The associations of morningness-eveningness with anger and impulsivity in the general population

Mapping insomnia symptoms and circadian preferences to mental health problems in men and women across the lifespan

This study identified subgroups in the general population based on combinations in three night-time insomnia symptoms and four dimensions of circadian preferences ("sleep profiles") and investigated the associations between sleep profiles and nine common mental health problems. The data came from the Lifelines cohort add-on study "Comorbid Conditions of ADHD" and included 37,716 individuals (aged 4-91 years) from the Dutch general population who completed a digital survey. Latent profile analysis was used to identify sleep profiles in twelve age-sex subgroups. Linear regression was used to investigate whether sleep profiles differ in mental health problems. Participants were classified into three sleep profiles: "Healthy Larks", who had early circadian preferences and no insomnia symptoms; "Sleepy Owls" with late circadian preferences and nonrestorative sleep; and "Sleepless Doves" with intermediate circadian preferences and severe insomnia symptoms. Compared to "Healthy Larks", all mental health problems were significantly more severe in "Sleepy Owls" and even worse in "Sleepless Doves". These associations were similar in men and women but weakened with age. However, "Sleepy Owls" and "Sleepless Doves" did not differ in heavy alcohol drinking, drug use, and smoking. Our findings strengthened the evidence for the universal role of healthy sleep in mental wellbeing.

The relationship of chronotypes with food addiction, impulsivity, and attention deficit hyperactivity disorder symptoms in a sample of undergraduate university students

The primary aim of the current study was to examine the frequency of food addiction in a group of university students and whether it differed among chronotypes. The second aim was to investigate the relationship of chronotypes with impulsivity, poor sleep quality and attention deficit/ hyperactivity disorder (ADHD) symptoms and to evaluate how this relationship affects food addiction. 328 university students were included in the study. Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale (ASRS), Morningness-Eveningness Questionnaire (MEQ), Barratt Impulsiveness Scale-11 Short Form (BIS-11-SF), Yale Food Addiction Scale (YFAS) and Pittsburgh Sleep Quality Index (PSQI) were administered. Evening types scored significantly higher on ASRS and BIS-11 SF (p < .001, p < .001 respectively). Based on YFAS scores, 12.5% (n = 41) of the participants met the criteria for food addiction. The number of participants fulfilling the criteria for food addiction was higher among the evening types compared to intermediate and morning types (p = .006, p = .004, respectively). The mean ASRS and BIS-11 SF scores of the students who met the criteria for food addiction were significantly greater than those who did not (p < .001, p < .001, respectively). 63.4% (n = 26) of the students meeting the criteria for food addiction scored 6 or higher on PSQI versus 32.0% (n = 92) of the students who did not (p < .001). Mediation analysis showed that the direct effect of MEQ scores on food addiction was not significant (β = -0.009, p = .723). However, lower MEQ scores had an indirect effect on food addiction through higher ASRS scores (β = -0.027; p < .05 bias corrected and accelerated 95% CI -0.052 to -0.011). The results of the present study suggest that higher prevalence of food addiction among evening types seems to be related to higher occurrence of ADHD symptoms in these chronotypes. Further population-based studies with a larger sample size are needed to confirm our findings.

It's About Time: The Circadian Network as Time-Keeper for Cognitive Functioning, Locomotor Activity and Mental Health

A variety of organisms including mammals have evolved a 24h, self-sustained timekeeping machinery known as the circadian clock (biological clock), which enables to anticipate, respond, and adapt to environmental influences such as the daily light and dark cycles. Proper functioning of the clock plays a pivotal role in the temporal regulation of a wide range of cellular, physiological, and behavioural processes. The disruption of circadian rhythms was found to be associated with the onset and progression of several pathologies including sleep and mental disorders, cancer, and neurodegeneration. Thus, the role of the circadian clock in health and disease, and its clinical applications, have gained increasing attention, but the exact mechanisms underlying temporal regulation require further work and the integration of evidence from different research fields. In this review, we address the current knowledge regarding the functioning of molecular circuits as generators of circadian rhythms and the essential role of circadian synchrony in a healthy organism. In particular, we discuss the role of circadian regulation in the context of behaviour and cognitive functioning, delineating how the loss of this tight interplay is linked to pathological development with a focus on mental disorders and neurodegeneration. We further describe emerging new aspects on the link between the circadian clock and physical exercise-induced cognitive functioning, and its current usage as circadian activator with a positive impact in delaying the progression of certain pathologies including neurodegeneration and brain-related disorders. Finally, we discuss recent epidemiological evidence pointing to an important role of the circadian clock in mental health.

