Trajectories of Actigraphy-Derived Sleep Duration, Quality, and Variability from Childhood to Adolescence: Downstream Effects on Mental Health

STUDY OBJECTIVES

We examined growth trajectories of four actigraphy-derived sleep parameters (sleep minutes, sleep efficiency, and variability in sleep minutes and efficiency across a week of assessments) across childhood and adolescence and examined individual differences in trajectories according to participants' race/ethnicity and sex. We also assessed the predictive effect of growth trajectories of sleep parameters on growth trajectories of mental health outcomes and moderation by race and sex.

METHOD

Youth (N=199, 49% female, 65% White, 32% Black, 3% biracial) and their parents participated in five waves of data (M ages were 9, 10, 11, 17, and 18 across waves). Participants were from a diverse range of socioeconomic backgrounds.

RESULTS

Across participants, sleep minutes, sleep efficiency, and variability in sleep minutes and efficiency demonstrated significant linear change across childhood and adolescence. Whereas sleep duration shortened over time, sleep efficiency improved. Youth exhibited increases in night-to-night variability in sleep minutes and reductions in night-to-night variability in sleep efficiency. Highlighting the importance of individual differences, some race- and sex-related effects emerged. Black youth and male youth experienced steeper declines in their sleep duration across development relative to their respective counterparts. Black youth also demonstrated smaller improvements in sleep efficiency and greater variability in sleep efficiency compared to White youth. Finally, trajectories of sleep efficiency and variability in sleep minutes predicted trajectories of internalizing symptoms and externalizing behaviors.

CONCLUSIONS

Findings showed significant changes in developmental trajectories of four sleep parameters across childhood and adolescence. We discuss empirical and translational implications of the findings.

Do Sleep Problems Exacerbate the Mental Health Consequences of Discrimination Among Adults?

OBJECTIVE

An emerging literature suggests that sleep may play an important role in moderating the association between discrimination and mental health problems among adolescents. However, few if any studies have considered this topic among adults. Addressing this knowledge gap, the current study examined multiple sleep parameters as moderating variables in the association between discrimination and mental health problems among adults.

METHODS

Participants were 874 adults residing in small towns and semirural contexts within the Southeastern region of the United States ( Mage = 41 years, SD = 7; 57% female; 31% Black, 69% White; 52% income-to-needs < 2). Sleep duration and night-to-night variability in duration were assessed using wrist actigraphy. Established self-report measures were used to assess global sleep problems, experiences of discrimination, and mental health problems (anxiety, depression, and externalizing symptoms).

RESULTS

Experiences of discrimination were associated with more depression, anxiety, and externalizing problems. Two out of three sleep parameters were found to moderate the effects of discrimination on mental health. The association between discrimination and externalizing problems (but not anxiety or depression) was attenuated among those with less night-to-night variability in sleep duration. The associations between discrimination and anxiety and externalizing problems (but not depression) were attenuated among those with fewer global sleep problems. Less variability in sleep duration and fewer global sleep problems were also directly associated with lower levels of depression, anxiety, and externalizing problems.

CONCLUSIONS

Greater consistency in sleep duration from night-to-night, and fewer overall sleep problems appear to mitigate risk of mental health problems among adults, particularly in contexts where discrimination is prevalent.

Coping Responses in the Context of Family Stress Moderate the Association Between Childhood Anxiety and Adolescent Depressive Symptoms

