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Throm JK, Schilling D, Löchner J, Micali N, Dörsam AF, Giel KE. Parental verbal communication and modeling behavior during mealtimes shape offspring eating behavior - A systematic review with a focus on clinical implications for eating disorders. Appetite 2024; 200:107584. [PMID: 38944057 DOI: 10.1016/j.appet.2024.107584] [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: 01/26/2024] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE The aim of this review is to provide an overview of parental communication patterns during mealtimes, with a special emphasis being placed on the differences between families with and without a history of eating disorders. METHODS The systematic review was conducted according to the PRISMA statement. A systematic literature search was carried out in PubMed, PubPsych and PsycINFO and the results were assessed for eligibility by two independent raters using the PICOS criteria. Only studies that included a mealtime observation were considered suitable for analysis of both explicit and implicit parental communication. RESULTS The results of the review suggest that mothers communicate more, with more complexity, and with a greater variety of words with their children during mealtimes compared to fathers. The intention and type of communication is diverse and heterogeneous. In general, parents often tried to encourage their children to eat. Verbal modeling and co-eating appeared to be common behaviors. Mothers with a history of eating disorders expressed more negative emotions during eating than mothers without eating disorders. Findings regarding the use of positive comments and controlling speech are contradicting. DISCUSSION The review outlines major fields of parent-child communication and modeling behavior around family meals which might be relevant to investigate and integrate into models of intergenerational transmission of eating behavior and disordered eating.
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Affiliation(s)
- Jana Katharina Throm
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany.
| | - Denise Schilling
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany
| | - Johanna Löchner
- German Center for Mental Health (DZPG), Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tuebingen, Germany
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Mental Health Services of the Capital Region of Denmark, Center for Eating and Feeding Disorders Research, Ballerup Psychiatric Centre, Copenhagen, Denmark
| | - Annica Franziska Dörsam
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
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Aboaja AM, Dewa LH, Perry AE, Carey JF, Steele R, Abdelsamie A, Alhasan GTA, Sharma IS, Watson F, Cairney SA. Sleep interventions for adults admitted to psychiatric inpatient settings: A systematic scoping review. Sleep Med Rev 2024; 76:101950. [PMID: 38788520 DOI: 10.1016/j.smrv.2024.101950] [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: 12/15/2022] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Sleep disturbances are common, affecting over half of adults with a mental disorder. For those admitted to a psychiatric ward, difficulties with sleep, particularly insomnia, are compounded by factors relating to the inpatient setting. We conducted a scoping review of sleep intervention studies involving adults admitted to psychiatric settings. We categorised the different types of sleep interventions and identified the effects on sleep and other mental and physical health outcomes. Instruments used to measure sleep were also examined. The search strategy yielded 4780 studies, of which 28 met the inclusion criteria. There was evidence of more non-pharmacological than pharmacological interventions having been tested in inpatient settings. Results indicated that non-pharmacological interventions based on cognitive behaviour therapy for insomnia improve sleep and may improve mental and physical health. Several distinct sleep measures were used in the studies. Gaps in the literature were identified, highlighting the importance of research into a wider range of sleep interventions tested against robust controls, using validated measures of sleep with evaluation of additional mental and physical health outcomes among a large sample size of adults in the psychiatric inpatient settings.
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Affiliation(s)
- Anne M Aboaja
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK; Mental Health and Addictions Research Group, University of York, York, UK.
| | - Lindsay H Dewa
- School of Public Health, Imperial College London, London, UK; NIHR Imperial Biomedical Research Centre, London, UK
| | - Amanda E Perry
- Mental Health and Addictions Research Group, University of York, York, UK
| | - Jon F Carey
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Rachel Steele
- Library and Information Services, Tees, Esk and Wear Valleys, NHS Foundation Trust, UK
| | - Ahmed Abdelsamie
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Gies T A Alhasan
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Ishwari S Sharma
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Florence Watson
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Scott A Cairney
- Department of Psychology, University of York, UK; York Biomedical Research Institute (YBRI), University of York, UK
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Liu X. Emotion dysregulation mediates the relationship between sleep problems and externalizing symptoms in early adolescents: A four-wave longitudinal study. J Affect Disord 2024; 363:221-229. [PMID: 39025439 DOI: 10.1016/j.jad.2024.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 06/29/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Despite the growing body of longitudinal research linking sleep problems and externalizing symptoms, regarding the direction of the effects of both variables, the results have been inconsistent. Given the mixed findings and inconsistent results in the literature, we propose that emotion dysregulation may link sleep problems and externalizing symptoms. METHODS The participants (N = 1281, 49.65 % female; M = 12.73 years at time 1, SD = 0.68) were middle school students who completed assessments for sleep problems, externalizing symptoms, and emotion dysregulation. The interval between each wave was six months, for two consecutive years. Autoregressive mediation models using longitudinal data and cross-sectional mediation models using baseline data were evaluated and compared through structural equation modeling. RESULTS The results revealed that severe sleep problems (at T1, T2, or T3) were associated with higher levels of externalizing symptoms later in adolescence (at T2, T3, or T4), but not vice versa. In addition, analyses of indirect effects indicated that emotion dysregulation mediated this link, such that greater sleep problems led to more emotion dysregulation, which, in turn, led to more externalizing symptoms. CONCLUSION The findings highlight the critical role that emotional regulation plays in the link between sleep problems and externalizing symptoms and emphasize the need for students as well as middle school administration to pay close attention to both the sleep and externalizing symptoms of early adolescents.
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Affiliation(s)
- Xiaoting Liu
- School of Psychology, Key Laboratory of Behavioral and Mental Health of Gansu Province, Northwest Normal University, Lanzhou 730070, China.
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4
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Yang J, Zhao Y. Examining bidirectional relations between sleep problems and non-suicidal self-injury/suicidal behavior in adolescents: emotion regulation difficulties and externalizing problems as mediators. Eur Child Adolesc Psychiatry 2024; 33:2397-2411. [PMID: 38150149 DOI: 10.1007/s00787-023-02334-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023]
Abstract
Based on previous empirical evidences and theoretical framework, sleep problems and non-suicidal self-injury (NSSI)/suicidal behavior may bidirectionally related to one another. However, this still needs to be examined through longitudinal research. Moreover, the mediating mechanisms accounting for their potential bidirectional relations have yet to be fully investigated. This study thus aimed to evaluate whether sleep problems and NSSI/suicidal behavior promoted each other directly or indirectly through the mediating roles of emotion regulation difficulties (ERD) and externalizing problems. A total of 1648 Chinese adolescents (48.12% boys; Mage = 13.69; SD = 0.82; Age range = 11-16 years old at T1) completed self-report measures on 3-time points across 1 year. Cross-lagged panel models were used to examine the focal longitudinal associations. Results revealed a predictive effect of sleep problems on NSSI and a positive bidirectional relation between sleep problems and suicidal behavior. Moreover, sleep problems exerted an indirect effect on NSSI through ERD, and vice versa. Additionally, both ERD and externalizing problems served as mediators in the pathway from suicidal behavior to sleep problems. This study disentangled the differential mediating roles of ERD and externalizing problems in the longitudinal associations between sleep problems and NSSI/suicidal behavior, which may help provide a more holistic theoretical framework through which to precisely identify key targets for early prevention and intervention of sleep problems and NSSI/suicidal behavior in adolescents.