Circadian preference is associated with multiple domains of trait and state level impulsivity

Impulsivity is a multidimensional construct with well-documented risk for substance use problems at both the trait- and state levels. A circadian preference towards eveningness has been linked to trait-level, global impulsivity, but whether this association holds true across multiple dimensions of impulsivity and whether actual sleep timing shows parallel associations with impulsivity remain unclear. Here, we extend existing literature by investigating whether eveningness is associated with multiple facets of both trait- and state-level impulsivity. We also examined these associations utilizing daily measures of sleep timing and duration and explored whether they differed by sex and/or race. All participants were moderate-to-heavy social drinkers aged 21-35. Primary analyses included 78 participants (100% White male participants: Sample 1) with circadian preference data (Composite Scale of Morningness: CSM) and sleep timing (midsleep) and duration assessed via daily self-report over 10 days. Five facets of impulsivity were assessed via the UPPS-P, both at baseline (full scale; trait-level) and up to 6 times per day over 10 days (reduced scale; state-level). Linear regression and mixed-effects models were used to examine between- and within-person associations of impulsivity with measures of circadian preference, timing, and duration, accounting for covariates. Exploratory analyses combined Sample 1 with an additional more diverse sample (Sample 2), resulting in a total of 182 participants (29.1% self-identified as Black, 29.7% as female) with daily self-report sleep timing and duration only (no circadian preference). Primary between-person models found that eveningness was associated with multiple facets of impulsivity, at trait (lack of perseverance) and state levels (negative and positive urgency, lack of perseverance, and lack of premeditation), while average midsleep and duration were generally unrelated to impulsivity. Primary within-person models largely paralleled the between-person findings. Exploratory analyses in the larger combined Samples 1 and 2 (without circadian preference) found that later midsleep timing was associated with greater mean state-level impulsivity across multiple facets, associations that may differ by race and sex. In a sample of White male participants, circadian preference for eveningness was strongly associated with multiple facets of impulsivity, at both trait- and state-levels, which may contribute to risk for substance use. Preliminary findings suggest sex and race differences in sleep-impulsivity associations, but future research with objective sleep/circadian measures in larger, more diverse samples will be important to clarify implications for sleep-focused prevention and/or treatment of substance use.

Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

Background

During adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings.

Aims

This prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups.

Method

A total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown–Goodwin Lifetime History of Aggression scale, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale and State–Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS).

Results

The sample comprised 28 individuals aged 18–29 years, 202 aged 30–49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18–29 years old) individuals were significantly more aggressive than older (≥50) ones (P < 0.001).

Conclusions

This study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.

Delayed circadian rhythms and substance abuse: dopamine transmission's time has come

Disrupted sleep and circadian rhythms are linked with substance abuse risk. Human studies that investigate relationships between sleep, circadian rhythm, and substance use reward generally rely on indirect means to infer dopaminergic function, such as functional magnetic resonance imaging. In this issue of the JCI, Zhang and colleagues used positron emission tomography (PET) to image striatal dopamine D1 (D1R) and D2/3 receptor (D/3R) availability in healthy adults. The authors assessed rest-activity rhythms, then conducted PET scans using radioligand antagonists selective for D1 receptors or D2/D3 receptors to measure D1R and D2/3R availability. They also measured the subjective drug effects of oral methylphenidate. Higher D1R availability in caudate and a greater methylphenidate reward sensitivity were associated with delayed rest-activity rhythms. Unexpectedly, lower overall activity was associated with higher D2/3R availability in the nucleus accumbens, which coincided with greater methylphenidate reward score. These findings may inform personalized prevention and/or treatment interventions.

Diurnal preference and depressive symptomatology: a meta-analysis

Eveningness, a preference for later sleep and rise times, has been associated with a number of negative outcomes in terms of both physical and mental health. A large body of evidence links eveningness to Major Depressive Disorder (MDD). However, to date, evidence quantifying this association is limited. The current meta-analysis included 43 effect sizes from a total 27,996 participants. Using a random-effects model it was demonstrated that eveningness is associated with a small effect size (Fisher's Z = - 2.4, 95% CI [- 0.27. - 0.21], p < 0.001). Substantial heterogeneity between studies was observed, with meta-regression analyses demonstrating a significant effect of mean age on the association between diurnal preference and depression. There was also evidence of potential publication bias as assessed by visual inspection of funnel plots and Egger's test. The association between diurnal preference and depression is small in magnitude and heterogenous. A better understanding of the mechanistic underpinnings linking diurnal preference to depression and suitably powered prospective studies that allow causal inference are required.

