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Giannotta F, Nilsson KW, Åslund C, Olofdotter S, Vadlin S, Larm P. Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents. J Youth Adolesc 2024; 53:1355-1369. [PMID: 38580891 PMCID: PMC11045630 DOI: 10.1007/s10964-024-01980-1] [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: 12/22/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.
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Affiliation(s)
- F Giannotta
- Division of Public Health, School of Health, Care and Social Welfare, Malardalen University, Box 883, Västerås, Sweden.
- Department of Public Health, Stockholm University, SE-106 91, Stockholm, Sweden.
- Department of Psychology, University of Turin, via Verdi 10, 10124, Turin, Italy.
| | - K W Nilsson
- Division of Public Health, School of Health, Care and Social Welfare, Malardalen University, Box 883, Västerås, Sweden
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - C Åslund
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - S Olofdotter
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
| | - S Vadlin
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
| | - P Larm
- Department of Public Health, Stockholm University, SE-106 91, Stockholm, Sweden
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Bartlett GR, Magson NM, Richardson CE, Rapee RM, Fardouly J, Oar EL. The meditating role of sleep in the longitudinal associations between peer victimization and internalizing symptoms: A cross-lagged panel analysis. Dev Psychopathol 2024; 36:878-892. [PMID: 36855808 DOI: 10.1017/s0954579423000159] [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: 03/02/2023]
Abstract
Adolescence is a time of heightened vulnerability for both peer victimization (PV) and internalizing symptoms. While the positive association between them is well established, there is little understanding of the mechanisms underpinning this relationship. To address this gap, the current study aimed to investigate sleep hygiene and school night sleep duration as individual and sequential mediators of the relationship between PV and both depressive and social anxiety symptoms during pre- to mid-adolescence. The study drew upon a community sample of 528 Australian youth aged 10-12 years at baseline (M age = 11.19, SD = .55; 51.1% boys) and data were collected over five annual measurement occasions. Direct and indirect longitudinal and bidirectional associations were examined using cross-lagged panel analysis. There was no evidence of sequential mediation through both sleep hygiene and sleep duration to depression and social anxiety. Instead, the findings show that sleep hygiene mediated the prospective association between PV and both depressive and social anxiety symptoms, and between PV and sleep duration. Overall, sleep hygiene represents a modifiable transdiagnostic factor that can be targeted to break the cycle of PV, inadequate sleep, and internalizing symptoms.
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Affiliation(s)
- Gillian R Bartlett
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natasha M Magson
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
| | - Cele E Richardson
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
- School of Psychological Science, Centre for Sleep Science, University of Western Australia, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
- School of Psychology, University of New South Wales, Australia
| | - Ella L Oar
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
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Seaver C, Bowers C, Beidel D, Holt L, Ramakrishnan S. A game-based learning approach to sleep hygiene education: a pilot investigation. Front Digit Health 2024; 6:1334840. [PMID: 38680214 PMCID: PMC11045930 DOI: 10.3389/fdgth.2024.1334840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/22/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Sleep hygiene education (SHE) consists of environmental and behavioral practices primarily intended to reduce sleep problems. Currently considered ineffective as a stand-alone treatment, the manner in which the education is typically delivered may be ineffective for the acquisition of new knowledge. The purpose of this study was to determine if a more engaging teaching medium may improve the efficacy of sleep hygiene education. This study examined the use of game-based learning to teach SHE to individuals with sleep problems. Methods 35 participants played the SHE games for 30 days. Differences in pre- and post-state anxiety and sleep quality measures were examined. Results Participants had significant improvements in sleep quality and state anxiety after using the app for 30 days, although scores for the majority of patients remained elevated. Discussion This pilot investigation provides initial evidence for the efficacy of a game-based approach to SHE.
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Affiliation(s)
- Christine Seaver
- UCF RESTORES, University of Central Florida, Orlando, FL, United States
| | - Clint Bowers
- UCF RESTORES, University of Central Florida, Orlando, FL, United States
| | - Deborah Beidel
- UCF RESTORES, University of Central Florida, Orlando, FL, United States
| | - Lisa Holt
- BlueHalo, Rockville, MD, United States
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Jääkallio P, Kuula L, Pesonen AK. Temporal pathways between circadian rhythm, depression and anxiety in the transition from adolescence to early adulthood. J Affect Disord 2024; 350:656-664. [PMID: 38244801 DOI: 10.1016/j.jad.2024.01.141] [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: 08/30/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Sleep and circadian rhythm problems intertwine with affective disorders. Adolescents are particularly vulnerable to developing sleep and affective problems. Yet, the temporal pathways between circadian rhythm, depression and anxiety in the transition phase from adolescence to early adulthood are not fully understood. METHODS 233 adolescents (76 % females) participated at two time points (T1 and T2) at an interval of 19-months (aged 16.8 and 18.4 years). We used The Beck Depression Inventory-II, Generalized Anxiety Disorder Assessment, GENEActiv actigraphy across 8 days (delayed sleep phase (DSP), sleep duration, midpoint, and regularity), and iButton 1922L thermologgers across 3 days (intrinsic circadian period length, amplitude, and mesor). RESULTS A shorter sleep duration at T1 associated with an increase in affective problems at T2, and affective problems at T1 associated with an increase in sleep irregularity at T2. A longer circadian period at T1 associated with an increase in males' affective problems at T2. Moderate to severe depression and anxiety at T1 associated with a 2.69-fold risk (95 % CI 1.38-5.26, p = 0.004) and 2.11-fold risk (95 % CI 1.04-4.25, p = 0.038) of poor sleep quality at T2. Moderate to severe generalized anxiety associated with a 3.17-fold risk (95 % CI 1.35-7.41, p = 0.008) of DSP at T2. LIMITATIONS The follow-up period is short. CONCLUSIONS The results revealed bidirectional temporal links between sleep and affective problems. Novel observations include a heightened risk of future DSP following a current anxiety disorder and a heightened risk of affective problems following a longer circadian period measured from the 24-hour temperature variation in males.
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Affiliation(s)
- Pirita Jääkallio
- Faculty of Medicine, SleepWell Research Program, University of Helsinki, Finland
| | - Liisa Kuula
- Faculty of Medicine, SleepWell Research Program, University of Helsinki, Finland
| | - Anu-Katriina Pesonen
- Faculty of Medicine, SleepWell Research Program, University of Helsinki, Finland.
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Zink J, O'Connor SG, Blachman-Demner DR, Wolff-Hughes DL, Berrigan D. Examining the Bidirectional Associations Between Sleep Duration, Screen Time, and Internalizing Symptoms in the ABCD Study. J Adolesc Health 2024; 74:496-503. [PMID: 37855753 PMCID: PMC10872986 DOI: 10.1016/j.jadohealth.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/10/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE The likelihood of meeting sleep duration and screen time guidelines decreases as children develop toward adolescence. Simultaneously, the prevalence of internalizing symptoms increases. The purpose of this paper was to examine the bidirectional associations between sleep duration and screen time with internalizing symptoms in a one-year longitudinal study starting in late childhood. METHODS Participants were 10,828 youth (47.8% female) enrolled in the Adolescent Brain Cognitive Development Study. At baseline (mean age 9.9 years) and one-year follow-up (mean age 10.9 years), youth self-reported screen time for weekdays and weekend days. Responses were separately dichotomized as >2 versus ≤2 hours/day (meeting behavioral guidelines). Caregiver-reported youth sleep duration was dichotomized as <9 versus 9-11 hours/night (meeting behavioral guidelines). Caregivers reported internalizing symptoms via the child behavior checklist. The withdrawn/depressed, anxious/depressed, and somatic symptom child behavior checklist subscale t-scores were separately dichotomized as ≥65 (borderline clinical levels of symptoms and above) versus <65. Analyses were gender-stratified. RESULTS In females, longer baseline sleep duration was protective against withdrawn/depressed symptoms (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.4-0.8) and somatic complaints (OR 0.8, 95% CI 0.6-0.97) one year later. In females, greater baseline weekend screen time was associated with increased risk of withdrawn/depressed symptoms (OR 1.6, 95% CI 1.1-2.2) one year later. No other significant associations were observed. DISCUSSION Longitudinal associations between sleep duration, weekend screen time, and internalizing symptoms were unidirectional (behavior preceding internalizing symptoms), among females only, and specific to withdrawn/depressed and somatic symptoms. These prospective study findings warrant attention and inform future research in this cohort.