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Affiliation(s)
- Jiaping Yang
- Department of Psychology, Guangzhou University, 230 Wai Huan Xi Rd, 510006, Guangzhou, China.
| | - Yinqiu Zhao
- School of Psychology, South China Normal University, 510631, Guangzhou, People's Republic of China
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5
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Ye Z, Wu D, Yue Y, Li T, Sun L, Yu P, Tong Y, Xiao L. The relationship between sleep disturbance and aggressive behaviour among community-dwelling schizophrenia patients: a moderated mesomeric effect model. BMC Public Health 2024; 24:1600. [PMID: 38879495 PMCID: PMC11179300 DOI: 10.1186/s12889-024-19090-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 06/10/2024] [Indexed: 06/19/2024] Open
Abstract
OBJECTIVE Sleep disturbance is the most common concern of patients with schizophrenia and can lead to a poor prognosis, a low survival rate and aggressive behaviour, posing a significant threat to social security and stability. The aim of this study was to explore the mediating role of depression in the relationship between sleep disturbance and aggressive behaviour in people with schizophrenia living in the community, as well as the regulatory role of family intimacy and adaptability. These findings, in turn, may provide a theoretical basis and constructive suggestions for addressing the physical and mental health problems of these patients. METHOD From September 2020 to August 2021, a convenience sampling method was used to select schizophrenia patients from the community attending follow-up appointments at the Fourth People's Hospital of Pengzhou City, China. The researchers conducted a survey in the form of a star questionnaire. The survey included questions about general demographic data and disease-related questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the revised Chinese version of the Modified Over Aggression Scale (MOAS), the Self-Rating Depression Scale (SDS), and the Family Adaptability and Cohesion Scale, Second Edition. FACES-II and SPSS 21.0 were used to organize and analyse the data. RESULTS A total of 818 schizophrenia patients living in the community participated in the survey, and 785 valid questionnaires were ultimately collected, for a response rate of 95.97%. The results of multivariate analysis indicated that sex, number of psychiatric medications used, outpatient follow-up, history of hospitalization for mental disorders and sleep disturbances were factors influencing aggressive behaviour. Depression played a partial mediating role between sleep disturbance and aggressive behaviour, and the indirect effect size was 0.043 (57.33% of the total). In addition to sleep disturbance, family intimacy (β=-0.009, P < 0.01) and adaptability (β=-0.145, P < 0.001) can significantly predict depression. CONCLUSION The findings indicate that sleep disturbance in schizophrenia patients in the community is a risk factor for aggressive behaviour, and depression plays a partial mediating role in the relationship among sleep disturbance, aggressive behaviour and family intimacy. In addition, adaptability plays a regulatory role in the relationship between depression and sleep disturbance.
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Affiliation(s)
- Zixiang Ye
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yuchuan Yue
- Administration Office, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Li
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Sun
- Department of Nursing, Pengzhou Fourth People's Hospital, Pengzhou, China
| | - Pei Yu
- Department of Nursing, Pengzhou Fourth People's Hospital, Pengzhou, China
| | - Yuhao Tong
- Operating room, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu, China
| | - Li Xiao
- Elderly Cardiovascular Care Unit III, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China
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Fuller-Rowell TE, Zeringue MM, Saini EK, Yip T, El-Sheikh M. Do Sleep Problems Exacerbate the Mental Health Consequences of Discrimination Among Adults? Psychosom Med 2024; 86:324-333. [PMID: 38588054 DOI: 10.1097/psy.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE An emerging literature suggests that sleep may play an important role in moderating the association between discrimination and mental health problems among adolescents. However, few if any studies have considered this topic among adults. Addressing this knowledge gap, the current study examined multiple sleep parameters as moderating variables in the association between discrimination and mental health problems among adults. METHODS Participants were 874 adults residing in small towns and semirural contexts within the Southeastern region of the United States ( Mage = 41 years, SD = 7; 57% female; 31% Black, 69% White; 52% income-to-needs < 2). Sleep duration and night-to-night variability in duration were assessed using wrist actigraphy. Established self-report measures were used to assess global sleep problems, experiences of discrimination, and mental health problems (anxiety, depression, and externalizing symptoms). RESULTS Experiences of discrimination were associated with more depression, anxiety, and externalizing problems. Two out of three sleep parameters were found to moderate the effects of discrimination on mental health. The association between discrimination and externalizing problems (but not anxiety or depression) was attenuated among those with less night-to-night variability in sleep duration. The associations between discrimination and anxiety and externalizing problems (but not depression) were attenuated among those with fewer global sleep problems. Less variability in sleep duration and fewer global sleep problems were also directly associated with lower levels of depression, anxiety, and externalizing problems. CONCLUSIONS Greater consistency in sleep duration from night-to-night, and fewer overall sleep problems appear to mitigate risk of mental health problems among adults, particularly in contexts where discrimination is prevalent.
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Affiliation(s)
- Thomas E Fuller-Rowell
- From the Department of Human Development and Family Science (Fuller-Rowell, El-Sheikh), Auburn University, Auburn, Alabama; Department of Psychology (Zeringue), Middle Tennessee State University, Murfreesboro, Tennessee; Department of Human Development and Family Studies (Saini), Pennsylvania State University, University Park, Pennsylvania; and Department of Psychology (Yip), Fordham University, Bronx, New York
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7
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Slebe R, Wenker E, Schoonmade LJ, Bouman EJ, Blondin DP, Campbell DJT, Carpentier AC, Hoeks J, Raina P, Schrauwen P, Serlie MJ, Stenvers DJ, de Mutsert R, Beulens JWJ, Rutters F. The effect of preprandial versus postprandial physical activity on glycaemia: Meta-analysis of human intervention studies. Diabetes Res Clin Pract 2024; 210:111638. [PMID: 38548105 DOI: 10.1016/j.diabres.2024.111638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024]
Abstract
This meta-analysis aims to investigate the effect of preprandial physical activity (PA) versus postprandial PA on glycaemia in human intervention studies. Medline and Embase.com were searched until February 2023 for intervention studies in adults, directly comparing preprandial PA versus postprandial PA on glycaemia. Studies were screened using ASReview (34,837) and full texts were read by two independent reviewers (42 full text, 28 included). Results were analysed using pooled mean differences in random-effects models. Studies were either acute response studies (n = 21) or Randomized Controlled Trials (RCTs) over multiple weeks (n = 7). In acute response studies, postprandial outcomes followed the expected physiological patterns, and outcomes measured over 24 h showed no significant differences. For the RCTs, glucose area under the curve during a glucose tolerance test was slightly, but not significantly lower in preprandial PA vs postprandial PA (-0.29 [95 %CI:-0.66, 0.08] mmol/L, I2 = 64.36 %). Subgroup analyses (quality, health status, etc.) did not significantly change the outcomes. In conclusion, we found no differences between preprandial PA versus postprandial PA on glycaemia both after one PA bout as well as after multiple weeks of PA. The studies were of low to moderate quality of evidence as assessed by GRADE, showed contradictive results, included no long-term studies and used various designs and populations. We therefore need better RCTs, with more similar designs, in larger populations and longer follow-up periods (≥12 weeks) to have a final answer on the questions eat first, then exercise, or the reverse?