Association of Prefrontal Cortex Thinning with High Impulsivity in Healthy Adults

OBJECTIVE

Studies have been conducted to identify brain structural alterations related to high impulsivity in psychiatric populations. However, research on healthy subjects is relatively less extensive. Therefore, we aimed to investigate the correlation between the cortical thickness of whole brain regions and the impulsivity level in a healthy population.

METHODS

We included 100 healthy participants aged 19-65 years. Their T1-weighted magnetic resonance images and the 23-item Barratt Impulsiveness Scale (BIS) score were obtained. The patients were divided into high and low impulsivity groups according to the 75th percentile score of the BIS in the sample. The thickness of each cortical region was calculated using the FreeSurfer, and the difference in cortical thickness of the whole brain between the high and low impulsivity groups was analyzed using one-way analysis of covariance including age, sex, education level, and total intracranial cavity volume as covariates.

RESULTS

The high impulsivity group showed significant cortical thinning in the left pars opercularis. The cortical thickness of the left pars opercularis significantly correlated negatively with the total, attention, and motor scores of the BIS scale.

CONCLUSION

Our findings suggest that prefrontal cortex thinning may play an important role in the development of high impulsivity in healthy adults.

Morning affect, eveningness, and amplitude of diurnal variation: associations with parent adult-child relationships, and adult attachment style

Eveningness, as opposed to other chronotypes, in childhood and adolescence is associated with more parental conflicts, such as regarding bed and rising times, which might adversely influence future relationships with parents, and adult attachments. The current survey of 524 Chinese university students (mean = 20.05 and range 18-36 years of age) investigated whether eveningness shows these adverse associations. Morning affect and amplitude distinctness facets of circadian functioning were also assessed. It was found that eveningness is not related to adults' perception of current parental relationships, or to adult attachment security, but low morning affect and stronger amplitude distinctness were associated with perception of more fatherly control, less regard for parents, and more attachment insecurity, and these were related to poorer wellbeing. These findings indicate that components of circadian functioning are related to the quality of adult relationships. Further research is needed to confirm these findings and establish explanatory mechanisms for these associations.

Associations between diurnal preference, impulsivity and substance use in a young-adult student sample

A diurnal preference for eveningness is common in young adulthood and previous research has associated eveningness with anxiety symptoms as well as increased smoking and alcohol use behaviors. There is some evidence that impulsivity might be an important explanatory variable in these associations, but this has not been comprehensively researched. Here we used both subjective and objective measures of impulsivity to characterize impulsive tendencies in young adults and investigated whether trait impulsivity or trait anxiety could mediate the link between eveningness and substance use. A total of 191 university students (169 females), age range 18-25 y, completed the study. Diurnal preference, sleep quality, anxiety, impulsivity, and substance use were assessed by questionnaire. Impulsivity was also measured using a delay discounting task. Eveningness correlated with trait anxiety and trait impulsivity, and these associations were still significant after controlling for sleep quality. On the delayed discounting task, eveningness correlated with a tendency to prefer smaller immediate rewards over delayed, larger ones. Evening types also reported higher levels of alcohol and cigarette use even after controlling for sleep quality. These associations were found to be completely mediated by self-reported impulsivity; anxiety did not contribute. The current results could help inform interventions aiming to reduce substance use in young adult populations.

Anger-Related Characteristics According to Chronotypes in Bipolar or Depressive Disorders

OBJECTIVE

Though anger was highly associated with eveningness in general population, there is no study on the relationship between chronotype and anger-related characteristics in bipolar or depressive disorders. This study aimed to investigate the difference of anger-related characteristics according to chronotypes in bipolar or depressive disorders.

METHODS

Patients with bipolar or depressive disorders (n=238) were included in this study. Their chronotypes and anger-related characteristics were assessed with a self-evaluation of the Composite Scale of Morningness (CSM), the State Trait Anger Expression Inventory (STAXI) and the Anger Coping Scale (ACS).

RESULTS

The eveningness group in patients with mood disorders showed the highest scores of anger-trait (p<0.001), anger-expression (p=0.002) and anger-in (p<0.001) in STAXI subscales, verbal aggression (p=0.010) in ACS subscales among three groups, but the morningess group showed the lowest scores of these subscales among three groups. However, there were no significant differences in all subscales of the STAXI and ACS according to diagnostic subtypes in the Friedman test.

