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Akram U, Stevenson JC, Gardani M, Allen S, Johann AF. Personality and insomnia: A systematic review and narrative synthesis. J Sleep Res 2023; 32:e14031. [PMID: 37654128 DOI: 10.1111/jsr.14031] [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: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/02/2023]
Abstract
The inherent nature of personality serves as a predisposing, and possible maintaining, factor of insomnia. However, methodological differences limit the ability to draw causal conclusions regarding the specific traits involved in the aetiology of the disorder. This systematic review of the relationship between insomnia and personality provides a narrative synthesis of the literature to date. Here, we identified N = 76 studies meeting the inclusion/exclusion criteria. The outcomes reliably evidenced the experience of insomnia to be associated with personality traits that are typically considered to be negative or maladaptive in nature. More specifically, insomnia was related to neuroticism, introversion, perfectionistic doubts and concerns, elevated personal standards, negative affect, social inhibition and avoidance, hysteria, hypochondriasis, psychasthenia, impulsive behaviour, anger, hostility, and psychopathic tendencies, schizotypal and borderline traits, reduced conscientiousness and self-directedness, and negatively perceived perception of the self. Several studies examined the role that personality plays in predicting the treatment efficacy and adherence of CBTi. Moving forward, longitudinal research, methodological consistency, the mediating role of treatment outcomes and adherence, and clinical and population representative samples should be prioritised. Methodological strengths and limitations of the literature are discussed alongside the next steps that should be taken to advance our understanding of the literature.
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Affiliation(s)
- Umair Akram
- School of Psychology, University of Lincoln, Lincoln, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Maria Gardani
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Sarah Allen
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
- Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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2
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Meyer N, Joyce DW, Karr C, de Vos M, Dijk DJ, Jacobson NC, MacCabe JH. The temporal dynamics of sleep disturbance and psychopathology in psychosis: a digital sampling study. Psychol Med 2022; 52:2741-2750. [PMID: 33431090 PMCID: PMC9647520 DOI: 10.1017/s0033291720004857] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/28/2020] [Accepted: 11/26/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sleep disruption is a common precursor to deterioration and relapse in people living with psychotic disorders. Understanding the temporal relationship between sleep and psychopathology is important for identifying and developing interventions which target key variables that contribute to relapse. METHODS We used a purpose-built digital platform to sample self-reported sleep and psychopathology variables over 1 year, in 36 individuals with schizophrenia. Once-daily measures of sleep duration and sleep quality, and fluctuations in psychopathology (positive and negative affect, cognition and psychotic symptoms) were captured. We examined the temporal relationship between these variables using the Differential Time-Varying Effect (DTVEM) hybrid exploratory-confirmatory model. RESULTS Poorer sleep quality and shorter sleep duration maximally predicted deterioration in psychosis symptoms over the subsequent 1-8 and 1-12 days, respectively. These relationships were also mediated by negative affect and cognitive symptoms. Psychopathology variables also predicted sleep quality, but not sleep duration, and the effect sizes were smaller and of shorter lag duration. CONCLUSIONS Reduced sleep duration and poorer sleep quality anticipate the exacerbation of psychotic symptoms by approximately 1-2 weeks, and negative affect and cognitive symptoms mediate this relationship. We also observed a reciprocal relationship that was of shorter duration and smaller magnitude. Sleep disturbance may play a causal role in symptom exacerbation and relapse, and represents an important and tractable target for intervention. It warrants greater attention as an early warning sign of deterioration, and low-burden, user-friendly digital tools may play a role in its early detection.
