1
|
Xiao H, Shen Y, Zhang W, Lin R. Applicability of the cognitive model of generalized anxiety disorder to adolescents' sleep quality: A cross-sectional and longitudinal analysis. Int J Clin Health Psychol 2023; 23:100406. [PMID: 37663041 PMCID: PMC10472235 DOI: 10.1016/j.ijchp.2023.100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Background Poor sleep quality is a prevalent health issue among adolescents, and few studies have examined the variables affecting adolescents' sleep quality from the perspective of the co-occurrence of sleep issues and anxiety disorders. Therefore, the current study investigated whether the cognitive model of generalized anxiety disorder applies to adolescents' sleep quality. Method In Study 1, a total of 2042 adolescents were recruited and they completed questionnaires relating to worry, intolerance of uncertainty (IU), negative problem orientation (NPO), cognitive avoidance (CA), and sleep quality. In Study 2, a total of 379 adolescents participated in a six-month longitudinal survey to verify the model that was obtained in Study 1. Results Study 1 showed the modified cognitive model of generalized anxiety disorder can be applied to adolescents' sleep quality. Specifically, IU was a higher-order vulnerability factor that directly affected worry, and indirectly fostered worry via NPO and CA, where worry only mediated the relationships between IU, NPO, and sleep quality. However, CA exerted no independent effect on worry or sleep quality beyond the influences of IU and NPO, therefore, it dropped out of the final model. Study 2 partially confirmed the above model again from the longitudinal perspective. Conclusion The present study constructs a new model to explain adolescents' sleep quality, providing a foundation for future interventions.
Collapse
Affiliation(s)
- Huiwen Xiao
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Yilin Shen
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
| | - Weizhong Zhang
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
| | - Rongmao Lin
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
| |
Collapse
|
2
|
Olatunji BO, Knowles KA, Cox RC, Cole DA. Linking repetitive negative thinking and insomnia symptoms: A longitudinal trait-state model. J Anxiety Disord 2023; 97:102732. [PMID: 37302163 DOI: 10.1016/j.janxdis.2023.102732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 05/21/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
Sleep disturbance is highly debilitating, and an abundance of research suggests that repetitive negative thinking (i.e., rumination, worry) may contribute to the development and maintenance of maladaptive sleep patterns, such as insomnia symptoms. Although repetitive negative thinking is often conceptualized as a 'trait' risk factor for anxiety-related disorders, it is unclear if it consists of time-varying (TV) or state-like features versus time-invariant (TI) or trait-like characteristics. Furthermore, it is unclear if it is the TV or TI components of repetitive negative thinking that contribute to insomnia symptoms that is commonly observed in anxiety-related disorders. In a 6-wave, 5-month longitudinal study, community participants (N = 1219) completed measures of rumination, worry, transdiagnostic repetitive negative thinking, and insomnia symptoms. A latent variable (trait-state-occasion) model was applied to the measures of repetitive negative thinking. The results showed that although estimates of TI factor variance and TV factor variance were both significant for latent repetitive negative thinking, worry, and rumination, the proportion of TI factor variance (0.82-0.89) was greater than the amount of TV factor variance (0.11-0.19). Although TV factor stability was statistically significant for latent repetitive negative thinking, rumination, and worry, the magnitude of the coefficients was small. Furthermore, regression weights for the latent repetitive negative thinking, rumination, and worry TI factor were significant and larger than those for the TV factor in predicting insomnia symptoms at each of the six time points. These findings suggest that repetitive negative thinking is largely TI, and it is this TI component that contributes to insomnia symptoms. Implications for conceptualizations of repetitive negative thinking as a predisposing and perpetuating factor in insomnia for anxiety and related disorders are discussed.