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Affiliation(s)
- Jennifer Zink
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
| | - Sydney G O'Connor
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Dara R Blachman-Demner
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland
| | - Dana L Wolff-Hughes
- Division of Cancer Control and Population Sciences, Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - David Berrigan
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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Lawrence-Sidebottom D, Huffman LG, Beam A, Parikh A, Guerra R, Roots M, Huberty J. Improvements in sleep problems and their associations with mental health symptoms: A study of children and adolescents participating in a digital mental health intervention. Digit Health 2024; 10:20552076241249928. [PMID: 38736734 PMCID: PMC11084994 DOI: 10.1177/20552076241249928] [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: 09/08/2023] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
Objective A growing number of youth are utilizing digital mental health interventions (DMHIs) for treatment of mental health problems such as anxiety, depression, and ADHD. Although these mental health symptoms are closely related to sleep problems, it is unknown whether nonsleep DMHIs indirectly confer improvements in sleep. Using retrospective data, the current study assesses (1) whether youth sleep problems improve over participation in a nonsleep DMHI, and (2) whether mental health symptom severity and improvement are correlated with sleep problem severity over time. Methods Sleep problems and mental health symptoms were assessed every 30 days among children (ages 5-12) and adolescents (ages 13-17) participating in a pediatric digital mental health intervention (DMHI; N = 1219). Results Children and adolescents with elevated sleep problems (39.3%; n = 479) were older (P < .001), more predominantly female (P < .001), and more likely to have elevated anxiety (P < .001), depressive (P < .001) and inattention symptoms (P = .001), as compared to those with nonelevated sleep problems (60.7%; n = 740). From the baseline to last assessment, 77.3% (n = 269) of members with elevated sleep problems exhibited improvements, with sleep problems decreasing significantly over each month in care (P < .001). Members with improvements in anxiety, depressive, and/or ADHD symptoms had larger improvements in sleep over time compared to their peers with no improvement in their mental health symptoms (Months in care*Change type: P < .001 for all). Conclusions Our results provide preliminary evidence that participation in a pediatric DMHI is associated with improvements in sleep problems, even when youth are not being treated directly for sleep problems. These findings highlight a valuable secondary benefit of participating in mental health care within pediatric DMHIs and warrant further experimental research.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc., Madison, WI, USA
- FitMinded Inc., Phoenix, AZ, USA
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Mathew GM, Reichenberger DA, Master L, Buxton OM, Chang AM, Hale L. Actigraphic Sleep Variability is Associated With Lower Positive Mood in Adolescents. J Adolesc Health 2023; 73:478-485. [PMID: 37410005 PMCID: PMC10524712 DOI: 10.1016/j.jadohealth.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/11/2023] [Accepted: 04/11/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Poor sleep health is associated with lower positive mood in adolescents, and more variable sleep is associated with more negative mood. There is a lack of research on the associations between sleep variability and positive mood in adolescents. We investigated whether several types of sleep variability, measured with actigraphy, were associated with positive mood reported on a daily diary in adolescents. METHODS Data were collected from a substudy of the Year 15 wave of the Future of Families and Child Wellbeing Study (n = 580; 53% female, mean age ± standard deviation [SD] = 15.4 ± 0.5 years, range 14.7-17.7). Adolescents wore an actigraphy device (M ± SD = 5.6 ± 1.4 nights per adolescent, range: 3-10) and completed daily diaries (M ± SD = 5.5 ± 1.4 days per adolescent, range: 3-9) for ∼1 week, where they rated their levels of happiness and excitement during that day from 0 (not at all) to 4 (extremely). Happiness and excitement were averaged into "positive mood." Separate linear regression models assessed whether actigraphy-measured variability of sleep duration, onset, and offset (residual individual standard deviation, riSD), sleep regularity index, social jetlag, and free night catch-up sleep were associated with average positive mood per person. Analyses adjusted for age, birth sex, race/ethnicity, household income, and the primary caregiver's education level. RESULTS Greater variability in sleep duration (p = .011, β = -0.11) and lower sleep regularity index (p = .034, β = 0.09) were associated with lower ratings of positive mood. There were no other significant associations (p ≥ .10). DISCUSSION Variable and irregular sleep are associated with lower levels of positive mood in adolescence, which may increase the risk of poor emotional health in adulthood.
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Affiliation(s)
- Gina Marie Mathew
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York.
| | - David A Reichenberger
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Lindsay Master
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Orfeu M Buxton
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Anne-Marie Chang
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
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Anan YH, Kahn NF, Garrison MM, McCarty CA, Richardson LP. Associations Between Sleep Duration and Positive Mental Health Screens During Adolescent Preventive Visits in Primary Care. Acad Pediatr 2023; 23:1242-1246. [PMID: 36905952 DOI: 10.1016/j.acap.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE The purpose of this paper was to understand associations between low sleep duration (<8.ßhours) and positive mental health screens among adolescents (ages 13...18) seen for preventive visits in primary care. METHODS Data were from two randomized controlled trials testing the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. Participants (n.ß=.ß601) completed screeners at baseline, 3 months, and 6 months which included sleep duration in hours and the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 screeners for depression and anxiety, respectively. Main analyses included adjusted logistic regressions testing associations between low sleep duration and positive mental health screens. RESULTS Adjusted models showed that low sleep duration was associated with significantly greater odds of a positive depression screen (OR.ß=.ß1.58, 95% CI: 1.06...2.37) but not with a positive anxiety screen or co-occurring positive depression and anxiety screens. However, follow-up analyses indicated an interaction between sleep duration and anxiety in the association with a positive depression screen, such that the association between low sleep and a positive depression screen was driven by those who did not screen positive for anxiety. CONCLUSIONS As pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are warranted to ensure effective early intervention for sleep and mental health problems during adolescence.
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Affiliation(s)
- Yomna H Anan
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash.
| | - Nicole F Kahn
- Division of Adolescent Medicine (NF Kahn, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Hospital, Wash
| | - Michelle M Garrison
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash; Department of Health Systems and Population Health (MM Garrison), University of Washington School of Public Health, Seattle; Division of Child & Adolescent Psychiatry (MM Garrison), Seattle Children...s Hospital, Wash
| | - Carolyn A McCarty
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash; Division of Adolescent Medicine (NF Kahn, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Hospital, Wash
| | - Laura P Richardson
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash; Division of Adolescent Medicine (NF Kahn, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Hospital, Wash
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Saunders R, Liu Y, Delamain H, O'Driscoll C, Naqvi SA, Singh S, Stott J, Wheatley J, Pilling S, Cape J, Buckman JEJ. Examining bi-directional change in sleep and depression symptoms in individuals receiving routine psychological treatment. J Psychiatr Res 2023; 163:1-8. [PMID: 37178582 PMCID: PMC10643991 DOI: 10.1016/j.jpsychires.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/03/2023] [Accepted: 05/01/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Sleep disturbance is a common symptom of depression. There is conflicting evidence whether improvements in sleep might impact depressive symptoms, or whether treating the core depressive symptoms might improve sleep disturbance. This study explored the bi-directional impact of sleep and depressive symptom change among individuals receiving psychological treatment. METHODS Session-by-session change in sleep disturbance and depressive symptom severity scores were explored in patients receiving psychological therapy for depression from Improving Access to Psychological Therapies services in England. Bi-directional change in sleep disturbance and depressive symptoms was modelled using random-intercept cross-lagged panel models with items from the PHQ-9. RESULTS The sample included 17,732 adults that had received three or more treatment sessions. Both depressive symptoms and sleep disturbance scores decreased. Between initial timepoints, higher sleep disturbance was associated with lower depression scores, but after this point positive cross-lagged effects were observed for both the impact of sleep disturbance on later depressive symptoms, and depressive symptoms on later sleep disturbance scores. The magnitude of effects suggested depressive symptoms may have more impact on sleep than the reverse, and this effect was larger in sensitivity analyses. CONCLUSIONS Findings provide evidence that psychological therapy for depression results in improvements in core depressive symptoms and sleep disturbance. There was some evidence that depressive symptoms may have more impact on sleep disturbance scores at the next therapy session, than sleep disturbance does on later depressive symptoms. Targeting the core symptoms of depression initially may optimise outcomes, but further research is needed to elucidate these relationships.