Anxiety and depressive symptoms are common and highly interrelated. A relatively consistent temporal pattern of anxious and depressive symptoms has emerged from previous studies, such that the development of anxiety tends to precede and predict the development of depression rather than the other way around. Whether high levels of childhood anxiety predict depressive symptoms in late adolescence may depend, in part, on the ways in which children cope with stressful events. Accordingly, the present study used latent intercept models to examine involuntary and voluntary coping responses to familial stress as potential moderators of the association between childhood anxiety and adolescent depressive symptoms. Two hundred twenty-seven participants completed questionnaires measuring demographic variables as well as anxiety, depressive symptoms, and coping responses at a minimum of one time point over four waves of data collection (T1 Mage = 10.26 years, T2 Mage = 15.77 years, T3 Mage = 16.75 years, T4 Mage = 17.68 years). We found that childhood anxiety was positively associated with adolescent depressive symptoms when children reported higher levels of involuntary responses to family stress (e.g., rumination or physiological arousal) in conjunction with either lower levels of voluntary engaged responses (e.g., problem solving or emotion regulation) or higher levels of voluntary disengaged responses (e.g., avoidance or denial). These results shed light on the conditions under which childhood anxiety is associated with adolescent depressive symptoms and underscore the need for continued longitudinal and developmental research on this topic.

Maternal psychological control and adolescent adjustment: Sleep as a moderator

Maternal psychological control has been linked consistently to poorer adjustment for adolescents, however, studies of variability in the association between psychological control and adjustment are rare. Sleep serves crucial bioregulatory functions that promote well-being and protect youths against poor adjustment associated with negative family environments. We hypothesised that the link between maternal psychological control and adolescent maladjustment would be strongest for youths with poorer actigraphy-based sleep. The current study included 245 adolescents (Mage  = 15.79 years, 52.2% girls, 33.1% Black/African American and 66.9% White/European American; 43% at or below the poverty line). Adolescents reported on their mothers' psychological control toward them, as well as their internalising and externalising symptoms (aggressive and rule breaking behaviours). Several sleep variables were derived: minutes, onset time, and variability in each parameter over 1 week. For youths with shorter, less consistent sleep (both mean levels and variability in minutes and onset), maternal psychological control was associated with adjustment difficulties, especially externalising symptoms. This association was not significant for youth obtaining longer, more consistent sleep. The results were most evident for variability in sleep minutes and onset as moderators of effects. The findings suggest that longer and more consistent sleep is an important protective factor in the context of more controlling parenting.

Longitudinal relations between interpartner aggression and internalizing symptoms among couples: The moderating role of sleep

Recipients of interpartner aggression often experience internalizing symptoms. However, individual differences exist, and elucidation of factors that attenuate or exacerbate risk are needed to explicate relations and better inform interventions aimed at reducing mental health sequelae of interpartner aggression. Sleep problems compromise coping abilities and are known to exacerbate risk for mental health problems in the context of family risk. We examined whether sleep problems moderated the extent to which the recipients of interpartner aggression experience internalizing symptoms over time. At the first wave, 194 couples participated (M age [women] = 41.81 years, SD = 5.85; M age [men] = 43.75 years, SD = 6.74; 71% White/European American, 26% Black/African American, 3% other race/ethnicity). Two years later, couples returned for a second wave. Psychological and physical forms of interpartner aggression were measured using self- and partner-reports. Sleep duration (minutes) and sleep quality (efficiency) were derived using actigraphy, and subjective sleep/wake problems were also assessed. Individuals self-reported on their own internalizing symptoms. After controlling for autoregressive effects, sleep moderated the extent to which the recipients of interpartner aggression experienced internalizing symptoms longitudinally. Lower sleep efficiency and more subjective sleep/wake problems among women exacerbated the extent to which interpartner aggression forecasted their internalizing symptoms. Lower sleep efficiency among men magnified relations between interpartner aggression and their internalizing symptoms. Findings help understand the multiplicative influence that family risk and sleep problems have on mental health over time.

The pandemic and social experience: For whom did discrimination and social isolation increase?

OBJECTIVE

The objective of this study was to examine whether experiences of discrimination have increased during the pandemic, particularly among negatively stigmatized racial/ethnic groups, and whether such experiences have exacerbated feelings of social isolation.

METHOD

Discrimination and social isolation were assessed before and during the pandemic in a sample of 263 Black and White young adults attending a large, predominantly White 4-year research university in the Southeastern region of the United States (52% Black, 48% White, 53% female, mean age = 19.2).