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Affiliation(s)
- Romy Slebe
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1089a, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands.
| | - Eva Wenker
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1089a, Amsterdam, the Netherlands
| | - Linda J Schoonmade
- University Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Emma J Bouman
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1089a, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands
| | - Denis P Blondin
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5H3, Canada; Department of Medicine, Division of Neurology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5H3, Canada
| | - David J T Campbell
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, AB, Canada; Department of Cardiac Sciences, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - André C Carpentier
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5H3, Canada; Department of Medicine, Division of Endocrinology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5H3, Canada
| | - Joris Hoeks
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Mireille J Serlie
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
| | - Dirk Jan Stenvers
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Joline W J Beulens
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1089a, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1089a, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands
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McCaffrey C, McClure J, Singh S, Melville CA. Exploring the relationship between sleep and aggression in adolescents: A cross sectional study using the UK Millennium cohort study. Clin Child Psychol Psychiatry 2024; 29:577-590. [PMID: 38232309 DOI: 10.1177/13591045231225824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
This study aimed to establish if a significant relationship exists between sleep and aggression in a large representative adolescent cohort and explores the impact of potential confounders. This cross-sectional secondary data analysis included 10,866 males and females aged 13-15 years, from the UK-based 2015 Millenium Cohort Study (sixth sweep). Independent variables included self-report measures of sleep duration and quality. The parent reported 'Strengths and Difficulties Questionnaire' conduct score measured aggression. Binary logistic regression examined independent associations between each sleep variable and aggression. Multiple regression models then adjusted for potential confounders: age, sex, socioeconomic status, arousal, and affect. Under 8 hours of sleep on average was significantly associated with aggression when age, sex and income were controlled (p = .008). This became insignificant following adjustment for both affect and arousal. Sleep quality remained significantly associated with aggression when all confounders were controlled: 'sleep onset latency >30 minutes' and 'wakening at least a good bit of the time' increased the odds of aggression by around 27.9% (p < .001) and 43.5% respectively (p < .001). A significant association exists between poor subjective sleep quality and heightened aggression in this cohort, when all our confounders are controlled, identifying sleep quality as a potential target in treating adolescent aggression.
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Affiliation(s)
- Caoimhe McCaffrey
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK
| | - John McClure
- School of Cardiovascular and Metabolic Health, University of Glasgow, UK
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Krizan Z, Boehm NA, Strauel CB. How emotions impact sleep: A quantitative review of experiments. Sleep Med Rev 2024; 74:101890. [PMID: 38154235 DOI: 10.1016/j.smrv.2023.101890] [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: 10/25/2022] [Revised: 10/10/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023]
Abstract
Although sleep and emotional processes are recognized as mutually dependent, the causal impact of emotions on sleep has been comparatively neglected. To appraise evidence for the causal influence of emotions on sleep, a meta-analysis of the existing experimental literature evaluated the strength, form, and context of experimental effects of emotion inductions on sleep parameters (k = 31). Quality of experiments was evaluated, and theoretically-relevant features were extracted and examined as moderating factors of observed effects (i.e., sleep parameter, design, sleep context, types of emotion inductions and emotions). Random-effect models were used to aggregate effects for each sleep parameter, while-mixed effect models examined moderators. There was a significant impact of emotion inductions on delayed sleep onset latency (D = 3.36 min, 95%CI [1.78, 4.94], g = 0.53), but not other parameters. There was little evidence of publication bias regarding sleep-onset latency effect, the studies overall were heterogeneous, sometimes of limited methodological quality, and could only detect moderate-to-large impacts. The findings supported the hypothesis that negative emotions delayed sleep onset, but evidence regarding other sleep parameters was inconclusive. The results call for more targeted investigation to disambiguate distinct features of emotions and their import for sleep.
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Affiliation(s)
- Zlatan Krizan
- Department of Psychology, Iowa State University, USA.
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10
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Zhu MQ, Oliveros H, Marín C, Mora-Plazas M, Villamor E. Middle childhood and adolescence sleep duration and behavior problems in adolescence. Dev Psychopathol 2024; 36:338-348. [PMID: 36373262 DOI: 10.1017/s0954579422001237] [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] [Indexed: 11/16/2022]
Abstract
We examined the associations of middle childhood and adolescence nighttime sleep duration with adolescence internalizing and externalizing behavior problems per the Youth Self-Report (YSR) and the Child Behavior Checklist (CBCL) questionnaires, in a cohort of 889 Colombian schoolchildren. We estimated adjusted differences with 95% confidence intervals (CI) in mean behavior problem t-scores in standardized units between recommended sleep duration categories and as a continuous exposure using multiple linear regression and restricted cubic spline models, respectively. Compared with sleep duration within recommendations, middle childhood sleep above recommendations was related to 4.6 (95% CI: 1.6, 7.6; p = .004) and 5.4 (95% CI: 1.2, 9.7; p = .01) adjusted units higher YSR and CBCL externalizing problem scores, respectively. In continuous exposure analyses, this association seemed restricted to children aged ≥11 years. Longer sleep, both in categories and as a continuous exposure, was also associated with increased CBCL internalizing problems. Results did not differ by sex or weekend/weekday sleep. Sleeping under recommendations in middle childhood was not significantly related to behavior problems; nevertheless, shorter sleep in adolescence, in both categorical and continuous scales, was significantly related to behavior problems. In conclusion, behavior problems in adolescence are associated with longer sleep in middle childhood and shorter sleep in adolescence.
