Sleep and school problems among children and adolescents in state custody

Associations between Childhood Maltreatment and Behavioral Sleep Disturbances Across the Lifespan: A Systematic Review

Childhood maltreatment has a range of long-term developmental and health consequences. Emerging research suggests that sleep disturbances may be a key behavioral health risk factor implicated in the relationship between maltreatment and poor health across the lifespan. This systematic review examined the association between maltreatment and behavioral sleep disturbances in childhood and adulthood. Studies were identified through PsycINFO, PubMed, and alternative search strategies such as Google Scholar and reference list checks, with an end date of July 2021. Quantitative, peer-reviewed articles examining behavioral sleep outcomes and/or characteristics among maltreatment-exposed samples were included. We assessed the potential risk of bias by examining study design and sleep and maltreatment assessment methods. Across 73 studies included in this review, there was a robust association between childhood maltreatment and behavioral sleep disturbances. Findings suggest that linkages between maltreatment and sleep outcomes diverge with respect to maltreatment characteristics, type of behavioral sleep disturbance assessed, use of subjective versus objective measures, and study design. Given that behavioral sleep disturbances are modifiable, more research is needed that incorporates objective measures of sleep and longitudinal designs to identify specific points of intervention to mitigate the potential long-term impacts of childhood maltreatment on health across socio-demographically diverse populations.

Sleep patterns and insomnia among adolescents receiving child welfare services: A population-based study

OBJECTIVES

Sleep problems are common in adolescence. We aimed to investigate sleep patterns and insomnia in Norwegian adolescents who have been in contact with child welfare services (CWS), both adolescents living in foster care (FC) and adolescents receiving in-home-services (IHS). Both groups were compared to youth who reported they were not receiving child welfare interventions.

DESIGN

Cross-sectional.

SETTING

The population-based study youth@hordaland from 2012 in Hordaland, Norway.

PARTICIPANTS

About 9421 adolescents (53.8% girls), age range 16-19 years, were divided into 3 groups; IHS group (n = 123), FC group (n = 132), and control group (n = 9166).

MEASUREMENTS

Self-reported information about demographics, detailed sleep patterns, sleep problems, and adverse life events.

RESULTS

Adolescents receiving IHS (vs. controls) had significantly shorter sleep duration, lower sleep efficiency, longer sleep onset latency (SOL), wake after sleep onset (WASO), and higher prevalence of insomnia. They had increased odds of insomnia (adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.19-2.62) and SOL ≥ 30 minutes (AOR = 1.95, CI = 1.32-2.87). Adolescents in FC (vs. controls) reported lower sleep efficiency and longer WASO. When adjusting for sex and age, the associations did not substantially change. When additionally adjusting for adverse life events, the associations were considerably attenuated for both groups, and were no longer significant for the FC group.

CONCLUSION

Our results indicate a higher rate of sleep problems among adolescents receiving interventions from CWS, particularly those receiving IHS. Adverse life events accounted for a substantial part of the increased risk of sleep problems.

Incorporating positive youth development into the therapeutic model for incarcerated young woman

Young women in the juvenile justice system have high rates of prior physical and sexual abuse, substance use and psychiatric disorders. Understandably services usually are based on a therapeutic model to address those needs. Positive Youth Development (PYD) is a complementary alternative format that aims to provide resilience, life competencies, and self efficacy for pro-social actions. We provide a narrative review of PYD programs with a focus on how those relate to youth in closed custody. Sleep and physical activity are two behaviors where incarcerated young women still have personal agency, and we present the additional relevance of those program aspects. We describe methods and findings from a feasibility trial of an existing evidence-based, peer-led program for young women high school athletes used with incarcerated young women. Findings are placed in the context of established models of behavior change. The program was feasible and acceptable, and in this small trial, results demonstrate the format's potential efficacy. PYD may provide a trajectory of success and assets that could durably assist these young women following incarceration.