RESULTS

Increases in discrimination were evident among Black but not White participants. Black participants also reported greater increases in social isolation than White participants, and changes in discrimination partially mediated the emergent racial disparity in social isolation.

CONCLUSIONS

Findings are consistent with theoretical perspectives on discrimination during times of stress and suggest the need for broader attention to the impact of the pandemic on unfair treatment of stigmatized groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Family income as a moderator of relations between sleep and physical health during adolescence

OBJECTIVES

Sleep duration, quality, and consistency are associated with overall physical health in adolescence, yet the effects of sleep on development may be not uniform because both sleep and physical health vary systematically along gradients of family income. To understand "for whom" sleep may be particularly beneficial, the present study tested family income as a moderator of relations between youth sleep and physical health.

METHODS

Three hundred twenty-three youth (M age=17.39years; 53% female; 41% Black, 59% White) wore wrist actigraphs for 1week at home. Four well-recognized sleep parameters were derived: minutes, efficiency, long wake episodes, and variability in minutes across the week. Parents reported family income, and mothers rated adolescents' physical health. In independent path models, physical health was regressed onto each indicator of sleep, family income, and Sleep × Family Income interactions to test potential moderation effects.

RESULTS

Associations between sleep and physical health were moderated by family income. Lower sleep efficiency, more long wake episodes, and more variability in sleep minutes were associated with poorer physical health among adolescents from lower-income families. At optimal levels of all sleep variables, income-based differences in physical health were mitigated. Youth from higher-income families tended to have better physical health regardless of their sleep.

CONCLUSIONS

Findings build evidence that sleep has relations with physical health for low-income youth in particular. Clinicians and other service providers working with youth might benefit from considering the role of sleep in prevention and interventions programs geared toward improving health.

Parental drinking and observations of parent-child problem-solving discussions: Do drinking motives matter?

Alcohol is often used for emotion-regulation purposes, yet there has been little research on how emotion-regulation drinking motives relate to parenting. The present study addresses this gap by investigating possible interactions between parent drinking and drinking motives in the prediction of parenting and child affectivity during a problem-solving interaction. Participants included 199 two-parent families with a child between the ages of 6 and 12 years. Mothers and fathers self-reported their drinking and drinking motivations, and each parent separately took part in a 5-min parent-child problem-solving discussion about a topic that the parent identified as a frequent source of conflict. These discussions were later coded for parent rejection and coercion and child positive and negative affectivity. Father enhancement motives were independently related to father harsh parenting and indirectly related to lower child positive affect and greater child negative affect. Mother drinking to regulate positive and negative emotions interacted with mother drinking in association with mother harsh parenting, father harsh parenting, and child positive and negative affect during father-child interactions. Although the pattern of these interactions differed, the combination of mother greater drinking and coping or enhancement motives tended to have higher harsh parenting, child positive affect, and child negative affect. These findings indicate that parents' emotion-regulation motives for drinking warrant greater attention from researchers to understand the impact of parent drinking on parenting and emotional development of children. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Parental Problem Drinking and Maladaptive Personality Features in Children: The Role of Marital Conflict

The personality characteristics of children of exposed to parental problem drinking have been of interest to clinicians and researchers for several decades, but personality research on this population often focuses on identifying a unique cluster of adult personality traits. The current study adopts a cutting-edge dimensional approach to understanding personality pathology as extreme variants of the five factor model, and examines pathways of risk to personality pathology through marital conflict and emotional insecurity. Participants were 199 two-parent families with a child between the ages of 6 and 12 years. Parents completed questionnaire measures of their problem drinking, marital conflict, child emotional insecurity (i.e., emotional reactivity to conflict), and child maladaptive personality traits. Structural equation models found an indirect pathway from mother and father problem drinking to pathological child disagreeableness, introversion, emotional instability, and compulsivity via greater mother destructive marital conflict behavior and child emotional reactivity to conflict. There was also some evidence that this pathway of effects was stronger for girls than for boys. Findings support the use of a dimensional approach to understanding maladaptive personality among individuals exposed to parental problem drinking.