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Affiliation(s)
- Mia Q Zhu
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Henry Oliveros
- Facultad de Medicina, Universidad de La Sabana, Chía, Colombia
| | - Constanza Marín
- Facultad de Medicina, Universidad de La Sabana, Chía, Colombia
| | | | - Eduardo Villamor
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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11
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Krizan Z, Freilich C, Krueger RF, Mann FD. Linking genetic foundations of sleep disturbances to personality traits: a study of mid-life twins. J Sleep Res 2024; 33:e13903. [PMID: 37052324 PMCID: PMC10570399 DOI: 10.1111/jsr.13903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023]
Abstract
Risk of sleep disturbances depends on individuals' personality, and a large body of evidence indicates that individuals prone to neuroticism, impulsivity, and (low) extraversion are more likely to experience them. Origins of these associations are unclear, but common genetic background may play an important role. Participants included 405 twin pairs (mean age of 54 years; 59% female) from the National Survey of Midlife Development in the United States (MIDUS) who reported on their personality traits (broad and specific), as well as sleep disturbances (problems with falling asleep, staying asleep, waking early, and feeling unrested). Uni- and bivariate biometric decompositions evaluated contributions of genetic and environmental factors to associations between personality and poor sleep, as well as unique contributions from individual traits. Neuroticism, extraversion, conscientiousness, and aggressiveness were the strongest phenotypic predictors of poor sleep. Genetic sources of covariance were about twice as large as non-shared environmental sources, and only shared genetic background accounted for links between aggressiveness and poor sleep. Neuroticism and extraversion accounted for most of the genetic overlap between personality and sleep disturbances. The findings shed light on developmental antecedents of ties between personality and poor sleep, suggesting a larger role of common genetic background than idiosyncratic life experiences. The results also suggest that emotion-related traits play the most important role for poor sleep, compared to other personality traits, and may partially account for genetic associations with other traits.
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Affiliation(s)
- Zlatan Krizan
- Department of Psychology, Iowa State University, Ames, Iowa, USA
| | | | | | - Frank D Mann
- Stony Brook University, Minneapolis, Minnesota, USA
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12
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Martín-Piñón O, McWood LM, Erath SA, Hinnant B, El-Sheikh M. Maternal psychological control and adolescent adjustment: Sleep as a moderator. J Sleep Res 2024; 33:e13986. [PMID: 37434367 DOI: 10.1111/jsr.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/13/2023]
Abstract
Maternal psychological control has been linked consistently to poorer adjustment for adolescents, however, studies of variability in the association between psychological control and adjustment are rare. Sleep serves crucial bioregulatory functions that promote well-being and protect youths against poor adjustment associated with negative family environments. We hypothesised that the link between maternal psychological control and adolescent maladjustment would be strongest for youths with poorer actigraphy-based sleep. The current study included 245 adolescents (Mage = 15.79 years, 52.2% girls, 33.1% Black/African American and 66.9% White/European American; 43% at or below the poverty line). Adolescents reported on their mothers' psychological control toward them, as well as their internalising and externalising symptoms (aggressive and rule breaking behaviours). Several sleep variables were derived: minutes, onset time, and variability in each parameter over 1 week. For youths with shorter, less consistent sleep (both mean levels and variability in minutes and onset), maternal psychological control was associated with adjustment difficulties, especially externalising symptoms. This association was not significant for youth obtaining longer, more consistent sleep. The results were most evident for variability in sleep minutes and onset as moderators of effects. The findings suggest that longer and more consistent sleep is an important protective factor in the context of more controlling parenting.
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Affiliation(s)
- Olivia Martín-Piñón
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Leanna M McWood
- Department of Human Development and Family Science, North Dakota State University, Fargo, North Dakota, USA
| | - Stephen A Erath
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Benjamin Hinnant
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
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13
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Dewa LH, Thibaut B, Pattison N, Campbell SJ, Woodcock T, Aylin P, Archer S. Treating insomnia in people who are incarcerated: a feasibility study of a multicomponent treatment pathway. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae003. [PMID: 38370440 PMCID: PMC10873789 DOI: 10.1093/sleepadvances/zpae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/11/2023] [Indexed: 02/20/2024]
Abstract
Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardized, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomized controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes. We used a within-participants pre-post design. The stepped-care pathway included: self-management with peer support, environmental aids, and cognitive behavioral therapy for insomnia (CBTi). Assessment measures for insomnia, well-being, mood, anxiety, suicidality, overall health, sleepiness, fatigue, and cognitive functioning were administered at baseline and pathway exit. Feasibility criteria included eligibility to participate, CBTi uptake, and assessment completion. Forty-two adult males who are incarcerated were approached of which 95.2% were eligible. Of those deemed eligible, most participated (36/40, 90.0%). Most who completed baseline completed post-assessments (28/36, 77.8%) and of these, most showed improvements in their subjective sleep (27/28, 96.4%). Large reductions were found from pre- to posttreatment in insomnia severity (d = -1.81, 95% CI: 8.3 to 12.9) and 57.0% reported no clinically significant insomnia symptoms at post-assessment. There was no overall change in actigraphy-measured sleep. Large treatment benefits were found for depression, anxiety, well-being, and cognitive functioning, with a medium benefit on suicidal ideation. The treatment pathway for insomnia in prison was feasible and may be an effective treatment for insomnia in people who are incarcerated, with additional promising benefits for mental health. A pragmatic RCT across different prison populations is warranted. This paper is part of the Sleep and Circadian Health in the Justice System Collection.
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Affiliation(s)
- Lindsay H Dewa
- Imperial College London, School of Public Health, London, UK
| | - Bethan Thibaut
- Imperial College London, School of Public Health, London, UK
| | | | | | - Thomas Woodcock
- Imperial College London, School of Public Health, London, UK
| | - Paul Aylin
- Imperial College London, School of Public Health, London, UK
| | - Stephanie Archer
- University of Cambridge, Department of Public Health and Primary Care, UK
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14
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Sadeghniiat-Haghighi K, Najafi A, Eftekhari S, Behkar A, Tarkhan S. Characterization of risk factors for obstructive sleep apnea and its association with absenteeism among nurses. Nursing 2024; 54:49-54. [PMID: 38126988 DOI: 10.1097/01.nurse.0000995580.16617.2c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE To characterize risk factors associated with obstructive sleep apnea (OSA) and its relationship with nurses' absenteeism. METHODS A cross-sectional study was conducted from 2018 to 2020 at a 1,000-bed academic hospital complex and biomedical research facility in Tehran, Iran. Participants were selected through consecutive sampling after obtaining ethical approval and informed consent. Data on demographics, medical conditions, occupational characteristics, and absenteeism were collected through face-to-face interviews. The STOP-Bang questionnaire was utilized to assess the probability of OSA. Statistical tests included the Mann-Whitney U, t-test, Chi-square, and multivariable regression. RESULTS In this study involving 304 nurses, the majority were female (81.3%), with an average age of 35. About 27 participants (8.9%) had a high probability of OSA, with male sex, older age, higher body mass index, neck circumference, and diastolic BP identified as the main determinants of OSA. Additionally, shift work and night shifts were associated with increased absenteeism, while sex showed no significant association with absenteeism rates among nurses. CONCLUSION Male sex, neck circumference (obesity), night shifts, and diastolic BP can predict OSA risk. However, unauthorized absence from work is not associated with a high risk for OSA (STOP-BANG ≥3) or the individual risk factors of OSA.