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Affiliation(s)
- Nicholas Meyer
- Department of Psychosis Studies, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Dan W. Joyce
- Department of Psychiatry, National Institute of Health Research, Oxford Health Biomedical Research Centre, Warneford Hospital, University of Oxford, Oxford, UK
| | - Chris Karr
- Audacious Technologies, Chicago, IL, USA
| | - Maarten de Vos
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
- ESAT, Department of Engineering & Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Derk-Jan Dijk
- Sleep Research Centre, University of Surrey, Surrey, UK
- UK Dementia Research Institute, London, UK
| | - Nicholas C. Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - James H. MacCabe
- Department of Psychosis Studies, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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3
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Bagrowska P, Pionke-Ubych R, Majchrowicz K, Gawęda Ł. The mediating effect of negative emotions on the relationship between subjective sleep quality and paranoia-like thoughts. J Psychiatr Res 2021; 145:132-136. [PMID: 34920163 DOI: 10.1016/j.jpsychires.2021.12.003] [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: 08/03/2021] [Revised: 11/25/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022]
Abstract
Sleep quality has been found to play an important role in paranoia-like thoughts both in clinical and non-clinical populations. Previous studies have shown that the presence of negative emotional states can mediate the link between sleep and paranoia, however, their role in the linkage is still not entirely clear. Hence, our study aimed to investigate further the mediating effect of negative emotions on the relationship between sleep quality and paranoia-like thoughts on a relatively large Polish sample drawn from the general population. We collected questionnaire data assessing paranoia-like thoughts, sleep quality and quantity, and negative affect from 604 Polish adults. We performed the correlation analysis and examined the mediating role of negative emotions in the relationship between sleep quality and paranoia. The results revealed significant moderate relationships between sleep quality and paranoia-like thoughts, negative emotions and paranoia-like thoughts, as well as between negative emotions and sleep quality. A mediation model for the relationship between sleep quality and paranoia-like thoughts revealed a complementary mediation by negative affect. The findings contribute to understanding the interrelatedness between sleep quality, negative emotions, and paranoia-like thoughts, as well as emphasize the importance of negative affect in the relationship between sleep and paranoia. Future research is needed to determine other factors that contribute to understanding the linkage as well as to determine the cause and effect.
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Affiliation(s)
- Paulina Bagrowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Kinga Majchrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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4
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Scott AJ, Webb TL, Martyn-St James M, Rowse G, Weich S. Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Med Rev 2021; 60:101556. [PMID: 34607184 PMCID: PMC8651630 DOI: 10.1016/j.smrv.2021.101556] [Citation(s) in RCA: 216] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 02/07/2023]
Abstract
The extent to which sleep is causally related to mental health is unclear. One way to test the causal link is to evaluate the extent to which interventions that improve sleep quality also improve mental health. We conducted a meta-analysis of randomised controlled trials that reported the effects of an intervention that improved sleep on composite mental health, as well as on seven specific mental health difficulties. 65 trials comprising 72 interventions and N = 8608 participants were included. Improving sleep led to a significant medium-sized effect on composite mental health (g+ = -0.53), depression (g+ = -0.63), anxiety (g+ = -0.51), and rumination (g+ = -0.49), as well as significant small-to-medium sized effects on stress (g+ = -0.42), and finally small significant effects on positive psychosis symptoms (g+ = -0.26). We also found a dose response relationship, in that greater improvements in sleep quality led to greater improvements in mental health. Our findings suggest that sleep is causally related to the experience of mental health difficulties. Future research might consider how interventions that improve sleep could be incorporated into mental health services, as well as the mechanisms of action that explain how sleep exerts an effect on mental health.
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Affiliation(s)
| | - Thomas L Webb
- Department of Psychology, The University of Sheffield, UK
| | | | - Georgina Rowse
- Clinical Psychology Unit, Department of Psychology, The University of Sheffield, UK
| | - Scott Weich
- School of Health and Related Research (ScHARR), The University of Sheffield, UK
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5
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Kaida K, Kaida N. Discrepancies Between Beliefs and Practices on Sleep as a Factor of Insomnia and Negative Feelings. Psychol Rep 2021; 125:2029-2051. [PMID: 34037482 DOI: 10.1177/00332941211012626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two online surveys were conducted in Japan to develop and validate the Sleep Belief-Practice Index (SBPI) scales, a pair of new scales designed to measure beliefs (SBPI-B) and practices (SBPI-P) on sleep and its environment. Their discrepancies (SBPI-D) were calculated as differences between SBPI-B and -P. In Survey 1 (N = 400), survey data of the pilot version of the scales were entered into an exploratory factor analysis to obtain a meaningful set of scale items. In Survey 2 (N = 2952), survey data were entered into a confirmatory factor analysis and then correlation analyses to confirm associations of SBPI-D with insomnia and positive and negative feelings. Furthermore, participants were categorized into four groups according to the degree and combination of sleep beliefs and practices to compare the status of insomnia and positive and negative feelings by the groups. As a result of factor analyses, we obtained 13 common item scales of SBPI-B and -P. SBPI-D was positively correlated with insomnia and negative feelings. In addition, the group with high-scoring beliefs in SBPI-B and low-scoring practices in SBPI-P showed the most severe insomnia and negative feelings among the four groups. These results suggest that the belief-practice discrepancy about sleep can explain one aspect of insomnia.
