated, wealthier and predominantly male, compared to "Selective users" and "Basic users," respectively.

An Evaluation of the Use of the Child and Adolescent Scale of Participation (CASP) to Measure Social Participation After Pediatric ABI in a Specialist Service in East Anglia

Pediatric acquired brain injury (ABI) can lead to lifelong challenges restricting social participation, which is an important goal for rehabilitation due to associations with improved wellbeing. This evaluation considered the utility of the Child Adolescent Scale of Participation (CASP) in ABI rehabilitation services. The 20-item measure is rated on a Likert scale with reference to what the rater would expect of their child at that age, including "not applicable" (N/A). It showed high internal consistency (α = 0.954-0.968). Two-step cluster analysis indicated greater difficulties in children with lower participation, including more impairments of executive function and higher staff involvement. Between-group analysis indicated higher rates of N/A answers for younger children and those of ethnic minorities. Overall, the CASP is reliable and clinically useful on an individual level, helping identify people who may need prioritizing for neurorehabilitation; however, group-level analyses were more challenging due to high frequency of N/A responses.

The "affected" pharmacist and the "business as usual" pharmacist: Exploring the experiences of pharmacists during COVID-19 through cluster analysis

BACKGROUND

The global coronavirus disease 2019 (COVID-19) pandemic has necessitated considerable changes in the delivery of pharmacy services, with pharmacists experiencing increasing demands and a high rate of burnout. The ability to categorize pharmacists based on their burnout risk and associated factors could be used to tailor burnout interventions.

OBJECTIVE

This study aimed to identify subgroups (profiles) of pharmacists and use these profiles to describe interventions tailored to improve pharmacist's well-being.

METHODS

A survey was disseminated to pharmacists working in Australia during April and June 2020. The survey measured demographics, burnout, and psychosocial factors associated with working during COVID-19. A two-step cluster analysis was used to categorize pharmacists based on burnout and other variables.

RESULTS

A total of 647 survey responses contained data that were used for analysis. Participants were mostly female (75.7%) and working full time (65.2%). The final cluster analysis yielded an acceptable two-cluster model describing 2 very different pharmacist experiences, using 10 variables. Cluster 2 (representing 53.1% of participants) describes the "affected" pharmacist, who has a high degree of burnout, works in community pharmacy, experiences incivility, is less likely to report sufficient precautionary measures in their workplace, and has had an increase in workload and overtime. In contrast, cluster 1 (representing 46.9% of participants) describes the profile of a "business as usual" hospital pharmacist with the opposite experiences. Interventions focused on the "affected" pharmacist such as financial support to employ specialized staff and equitable access to personal protective equipment should be available to community pharmacists, to reduce the risk to these frontline workers.

CONCLUSION

The use of cluster analysis has identified 2 distinct profiles of pharmacists working during COVID-19. The "affected" pharmacist warrants targeted interventions to address the high burnout experienced in this group.

Sleep Quality and Insomnia Severity among Italian University Students: A Latent Profile Analysis

Insomnia is a widespread sleep disorder associated with physical and mental health conditions. Although the heterogeneity of insomnia presentations has been acknowledged, research investigating clinically meaningful insomnia subtypes is still ongoing. This study aimed at exploring insomnia subtypes according to widely-used measures of symptoms severity and sleep quality among Italian university students using a latent profile analysis. Data were collected from 490 students reporting relevant insomnia symptoms through an online cross-sectional survey comprising the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the 21-item Depression Anxiety Stress Scale, and the Short Form-12. Latent profile analysis identified five insomnia subtypes. The severe insomnia (8.8%) group showed the highest insomnia severity, with diverse complaints concerning sleep quality and daytime functioning. Moderate insomnia with sleep duration complaints (8.4%) and moderate insomnia with medication use (15.9%) subgroups were characterized by middle range insomnia severity, with problems of sleep continuity and sleep medication use, respectively. Subthreshold insomnia with sleep latency complaints (20.4%) and subthreshold insomnia (46.5%) groups showed attenuated insomnia symptoms. Higher psychological complaints and worse quality of life were associated with greater sleep complaints. Overall, these findings highlight the relevance of sleep quality domains in identifying insomnia subtypes and might help optimize insomnia treatments.

Profiles of Stress and Coping Associated With Mental, Behavioral, and Internet Use Problems Among Adolescents During the COVID-19 Pandemic: A Stratified Random Sampling and Cluster Analysis

Background

Adolescents are vulnerable to behavioral and mental health problems, which might be further exacerbated during the COVID-19 pandemic. This study explored how participants with different profiles of stressful life events, coping resources (i.e., self-esteem and perceived social support) and coping strategies (i.e., maladaptive and adaptive coping) varied in the prevalence of mental, behavioral, and Internet use problems.

Methods

Data were collected from a large and representative sample of Chinese secondary school students in Hong Kong (n = 3,136) from September to November 2020 (48.1% males; mean age = 13.6 years old). Cluster analysis and logistic regression models were used for analysis.

Results

The prevalence of suicidal ideation and sleep disturbance was 29.8 and 55.4%, respectively. Behavioral problems were most frequently reported in excessive social media use (53.5%), followed by excessive Internet gaming (43.6%), obesity (34.1%), damaging properties (14.6%), and alcohol or substance abuse (5.1%). The results of cluster analysis yielded three distinctive stress and coping profiles: severe profile (High Risk/Low Protective; 17.0%), moderate profile (Moderate Risk/Moderate Protective; 35.8%), and mild profile (Low Risk/High Protective; 47.2%). Participants with severe and moderate profiles displayed significantly higher levels of mental (range for AOR: 2.08–15.06; all p < 0.001) and behavioral health problems (range for AOR: 1.22–11.22; all p < 0.05) compared to the mild profile cluster.

Conclusions

Adolescents' mental and behavioral health may be shaped by a combination of stressful life events and variations in coping resources as well as strategies. Transdiagnostic and multimodal interventions on these factors are warranted to reduce mental, behavioral, and Internet use problems among adolescents.

Sleep Disturbances in Patients with Persistent Delusions: Prevalence, Clinical Associations, and Therapeutic Strategies

Sleep disturbances accompany almost all mental illnesses, either because sound sleep and mental well-being share similar requisites, or because mental problems lead to sleep problems, or vice versa. The aim of this narrative review was to examine sleep in patients with delusions, particularly in those diagnosed with delusional disorder. We did this in sequence, first for psychiatric illness in general, then for psychotic illnesses where delusions are prevalent symptoms, and then for delusional disorder. The review also looked at the effect on sleep parameters of individual symptoms commonly seen in delusional disorder (paranoia, cognitive distortions, suicidal thoughts) and searched the evidence base for indications of antipsychotic drug effects on sleep. It subsequently evaluated the influence of sleep therapies on psychotic symptoms, particularly delusions. The review’s findings are clinically important. Delusional symptoms and sleep quality influence one another reciprocally. Effective treatment of sleep problems is of potential benefit to patients with persistent delusions, but may be difficult to implement in the absence of an established therapeutic relationship and an appropriate pharmacologic regimen. As one symptom can aggravate another, comorbidities in patients with serious mental illness all need to be treated, a task that requires close liaison among medical specialties.