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Affiliation(s)
- Khosro Sadeghniiat-Haghighi
- At Tehran University of Medical Sciences in Tehran, Iran, Khosro Sadeghniiat-Haghighi is a professor at the Sleep Breathing Disorders Research Center, Arezu Najafi is an associate professor at the Occupational Sleep Research Center, Sahar Eftekhari is an associate professor at the Center for Research on Occupational Diseases, Atefeh Behkar is a research assistant at the Occupational Sleep Research Center, and Samareh Tarkhan works at the Center for Research on Occupational Diseases
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15
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Rückholdt M, Tofler GH, Randall S, Cistulli PA, Whitfield V, Washington K, Ward C, Fethney J, Morrel-Kopp MC, Buckley T. Impact of hospitalisation on behavioural and physiological stress responses associated with cardiovascular risk in visiting family members. Aust Crit Care 2023; 36:762-768. [PMID: 36371291 DOI: 10.1016/j.aucc.2022.09.009] [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: 04/25/2022] [Revised: 09/02/2022] [Accepted: 09/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The hospitalisation of a patient in intensive care impacts the psychological health of family members, with a high prevalence of anxiety, depression, and post-traumatic stress symptoms reported among families of critically ill patients. Understanding of the behavioural and physiological impact is limited and presents a new area of focus. OBJECTIVES The objective of this study was to evaluate behavioural and physiological stress responses of visiting family members following hospitalisation of their adult relative. METHODS Prospective longitudinal evaluation included 40 family members of adult patients with admission to intensive or coronary care in a large tertiary care metropolitan hospital. Assessments were conducted at three timepoints: in-hospital within 1 week of admission and 2 weeks and 3 months post discharge. Assessments included duration and quality of sleep (self-reported and actigraphy measured), physical activity, dietary and alcohol patterns, resting heart rate and blood pressure, and morning blood cortisol and lipid levels. Assessment of a reference group of 40 non-hospital-exposed control participants was also conducted. RESULTS At the in-hospital assessment, study participants reported lower sleep time, altered 24-h physical activity patterns, reduced dietary and alcohol intake, and higher systolic and diastolic blood pressure than a nonhospitalised reference group. Compared to in-hospital assessment, these altered behavioural and physiological responses improved over time except for systolic blood pressures which remained unchanged at 3 months post family member discharge. CONCLUSION Hospitalisation is associated with altered behavioural and physiological responses in family members. These findings contribute to understanding of the impact of unexpected hospitalisation on family members' cardiovascular risk factors and provide insights into potential mechanisms for the proposed increased risk during this time. Elevated systolic blood pressure at 3 months post discharge suggests a prolonged cardiovascular stress response in many family members of critical care patients that requires further study, with a focus on contributing and potential modifiable factors.
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Affiliation(s)
- Monica Rückholdt
- University of Sydney, Australia; Royal North Shore Hospital, Sydney, Australia; Australian Catholic University, Australia.
| | - Geoffrey H Tofler
- University of Sydney, Australia; Royal North Shore Hospital, Sydney, Australia
| | | | - Peter A Cistulli
- University of Sydney, Australia; Royal North Shore Hospital, Sydney, Australia
| | | | | | - Chris Ward
- University of Sydney, Australia; Royal North Shore Hospital, Sydney, Australia; Kolling Institute, Sydney, Australia
| | | | | | - Thomas Buckley
- University of Sydney, Australia; Royal North Shore Hospital, Sydney, Australia; Kolling Institute, Sydney, Australia
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16
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Shi X, Qiao X, Zhu Y. Emotional dysregulation as a mediator linking sleep disturbance with aggressive behaviors: Disentangling between- and within-person associations. Sleep Med 2023; 108:90-97. [PMID: 37343336 DOI: 10.1016/j.sleep.2023.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/20/2023] [Accepted: 06/01/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Sleep problems and aggressive behaviors are two prevalent and highly related problems among adolescents and emerging adults worldwide. This longitudinal study examined the reciprocal relations between sleep disturbance with aggressive behaviors and whether emotional dysregulation functioned as mediator of the relations, after separating within-person effects from between-person effects. METHODS A total of 4352 freshman students participated in a five-wave longitudinal study across two and half years. Data from the second wave to the fourth wave was used in this study. Random intercept cross-lagged panel models (RI-CLPM) were utilized to separate between- and within-person effects. RESULTS Results from RI-CLPM showed: (a) Sleep disturbance and aggressive behaviors bidirectionally predicted each other at the within-person level; (b) Emotional dysregulation functioned as a mediator of the associations from sleep disturbance to aggressive behaviors at the within-person level. CONCLUSION These findings advanced the literature by elucidating longitudinal associations among sleep disturbance, emotional dysregulation, and aggressive behaviors at the within-person level, suggesting that prevention and intervention programs targeted at improving emotional regulation skills may be helpful to prevent the developmental pathway from sleep disturbance to aggressive behaviors among college students.
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Affiliation(s)
- Xuliang Shi
- College of Education, Hebei University, Baoding, 071002, Hebei Province, China.
| | - Xiaofei Qiao
- College of Education, Hebei University, Baoding, 071002, Hebei Province, China
| | - Ya Zhu
- Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, 523083, Guangdong Province, China
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17
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Cao L, Wang S, Li Y, Li Y, Yuan M, Wang G, Su P. Bidirectional association between sleep quality or duration and aggressive behaviour in early adolescents: A cross-lagged longitudinal study. J Affect Disord 2023; 334:197-204. [PMID: 37150219 DOI: 10.1016/j.jad.2023.04.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Several cross-sectional studies have suggested a strongly positive link between sleep and aggressive behaviour; however, longitudinal studies reporting the relationship between sleep and aggressive behaviour are lacking. This study aimed to examine whether a bidirectional relationship exists between sleep quality or duration and aggressive behaviour in early adolescents. METHODS A total of 1579 early adolescents (60.9 % boys) from the Chinese Early Adolescents Cohort study were included in this study. Data on sleep quality, sleep duration and aggressive behaviour collected at two time points (September 2019 and September 2021) were used, and the bidirectional relationship between sleep quality or duration and aggressive behaviour was examined using a cross-lagged model. RESULTS The results revealed a bidirectional relationship between low sleep quality and highly aggressive behaviour. A shorter sleep duration did not predict highly aggressive behaviour, whereas only highly aggressive behaviour predicted a shorter sleep duration. CONCLUSIONS Sleep quality and aggressive behaviour were interrelated over time among adolescents. However, sleep duration did not predict aggressive behaviour, suggesting that sleep quality, instead of sleep duration, should be the primary target for managing aggressive behaviour.