Collapse
|
3
|
Shi C, Wang S, Tang Q, Liu X, Li Y. Cross-lagged relationship between anxiety, depression, and sleep disturbance among college students during and after collective isolation. Front Public Health 2022; 10:1038862. [PMID: 36561855 PMCID: PMC9766954 DOI: 10.3389/fpubh.2022.1038862] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Object Repeated quarantine policies over the past 3 years have led to poor psychological consequences for the public. Previous studies have proved that the quarantine policy leaves individuals vulnerable to anxiety, depression, and insomnia, especially among college students. This study aims to explore whether psychological problems during isolation continue with the release of isolation. Methods Overall, 2,787 college students both answered a web-based survey during and after the closure management was lifted. The Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Youth Self-rating Insomnia Scale were measured. The cross-lagged path model was used to explore the influence of psychological impact during isolation on the individual after the release. Results We found that anxiety and sleep disturbance levels alleviated significantly after quarantine, except for depression. As expected, a bidirectional relationship exists between anxiety, depression, and sleep disturbance. Moreover, depression and sleep disturbance can predict post quarantine depression, sleep disturbance, and anxiety, yet anxiety cannot predict sleep disturbance afterward. Conclusion Timely and effective intervention for anxiety, depression, and insomnia during isolation is essential for individuals to repair themselves quickly after the release.
Collapse
Affiliation(s)
- Congying Shi
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Shujian Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Qihui Tang
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, China
| | - Yue Li
- Faculty of Arts, Shenzhen University, Shenzhen, China,*Correspondence: Yue Li
| |
Collapse
|
4
|
Do alexithymia and negative affect predict poor sleep quality? The moderating role of interoceptive sensibility. PLoS One 2022; 17:e0275359. [PMID: 36191028 PMCID: PMC9529110 DOI: 10.1371/journal.pone.0275359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/15/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Emotion-related hyperarousal is an important core pathology of poor sleep. Studies investigating the interplay of alexithymia and affective experiences in determining sleep quality have yielded mixed results. To disentangle the inconsistency, this study examined the concurrent predictive power of alexithymia, and negative and positive affect, while incorporating interoceptive sensibility (IS) as a possible moderator. METHODS A sample of 224 (70.10% were female) participants completed the Toronto Alexithymia Scale, Positive and Negative Affect Schedule, Pittsburgh Sleep Quality Index, Multidimensional Assessment of Interoceptive Awareness (MAIA), and Marlowe-Crowne Social Desirability Scale (for controlling response bias) using paper and pencil. A two-stage cluster analysis of the MAIA was used to capture IS characteristics. Stepwise regression was conducted separately for each IS cluster. RESULTS A three-group structure for IS characteristics was found. Higher alexithymia was predictive of poor sleep quality in the low IS group, while higher negative affect predicted poor sleep quality in the moderate and high IS groups. Additionally, alexithymia and positive affect were significantly different in the three IS groups, while negative affect and sleep quality were not. CONCLUSIONS Emotion and cognitive arousal may impact sleep quality differently in individuals with different levels of internal focusing ability, depending on physiological versus emotional self-conceptualization. The implications on pathological research, clinical intervention, study limitations and future directions are discussed.
Collapse
|
5
|
Frøjd LA, Papageorgiou C, Munkhaugen J, Moum T, Sverre E, Nordhus IH, Dammen T. Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up. J Clin Sleep Med 2022; 18:779-787. [PMID: 34633284 PMCID: PMC8883089 DOI: 10.5664/jcsm.9712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Insomnia is highly prevalent and associated with anxiety and depression in patients with coronary heart disease patients. The development of effective psychological interventions is needed. Worry and rumination are potential risk factors for the maintenance of insomnia, anxiety, and depression that may be modified by psychological treatment grounded in the Self-Regulatory Executive Function model. However, the relationships between worry, rumination, anxiety and depression, and insomnia are not known. Therefore, we investigated these relationships both cross-sectionally and longitudinally among patients with coronary heart disease. METHODS A cross-sectional study consecutively included 1,082 patients in 2014-2015, and 686 were followed up after mean of 4.7 years. Data were gathered from hospital records and self-report questionnaires comprising assessment of worry (Penn State Worry Questionnaire), rumination (Ruminative Responses Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and insomnia (Bergen Insomnia Scale). RESULTS Insomnia correlated moderately with all other psychological variables (R 0.18-0.50, all P values < .001). After adjustments for anxiety and depression, odds ratios for insomnia at baseline were 1.27 (95% confidence interval 1.08-1.50) and 1.60 (95% confidence interval 1.31-1.94) per 10 points increase of worry and rumination, respectively. Corresponding odds ratios for insomnia at follow-up were 1.28 (95% confidence interval 1.05-1.55) and 1.38 (95% confidence interval 1.09-1.75). Depression was no longer significantly associated with insomnia after adjustments for worry and rumination, but anxiety remained significant. CONCLUSIONS Worry and rumination predicted insomnia both cross-sectionally and prospectively, even after controlling for anxiety and depression, although anxiety remained significant. Future studies may test psychological interventions targeting these factors in patients with coronary heart disease and insomnia. CITATION Frøjd LA, Papageorgiou C, Munkhaugen J, et al. Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up. J Clin Sleep Med. 2022;18(3):779-787.