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Affiliation(s)
- R Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom.
| | - Y Liu
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom
| | - H Delamain
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom
| | - C O'Driscoll
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom
| | - S A Naqvi
- Barking & Dagenham and Havering IAPT Services - North East London NHS Foundation Trust, London, United Kingdom
| | - S Singh
- Waltham Forest Talking Therapies - North East London NHS Foundation Trust, London, United Kingdom
| | - J Stott
- ADAPTlab, Research Department of Clinical Educational and Health Psychology, UCL, London, United Kingdom
| | - J Wheatley
- Talk Changes: City & Hackney IAPT Service - Homerton University Hospital NHS Foundation Trust, London, United Kingdom
| | - S Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom; Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - J Cape
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom
| | - J E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom; iCope -Camden and Islington Psychological Therapies Services - Camden & Islington NHS Foundation Trust, London, United Kingdom
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Tadesse A, Badasso K, Edmealem A. Poor Sleep Quality and Associated Factors among People Living with HIV/AIDS Attending ART Clinic at Tirunesh Beijing Hospital, Addis Ababa, Ethiopia. AIDS Res Treat 2023; 2023:6381885. [PMID: 37359994 PMCID: PMC10289871 DOI: 10.1155/2023/6381885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/18/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023] Open
Abstract
Background Sleep is a universal need of all higher life forms, including humans. However, sleep problems are one of the most common problems raised by patients living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Poor sleep quality is one of the hidden and unrecognized factors contributing to poor medication adherence and functional inactivity among people living with human immunodeficiency virus/acquired immunodeficiency syndrome. Methods A hospital-based cross-sectional study was conducted from April 15, 2022, to May 30, 2022, at an antiretroviral therapy (ART) clinic of Tirunesh Beijing Hospital. A systematic sampling technique was used to select study participants. A total of 413 people who are living with human immunodeficiency virus/acquired immunodeficiency syndrome were enrolled in the study. Data were collected through interviews when study participants finished their visit. Variables whose P value was less than 0.2 in bivariable logistic regression were entered into multivariable binary logistic regression to identify factors associated with poor sleep quality. Result The level of poor sleep quality among people living with HIV/AIDS was 73.7%. People living with HIV/AIDS who had poor sleep hygiene were 2.5 times more likely to have poor sleep quality compared with those patients who had good sleep hygiene. Moreover, study participants who had anxiety were three times more likely to have poor sleep quality compared with those who did not have anxiety (AOR: 3.09; 95% CI = 1.61-5.89). Study participants who had chronic diseases in addition to HIV/AIDS were 3 times more likely to have poor sleep quality compared with those who do not have it (AOR: 2.99; 95% CI = 1.15-7.79). Additionally, people living with HIV/AIDS who were stigmatized due to their disease were 2.5 times more likely to have poor sleep quality compared with their counterparts (AOR = 2.49; 95% CI = 1.43-4.21). Conclusion In this study, the magnitude of poor sleep quality among people living with HIV/AIDS was high. Being a farmer, being a merchant, having chronic diseases, having anxiety, having a CD4 count of 200-499 cells/mm3, being stigmatized, and having poor sleep hygiene were factors that had an association with poor sleep quality. Healthcare providers should screen people living with HIV/AIDS for anxiety and encourage them to practice good sleep hygiene during follow-up.
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Affiliation(s)
| | - Kufa Badasso
- Department of Psychiatry, Menelik II Health Science College, Addis Ababa, Ethiopia
| | - Afework Edmealem
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
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Cooper R, Di Biase MA, Bei B, Quach J, Cropley V. Associations of Changes in Sleep and Emotional and Behavioral Problems From Late Childhood to Early Adolescence. JAMA Psychiatry 2023; 80:585-596. [PMID: 37017952 PMCID: PMC10077137 DOI: 10.1001/jamapsychiatry.2023.0379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/29/2023] [Indexed: 04/06/2023]
Abstract
Importance Sleep problems and psychopathology symptoms are highly comorbid and bidirectionally correlated across childhood and adolescence. Whether these associations are specific to discrete profiles of sleep problems and specific internalizing and externalizing phenomena is currently unclear. Objective To characterize individual changes in profiles of sleep problems and their prospective associations with psychopathology symptoms across the transition from childhood to adolescence. Design, Setting, and Participants This observational cohort study used baseline data (participant age of 9 to 11 years) and 2-year follow-up data (participant age of 11 to 13 years) from the community-setting, multicenter Adolescent Brain Cognitive Development (ABCD) study. Individuals were assessed for a range of sleep problems at both waves and categorized into profiles via latent profile analysis. The stability and change in these profiles over time was assessed via latent transition analysis. Logistic regression models examined whether psychopathology symptoms were cross-sectionally associated with profile membership and whether transitions between profiles were associated with changes psychopathology symptoms over time. Data were collected from September 2016 to January 2020, and data were analyzed from August 2021 to July 2022. Exposures Sleep problems were assessed at both baseline and follow-up via the parent-reported Sleep Disturbance Scale for Children (SDSC). Main Outcomes and Measures Psychopathology symptoms at both baseline and follow-up were assessed using the internalizing and externalizing dimension scores derived from the parent-reported Child Behavior Checklist. Results A total of 10 313 individuals (4913 [47.6%] were female) were categorized into 4 latent profiles of sleep problems at both baseline and follow-up: a low disturbance profile, a sleep onset/maintenance problems profile, a moderate and nonspecific disturbance profile (termed mixed disturbance), and a high disturbance profile. Individuals in the 3 more severe problem profiles displayed greater risk of concurrent internalizing symptoms (sleep onset/maintenance problems: odds ratio [OR], 1.30; 95% CI, 1.25-1.35; P < .001; mixed disturbance: OR, 1.29; 95% CI, 1.25-1.33; P < .001; high disturbance: OR, 1.44; 95% CI, 1.40-1.49; P < .001) and externalizing symptoms (sleep onset/maintenance problems: OR, 1.20; 95% CI, 1.16-1.23; P < .001; mixed disturbance: OR, 1.17; 95% CI, 1.14-1.20; P < .001; high disturbance: OR, 1.24; 95% CI, 1.21-1.28; P < .001). Transitions between sleep profiles over time were associated with prospective internalizing and externalizing symptoms, but not vice versa. Conclusions and Relevance There are substantial changes in sleep problems across the transition to adolescence that are associated with later internalizing and externalizing symptoms. Sleep profiles could be targeted in future intervention and treatment programs to improve sleep-related and mental health-related outcomes across development.
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Affiliation(s)
- Rebecca Cooper
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Maria A. Di Biase
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, Australia
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jon Quach
- Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
- Learning Intervention, Melbourne Graduate School of Education, The University of Melbourne, Parkville, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia
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12
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Sleep and Mental Health Problems in Children and Adolescents. Sleep Med Clin 2023; 18:245-254. [PMID: 37120167 DOI: 10.1016/j.jsmc.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Previous reviews have described the links between sleep and mental health extensively. In this narrative review, we focus on literature published during the last decade investigating the links between sleep and mental health difficulties in childhood and adolescence. More specifically, we focus on the mental health disorders listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders. We also discuss possible mechanisms underlying these associations. The review ends with a discussion of possible future lines of enquiry.
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13
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Cepuch G, Kruszecka-Krówka A, Liber P, Micek A. Association between Suicidal Behaviors in Adolescence and Negative Emotions, the Level of Stress, Stress Coping Strategies and the Quality of Sleep. Healthcare (Basel) 2023; 11:healthcare11030306. [PMID: 36766881 PMCID: PMC9914235 DOI: 10.3390/healthcare11030306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Suicidal behaviors in adolescents stem from complex processes deeply rooted in various spheres of life and functioning. The study was aimed at assessing the relationship between selected negative emotions, the quality of sleep, the level of perceived stress as well as stress coping strategies and suicidal ideation and attempts among high school students. The examined group consisted of adolescents aged 16-18 recruited by social-media groups in Poland. The study was based on a diagnostic survey with the application of CAWI method. The other research tools applied in the study included: Hospital Anxiety and Depression Scale-Modified, Perceived Stress Scale-10, How do you cope?-Questionnaire, Athens Insomnia Scale as well as the authors' own questionnaire on suicidal ideation and suicide attempts. Anxiety, depression, aggression and insomnia as well as a high level of stress were statistically more common in girls than in boys (p < 0.001). The high level of negative emotions and insomnia, in turn, increased the risk of suicidal ideation (OR = 3.59, 95% CI: 2.13-6.06 and OR = 2.35, 95% CI: 1.60-3.46), as well as suicide attempts (OR = 6.29, 95% CI: 2.93-14.80 and OR = 3.29, 95% CI: 2.07-5.35). Additionally, high level of stress was associated with more than twice larger odds of suicidal ideation (OR = 2.26, 95% CI: 1.13-4.63). Significantly higher prevalence of suicidal ideation (p = 0.017) and suicide attempts (p = 0.016) was observed in girls. A high level of negative emotions and stress accompanied by a low quality of sleep are factors predisposing people to suicidal ideation and attempted suicide.