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Affiliation(s)
- Kosuke Kaida
- Institute for Information Technology and Human Factors, 13508National Institute of Advanced Industrial Science and Technology, Japan
| | - Naoko Kaida
- Faculty of Engineering, Information and Systems, 13121University of Tsukuba, Japan
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de Crom SAM, Haan LD, Schirmbeck F. The association between sleep disturbances and negative symptom severity in patients with non-affective psychotic disorders, unaffected siblings and healthy controls. Psychiatry Res 2021; 297:113728. [PMID: 33493731 DOI: 10.1016/j.psychres.2021.113728] [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: 09/28/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
Sleep disturbances in patients with psychotic disorders are common and associated with poor clinical outcomes, but research on negative symptoms is limited. This study aimed to examine the association between subjective sleep disturbances and negative symptoms in 525 patients with non-affective psychotic disorders, 569 unaffected siblings and 265 healthy controls (HC) from the Genetic Risk and Outcome of Psychosis (GROUP) study. Several aspects of subjective sleep disturbances were assessed: sleep satisfaction, sleep onset insomnia, midnocturnal insomnia, early morning insomnia, and hypersomnia. Regression analyses revealed significant negative associations between sleep satisfaction and negative symptoms in all three groups. In addition, significant associations with sleep onset insomnia and hypersomnia were found in patients and with early morning insomnia and hypersomnia in siblings. Exploratory mediation analyses showed that depressive symptoms partly mediated all associations on the subclinical level in siblings and healthy controls, whereas only the association with sleep onset insomnia was mediated in patients. The results of this study implicate specific sleep disturbances and depressive symptoms as potential targets in prevention or intervention strategies focussed on negative symptoms in individuals suffering from, or at risk of non-affective psychotic disorders.
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Affiliation(s)
- Sophia A M de Crom
- Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Arkin Institute for Mental Health, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Arkin Institute for Mental Health, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands.
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7
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Freeman D, Loe BS, Kingdon D, Startup H, Molodynski A, Rosebrock L, Brown P, Sheaves B, Waite F, Bird JC. The revised Green et al., Paranoid Thoughts Scale (R-GPTS): psychometric properties, severity ranges, and clinical cut-offs. Psychol Med 2021; 51:244-253. [PMID: 31744588 PMCID: PMC7893506 DOI: 10.1017/s0033291719003155] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 10/02/2019] [Accepted: 10/15/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND The Green et al., Paranoid Thoughts Scale (GPTS) - comprising two 16-item scales assessing ideas of reference (Part A) and ideas of persecution (Part B) - was developed over a decade ago. Our aim was to conduct the first large-scale psychometric evaluation. METHODS In total, 10 551 individuals provided GPTS data. Four hundred and twenty-two patients with psychosis and 805 non-clinical individuals completed GPTS Parts A and B. An additional 1743 patients with psychosis and 7581 non-clinical individuals completed GPTS Part B. Factor analysis, item response theory, and receiver operating characteristic analyses were conducted. RESULTS The original two-factor structure of the GPTS had an inadequate model fit: Part A did not form a unidimensional scale and multiple items were locally dependant. A Revised-GPTS (R-GPTS) was formed, comprising eight-item ideas of reference and 10-item ideas of persecution subscales, which had an excellent model fit. All items in the new Reference (a = 2.09-3.67) and Persecution (a = 2.37-4.38) scales were strongly discriminative of shifts in paranoia and had high reliability across the spectrum of severity (a > 0.90). The R-GPTS score ranges are: average (Reference: 0-9; Persecution: 0-4); elevated (Reference: 10-15; Persecution: 5-10); moderately severe (Reference: 16-20; Persecution:11-17); severe (Reference: 21-24; Persecution: 18-27); and very severe (Reference: 25+; Persecution: 28+). Recommended cut-offs on the persecution scale are 11 to discriminate clinical levels of persecutory ideation and 18 for a likely persecutory delusion. CONCLUSIONS The psychometric evaluation indicated a need to improve the GPTS. The R-GPTS is a more precise measure, has excellent psychometric properties, and is recommended for future studies of paranoia.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S. Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - David Kingdon