Collapse
Affiliation(s)
- Lars Aastebøl Frøjd
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Address correspondence to: Lars Aastebøl Frøjd, StudMed, Department of Behavioural Medicine, Institute of Basic Medical Sciences, Institute of Medicine, University of Oslo. Postal address: Postboks 1111 Blindern 0317 Oslo, Norway;
| | - Costas Papageorgiou
- Priory Hospital Altrincham, Cheshire, United Kingdom,Department of Psychology, University of Oslo, Oslo, Norway
| | - John Munkhaugen
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Department of Medicine, Drammen Hospital, Drammen, Norway
| | - Torbjørn Moum
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway
| | - Elise Sverre
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Department of Medicine, Drammen Hospital, Drammen, Norway
| | - Inger Hilde Nordhus
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Department of Clinical Psychology, University of Bergen, Bergen Norway
| | - Toril Dammen
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
6
|
Development of the Perth Adolescent Worry Scale (PAWS). Res Child Adolesc Psychopathol 2021; 50:521-535. [PMID: 34415493 PMCID: PMC8940868 DOI: 10.1007/s10802-021-00853-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 11/05/2022]
Abstract
Tools to assess worry among adolescents exist but do not capture the content of worries. This study reports on the development of a brief, psychometrically sound measure of worry for use with adolescents. Phase 1 involved identification of 27 potential items from existing instruments as well as item generation identified in interviews with students, teachers, school psychologists, and parents. In Phase 2, the candidate items were completed by 835 Australian adolescents (317 males, 508 females, 10 unspecified; Mean age = 13.55, SD = 1.31) from Grades 5 to 10. These data were randomly split in half, and an exploratory factor analysis on the first half identified a two-factor solution with 12 items: Peer Relationships (6 items) and Academic Success and the Future (6 items). On the second half of the data, confirmatory factor analyses supported the factor structure and supported strong invariance across age, socioeconomic status, and presence/absence of a diagnosed neurodevelopmental disorder. Weak invariance was evident across sex. Differences across groups are reported as are correlations with indicators of psychological wellbeing. In conclusion, the Perth Adolescent Worry Scale provides both applied professionals and researchers with a short, easy-to-administer, and psychometrically strong instrument to evaluate adolescents’ everyday worries.
Collapse
|
7
|
Ballesio A, Bacaro V, Vacca M, Chirico A, Lucidi F, Riemann D, Baglioni C, Lombardo C. Does cognitive behaviour therapy for insomnia reduce repetitive negative thinking and sleep-related worry beliefs? A systematic review and meta-analysis. Sleep Med Rev 2020; 55:101378. [PMID: 32992228 DOI: 10.1016/j.smrv.2020.101378] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/19/2022]
Abstract
Repetitive negative thinking (RNT), i.e., worry, rumination, and transdiagnostic repetitive thinking, is thought to exacerbate and perpetuate insomnia in cognitive models. Moreover, RNT is a longitudinal precursor of depression and anxiety, which are often co-present alongside insomnia. Whilst accumulating evidence supports the efficacy of cognitive behavioural therapy for insomnia (CBT-I) in reducing depression and anxiety symptoms, the literature on the effects of CBT-I on RNT has never been systematically appraised. Importantly, preliminary evidence suggests that reduction of RNT following CBT-I may be associated with reduction of depression and anxiety. Therefore, we aimed to conduct a systematic review and meta-analysis on the effects of CBT-I on RNT. Seven databases were searched, and 15 randomised controlled trials were included. Results showed moderate-to-large effects of CBT-I on worry (Hedge's g range: -0.41 to g = -0.71) but small and non-reliable effects on rumination (g = -0.13). No clear evidence was found for an association between post-treatment reduction in RNT and post-treatment reduction in depression and anxiety. Although the literature is small and still developing, CBT-I seems to have a stronger impact on sleep-related versus general measures of RNT. We discuss a research agenda aimed at advancing the study of RNT in CBT-I trials.