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14
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Slavish DC, Ruggero CJ, Briggs M, Messman BA, Contractor AA, Miao J, Oltmanns JR, Waszczuk MA, Luft BJ, Kotov R. Longitudinal associations between PTSD and sleep disturbances among World Trade Center responders. Sleep Med 2023; 101:269-277. [PMID: 36462305 DOI: 10.1016/j.sleep.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/28/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE/BACKGROUND Post-traumatic stress disorder (PTSD) is characterized by substantial disruptions in sleep quality, continuity, and depth. Sleep problems also may exacerbate PTSD symptom severity. Understanding how PTSD and sleep may reinforce one another is critical for informing effective treatments. PATIENTS/METHODS In a sample of 452 World Trade Center 9/11 responders (mean age = 55.22, 89.4% male, 66.1% current or former police), we examined concurrent and cross-lagged associations between PTSD symptom severity, insomnia symptoms, nightmares, and sleep quality at 3 time points ∼1 year apart. Data were analyzed using random intercept cross-lagged panel models. RESULTS PTSD symptom severity and sleep variables were relatively stable across time (intraclass correlation coefficients: 0.63 to 0.84). Individuals with more insomnia symptoms, more nightmares, and poorer sleep quality had greater PTSD symptom severity, on average. Within-person results revealed that greater insomnia symptoms and nightmares at Time 1 were concurrently associated with greater PTSD symptoms at Time 1. Insomnia symptoms were also concurrently associated with PTSD symptoms at Times 2 and 3, respectively. Cross-lagged and autoregressive results revealed that PTSD symptoms and nightmares predicted nightmares at the next timepoint. CONCLUSIONS Overall, results suggest PTSD and sleep problems may be linked at the same point in time but may not always influence each other longitudinally. Further, individuals who experience more sleep disturbances on average may suffer from more debilitating PTSD. Evidence-based treatments for PTSD may consider incorporating treatment of underlying sleep disturbances and nightmares.
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Affiliation(s)
- Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, 76203, USA.
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, TX, 76203, USA.
| | - Madasen Briggs
- Department of Psychology, University of North Texas, Denton, TX, 76203, USA.
| | - Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, 76203, USA.
| | - Ateka A Contractor
- Department of Psychology, University of North Texas, Denton, TX, 76203, USA.
| | - Jiaju Miao
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Joshua R Oltmanns
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA.
| | - Benjamin J Luft
- Department of Medicine, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, 11794, USA.
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15
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Sutherland BD, Viera Perez PM, Crooks KE, Flannery JS, Hill-Bowen LD, Riedel MC, Laird AR, Trucco EM, Sutherland MT. The association of amygdala-insula functional connectivity and adolescent e-cigarette use via sleep problems and depressive symptoms. Addict Behav 2022; 135:107458. [PMID: 35998541 PMCID: PMC9730909 DOI: 10.1016/j.addbeh.2022.107458] [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: 02/17/2022] [Revised: 06/16/2022] [Accepted: 08/02/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Adolescent electronic cigarette (e-cigarette) use remains high. Elucidating contributing factors may enhance prevention strategies. Neurobiologically, amygdala-insula resting-state functional connectivity (rsFC) has been linked with aspects of sleep, affect, and substance use (SU). As such, we hypothesized that amygdala's rsFC with the insula would be associated with e-cigarette use via sleep problems and/or depression levels. METHODS An adolescent sample (N = 146) completed a rs-fMRI scan at time 1 and self-reports at time 2 (∼15 months later). Given consistent associations between mental health outcomes and the rsFC of the laterobasal amygdala (lbAMY) with the anterior insula, we utilized a seed region (lbAMY) to region of interest (ROI) analysis approach to characterize brain-behavior relationships. Two serial mediation models tested the interrelations between amygdala's rsFC with distinct anterior insula subregions (i.e., ventral insula [vI], dorsal insula [dI]), sleep problems, depression levels, and days of e-cigarette use. RESULTS An indirect effect was observed when considering the lbAMY's rsFC with the vI. Greater rsFC predicted more sleep problems, more sleep problems were linked with greater depressive symptoms, and greater depressive symptoms were associated with more e-cigarette use (indirect effect = 0.08, CI [0.01,0.21]). Indicative of a neurobiological dissociation, a similar indirect effect linking these variables was not observed when considering the lbAMY's rsFC with the dI (indirect effect = 0.03, CI [-0.001,0.10]). CONCLUSIONS These outcomes highlight functional interactions between the amygdala and insula as a neurobiological contributor to sleep problems, depressive symptoms, and ultimately SU thereby suggesting potential intervention points to reduce teen e-cigarette use.
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Affiliation(s)
| | | | - Katharine E Crooks
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Jessica S Flannery
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, United States
| | - Lauren D Hill-Bowen
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael C Riedel
- Department of Physics, Florida International University, Miami, FL, United States
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, United States
| | - Elisa M Trucco
- Department of Psychology, Florida International University, Miami, FL, United States; Addiction Center, University of Michigan, Ann Arbor, MI, United States; Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, Miami, FL, United States
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16
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Longitudinal Associations Between Peer Victimization and Emotional Difficulties in Schoolchildren: The Role of Sleep Quality. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-022-09558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Caycho-Rodríguez T, Ventura-León J, Valencia PD, Vilca LW, Carbajal-León C, Reyes-Bossio M, Delgado-Campusano M, Rojas-Jara C, Polanco-Carrasco R, Gallegos M, Cervigni M, Martino P, Palacios DA, Moreta-Herrera R, Samaniego-Pinho A, Elías Lobos Rivera M, Figares AB, Puerta-Cortés DX, Corrales-Reyes IE, Calderón R, Tapia BP, Arias Gallegos WL, Petzold O. Network analysis of the relationships between conspiracy beliefs towards COVID-19 vaccine and symptoms of fear of COVID-19 in a sample of latin american countries. CURRENT PSYCHOLOGY 2022:1-16. [PMID: 36090914 PMCID: PMC9449951 DOI: 10.1007/s12144-022-03622-w] [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: 05/25/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/19/2022]
Abstract
The present study examined how conspiracy beliefs about COVID-19 vaccines specifically relate to symptoms of fear of COVID-19 in a sample of four South American countries. A total of 1785 people from Bolivia, Colombia, Ecuador, and Peru participated, responding to a sociodemographic survey, the Fear of COVID-19 scale (FCV-19 S) and the Vaccine Conspiracy Beliefs Scale-COVID-19 (VCBS-COVID-19). Network analysis identified the most important symptoms of fear and conspiracy beliefs about COVID-19 vaccines (nodes) and the associations between them (edges). In addition, the robustness of the network of these indicators of centrality and the possible differences in the structure and connectivity of the networks between the four countries were evaluated. The results suggest that the nodes with the highest centrality were items 2 and 5 of the FCV-19 S and item 2 of the VCBS-COVID-19. Likewise, item 6 is the belief that most predicts conspiracy beliefs about vaccines against COVID-19; while item 6 was the symptom that most predicts fear of COVID-19. The findings strongly support cross-cultural similarities in the networks across the four countries rather than differences. Although it was expected that a higher presence of symptoms of fear of COVID-19 may lead people to compensate for their fear by believing in conspiratorial ideas about vaccines and, consequently, rejecting the COVID-19 vaccine, the results do not clearly show this relationship. This could lead other researchers to generate evidence to explain the differences between Latin American countries and countries in other contexts in terms of vaccination rates. This evidence could be useful to develop policies favoring vaccination against COVID-19 that are more contextualized to the Latin American region, characterized by social instability and economic recession during the pandemic.