- Academic Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | | | - Laina Rosebrock
- Department of Psychiatry, University of Oxford
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Poppy Brown
- Department of Psychiatry, University of Oxford
| | - Bryony Sheaves
- Department of Psychiatry, University of Oxford
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jessica C. Bird
- Department of Psychiatry, University of Oxford
- Oxford Health NHS Foundation Trust, Oxford, UK
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8
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Bidirectional pathways between psychosocial risk factors and paranoid ideation in a general nonclinical population. Dev Psychopathol 2020; 34:421-430. [PMID: 33084551 DOI: 10.1017/s0954579420001030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We investigated (a) whether psychosocial factors (experienced stress, anticipatory worry, social detachment, sleeping disturbances, alcohol use) predict the course of paranoid ideation between the ages of 24 to 50 years and (b) whether the predictive relationships are more likely to proceed from the psychosocial factors to paranoid ideation, or vice versa. The participants (N = 1534-1553) came from the population-based Young Finns study. Paranoid ideation and psychosocial factors were assessed by reliable self-report questionnaires in 2001, 2007, and 2011/2012. The data were analyzed using growth curve and structural equation models. High experienced stress, anticipatory worry, social detachment, frequent sleeping disturbances, and frequent alcohol use predicted more paranoid ideation. More risk factors predicted increasing paranoid ideation. There were bidirectional predictive relationships of paranoid ideation with experienced stress, anticipatory worry, social detachment, and sleeping disturbances. The link between alcohol use and paranoid ideation was only correlative. In conclusion, paranoid ideation increases by reciprocal interactions with stress, worry, social detachment, and sleeping disturbances. The findings support the threat-anticipation model of paranoid ideation, providing important implications for treatment of paranoia.
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9
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Waite F, Sheaves B, Isham L, Reeve S, Freeman D. Sleep and schizophrenia: From epiphenomenon to treatable causal target. Schizophr Res 2020; 221:44-56. [PMID: 31831262 PMCID: PMC7327507 DOI: 10.1016/j.schres.2019.11.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic experiences (paranoia and hallucinations). Hence sleep disruption may be a potential treatment target to prevent the onset of psychosis and reduce persistent psychotic experiences. The aim of this review is to describe developments in understanding the nature, causal role, and treatment of sleep disruption in psychosis. METHOD A systematic literature search was conducted to identify studies, published in the last five years, investigating subjective sleep disruption and psychotic experiences. RESULTS Fifty-eight papers were identified: 37 clinical and 21 non-clinical studies. The studies were correlational (n = 38; 20 clinical, 18 non-clinical), treatment (n = 7; 1 non-clinical), qualitative accounts (n = 6 clinical), prevalence estimates (n = 5 clinical), and experimental tests (n = 2 non-clinical). Insomnia (50%) and nightmare disorder (48%) are the most prevalent sleep problems found in patients. Sleep disruption predicts the onset and persistence of psychotic experiences such as paranoia and hallucinations, with negative affect identified as a partial mediator of this relationship. Patients recognise the detrimental effects of disrupted sleep and are keen for treatment. All psychological intervention studies reported large effect size improvements in sleep and there may be modest resultant improvements in psychotic experiences. CONCLUSIONS Sleep disruption is a treatable clinical problem in patients with psychosis. It is important to treat in its own right but may also lessen psychotic experiences. Research is required on how this knowledge can be implemented in clinical services.