Sleep disorder prevalence in at-risk adolescents and potential effects of nightmare triad syndrome

Objective At-risk high school students, those considered to have a higher probability for academic failure or dropping out, were assessed for various sleep disorders. Effects were compared between students with and without the nightmare triad syndrome (NTS+), the sleep disorders' cluster of frequent nightmares, insomnia disorder and suspected sleep-disordered breathing (SDB). Methods Data were gathered at a charter school for at-risk youth using: computer based surveys, physical airway exams, and mental health interviews by school social worker. Ninety-two students were enrolled, and 70 completed all study components. Results Students were teenaged [17.10 (1.50) years], male (52.2%) slightly overweight [BMI 25.50 (6.41)] Hispanics (87.0%); two-thirds (65 of 92) subjectively reported a sleep problem. Frequent nightmares (39.1%), insomnia (ISI ≥ 12, 41.3%), and SDB risk (79.3%) were common. Several presumptive sleep disorders (insomnia, SDB risk, parasomnia, or nightmares) were associated with worse sleep quality and lower quality of life. Nineteen students met criteria for NTS. Compared to NTS-, NTS+ showed significantly lower quality of life (p < 0.003, g = 0.84). Regression analyses revealed higher levels of depression and anxiety symptoms in NTS+ students. NTS was associated with reduced quality of life independent of anxiety symptoms. Conclusion Prevalence of presumptive sleep disorders was high with a tendency for clusters of sleep disorders in the same individual. Students with NTS+ showed worse outcomes and reduced quality of life, mediated partially by depression and anxiety. To examine relationships between sleep disorders and mental health in at-risk adolescents, research investigations must include both subjective and objective measurements of sleep.

The role of strengths in anger and conduct problems in maltreated adolescents

Despite multi-type maltreatment, some individuals demonstrate positive adaptation and continue to develop in a healthy way. A multitude of strength factors have been linked to adaptive functioning and resilience, but this has not been adequately examined in maltreated adolescent's psychosocial functioning. This study sought to examine the role of strengths such as having talents/interests, family relationships, educational support, the role of the recognition and application of these strengths, and the role of multi-type maltreatment on anger control and conduct problems. One hundred and thirty participants (61 males; 69 females) aged 13-19 years old were rated using the Singapore version of Child and Adolescent Needs and Strengths (CANS) tool. The results revealed that certain strengths were associated with anger and conduct problems, but the recognition and application of strengths emerged as a consistently significant predictor for both outcomes. Hence, to understand and apply one's strengths may be equally as important as merely possessing those strengths. This study extends current understanding of the importance of strengths with a group of maltreated adolescents in an Asian context. Adopting a person-centered and strength-based approach will further enhance the effectiveness of interventions and improve outcomes for maltreated adolescents living in residential care.

Adopted youth and sleep difficulties

Sleep is a critical component of healthy development for youth, with cascading effects on youth’s biological growth, psychological well-being, and overall functioning. Increased sleep difficulties are one of many disruptions that adopted youth may face throughout the adoption process. Sleep difficulties have been frequently cited as a major concern by adoptive parents and hypothesized in the literature as a problem that may affect multiple areas of development and functioning in adopted youth. However, there is limited research exploring this relationship. Using a biopsychosocial framework, this paper reviews the extant literature to explore the development, maintenance, and impact of sleep difficulties in adopted youth. Finally, implications for future research and clinical interventions are outlined.

Prevalence and Demographic Distribution of Adult Survivors of Child Abuse in Japan

A cross-sectional study was conducted with a national epidemiological survey to investigate the prevalence and demographic distribution of adult survivors of child abuse in Japan. A self-administered questionnaire was used to measure the history of child abuse and the demographic characteristics. The participants reported the following 4 types of child abuse: physical abuse (3%), sexual abuse (0.6%), neglect (0.8%), and psychological abuse (4%). Significant unequal distribution of child abuse was found to be associated with sex, living region, marital status, job status, and educational status. We determined the prevalence of adult survivors of child abuse in Japan and found that their demographic characteristics were unequally distributed. Policy makers and public health providers should take these demographic disparities into account in considering effective public health interventions for survivors of child abuse.