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Affiliation(s)
- Tomás Caycho-Rodríguez
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Av. Alfredo Mendiola, 6062 Lima, Los Olivos Peru
| | - José Ventura-León
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Pablo D. Valencia
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de Mexico, Tlanepantla de Baz, State of Mexico Mexico
| | - Lindsey W. Vilca
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | | | - Mario Reyes-Bossio
- Facultad de Psicología, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Claudio Rojas-Jara
- Facultad de Ciencias de la Salud. Departamento de Psicología, Universidad Católica del Maule, Talca, Chile
| | | | - Miguel Gallegos
- Facultad de Ciencias de la Salud. Departamento de Psicología, Universidad Católica del Maule, Talca, Chile
- Pontificia Universidade Católica de Minas Gerais, Belo Horizonte, Brasil
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
| | - Mauricio Cervigni
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento, Universidad Adventista del Plata, Consejo Nacional de Investigaciones Científicas y Técnicas, Rosario, Argentina
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
| | - Pablo Martino
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Argentina
| | | | | | - Antonio Samaniego-Pinho
- Carrera de Psicología, Facultad de Filosofía, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Marlon Elías Lobos Rivera
- Escuela de Psicología, Facultad de Ciencias Sociales, Universidad Tecnológica de El Salvador, San Salvador, El Salvador
| | | | | | - Ibraín Enrique Corrales-Reyes
- Servicio de Cirugía Maxilofacial, Hospital General Universitario Carlos Manuel de Céspedes, Universidad de Ciencias Médicas de Granma, Bayamo, Granma, Cuba
| | - Raymundo Calderón
- Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad del Valle de Mexico, Ciudad de Mexico, Mexico
| | - Bismarck Pinto Tapia
- Carrera de Psicología, Universidad Católica Boliviana San Pablo, La Paz, Bolivia
| | | | - Olimpia Petzold
- Lone Star College-Conroe Center, Conroe, TX USA
- Université Libre de Bruxelles, Brussels, Belgium
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Akbar SA, Mattfeld AT, Laird AR, McMakin DL. Sleep to Internalizing Pathway in Young Adolescents (SIPYA): A proposed neurodevelopmental model. Neurosci Biobehav Rev 2022; 140:104780. [PMID: 35843345 PMCID: PMC10750488 DOI: 10.1016/j.neubiorev.2022.104780] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/28/2023]
Abstract
The prevalence of internalizing disorders, i.e., anxiety and depressive disorders, spikes in adolescence and has been increasing amongst adolescents despite the existence of evidence-based treatments, highlighting the need for advancing theories on how internalizing disorders emerge. The current review presents a theoretical model, called the Sleep to Internalizing Pathway in Young Adolescents (SIPYA) Model, to explain how risk factors, namely sleep-related problems (SRPs), are prospectively associated with internalizing disorders in adolescence. Specifically, SRPs during late childhood and early adolescence, around the initiation of pubertal development, contribute to the interruption of intrinsic brain networks dynamics, both within the default mode network and between the default mode network and other networks in the brain. This interruption leaves adolescents vulnerable to repetitive negative thought, such as worry or rumination, which then increases vulnerability to internalizing symptoms and disorders later in adolescence. Sleep-related behaviors are observable, modifiable, low-stigma, and beneficial beyond treating internalizing psychopathology, highlighting the intervention potential associated with understanding the neurodevelopmental impact of SRPs around the transition to adolescence. This review details support for the SIPYA Model, as well as gaps in the literature and future directions.
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Affiliation(s)
- Saima A Akbar
- Department of Psychology, Florida International University, Miami, FL, USA.
| | - Aaron T Mattfeld
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
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Physical multimorbidity predicts the onset and persistence of anxiety: A prospective analysis of the Irish Longitudinal Study on Ageing. J Affect Disord 2022; 309:71-76. [PMID: 35452758 DOI: 10.1016/j.jad.2022.04.022] [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: 12/30/2021] [Revised: 04/02/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aims of the present study were to examine prospective associations of multimorbidity (i.e., ≥2 chronic conditions) at baseline with incident and persistent anxiety over a two-year follow-up period among Irish older adults, and to quantify the extent to which sleep, pain, and disability mediate the multimorbidity-anxiety relationship. METHODS Data from The Irish Longitudinal Study on Aging (TILDA) conducted between 2009 and 2011 with a follow-up after two years were analyzed. Anxiety referred to score ≥ 8 on the anxiety section of the Hospital Anxiety and Depression Scale. Lifetime diagnosis of 14 chronic conditions was obtained. Outcomes were incident and persistent anxiety at two-year follow-up. RESULTS Data on 5871 adults aged ≥50 years at baseline were analyzed [Mean (SD) age 63.3 (9.0) years; 51.2% women]. After adjustment for potential confounders, compared to no chronic physical conditions at baseline, ≥3 chronic conditions were associated with a significant 1.89 (95% CI = 1.16-3.08) times higher risk for new onset anxiety at follow-up. Furthermore, having 1, 2, and ≥3 conditions at baseline were associated with significant 1.48 (95% CI 1.02, 2.14), 1.74 (95% CI 1.19, 2.53), and 1.84 (95% CI 1.27, 2.68) times higher risk for persistent anxiety at follow-up. Sleep problems, pain, and disability were identified as significant mediators, explaining 22.9%-37.8% of the associations. CONCLUSION Multimorbidity was associated with both new onset and persistent anxiety among Irish older adults. Future interventional studies should examine whether addressing the identified mediators may lead to lower risk for incident or persistent anxiety among those with physical multimorbidity.
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Žilinskas E, Puteikis K, Mameniškienė R. Quality of Sleep and Work Productivity among White-Collar Workers during the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070883. [PMID: 35888602 PMCID: PMC9323147 DOI: 10.3390/medicina58070883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 12/01/2022]
Abstract
Background and Objectives: The COVID-19 pandemic has disrupted routine sleep and work patterns in the general population. We conducted an anonymous online survey among white-collar workers from various finance, IT and technology companies in Lithuania to define factors associated with worse sleep quality and diminished productivity during a COVID-19 lockdown. Materials and Methods: Employees of selected companies in Lithuania completed an anonymous questionnaire online that included the Pittsburgh Sleep Quality Index (PSQI), The Sleep Locus of Control (SLOC), the Generalized Anxiety Disorder Scale-7 (GAD-7), and the World Health Organization’s Health and Work Performance Questionnaire (WHO-HPQ). Respondents also provided information about their sleep hygiene, physical activity and alcohol use. Results: Data of 114 respondents (56, 49.1% male) were used for analysis. Among them, 49 (43.0%) suffered from poor sleep and 29 (25.4%) had clinically relevant levels of anxiety. However, there were only negligible levels of absenteeism in the sample (a median of zero hours of work lost over the past month). In a stepwise linear regression model (F(5,108) = 11.457, p < 0.001, R2adj = 0.316), high levels of anxiety, daily hours spent using the screen, use of electronic devices in the bedroom, smoking in the evening, and COVID-19-related changes in appetite were associated with worse sleep quality. Absenteeism was associated with physical activity of moderate intensity and decreased self-reported productivity during the pandemic (F(2,111) = 7.570, p = 0.001, R2adj = 0.104). However, there was no strong relationship between sleep-related variables (i.e., sleep hygiene, sleep locus of control, quality of sleep) or levels of anxiety and measures of work productivity. Conclusions: Our findings suggest that while bad sleep hygiene, anxiety, and changes in appetite are associated with worse sleep quality among white-collar workers during the pandemic, work productivity may remain high irrespective of disrupted sleep.
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Affiliation(s)
- Emilijus Žilinskas
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (E.Ž.); (K.P.)
| | - Kristijonas Puteikis
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (E.Ž.); (K.P.)
| | - Rūta Mameniškienė
- Center for Neurology, Vilnius University, 08661 Vilnius, Lithuania
- Correspondence:
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21
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Vazsonyi AT, Liu D, Blatny M. Longitudinal bidirectional effects between sleep quality and internalizing problems. J Adolesc 2022; 94:448-461. [DOI: 10.1002/jad.12039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/05/2022] [Accepted: 02/23/2022] [Indexed: 11/06/2022]
Affiliation(s)
| | - Dan Liu
- Department of Family Sciences University of Kentucky Lexington Kentucky USA
| | - Marek Blatny
- Department of Psychology Masaryk University Brno Czech Republic
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22
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Kelly RJ, Zeringue MM, El-Sheikh M. Adolescents' sleep and adjustment: Reciprocal effects. Child Dev 2022; 93:540-555. [PMID: 34757645 PMCID: PMC8930734 DOI: 10.1111/cdev.13703] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Reciprocal relations between sleep and adjustment were investigated. Participants included 246 adolescents (M = 15.80 years; 67.5% White, 32.5% Black/African American; 53% female, 47% male) at Time 1 (data collected 2012-2013), 227 at Time 2 (M = 16.78 years) and 215 at Time 3 (M = 17.70 years). Sleep-wake variables were measured with self-reports (sleepiness) and actigraphy (average sleep minutes and efficiency, variability in sleep minutes and efficiency). Adolescents reported on depression and anxiety symptoms, and parents reported on externalizing problems. Greater variability in sleep duration and efficiency as well as sleepiness predicted adjustment problems (range of R2 : 36%-60%). Reciprocal relations were supported mostly for sleepiness (range of R2 : 16%-32%). Results help understand bidirectional relations between sleep and adjustment.