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Affiliation(s)
- Leilei Cao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Shaojie Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Yuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Yonghan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Mengyuan Yuan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Gengfu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Puyu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, China.
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18
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Sampaio F, Gaspar S, Fonseca C, Lopes MJ, Paiva T, Guedes de Pinho L. Sleep Quality between Nurses and the General Population during the COVID-19 Pandemic in Portugal: What Are the Differences? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085531. [PMID: 37107813 PMCID: PMC10139164 DOI: 10.3390/ijerph20085531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
Although several studies have described the impact of the COVID-19 pandemic, particularly on sleep quality, there are few studies that, in the same time period and using the same assessment tools, compare sleep quality and mental health status between nurses and the general population. Thus, the aim of this study was to (a) examine whether there were differences between nurses and the general population regarding sleep quality and mental health status during the COVID-19 pandemic and (b) identify which factors may explain sleep quality during the COVID-19 pandemic. To do that, we carried out a cross-sectional study in Portugal. Data were collected using an online survey platform during the first COVID-19 wave, from April to August 2020. Nurses presented poorer sleep quality than the general population, as well as higher anxiety levels. Irritability and worries about the future were two of the factors that might explain those differences. Thus, we can conclude that irritability and worries about the future are dimensions of anxiety that were associated with poor sleep quality during the COVID-19 pandemic. Thus, it would be important to adopt regular anxiety and sleep assessments, particularly for nurses, and to implement strategies to reduce this problem.
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Affiliation(s)
- Francisco Sampaio
- Nursing School of Porto, Rua Dr. António Bernardino de Almeida, 830, 844, 856, 4200-072 Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
- Correspondence: (F.S.); (L.G.d.P.)
| | - Susana Gaspar
- School of Health, Polytechnic Institute of Beja, R. Dr. José Correia Maltez, 7800-111 Beja, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, 1649-026 Lisboa, Portugal
| | - César Fonseca
- Nursing Department, Universidade de Évora, Largo do Senhor da Pobreza, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo do Senhor da Pobreza, 7000-811 Évora, Portugal
| | - Manuel José Lopes
- Nursing Department, Universidade de Évora, Largo do Senhor da Pobreza, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo do Senhor da Pobreza, 7000-811 Évora, Portugal
| | - Teresa Paiva
- CENC—Sleep Medicine Center, Rua Conde das Antas, 5, 1070-068 Lisboa, Portugal;
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, 1649-026 Lisboa, Portugal
- Comprehensive Health Research Center, Nova Medical School, Universidade Nova de Lisboa, Rua do Instituto Bacteriológico, 5, 1150-082 Lisboa, Portugal
| | - Lara Guedes de Pinho
- Nursing Department, Universidade de Évora, Largo do Senhor da Pobreza, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo do Senhor da Pobreza, 7000-811 Évora, Portugal
- Correspondence: (F.S.); (L.G.d.P.)
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19
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Khazaie H, Najafi F, Chehri A, Rahimi-Movaghar A, Amin-Esmaeili M, Moradinazar M, Zakiei A, Pasdar Y, Brühl AB, Brand S, Sadeghi-Bahmani D. Physical Activity Patterns, Circadian Rhythms, and Aggressive and Suicidal Behavior among a Larger Sample of the General Population Aged 15 to 34 Years. J Clin Med 2023; 12:jcm12082821. [PMID: 37109158 PMCID: PMC10141705 DOI: 10.3390/jcm12082821] [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: 03/14/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND From a psychological perspective, aggressive behavior, non-suicidal self-injury and suicidal behavior could be considered dysfunctional coping strategies. Poor sleep patterns may further increase such dysfunctional coping. In contrast, regular physical activity may have the power to counteract such dysfunctional coping. Given this background, the aim of the present study was to combine categories of circadian rhythms as a proxy of normative sleep patterns and categories of physical activity patterns, and to associate these categories with aggressive behavior, non-suicidal self-injury and suicidal behavior among a larger sample of adolescents and young adults, aged 15 to 34 years. METHOD A total of 2991 (55.6% females) individuals aged 15 to 34 years of the so-called Ravansar non-communicable disease cohort study (RaNCD) took part in this study. Participants completed self-rating questionnaires covering circadian-related sleep patterns, regular physical activity, socio-demographic information and dimensions of aggression, non-suicidal self-injury and suicidal behavior. RESULTS In a first step, both sleep patterns (circadian rhythm disorder: yes vs. no) and physical activity patterns (high vs. low) were dichotomized. Next, participants were assigned to one of four prototypical clusters: No circadian sleep disorders and high physical activity ("Hi-Sleep-Hi-PA"); no circadian sleep disorders and low physical activity ("Hi-Sleep-Lo-PA"); circadian sleep disorders and high physical activity ("Lo-Sleep-Hi-PA"); circadian sleep disorders and low physical activity ("Lo-Sleep-Lo-PA"). Projecting these four clusters on dimensions of aggressive behavior, non-suicidal self-injury and suicidal behavior, the following findings were observed: Participants of the "Hi-Sleep-Hi-PA" reported the lowest scores for aggressive behavior, self-injury and suicidal behavior, compared to participants of the "Lo-Sleep-Lo-PA" cluster. No differences for aggressive behavior, self-injury and suicidal behavior were observed among participants of the "Hi-Sleep-Lo-PA" and the "Lo-Sleep-Hi-PA" clusters. CONCLUSIONS It appeared that the combination of favorable circadian sleep patterns and high physical activity patterns was associated with lower aggressive behavior, lower self-injury and suicidal behavior as proxies of favorable psychological functioning. In contrast, persons reporting high circadian sleep disorders and low physical activity patterns appeared to demand particular attention and counseling for both their lifestyle issues (sleep and physical activity) and their dysfunctional coping strategies.
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Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Farid Najafi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Azita Chehri
- Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah 6714673159, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran 1419733141, Iran
| | - Masoumeh Amin-Esmaeili
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran 1419733141, Iran
| | - Mahdi Moradinazar
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, University of Basel, 4002 Basel, Switzerland
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, University of Basel, 4002 Basel, Switzerland
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4002 Basel, Switzerland
- Addiction Research Prevention Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 1419733141, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, University of Basel, 4002 Basel, Switzerland
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- Department of Psychology and Department of Epidemiology, Stanford University, Stanford, CA 94305, USA
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Bhatara VS, Bernstein B, Fazili S. Complementary and Integrative Treatments of Aggressiveness/Emotion Dysregulation: Associated with Disruptive Disorders and Disruptive Mood Dysregulation Disorder. Child Adolesc Psychiatr Clin N Am 2023; 32:297-315. [PMID: 37147041 DOI: 10.1016/j.chc.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Youth with emotional dysregulation (ED) and irritability/aggression, common in disruptive disorders (frequently comorbid with attention-deficit/hyperactivity disorder), are underserved by conventional treatments. Anger dysregulation is usually the core feature of ED. Complementary and integrative Medicine (CIM) treatments for youth with disruptive disorders and ED are reviewed. Broad-spectrum micronutrient supplementation has a medium effect and is supported by two double-blind randomized controlled trials using similar formulations. Other CIM treatments supported by controlled data but needing further research, include omega-3 fatty acid supplementation, music therapy, martial arts, restricting exposure to media violence, decreasing sleep deprivation, and increased exposure to green-blue spaces.