Collapse
Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Italy; Department of Developmental and Social Psychology, Sapienza University of Rome, Italy.
| | - Valeria Bacaro
- Department of Human Sciences, University of Rome "G. Marconi"- Telematic, Italy
| | | | - Andrea Chirico
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Chiara Baglioni
- Department of Human Sciences, University of Rome "G. Marconi"- Telematic, Italy; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | | |
Collapse
|
8
|
Bully victimization is a correlate of sleep loss over worry (SLOW) among adolescents in four South-East Asian countries. Sleep Med 2020; 69:179-188. [PMID: 32109840 DOI: 10.1016/j.sleep.2020.01.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 01/05/2020] [Accepted: 01/23/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine the unique contribution of bully victimization to sleep loss over worry (SLOW) among adolescents in four Southeast Asian countries, while controlling for loneliness and selected lifestyle factors. METHODS Data was derived from the Global School-Based Student Health Survey (2014-2015). Responses from a total of 13,043 adolescents in four Southeast Asian countries (Bangladesh, Brunei, Indonesia, and Timor Leste) were examined. Weighted frequencies of SLOW, bully victimization, loneliness, and selected lifestyle factors were first calculated, and Pearson's chi-square test was used to compare sample characteristics by severity of SLOW. A multivariate logistic regression analysis was constructed for each country to assess the unique contribution of bully victimization to SLOW, adjusting for demographics, loneliness, and selected lifestyle factors. RESULTS The prevalence of SLOW and bully victimization ranged between 38.0% and 44.6%, and 20.5%-24.9% respectively. Bully victimization and loneliness were consistently and positively linked to SLOW, with greater odds seen among students with severe SLOW who were bullied for 3 days or more (adjusted odds ratios (AORs) and 95% confidence intervals (CIs) Bangladesh: 6.00 [2.57-14.01]; Brunei: 2.48 [1.42-4.32]; Indonesia: 3.36 [2.02-5.59]; Timor Leste: 4.27 [2.15-8.48]) and experienced high level of loneliness (AORs and 95% CIs Bangladesh: 7.03 [3.46-14.29]; Brunei: 4.97 [3.63-6.79]; Indonesia: 8.71 [4.55-16.69]; Timor Leste: 2.97 [2.25-3.93]). Increased odds of severe SLOW were also seen among those engaged in sedentary behavior for 3 h or more per day (AORs and 95% CIs Indonesia: 1.85 [1.40-2.45]; Timor Leste: 1.61 [1.18-2.19]), and among those consuming fast food for three or more days per week (AORs and 95% CIs Brunei: 2.20 [1.26-3.86]; Indonesia: 1.98 [1.19-3.31]). The association of lifestyle factors and SLOW differed across countries. CONCLUSION Given the unique contributions of bully victimization to SLOW, we recommend countries in Southeast Asia to include sleep health as a component of adolescent health promotion, and to include reducing bully and bully victimization in strategies aimed at improving sleep health.
Collapse
|
9
|
Richards A, Kanady JC, Neylan TC. Sleep disturbance in PTSD and other anxiety-related disorders: an updated review of clinical features, physiological characteristics, and psychological and neurobiological mechanisms. Neuropsychopharmacology 2020; 45:55-73. [PMID: 31443103 PMCID: PMC6879567 DOI: 10.1038/s41386-019-0486-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 02/08/2023]
Abstract
The current report provides an updated review of sleep disturbance in posttraumatic stress disorder and anxiety-related disorders. First, this review provides a summary description of the unique and overlapping clinical characteristics and physiological features of sleep disturbance in specific DSM anxiety-related disorders. Second, this review presents evidence of a bidirectional relationship between sleep disturbance and anxiety-related disorders, and provides a model to explain this relationship by integrating research on psychological and neurocognitive processes with a current understanding of neurobiological pathways. A heuristic neurobiological framework for understanding the bidirectional relationship between abnormalities in sleep and anxiety-related brain pathways is presented. Directions for future research are suggested.