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Affiliation(s)
- Ryan J. Kelly
- Department of Individual, Family and Community Education, University of New Mexico
| | - Megan M. Zeringue
- Department of Human Development and Family Studies, Auburn University
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University
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23
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Kim H, Kim SH, Jang SI, Park EC. Association between sleep quality and anxiety in South Korean adolescents. J Prev Med Public Health 2022; 55:173-181. [PMID: 35391529 PMCID: PMC8995938 DOI: 10.3961/jpmph.21.498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/06/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives Anxiety disorder is among the most prevalent mental illnesses among adolescents. Early detection and proper treatment are important for preventing sequelae such as suicide and substance use disorder. Studies have suggested that sleep duration is associated with anxiety disorder in adolescents. In the present study, we investigated the association between sleep quality and anxiety in a nationally representative sample of Korean adolescents. Methods This cross-sectional study was conducted using data from the 2020 Korea Youth Risk Behavior Web-based Survey. The Generalized Anxiety Disorder-7 questionnaire was used to evaluate anxiety. The chi-square test was used to investigate and compare the general characteristics of the study population, and multiple logistic regression analysis was used to analyze the relationship between sleep quality and anxiety. Results In both sexes, anxiety was highly prevalent in participants with poor sleep quality (adjusted odds ratio [aOR], 1.56; 95% confidence interval [CI], 1.43 to 1.71 in boys; aOR, 1.30; 95% CI, 1.19 to 1.42 in girls). Regardless of sleep duration, participants with poor sleep quality showed a high aOR for anxiety. Conclusions This study identified a consistent relationship between sleep quality and anxiety in Korean adolescents regardless of sleep duration.
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Affiliation(s)
- Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul,
Korea
- Institute of Health Services Research, Yonsei University, Seoul,
Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul,
Korea
| | - Seung Hoon Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul,
Korea
- Institute of Health Services Research, Yonsei University, Seoul,
Korea
| | - Sung-In Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul,
Korea
- Institute of Health Services Research, Yonsei University, Seoul,
Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul,
Korea
- Institute of Health Services Research, Yonsei University, Seoul,
Korea
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Kleppang AL, de Ridder K, Haugland SH, Stea TH. Physical activity, sugar-sweetened beverages, whole grain bread and insomnia among adolescents and psychological distress in adulthood: prospective data from the population-based HUNT study. Int J Behav Nutr Phys Act 2021; 18:143. [PMID: 34724961 PMCID: PMC8559387 DOI: 10.1186/s12966-021-01215-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/21/2021] [Indexed: 12/31/2022] Open
Abstract
Background In this study, we examined the relationship between low levels of physical activity, high consumption of sugar-sweetened beverages and low consumption of whole grain bread and experiencing insomnia in adolescence and psychological distress in young adults. Methods This prospective study was based on information retrieved from the Trøndelag Health Study (HUNT) in Norway and included adolescents (age 13–19) participating in Young-HUNT3 (2006–2008) and in HUNT4 (2017–2019) 11 years later (age 23–31). The study sample consisted of 2,230 participants (1,287 females and 943 males). The exposure variables collected in adolescence included self-reported physical activity, consumption of sugar-sweetened beverages and whole grain bread and insomnia, and psychological distress in young adulthood was used as an outcome variable. The relationship between lifestyle behaviours in adolescence and psychological distress in young adulthood was examined using multivariable logistic regression, adjusted for gender, age and psychological distress in adolescence and educational level in young adulthood. Results An increased odds of psychological distress was shown among young adults who reported low levels of physical activity (OR: 1.44, 95 % CI: 1.10–2.89), high consumption of sugar-sweetened beverages (OR: 1.49, 95 % CI: 1.12–1.98), low consumption of whole grain bread (OR: 1.35, 95 % CI: 1.04–1.77) and insomnia (OR: 1.69, 95 % CI: 1.23–2.33) in adolescence. In terms of absolute differences, unhealthy lifestyle behaviours increased the risk of psychological distress in young adulthood between 3.18 (95 % CI: 0.29–6.07) (low whole grain bread consumption) and 6.01 (95 % CI: 1.95–10.07) (insomnia) percentage points. Conclusions Low levels of physical activity, high consumption of sugar-sweetened beverages and low consumption of whole grain bread and insomnia during adolescence were associated with psychological distress in young adulthood.
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Affiliation(s)
- Annette Løvheim Kleppang
- Department of Health and Nursing Science, University of Agder, Postboks 422 4604, Kristiansand, Norway.
| | - Karin de Ridder
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Siri Håvås Haugland
- Department of Psychosocial Health, University of Agder, Kristiansand, Norway
| | - Tonje Holte Stea
- Department of Child and Adolescence Mental Health, Sørlandet Hospital, Kristiansand, Norway
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Ralph-Nearman C, Williams BM, Ortiz AML, Smith AR, Levinson CA. Pinpointing core and pathway symptoms among sleep disturbance, anxiety, worry, and eating disorder symptoms in anorexia nervosa and atypical anorexia nervosa. J Affect Disord 2021; 294:24-32. [PMID: 34256182 DOI: 10.1016/j.jad.2021.06.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sleep, anxiety, and worry are strongly related to psychiatric illness and in particular to eating disorder (ED) symptoms. However, it is unclear how these specific sleep and anxiety symptoms are interrelated with anorexia nervosa (AN) pathology. METHODS We utilized network analysis to test our theoretically-based conceptual model, by identifying core features and illness (i.e., bridge) pathways among sleep disturbance, anxiety, worry, and ED symptoms in 267 participants with a diagnosis of AN or atypical AN. RESULTS The following core symptoms were identified: shape judgement, restriction, and feeling tired. The strongest bridge symptoms included worry, feeling tired, loss of energy, and physical anxiety. Worry was connected positively to fasting, fear of gaining weight or becoming fat, loss of energy, and feeling tired, and negatively to changes in sleeping patterns. Feeling tired was connected to restriction, fasting, binge eating, and worry. Loss of energy was connected to loss of control over eating and worry. Physical anxiety was negatively connected to restriction. CONCLUSIONS We identified specific core symptoms and illness pathways supporting our theoretical conceptual model of how ED symptoms, anxiety, worry, and sleep disturbances inter-relate in AN and atypical AN. In particular we found that symptoms associated with sleep and anxiety were central and had strong connections with AN symptoms. In addition to targeting AN symptoms, these data suggest that targeting sleep disturbance, anxiety, and worry could improve treatment for AN.
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Affiliation(s)
| | - Brenna M Williams
- University of Louisville, Department of Psychological and Brain Sciences, United States
| | | | - April R Smith
- Auburn University, Department of Psychological Sciences, United States
| | - Cheri A Levinson
- University of Louisville, Department of Psychological and Brain Sciences, United States
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Liu J, Glenn AL, Cui N, Raine A. Longitudinal bidirectional association between sleep and behavior problems at age 6 and 11 years. Sleep Med 2021; 83:290-298. [PMID: 34091178 PMCID: PMC10117417 DOI: 10.1016/j.sleep.2021.04.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although a growing number of longitudinal studies have found that sleep problems precede behavior problems, few have examined potential bidirectional relationships longitudinally. The present study examined prospective associations between sleep problems and internalizing, externalizing, and attention problems over the course of childhood. METHODS Participants included 775 children from the China Jintan Cohort Study. Sleep problems were rated by mothers at ages six and 11.5, as well as self-reported by children at age 11.5. Behavior problems were rated by mothers and teachers at ages six and 11.5, and self-reported by children at age 11.5. RESULTS At age six, 15.0% of children were reported to have sleep problems as rated by mothers. At age 11, this prevalence was 12% as rated by mothers and 20% as rated by youth. Bidirectional relationships between sleep problems and behavior problems were observed. Mother-reported sleep problems at age six were predictive of self-reported internalizing and attention problems at age 11.5, even after controlling for baseline behavioral problems. At age six, teacher-reported externalizing, internalizing, and attention problems, and mother-rated internalizing and externalizing problems were all related to sleep problems at age 11.5, even after controlling for baseline sleep problems. Other sociodemographic covariates including child sex, age, and parental education were controlled for. CONCLUSIONS Findings provide further support for the reciprocal relationship between sleep problems and behavior problems. Early interventions that target both types of problems may be especially effective in preventing this aggravating health-behavior cycle.
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Affiliation(s)
- Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
| | - Andrea L Glenn
- University of Alabama, Center for Youth Development and Intervention, Department of Psychology, Tuscaloosa, AL, USA
| | - Naixue Cui
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA; Shandong University School of Nursing and Rehabilitation, Jinan, Shandong Province, China
| | - Adrian Raine
- University of Pennsylvania, Departments of Criminology, Psychiatry, and Psychology, Philadelphia, PA, USA
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Jiang F, Xiao Y, Dong H, Liu S, Guo F, Gong Z, Xiao S, Shen M, Zhou Q, Li J. Sleep Quality in Medical Staffs During the Outbreak of Coronavirus Disease 2019 in China: A Web-Based Cross-Sectional Study. Front Psychiatry 2021; 12:630330. [PMID: 34177639 PMCID: PMC8221287 DOI: 10.3389/fpsyt.2021.630330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/06/2021] [Indexed: 12/28/2022] Open
Abstract
Background: The aim of this study was to describe the sleep quality and its influencing factors among medical workers of different working statuses and staff types during the coronavirus disease 2019 (COVID-19) epidemic. Methods: Through an online questionnaire survey, all medical staffs in Xiangya Hospital were invited to complete sections on general information, the Self-Rating Scale of Sleep (SRSS), the Depression, Anxiety and Stress Scale (DASS-21), the Social Support Rating Scale (SSRS), and the Simplified Coping Style Questionnaire (CSQ). Results: A total of 4,245 respondents completed the survey. Among them, 38.7% had sleep disturbance. After matching, the SRSS scores in the staffs who were assigned to the intensive care unit (ICU) of Union Hospital in Wuhan and working in the epidemic area of Xiangya Hospital were not significantly different (P > 0.05); the SRSS scores in the battlefront staffs were significantly higher than (P < 0.05) those who were not treating patients infected with COVID-19. The SRSS scores of nurses were significantly higher than those of doctors and hospital administrators (P < 0.01). Anxiety, depression, and coping style were associated with sleep disturbance. Conclusion: The sleep quality of the medical staffs has been impaired during the epidemic period, especially among nurses, doctors, and administrators who are working on the front line. Medical institutions should strengthen psychological services and coping strategies for medical staffs.