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Affiliation(s)
- Vinod S Bhatara
- Department of Psychiatry, University of South Dakota, Sanford School of Medicine, Sioux Falls, SD, USA; Department of Pediatrics, University of South Dakota, Sanford School of Medicine, Sioux Falls, SD, USA.
| | - Bettina Bernstein
- Philadelphia College of Osteopathic Medicine, 4170 City Ave, Philadelphia, PA 19131, USA; Department of Child and Adolescent Psychiatry, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Sheeba Fazili
- University of South Dakota Sanford School of Medicine, 4400 West 69th street, suite 1500, Sioux Falls, SD 57104, USA
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21
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He X, Hao J, Song Y, Cao H, Chen Y, Yang H. Effectiveness of non-pharmacological interventions for sleep disturbances in people living with dementia: A systematic review and meta-analysis. Geriatr Nurs 2023; 51:76-83. [PMID: 36921396 DOI: 10.1016/j.gerinurse.2023.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 03/14/2023]
Abstract
We summarize the evidence on non-pharmacological interventions for sleep disturbances in people living with dementia(PlwD). A literature search was performed using PubMed, Embase, Cochrane library, Web of Science, PsycINFO, CINAHL, and clinicaltrials.gov. Up to August 20, 2022. Six studies met our eligibility criteria. Light therapy, the therapeutic pet-type robotic seal(PRAO), and slow-stroke back massage(SSBM) are non-pharmacological interventions for sleep disturbances in PlwD.PARO increased night-time sleep duration (p < 0.05). The benefit of SSBM for sleep disturbances in PlwD is unclear (p > 0.05). Although there is a lack of evidence for the effect of light therapy on sleep disturbances in PlwD (p > 0.05), light therapy reduced sleep disturbance (SMD = -0.38; 95% CI:1.25, 0.48), increased sleep efficiency (MD = 3.77; 95% CI:-0.23, 7.78), and also reduced depression (MD = -2.49; 95% CI: -2.92, -2.06). More large-scale randomized controlled trials are needed and consider combining multiple non-pharmacological measures for sleep interventions in PlwD.
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Affiliation(s)
- Xingyue He
- Nursing College of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiaqi Hao
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China; Hunan International Scientific and Technological Cooperation Base of Brain Tumor Research, Xiangya Hospital, Central South University, Changsha, China
| | - Yejun Song
- Department of Nursing, The Third people's Hospital of Taiyuan, Taiyuan, Shanxi, China
| | - Huili Cao
- Nursing College of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yangjie Chen
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hui Yang
- Nursing College of Shanxi Medical University, Taiyuan, Shanxi, China; Department of Nursing, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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Cybulska AM, Weymann A, Rachubińska K, Grochans S, Wójcik G, Grochans E. Factors Associated with Insomnia and Aggression among Healthcare Workers during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1433. [PMID: 36674188 PMCID: PMC9859312 DOI: 10.3390/ijerph20021433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
(1) Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic. The aim of the study was to assess insomnia, sleep disturbances, and aggression and identify the associated risk factors among healthcare workers during the COVID-19 pandemic. (2) A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss−Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a self-administered questionnaire. (3) The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p = 0.038), marital status (p = 0.043), and working with patients suffering from COVID-19 (p = 0.024) were statistically significant contributors to insomnia. Age was found to significantly correlate with total aggression (r = −0.133 p = 0.031), verbal aggression (r = −0.138 p = 0.025), and anger (r = −0.151 p = 0.014). The analysis demonstrated statistically significant relationships between gender and physical aggression (p = 0.017), anger (p = 0.032), and hostility (p = 0.002). A statistically significant positive correlation between the quality of sleep as per the PSQI and all subscales of the BPAQ was found (p < 0.001). (4) A considerable proportion of HCWs experienced sleep disturbances during the outbreak, stressing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and mental health problems and adjust interventions under pandemic conditions.
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Affiliation(s)
- Anna Maria Cybulska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Agnieszka Weymann
- Independent Clinical Public Hospital No. 2 in Szczecin, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 72-111 Szczecin, Poland
| | - Kamila Rachubińska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Szymon Grochans
- Department of Clinical Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Grzegorz Wójcik
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
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23
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Effect of subjective sleep quality on aggression: A two-year longitudinal and fMRI pilot study. Biol Psychol 2023; 176:108454. [PMID: 36535515 DOI: 10.1016/j.biopsycho.2022.108454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/25/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND/OBJECTIVE To examine the causal relationship between sleep quality and aggression and their reliable cognitive neural mechanisms. METHOD We conducted two follow-up measures on subjective sleep quality, aggression, and resting-state functional magnetic resonance imaging (rs-fMRI) of 455 college students, with a two-year interval between the two follow-up measures. We used cross-lag model on the questionnaire and amplitude of low-frequency fluctuation (ALFF) on rs-fMRI for data analysis. RESULTS 1) The cross-lag model showed that sleep quality at the first time could predict aggression at the second time. 2) ALFF showed poor sleep quality decreased spontaneous activity in prefrontal regions, but increased activity in limbic system regions, which may be the possible neural basis linking poor sleep quality with increased aggressive behavior. CONCLUSIONS There is a causal relationship between subjective sleep quality and aggressive behavior. Our finding proposes a new view of how sleep quality affects aggressive behavior.