Collapse
Affiliation(s)
- Anne Richards
- The San Francisco VA Health Care System, San Francisco, CA, USA.
- The University of California, San Francisco, San Francisco, CA, USA.
| | - Jennifer C Kanady
- The San Francisco VA Health Care System, San Francisco, CA, USA
- The University of California, San Francisco, San Francisco, CA, USA
| | - Thomas C Neylan
- The San Francisco VA Health Care System, San Francisco, CA, USA
- The University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
10
|
Akram U, Barclay NL, Milkins B. Sleep-Related Attentional Bias in Insomnia: Time to Examine Moderating Factors? Front Psychol 2018; 9:2573. [PMID: 30618989 PMCID: PMC6301999 DOI: 10.3389/fpsyg.2018.02573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/30/2018] [Indexed: 11/16/2022] Open
Affiliation(s)
- Umair Akram
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, United Kingdom
- Nuffield Department of Clinical Neurosciences, Sir William Dunn School of Pathology, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, United Kingdom
| | - Nicola L. Barclay
- Nuffield Department of Clinical Neurosciences, Sir William Dunn School of Pathology, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, United Kingdom
| | - Bronwyn Milkins
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, University of Western Australia, Perth, WA, Australia
| |
Collapse
|
11
|
Marques DR, Gomes AA, Clemente V, dos Santos JM, Duarte IC, Caetano G, Castelo-Branco M. Self-Referential Dysfunction and Default-Mode Hyperactivation in Psychophysiological Insomnia Patients. J PSYCHOPHYSIOL 2018. [DOI: 10.1027/0269-8803/a000194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Psychophysiological insomnia (PI) is one of the most frequent sleep disorders. In this study we tested whether differences in terms of neural activation are present between a group of PI patients and a healthy-control group while they are exposed to idiosyncratic ruminations and worries, evoked visually by words, so as to explore their hypothetical link with default-mode network (DMN) dysfunction in PI. We recruited five PI patients diagnosed according to the International Classification of Sleep Disorders, version 2 (ICSD-2) of American Academy of Sleep Medicine (AASM) and five age- and sex-matched healthy controls. Patients were recruited at the outpatient Sleep Medicine Centre of the Coimbra University Hospital Centre. We used a functional magnetic resonance imaging (fMRI) block-design paradigm where the participants visualized lists of words related to past/present and future concerns and also emotionally neutral words. The results suggested that the PI patients showed a failure of the DMN to deactivate. Moreover, when these patients were exposed to words concerning both past/present ruminations and future worries, there was a pronounced and significant over-recruitment of brain areas related to DMN and self-referential processing when they were compared to healthy volunteers. The differences between the patient and control groups were also evident in self-report measures. In sum, despite the relatively small sample size, our study clearly suggests that in PI there is a dysfunction in brain regions pertaining to self-referential processing, which is corroborated by an overall pattern of hyperarousal in brain regions comprising the DMN. These data may be useful in the improvement of pathophysiological models, diagnostic and therapeutic interventions for insomnia.