CONCLUSION

The results of this study suggested that eveningness in patients with mood disorders might be related to anger proneness and maladaptive anger coping. To manage anger emotion in the patients with mood disorders, therapeutic interventions to modulate eveningness might be helpful.

Angry night birds: Emotionality, activity and sociability temperament in adolescent chronotypes

There is growing interest in personality profiles associated with morningness-eveningness to foster an understanding of the behaviors and mental states of chronotypes. This study aimed to analyze the domains of emotionality, activity and sociability (EAS) temperament in relation to morningness-eveningness in adolescents. A sample of 539 school pupils aged 13-19 years completed the EAS Temperament Survey, the Composite Scale of Morningness and the Munich Chronotype Questionnaire. Amongst the five EAS domains (emotionality-distress, emotionality-fearfulness, emotionality-anger, activity and sociability), greater emotionality-anger was related to eveningness, while greater emotionality-distress was related to lower social jet lag. The results suggest that evening chronotypes can be temperamentally inclined to anger. The possible mechanisms of this association are discussed.

Diurnal Preference and Grey Matter Volume in a Large Population of Older Adults: Data from the UK Biobank

Eveningness (a diurnal preference for evening time) is associated with a number of negative health outcomes and risk and prevalence for psychiatric disorder. Our understanding of the anatomical substrates of diurnal preference, however, is limited. The current study used Voxel-Based Morphometry to compare grey matter volume in a large sample (N = 3730) of healthy adults determined by questionnaire to be either definite morning-type or definite evening-type. Eveningness was associated with increased grey matter volume in precuneus, brain regions implicated in risk and reward processing (bilateral nucleus accumbens, caudate, putamen and thalamus) and orbitofrontal cortex. These results indicate an anatomical-basis for diurnal preference which may underlie reported differences in behaviour and brain function observed in these individuals.

Are Owls and Larks Different When it Comes to Aggression? Genetics, Neurobiology, and Behavior

This review focuses on the contribution of circadian rhythms to aggression with a multifaceted approach incorporating genetics, neural networks, and behavior. We explore the hypothesis that chronic circadian misalignment is contributing to increased aggression. Genes involved in both circadian rhythms and aggression are discussed as a possible mechanism for increased aggression that might be elicited by circadian misalignment. We then discuss the neural networks underlying aggression and how dysregulation in the interaction of these networks evoked by circadian rhythm misalignment could contribute to aggression. The last section of this review will present recent human correlational data demonstrating the association between chronotype and/or circadian misalignment with aggression. With circadian rhythms and aggression being a burgeoning area of study, we hope that this review initiates more interest in this promising and topical area.

Time of Day Matters: An Exploratory Assessment of Chronotype in a Forensic Psychiatric Hospital

A growing body of evidence links the late chronotype to mental illness, aggression, and aversive personality traits. However, much of what we know about these associations is based on healthy cohorts, and it is unclear how individuals with high levels of aggression, including forensic psychiatric populations, but not offenders, are affected. The present study aimed to measure chronotype in a forensic psychiatric inpatient population, evaluate the impact of diagnosis, and identify any interactive relationships between chronotype, diagnosis, aggression, and dark triad traits. Subjects completed the reduced Morningness-Eveningness Questionnaire (rMEQ), Munich ChronoType Questionnaire (MCTQ), Pittsburgh Sleep Quality Index (PSQI), Buss Perry Aggression Questionnaire-Short Form (BPAQ-SF), and Short Dark Triad Questionnaire (SD3). We sampled 55 forensic psychiatric patients (52 males) between the ages of 23 and 73 years (mean ± SD: 39.6 ± 14.3 years). Among the patients sampled, 25% were evening types and 36% were morning types. Eveningness was greater in patients with a personality disorder; however, no chronotype differences were found for psychosis patients. Patients without psychosis had a positive association between anger and eveningness, as well as between hostility and eveningness. For subjects with a substance use disorder, morningness was positively associated with narcissism. Conversely, an association between eveningness and greater narcissism was identified in patients who did not have a substance use disorder. These findings suggest that, compared to the general population, evening types are more prevalent in forensic psychiatric populations, with the strongest preference among patients diagnosed with a personality disorder. No differences in chronotype were identified for psychosis patients, which may be related to anti-psychotic medication dosing. Given the sex distribution of the sample, these findings may be more relevant to male populations.