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Affiliation(s)
- Furong Jiang
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Xiao
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Huixi Dong
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Siyu Liu
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Feng Guo
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Zhicheng Gong
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Administration, Xiangya School of Public Health, Central South University, Changsha, China
| | - Minxue Shen
- Department of Social Medicine and Health Administration, Xiangya School of Public Health, Central South University, Changsha, China
| | - Qiuhong Zhou
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Jianling Li
- Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
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Change patterns of sleep problems predict mental health problems among adolescents: a 10-year cohort study of Chinese Wenchuan earthquake. J Affect Disord 2021; 287:138-144. [PMID: 33780829 DOI: 10.1016/j.jad.2021.02.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/02/2021] [Accepted: 02/28/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The predictive effects of change patterns of sleep problems on mental health after a long-term disaster remain poorly known. We examined the change patterns of sleep problems after the Wenchuan earthquake, and tested whether specific sleep-related change patterns could predict mental health problems (posttraumatic stress disorder [PTSD], anxiety, and depression) in the 10 years after Wenchuan earthquake. METHODS 1357 adolescents exposed to the Wenchuan earthquake were surveyed on potential sleep problems at 18 months (T18m) and 30 months (T30m) post-earthquake. Among them, 799 participants completed the followed-up survey online 10 years after the earthquake (T10y). Since some participants did not provide sleep problems data at both T18m and T30m, 707 samples were included in final analyses. Linear regression analysis was performed. RESULTS Four different patterns of sleep problems were identified: stable-low pattern (61.1%), stable-high pattern (15.3%), decreasing pattern (13.2%), and increasing pattern (10.5%). Additionally, we found that individuals in stable-high and increasing patterns were more likely to experience PTSD, anxiety, and depression at T10y in the crude model. After controlling for confounders (e.g., earthquake exposure), these patterns were strongly predictive of depression at T10y. LIMITATIONS Only two waves of sleep problems were collected and subjective sleep outcomes methods were used to collect data instead of objective methods. CONCLUSIONS Sleep problems had heterogeneity after a deadly earthquake. Individuals in stable-high and increasing patterns should be given more attention. Timely assessment and targeted interventions on specific sleep problems are necessary for preventing an escalation of adverse mental health outcomes.
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Chang LY, Chang YH, Wu CC, Chang JJ, Yen LL, Chang HY. Resilience buffers the effects of sleep problems on the trajectory of suicidal ideation from adolescence through young adulthood. Soc Sci Med 2021; 279:114020. [PMID: 34004572 DOI: 10.1016/j.socscimed.2021.114020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/28/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To examine both the between-person and within-person effects of sleep problems on the trajectory of suicidal ideation from ages 14 to 22 and investigate whether resilience moderates the effects. Age and sex differences were explored in the main and interaction effects of sleep problems and resilience on suicidal ideation. METHODS The study sample included 2491 adolescents (1260 males and 1231 females) who participated in a prospective study spanning 2009 through 2016 in northern Taiwan. Sex-stratified multilevel models were used to examine the between-person and within-person effects of sleep problems and the moderating effects of resilience on the trajectory of suicidal ideation in males and females. RESULTS Across adolescents, higher levels of sleep problems contributed to an elevated risk of suicidal ideation for both sexes. Within individuals, a higher risk of suicidal ideation was observed when an adolescent's sleep problems exceeded their typical levels. The within-person effects of sleep problems were further determined to vary by age in males, with the effects gradually decreasing throughout late adolescence but increasing again in young adulthood. The buffering effects of resilience were only observed in females. The relationships between the within-person effects of sleep problems and suicidal ideation were only significant in female adolescents with low levels of resilience. CONCLUSIONS Our findings extend the research by demonstrating both the between-person and within-person association between sleep problems and suicidal ideation. We further revealed age and sex differences in the within-person effects of sleep problems and the buffering effects of resilience. Prevention and intervention programs that target sleep problems could be tailored based on individuals' age, sex, and levels of resilience to prevent suicidal ideation.
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Affiliation(s)
- Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Yi-Han Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chi-Chen Wu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan
| | - Jen Jen Chang
- Department of Epidemiology and Biostatistics, College of Public Health and Social Justice, Saint Louis University, USA
| | - Lee-Lan Yen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan
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Philbrook LE, Macdonald-Gagnon GE. Bidirectional Relations Between Sleep and Emotional Distress in College Students: Loneliness as a Moderator. The Journal of Genetic Psychology 2021; 182:361-373. [PMID: 33952050 DOI: 10.1080/00221325.2021.1913982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mental health symptoms are of increasing concern among college students in the United States and are often associated with insufficient sleep. However, the predictive relations between sleep and mental health are not well understood. The present study examined the daily, bidirectional associations between multiple sleep variables (subjective rating of morning restedness, objective measurement of nighttime sleep minutes) and college students' feelings of emotional distress. Self-reported loneliness was assessed as a moderator of these bidirectional relations. Participants were 101 undergraduate students (80% women) attending a liberal arts college in the northeastern United States. Students wore an actigraph to monitor nighttime sleep minutes across four weeknights (Monday-Thursday). They self-reported loneliness on the first day of the study and completed daily electronic assessments regarding restedness and emotional distress (worry, stress) each day for the remainder of the week. Multilevel modeling analyses demonstrated that greater restedness was predictive of less worry and stress that day. Further, the associations between better sleep (more rested, more nighttime sleep minutes) and less distress were stronger for less lonely students. In contrast, none of the distress indices were directly predictive of next-day restedness or nighttime sleep minutes, though one significant interaction demonstrated that the association between less worry and feeling more rested the next day was stronger for students who reported low compared to high loneliness. Together, the results point to sleep as a stronger influence on emotional distress than the reverse pathway and may suggest that social connection facilitates the positive influence of good sleep on student mental health.
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Affiliation(s)
- Lauren E Philbrook
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, NY, USA
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31
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Shimizu M, Zeringue MM, Erath SA, Hinnant JB, El-Sheikh M. Trajectories of sleep problems in childhood: associations with mental health in adolescence. Sleep 2021; 44:5916520. [PMID: 33001174 DOI: 10.1093/sleep/zsaa190] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/06/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES We examined initial levels (intercepts) of sleep-wake problems in childhood and changes in sleep-wake problems across late childhood (slopes) as predictors of externalizing behavior problems, depressive symptoms, and anxiety in adolescence. To ascertain the unique effects of childhood sleep problems on adolescent mental health, we controlled for both childhood mental health and adolescent sleep problems. METHODS Participants were 199 youth (52% boys; 65% White/European American, 35% Black/African American). Sleep-wake problems (e.g. difficulty sleeping and waking up in the morning) were assessed during three time points in late childhood (ages 9, 10, and 11) with self-reports on the well-established School Sleep Habits Survey. At age 18, multiple domains of mental health (externalizing behavior problems, depressive symptoms, and anxiety) and sleep-wake problems were assessed. RESULTS Latent growth curve modeling revealed that children with higher levels of sleep-wake problems at age 9 had consistently higher levels of such problems between ages 9 and 11. The initial level of sleep-wake problems at age 9 predicted externalizing behaviors, depressive symptoms, and anxiety at age 18, controlling for mental health in childhood and concurrent sleep-wake problems in adolescence. The slope of sleep-wake problems from ages 9 to 11 did not predict age 18 mental health. CONCLUSIONS Youth who had higher sleep-wake problems during late childhood had higher levels of mental health problems in adolescence even after controlling for childhood mental health and concurrent sleep-wake problems. Findings illustrate that childhood sleep problems may persist and predict adolescent mental health even when potentially confounding variables are rigorously controlled.