Collapse
Affiliation(s)
- Daniel Ruivo Marques
- Department of Education and Psychology, University of Aveiro, Portugal
- Institute for Biomedical Imaging and Life Sciences (IBILI), Coimbra, Portugal
| | - Ana Allen Gomes
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
- CINEICC – Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo-Comportamental/Research & Development Unit (FCT): Cognitive and Behavioural Center for Research and Intervention, Coimbra, Portugal
| | - Vanda Clemente
- Sleep Medicine Centre, Coimbra University Hospital Centre (CHUC), Portugal
| | | | | | - Gina Caetano
- Institute for Biomedical Imaging and Life Sciences (IBILI), Coimbra, Portugal
- Brain Imaging Network, ICNAS, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Institute for Biomedical Imaging and Life Sciences (IBILI), Coimbra, Portugal
- Brain Imaging Network, ICNAS, Coimbra, Portugal
| |
Collapse
|
12
|
Cox RC, Cole DA, Kramer EL, Olatunji BO. Prospective Associations Between Sleep Disturbance and Repetitive Negative Thinking: The Mediating Roles of Focusing and Shifting Attentional Control. Behav Ther 2018; 49:21-31. [PMID: 29405919 DOI: 10.1016/j.beth.2017.08.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/13/2017] [Accepted: 08/08/2017] [Indexed: 10/19/2022]
Abstract
Although considerable evidence has linked sleep disturbance to symptoms of psychopathology, including repetitive negative thinking, few studies have examined how sleep disturbance may predict repetitive negative thinking over time. Further, no study to date has examined specific mechanisms that may account for this relationship. The present study sought to address these gaps in the literature by testing focusing and shifting attentional control as two potential mediators of the relationship between sleep disturbance and repetitive negative thinking over a 6-month period. A final sample of 445 unselected community participants completed measures of sleep disturbance and repetitive negative thinking at Time 1, measures of focusing and shifting attentional control 3 months later, and measures of repetitive negative thinking again 6 months later. Results revealed that focusing, but not shifting, attentional control mediated the relationship between sleep disturbance and repetitive negative thinking, specifically, worry, rumination, and obsessions. These findings provide preliminary evidence for focusing attentional control as a candidate mechanism that may explain the causal role of sleep disturbance in the development of repetitive negative thinking observed in various disorders.
Collapse
|
13
|
Lancee J, Eisma MC, van Zanten KB, Topper M. When Thinking Impairs Sleep: Trait, Daytime and Nighttime Repetitive Thinking in Insomnia. Behav Sleep Med 2017; 15:53-69. [PMID: 26651373 DOI: 10.1080/15402002.2015.1083022] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We performed two studies in individuals with sleep problems to investigate trait, daytime, and nighttime repetitive thinking as risk factors for insomnia. In Study 1, 139 participants completed questionnaires on worry, rumination, insomnia, anxiety, depression, and a sleep diary. Trait rumination and trait worry were not associated with sleep impairment. In Study 2, 64 participants completed similar measures and a daytime and nighttime sleep-related worry diary. Only nighttime sleep-related worry was consistently associated with sleep impairment. Overall, results indicate that nighttime sleep-related worry is important in the maintenance of insomnia, whereas effects of trait and daytime repetitive thinking are more benign. Treatment for insomnia can potentially be improved by focusing more on nighttime sleep-related worry.
Collapse
Affiliation(s)
- Jaap Lancee
- a Department of Clinical Psychology , University of Amsterdam , Amsterdam , Netherlands
| | - Maarten C Eisma
- b Department of Clinical and Health Psychology , Utrecht University , Utrecht , Netherlands
| | | | - Maurice Topper
- a Department of Clinical Psychology , University of Amsterdam , Amsterdam , Netherlands
| |
Collapse
|
14
|
Danielsson NS, Norell-Clarke A, Hagquist C. Associations between adolescent sleep disturbance and different worry themes: findings from a repeated cross-sectional study from 1988 to 2011. Sleep Health 2016. [DOI: 10.1016/j.sleh.2016.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
15
|
Abstract
Anxiety is adaptive and plays an important role in keeping us safe. However, when anxiety becomes too extreme, it can cause significant disruptions and distress. Understanding the mechanisms underlying excessive anxiety and how to best treat it is a priority for researchers and clinicians. There is increasing recognition that disruptions in the amount and timing of sleep are associated with anxiety symptoms and characteristics. In the current paper, we explore the intersections between sleep, circadian rhythms, and anxiety. First, we review accumulating evidence that anxiety is associated with disruptions in sleep and circadian rhythms in both clinical and nonclinical samples and across ages. Next, we discuss the data linking sleep disruptions with anxiety-related traits (anxiety sensitivity, neuroticism, and perfectionism) and patterns of cognition and emotion. Finally, potential treatment implications are highlighted. Overall, these data suggest that delineating the role of disruptions in the amount and timing of sleep holds promise for improving the lives of individuals with heightened anxiety.
Collapse
|
16
|
Linking Sleep Disturbance and Maladaptive Repetitive Thought: The Role of Executive Function. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9713-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|