Neighborhood environment and adolescent sleep: The role of family socioeconomic status

OBJECTIVES

Socioeconomic status (SES) and neighborhood context are influential predictors of adolescent sleep, yet little is known about how they may interact to influence sleep. We examined multiple dimensions of family SES as moderators of associations between neighborhood risk and multiple sleep parameters.

METHODS

Participants were 323 adolescents (Mage = 17.4 years, SD = 0.86; 48% male; 60% White/European American, 40% Black/African American). Sleep was assessed using 7 nights of actigraphy from which sleep duration (minutes from onset to wake time), efficiency, long wake episodes, and variability in minutes over the week were derived. Youth reported on their sleep/wake problems and sleepiness, as well as their perceptions of safety and violence in their neighborhoods. Parents reported on SES indices, including income-to-needs ratio and perceived financial stability.

RESULTS

Lower SES (income-to-needs, perceived financial stability) was associated with lower sleep efficiency and more frequent long wake episodes. Lower neighborhood safety and greater community violence concerns were related to greater subjective sleep problems. Moderation effects illustrated two general patterns. For actigraphy-derived sleep variables, lower neighborhood safety was associated with poor sleep only among youth from lower-income families. For subjective sleep/wake problems and daytime sleepiness, associations between neighborhood risk and sleep difficulties were pronounced for higher SES youth, while lower SES youth had greater sleep problems regardless of neighborhood factors.

CONCLUSIONS

Findings suggest that several dimensions of SES and neighborhood risk may be consequential for adolescents' sleep. Moderation effects highlight the significance of considering multiple contextual influences towards a better understanding of adolescents' sleep.

Effect of a self-care program among women with urinary incontinence: A quasi-experimental study

Urinary incontinence is a multifactorial health problem that significantly affects women's quality of life. This quasi-experimental pre/post-test study aimed to evaluate the effect of a self-care program on women suffering from urinary incontinence. The study was conducted at the urodynamic unit within Ain Shams Maternity University Hospital, with a purposive sample of 100 women diagnosed with urinary incontinence, with no medical or surgical conditions, and who were not pregnant. A structured interview questionnaire and women's self-care practices checklists were used as study tools. The results showed that 72.0% of the study group and 68.0% of the control group were housewives. Significantly improved self-care practices and bladder retraining were observed in the study group compared to the control group post-intervention and during follow-up (p<0.001). Furthermore, the study group demonstrated a reduction in the severity of urinary incontinence and improved health practices, whereas the control group did not exhibit significant changes. These findings emphasize the significance of self-care programs in managing urinary incontinence and enhancing women's quality of life.

Social class discrimination during adolescence as a mediator of socioeconomic disparities in actigraphy-assessed and self-reported sleep

OBJECTIVE

To examine social class discrimination as a mediator of socioeconomic disparities in sleep outcomes in an adolescent sample.

METHODS

Sleep was assessed from established actigraphy (efficiency, long wake episodes, duration) and self-report (sleep/wake problems, daytime sleepiness) measures among 272 high school students in the Southeastern region of the United States (35% low income; 59% White, 41% Black, 49% female, Mean age = 17.3, SD = 0.8). Social class discrimination was assessed using a new measure, the Social Class Discrimination Scale (SCDS; 22-items), and an established measure, the Experiences of Discrimination Scale (EODS; 7-items). Socioeconomic disadvantage (SED) was measured as an aggregate of six indicators.