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Affiliation(s)
- Mina Shimizu
- Department of Human Development and Family Science, Auburn University, Auburn, AL
| | - Megan M Zeringue
- Department of Human Development and Family Science, Auburn University, Auburn, AL
| | - Stephen A Erath
- Department of Human Development and Family Science, Auburn University, Auburn, AL
| | - J Benjamin Hinnant
- Department of Human Development and Family Science, Auburn University, Auburn, AL
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Narmandakh A, Oldehinkel AJ, Masselink M, de Jonge P, Roest AM. Affect, worry, and sleep: Between- and within-subject associations in a diary study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Suffren S, Dubois-Comtois K, Lemelin JP, St-Laurent D, Milot T. Relations between Child and Parent Fears and Changes in Family Functioning Related to COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1786. [PMID: 33673155 PMCID: PMC7918466 DOI: 10.3390/ijerph18041786] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/18/2022]
Abstract
In adults, higher anxiety level related to COVID-19 has been associated with having a pre-existing medical or mental health condition and poor sleep quality. However, no study yet has looked at these links in children. The present study's main aim was to assess family changes associated with child and parent fears and concerns about COVID-19. We conducted a cross-sectional study among 144 families with children aged 9-12 years during the COVID-19 lockdown period. Families came from Quebec, Canada, and the survey was done in the early stages of the lockdown (April-May 2020). A phone-based survey assessed parent and child COVID-19-related fears and concerns, family-related changes and health issues. Results showed the more fears parents have about COVID-19, the more fears their child also has. Moreover, changes in family sleep habits were associated with parental and child fears and concerns about COVID-19. Reduced access to health services was associated with parental concerns about COVID-19. If another lockdown was to be put in place in the future, it would be important to inform families on the importance of sleep schedules and to maintain or increase health appointments when possible.
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Affiliation(s)
- Sabrina Suffren
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (S.S.); (D.S.-L.)
- Centre de Recherche Universitaire sur les Jeunes et les Familles (CRUJeF), Québec, QC G1C 3S2, Canada; (J.-P.L.); (T.M.)
- Centre de Recherche and Hôpital en Santé Mentale Albert-Prévost, CIUSSS du Nord-de-l’Ile-de-Montreal, Montreal, QC H4K 1B3, Canada
| | - Karine Dubois-Comtois
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (S.S.); (D.S.-L.)
- Centre de Recherche and Hôpital en Santé Mentale Albert-Prévost, CIUSSS du Nord-de-l’Ile-de-Montreal, Montreal, QC H4K 1B3, Canada
| | - Jean-Pascal Lemelin
- Centre de Recherche Universitaire sur les Jeunes et les Familles (CRUJeF), Québec, QC G1C 3S2, Canada; (J.-P.L.); (T.M.)
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Diane St-Laurent
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (S.S.); (D.S.-L.)
- Centre de Recherche Universitaire sur les Jeunes et les Familles (CRUJeF), Québec, QC G1C 3S2, Canada; (J.-P.L.); (T.M.)
| | - Tristan Milot
- Centre de Recherche Universitaire sur les Jeunes et les Familles (CRUJeF), Québec, QC G1C 3S2, Canada; (J.-P.L.); (T.M.)
- Département de Psychoéducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada
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Rosano J, Howell T, Conduit R, Bennett P. Co-Sleeping between Adolescents and Their Pets May Not Impact Sleep Quality. Clocks Sleep 2021; 3:1-11. [PMID: 33406702 PMCID: PMC7838871 DOI: 10.3390/clockssleep3010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/16/2020] [Indexed: 11/25/2022] Open
Abstract
Pet–owner co-sleeping is increasingly common in some parts of the world. Adult owners often subjectively report benefits of co-sleeping with pets, although objective actigraphy reports conversely indicate sleep disruptions due to the pet. Because limited research is available regarding pet–owner co-sleeping in non-adult samples, the aim of this two-part study was to explore whether co-sleeping improves sleep quality in adolescents, an age group in which poor sleep patterns are well documented. In Study One, an online survey with 265 pet-owning 13-to-17-year-old participants found that over 78% co-slept with their pet. Average sleep quality scores for co-sleepers and non-co-sleepers indicated generally poor sleep, with no differences in sleep quality depending on age, gender, or co-sleeping status. Study Two consisted of two preliminary case studies, using actigraphy on dog–adolescent co-sleepers. In both cases, high sleep concordance was observed, but owners again experienced generally poor sleep quality. Future actigraphy research is needed, including larger sample sizes and a control group of non-co-sleepers, to validate the preliminary findings from this study, but our limited evidence suggests that co-sleeping with a pet may not impact sleep quality in adolescents.
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Affiliation(s)
- Jessica Rosano
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia; (J.R.); (P.B.)
| | - Tiffani Howell
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia; (J.R.); (P.B.)
- Correspondence:
| | - Russell Conduit
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3083, Australia;
| | - Pauleen Bennett
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia; (J.R.); (P.B.)
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35
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Life Conditions during COVID-19 Lockdown and Mental Health in Spanish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197327. [PMID: 33036461 PMCID: PMC7579639 DOI: 10.3390/ijerph17197327] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 12/20/2022]
Abstract
Spanish children were locked down for 72 days due to COVID-19, causing severe disruption to their normal life. The threat posed by COVID-19 continues and clinicians, administrators, and families need to know the life conditions associated with more psychological problems to modify them and minimize their effect on mental health. The goal was to study the life conditions of adolescents during lockdown and their association with psychological problems. A total of 226 parents of 117 girls and 109 boys (mean age: 13.9; Standard deviation: 0.28) from the community that were participants in a longitudinal study answered an online questionnaire about life conditions during lockdown and the Strengths and Difficulties Questionnaire (SDQ). Stepwise regression analyses controlling by previous reports of SDQ were performed. Conduct, peer, prosocial, and total problems scores increased after lockdown. After adjusting for previous measures of psychopathology, worse adolescents’ mental health during COVID-19 lockdown was associated with unhealthy activities, worsening of the relationships with others, and dysfunctional parenting style. It seems important to mitigate psychological stress in a situation of isolation due to a state of emergency by keeping the adolescent active and maintaining their daily habits and routines in a non-conflictive atmosphere and give support to parents.
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Ge F, Zhang D, Wu L, Mu H. Predicting Psychological State Among Chinese Undergraduate Students in the COVID-19 Epidemic: A Longitudinal Study Using a Machine Learning. Neuropsychiatr Dis Treat 2020; 16:2111-2118. [PMID: 32982249 PMCID: PMC7505704 DOI: 10.2147/ndt.s262004] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The outbreak of the 2019 novel coronavirus disease (COVID-19) not only caused physical abnormalities, but also caused psychological distress, especially for undergraduate students who are facing the pressure of academic study and work. We aimed to explore the prevalence rate of probable anxiety and probable insomnia and to find the risk factors among a longitudinal study of undergraduate students using the approach of machine learning. METHODS The baseline data (T1) were collected from freshmen who underwent psychological evaluation at two months after entering the university. At T2 stage (February 10th to 13th, 2020), we used a convenience cluster sampling to assess psychological state (probable anxiety was assessed by general anxiety disorder-7 and probable insomnia was assessed by insomnia severity index-7) based on a web survey. We integrated information attained at T1 stage to predict probable anxiety and probable insomnia at T2 stage using a machine learning algorithm (XGBoost). RESULTS Finally, we included 2009 students (response rate: 80.36%). The prevalence rate of probable anxiety and probable insomnia was 12.49% and 16.87%, respectively. The XGBoost algorithm predicted 1954 out of 2009 students (translated into 97.3% accuracy) and 1932 out of 2009 students (translated into 96.2% accuracy) who suffered anxiety and insomnia symptoms, respectively. The most relevant variables in predicting probable anxiety included romantic relationship, suicidal ideation, sleep symptoms, and a history of anxiety symptoms. The most relevant variables in predicting probable insomnia included aggression, psychotic experiences, suicidal ideation, and romantic relationship. CONCLUSION Risks for probable anxiety and probable insomnia among undergraduate students can be identified at an individual level by baseline data. Thus, timely psychological intervention for anxiety and insomnia symptoms among undergraduate students is needed considering the above factors.
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Affiliation(s)
- Fenfen Ge
- Clinical Psychology Department, Qingdao Municipal Hospital, Qingdao266000, Shandong, People’s Republic of China
| | - Di Zhang
- Mental Health Education and Counseling Center, Ocean University of China, Qingdao266100, Shandong, People’s Republic of China
| | - Lianhai Wu
- Mental Health Education and Counseling Center, Ocean University of China, Qingdao266100, Shandong, People’s Republic of China
| | - Hongwei Mu
- Mental Health Education and Counseling Center, Ocean University of China, Qingdao266100, Shandong, People’s Republic of China
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