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Affiliation(s)
- Felicity Waite
- Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK; Sleep and Circadian Neuroscience Institute, University of Oxford, UK.
| | - Bryony Sheaves
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK,Sleep and Circadian Neuroscience Institute, University of Oxford, UK
| | - Louise Isham
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK
| | | | - Daniel Freeman
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK,Sleep and Circadian Neuroscience Institute, University of Oxford, UK
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Sleep and psychotic symptoms: An actigraphy and diary study with young adults with low and elevated psychosis proneness. Schizophr Res 2020; 221:12-19. [PMID: 31796308 DOI: 10.1016/j.schres.2019.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 12/16/2022]
Abstract
Experimental research has shown that poor sleep triggers psychotic experiences, even in healthy participants. This warrants an in-depth investigation of this mechanism in a naturalistic environment, an exploration of which particular aspects of poor sleep trigger psychotic symptoms, and a test for reverse effects of symptoms on sleep. For this purpose, we conducted a 14-day ambulatory assessment study with 82 young adults (age: M = 21.24 years, SD = 1.54; 64.6% female), half of which were characterized by elevated psychosis proneness. Objective sleep parameters (actigraphically-measured sleep time, wake after sleep onset, sleep efficiency), self-reported sleep parameters (feeling rested, dream recall, dream valence), and psychotic symptoms (paranoid symptoms, hallucinatory experiences) were assessed once per day. Using multilevel regressions (928 data points), we found that shorter sleep time and negative dream valence predicted paranoid symptoms, whereas feeling less rested and dream recall predicted hallucinatory experiences. In participants with elevated psychosis proneness, associations with the aforementioned sleep parameters were increased for hallucinatory experiences but not for paranoid symptoms. Finally, we found bidirectional associations between poor sleep and paranoid symptoms but only unidirectional associations between poor sleep and hallucinatory experiences. The findings corroborate the relevance of sleep disturbance as a predictor of psychotic experiences. Future studies should further investigate the potential of sleep interventions to prevent psychotic symptoms and disorders.
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11
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Scott AJ, Flowers O, Rowse G. A comparative study of the nature and magnitude of problems sleeping in inflammatory bowel disease (IBD) compared to healthy controls. PSYCHOL HEALTH MED 2020; 25:958-968. [DOI: 10.1080/13548506.2019.1707240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Alexander J. Scott
- The School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Olivia Flowers
- The School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Georgina Rowse
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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12
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Sahbaz C, Kurtulmus A. Association between emotional functioning and biological rhythm disruptions in patients with schizophrenia. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1682853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Cigdem Sahbaz
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | - Ayse Kurtulmus
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
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13
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Lin CY, Strong C, Scott AJ, Broström A, Pakpour AH, Webb TL. A cluster randomized controlled trial of a theory-based sleep hygiene intervention for adolescents. Sleep 2019; 41:5078617. [PMID: 30423178 DOI: 10.1093/sleep/zsy170] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Indexed: 12/15/2022] Open
Abstract
Study Objectives To use theory to design and evaluate an intervention to promote sleep hygiene and health among adolescents. Methods The Theory of Planned Behavior (TPB) and the Health Action Process Approach (HAPA) were used to develop an intervention, which was then evaluated in a cluster randomized trial. Participants were high school students (N = 2,841, M age = 15.12, SD = 1.50). Adolescents in the intervention group received four face-to-face sessions providing behavior change techniques targeting the theoretical determinants of sleep hygiene. Adolescents in the control group only received educational material at the end of the study. The primary outcome was sleep hygiene measured at 1 and 6 months postintervention. A number of secondary outcomes were also measured, including beliefs about sleep, self-regulatory processes, and outcomes related to health and wellbeing. Results Sleep hygiene was improved in the intervention group when compared with the control group at both follow-up points (coefficients = 0.16 and 0.19, 95% CIs = 0.12-0.20 and 0.15-0.23 at 1 and 6 months, respectively, for scores on the Adolescent Sleep Hygiene Scale), as were psychosocial and general aspects of health. Mediation analyses suggested that beliefs about sleep hygiene as specified by the TPB, along with self-regulatory processes from HAPA, both mediated the effect of the intervention on outcomes. In turn, the effects of the intervention on sleep hygiene mediated its impact on general health. Conclusions Healthcare practitioners might consider intervention programs based on the TPB and the HAPA to improve sleep among adolescents. Clinical Trial Registration Clinicaltrials.gov (NCT02551913) https://clinicaltrials.gov/ct2/show/NCT02551913.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Alexander J Scott