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24
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Zhang H, Xu D, Wang Y, Lei X. The Relation Between the Power of Prefrontal Gamma in Rest-state EEG Under Normal Sleep and Reactive Aggression Behaviour After Sleep Deprivation. Brain Topogr 2023; 36:42-51. [PMID: 36315300 DOI: 10.1007/s10548-022-00921-0] [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: 04/09/2022] [Accepted: 10/09/2022] [Indexed: 01/14/2023]
Abstract
Whether sleep deprivation affects aggressive behaviour is still under debate. The present study examined the influence of individual differences in reactive aggressive behaviour after sleep deprivation and preliminarily explored an electrophysiological marker to identify individuals with more aggressive behaviour after sleep deprivation. Thirty participants performed the Taylor Aggression Paradigm task under two sleep conditions: normal sleep (NS, one night of regular sleep) and total sleep deprivation (SD, 30 h of wakefulness), and 5-minute resting-state electroencephalogram (EEG) acquisition was completed under the NS condition. The results found that although sleep deprivation did not have significant effects on aggressive behaviour in the overall analysis, the participants can be classified as an increased group (n = 16) and a no-increased group (n = 14) by different changes in the two sleep conditions (SD-NS). In addition, prefrontal gamma (γ) power was significantly lower in the increased group than in the no-increased group, which may reflect the difference in ability on inhibition. Furthermore, more critical is that γ power was significantly negatively correlated with change in the reactive aggressive behaviour. These results indicate that the effect of SD on reactive aggression varies between individuals, and prefrontal γ power may be an effective electrophysiological marker for identifying people at risk of aggressive behaviour after SD.
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Affiliation(s)
- Haobo Zhang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, 400715, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, 400715, Chongqing, China
| | - Dan Xu
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, 400715, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, 400715, Chongqing, China
| | - Yulin Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, 400715, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, 400715, Chongqing, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, 400715, Chongqing, China.
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, 400715, Chongqing, China.
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25
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See YN, Khor PF, Koh HY, Leung P, Del-Pino-Casado R, Orgeta V. Anger and Dementia Caregiving: A Systematic Review of the Effects of Anger and Hostility on Caregivers' Physical Health. J Alzheimers Dis Rep 2022; 6:685-698. [PMID: 36606206 PMCID: PMC9741750 DOI: 10.3233/adr-220040] [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: 06/23/2022] [Accepted: 10/05/2022] [Indexed: 11/09/2022] Open
Abstract
Background Anger is commonly experienced by family caregivers of people living with dementia yet its effect on caregivers' physical health remains unknown. Objective The primary aim of this study was to systematically review current evidence on the effects of anger and hostility on caregivers' physical health. Methods We searched Medline, EMBASE, PubMed, and PsycINFO up to January 2022. Two review authors independently extracted data on study characteristics, study quality, and effect sizes of associations of anger and hostility with caregiver health outcomes. Results We found eight studies examining the effects of anger and hostility on caregivers' physical health reporting on a total of 937 participants, of which four were cross-sectional and four were longitudinal. Overall findings indicated that higher levels of anger and hostility exerted a negative effect on caregivers' physical health. Higher anger control was longitudinally associated with increased weight gain (β= 1.13, p < 0.001), whereas higher anger out predicted higher glucose dysregulation at long-term follow-up (r = 0.27, p < 0.05). Higher levels of caregiver hostility were associated with increased risk of chronic low-grade inflammation long-term (r = 0.18, p < 0.05), and increased risk of cognitive decline over time (r = -0.16, p < 0.05). Conclusion Our review provides the first systematic synthesis of the evidence demonstrating the harmful effects of anger and hostility on dementia caregivers' health and highlights the need for preventative interventions to support family caregivers experiencing high levels of anger.
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Affiliation(s)
| | | | | | - Phuong Leung
- Division of Psychiatry, University College London, UK
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26
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Van Veen M, Lancel M, Şener O, Verkes R, Bouman E, Rutters F. Observational and experimental studies on sleep duration and aggression: A systematic review and meta-analysis. Sleep Med Rev 2022; 64:101661. [DOI: 10.1016/j.smrv.2022.101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 10/15/2022]
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27
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Hruska B, Anderson L, Barduhn MS. Multilevel analysis of sleep quality and anger in emergency medical service workers. Sleep Health 2022; 8:303-310. [PMID: 35450834 DOI: 10.1016/j.sleh.2022.02.005] [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: 08/06/2021] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Poor sleep quality characterizes the emergency medical service (EMS) profession. Anger is particularly affected by sleep disturbance and may be related to sleep quality at both between- and within-person levels, yet this has never been examined. The current study performed a multilevel analysis of the relationship between sleep quality and anger among EMS workers. DESIGN Ecological momentary assessment PARTICIPANTS: Seventy-nine EMS workers employed at an emergency medical service provider in Central New York. MEASUREMENTS Participants completed 8 daily assessments that inquired about sleep quality and anger. RESULTS EMS workers who typically experienced poorer sleep quality reported greater anger levels; for instance, workers who routinely experienced poor sleep quality reported anger levels that were 18%-35% higher compared to workers receiving fair sleep quality. Regardless of their typical sleep quality, days when workers experienced poorer sleep than usual was characterized by higher levels of anger: on a day when a worker experienced poorer sleep quality than usual for them, their anger levels were 5% higher on that day regardless of their typical sleep quality. CONCLUSIONS EMS workers regularly experiencing poor sleep quality experience more anger. However, even workers who typically have better sleep quality experience anger elevations following poor sleep. These findings suggest that interventions targeting both between- and within-person factors impacting sleep may be important for addressing sleep quality's influence on anger in the EMS profession.
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Affiliation(s)
- Bryce Hruska
- Department of Public Health, Syracuse University, Syracuse, NY, USA.
| | - Lauren Anderson
- Department of Public Health, Syracuse University, Syracuse, NY, USA
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28
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Smith TW. Intimate Relationships and Coronary Heart Disease: Implications for Risk, Prevention, and Patient Management. Curr Cardiol Rep 2022; 24:761-774. [PMID: 35380384 PMCID: PMC8981884 DOI: 10.1007/s11886-022-01695-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 12/15/2022]
Abstract
Purpose of Review Research and clinical services addressing psychosocial aspects of coronary heart disease (CHD) typically emphasize individuals, focusing less on the context of intimate relationships such as marriage and similar partnerships. This review describes current evidence regarding the role of intimate relationships in the development, course, and management of CHD. Recent Findings Having an intimate partner is associated with reduced risk of incident CHD and a better prognosis among patients, but strain (e.g., conflict) and disruption (i.e., separation, divorce) in these relationships are associated with increased risk and poor outcomes. These associations likely reflect mechanisms involving health behavior and the physiological effects of emotion and stress. Importantly, many other well-established psychosocial risk and protective factors (e.g., low SES, job stress, depression, and optimism) are strongly related to the quality of intimate relationships, and these associations likely contribute to the effects of those other psychosocial factors. For better or worse, intimate partners can also affect the outcome of efforts to alter health behaviors (physical activity, diet, smoking, and medication adherence) central in the prevention and management CHD. Intimate partners also influence—and are influenced by—stressful aspects of acute coronary crises and longer-term patient adjustment and management. Summary Evidence on each of these roles of intimate relationships in CHD is considerable, but direct demonstrations of the value of couple assessments and interventions are limited, although preliminary research is promising. Research needed to close this gap must also address issues of diversity, disparities, and inequity that have strong parallels in CHD and intimate relationships.
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Affiliation(s)
- Timothy W Smith
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
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