Individual Differences in the Neural Basis of Response Inhibition After Sleep Deprivation Are Mediated by Chronotype

Sleep deprivation (SD) has been reported to severely affect executive function, and interindividual differences in these effects may contribute to the SD-associated cognition impairment. However, it is unclear how individual differences in chronotypes (morning-type, MT; evening-type, ET) influence neurobehavioral functions after SD. To address this question, we used functional magnetic resonance imaging (fMRI) to evaluate whether 24 h of SD differentially affect response inhibition, a core component of executive function, in MT and ET individuals. Accordingly, MT and ET participants were instructed to follow their preferred 7–9-h sleep schedule for 2 weeks at home both prior to and throughout the course of the study, and then performed a go/no-go task during fMRI scanning at 08:00 a.m. both at rested wakefulness (RW) and following SD. We also examined whether the neurobehavioral inhibition differences in the chronotypes in each session can be predicted by subjective ratings (sleepiness, mood, and task) or objective attention. Behaviorally, SD led to an increased response time of go trials (hit RT), more attentional lapses, higher subjective sleepiness, and worse mood indices, but it did not impair the accuracy of go trials (hit rate) and no-go trials (stop rate). Regardless of the presence of SD, ET individuals exhibited a lower stop rate, higher subjective ratings of sleepiness, exhausted mood, and task difficulty in comparison with MT individuals. On the neural level, SD resulted in decreased inhibition-related activation of the right lateral inferior frontal gyrus (rIFG) in MT individuals and increased rIFG activation in ET individuals. Moreover, the rIFG activation in ET individuals after SD was positively correlated to the subjective ratings of sleepiness and effort put into the task, which was considered as a compensatory response to the adverse effects of SD. These findings suggest that individual differences in inhibition-related cerebral activation after SD are influenced by chronotypes. In addition, ET individuals may be vulnerable to response inhibition. Thus, it is essential to take into consideration the chronotype in SD research and sleep medicine.

Biological Clocks and Rhythms of Anger and Aggression

The body’s internal timekeeping system is an under-recognized but highly influential force in behaviors and emotions including anger and reactive aggression. Predictable cycles or rhythms in behavior are expressed on several different time scales such as circadian (circa diem, or approximately 24-h rhythms) and infradian (exceeding 24 h, such as monthly or seasonal cycles). The circadian timekeeping system underlying rhythmic behaviors in mammals is constituted by a network of clocks distributed throughout the brain and body, the activity of which synchronizes to a central pacemaker, or master clock. Our daily experiences with the external environment including social activity strongly influence the exact timing of this network. In the present review, we examine evidence from a number of species and propose that anger and reactive aggression interact in multiple ways with circadian clocks. Specifically, we argue that: (i) there are predictable rhythms in the expression of aggression and anger; (ii) disruptions of the normal functioning of the circadian system increase the likelihood of aggressive behaviors; and (iii) conversely, chronic expression of anger can disrupt normal rhythmic cycles of physiological activities and create conditions for pathologies such as cardiovascular disease to develop. Taken together, these observations suggest that a comprehensive perspective on anger and reactive aggression must incorporate an understanding of the role of the circadian timing system in these intense affective states.

Sleep Problems in Relation to Smoking and Alcohol Use in Chinese Adolescents

This study examined sleep patterns and sleep problems in relation to smoking and alcohol use in Chinese adolescents. A questionnaire survey of 2090 adolescent students was conducted in Lijin County, Shandong, China. A self-administered questionnaire was used to collect the data. After adjustment for demographics and internalizing and externalizing problems, poor sleep quality was associated with increased risk of smoking (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.24-5.40), alcohol use (OR, 2.65; 95% CI, 2.81-3.89), and getting drunk (OR, 2.81; 95% CI, 1.72-4.57); sleeping 7 hours (OR, 1.64; 95% CI, 1.20-2.43) and sleeping 6 hours or less per night on weekdays (OR, 1.97; 95% CI, 1.25-3.10) were significantly associated with increased risk for alcohol use, and sleeping 6 hours or less per night on weekends (OR, 2.09; 95% CI, 1.18-3.70) were significantly associated with increased risk for getting drunk; and hypnotic medication use was significantly associated with ever smoking (OR, 1.80; 95% CI, 1.08-2.99). These findings highlight the potential role of sleep intervention in the prevention of adolescent substance use.