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Thomas L Webb
- Department of Psychology, University of Sheffield, Sheffield, UK
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14
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Simor P, Báthori N, Nagy T, Polner B. Poor sleep quality predicts psychotic-like symptoms: an experience sampling study in young adults with schizotypal traits. Acta Psychiatr Scand 2019; 140:135-146. [PMID: 31250426 DOI: 10.1111/acps.13064] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Psychotic-like experiences (PLEs) are unusual experiences such as perceptual abnormalities and delusional-like thoughts that resemble the symptoms of psychosis at the sub-clinical level. PLEs are associated with sleep complaints in healthy and clinical samples; however, evidence for day-to-day associations between poor sleep and subsequent PLEs under naturalistic conditions is scarce. We hypothesized that poor sleep quality would predict next days' PLEs, and vice versa, daytime PLEs would be associated with worse subsequent sleep quality. METHOD Seventy-three university students with moderate to high levels of positive schizotypy participated in an experience sampling study. Participants rated their sleep each morning, as well as PLEs and affective states during the day over 3 weeks. RESULTS Multilevel regression models indicated that poor sleep quality predicted increased PLEs the following day. Poor sleep was linked to negative daytime mood that partially mediated the associations between sleep quality and next days' PLEs. Furthermore, PLEs were enhanced in the evening as compared to daytime reports. The prediction of poor sleep quality by previous days' PLEs was negligible. CONCLUSIONS The results are consistent with the position that sleep-related interventions might reduce the risk of psychosis, especially in individuals that tend to experience psychotic-like phenomena and negative affect.
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Affiliation(s)
- P Simor
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - N Báthori
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - T Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - B Polner
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
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Latif I, Hughes ATL, Bendall RCA. Positive and Negative Affect Mediate the Influences of a Maladaptive Emotion Regulation Strategy on Sleep Quality. Front Psychiatry 2019; 10:628. [PMID: 31543841 PMCID: PMC6730659 DOI: 10.3389/fpsyt.2019.00628] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/05/2019] [Indexed: 01/16/2023] Open
Abstract
Positive affect, negative affect, and emotion regulation strategies are related to sleep quality. Emotion regulation can also act as either a protective factor against the development of psychopathologies, or as a risk factor for their development, and therefore may be one mechanism linking mental health and sleep. However, currently it is not known whether affect can mediate the impact of emotion regulation strategy use on sleep quality. An opportunity sample in a healthy population completed the Positive and Negative Affect Schedule providing measures of positive and negative affect, the Pittsburgh Sleep Quality Index providing a measure of sleep quality, and the Emotion Regulation Questionnaire to record habitual use of emotion regulation strategies. Data were analysed using regression and mediation analyses. Negative affect and expressive suppression were positively correlated with PSQI score suggesting that as negative affect and expressive suppression use increased, sleep quality decreased. Positive affect was negatively correlated with PSQI score suggesting that as positive affect increased sleep quality improved. Further, mediation analyses revealed that both positive affect and negative affect mediated the impact of expressive suppression on sleep quality. Moreover, this partial mediation provides the first description that the influences of affect and expressive suppression on sleep quality are at least partially distinct. Targeting improvements in negative affect and effective emotion regulation strategy use may improve the efficacy of interventions aimed at improving sleep quality and the reduction in symptomology in psychopathologies.
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Affiliation(s)
- Iqra Latif
- Directorate of Psychology & Public Health, School of Health and Society, University of Salford, Salford, United Kingdom
| | - Alun T L Hughes
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Robert C A Bendall
- Directorate of Psychology & Public Health, School of Health and Society, University of Salford, Salford, United Kingdom
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