RESULTS

The SCDS was associated with sleep efficiency, long wake episodes, sleep/wake problems and daytime sleepiness (but not sleep duration), and significantly mediated the socioeconomic gradient in each sleep outcome. Black males experienced higher levels of social class discrimination than Black females, White males, or White females. A race by gender moderation effect was evident for two of the five sleep outcomes (sleep efficiency and long wake episodes) suggesting a stronger association between social class discrimination and sleep problems for Black females than White females but no clear race differences among males. The EODS was not associated with objective sleep outcomes or SED but was associated with self-reported sleep and showed a similar pattern of moderation effects.

CONCLUSIONS

Findings suggest that social class discrimination may contribute to socioeconomic disparities in sleep problems, with some variability across measures and demographic groups. Results are discussed in light of evolving trends in socioeconomic health disparities.

Socioeconomic Disparities, Nighttime Bedroom Temperature, and Children's Sleep

We investigated associations between family income-to-needs, nighttime bedroom temperature (NBT), and children's sleep. Using a sample of 46 children (M age = 11.5), we recorded NBT and objective sleep parameters via actigraphy nightly for one week to evaluate within- (night-to-night) and between-person associations. We found consistent evidence for a curvilinear association between NBT and sleep variables at the between-person level, indicating that children who slept in rooms that were "too hot" or "too cold" experienced poorer sleep. Moreover, children in lower income-to-needs families had more extreme NBTs. There was some evidence that family income-to-needs is indirectly related to sleep via NBT, but with interpretational caveats. These findings point to NBT as a potentially modifiable variable, which has implications for practical applications to mitigate effects of socioeconomic disparities on children's sleep.

Attachment to Mother and Father, Sleep, and Well-Being in Late Middle Childhood

The security of attachment has been related to several advantageous developmental outcomes, such as good sleep quality and higher well-being indicators. However, few studies concern the associations between attachment dimensions to both parents, sleep, and well-being in late middle childhood. Our study aims to expand knowledge in this area, clarifying the above-mentioned associations by considering the secure base and safe haven dimensions of attachment. We also investigate the role of sleep as a mediator of the relationship between attachment and well-being. The 258 participants (49.2% girls, mean age = 11.19, SD = 0.85) completed self-report questionnaires regarding attachment (KSS), sleep (SSR), and well-being (CHIP-CE). The results show significant associations between attachment to both parents (0.40 ** ≤ r ≤ 0.61 **) and between attachment security, sleep (-0.21 ** ≤ r ≤ -0.35 **) and child well-being (0.42 ** ≤ r ≤ 0.47 **). Besides, sleep quality partially mediated the relations between all attachment dimensions to both parents and well-being. The results are discussed in light of attachment theory, focusing on the comparison between attachment to mother and father as a valid framework to unravel differences in child well-being, with sleep as a process that can help to explain the mechanisms through which attachment security enables subjective perceptions of well-being.

Longitudinal associations between coping and peer victimization: Moderation by gender and initial peer victimization

Stress coping theories suggest that the effectiveness of coping depends on the level of stress experienced. Existing research shows that efforts to cope with high levels of peer victimization may not prevent subsequent peer victimization. Additionally, associations between coping and peer victimization often differ between boys and girls. The present study included 242 participants (51% girls; 34% Black, 65% White; Mage = 15.75 years). Adolescents reported on coping with peer stress at age 16 and on overt and relational peer victimization at ages 16 and 17. Greater use of primary control engaged coping (e.g., problem-solving) was associated positively with overt peer victimization for boys with higher initial overt victimization. Primary control coping was also associated positively with relational victimization regardless of gender or initial relational peer victimization. Secondary control coping (e.g., cognitive distancing) was associated negatively with overt peer victimization. Secondary control coping was also associated negatively with relational victimization for boys. Greater use of disengaged coping (e.g., avoidance) was associated positively with overt and relational peer victimization for girls with higher initial victimization. Gender differences and the context and level of stress should be considered in future research and interventions related to coping with peer stress.

Attachment and prosocial behavior in middle childhood: The role of emotion regulation

There is a lack of research on the development of prosocial behavior in middle childhood. The current study addressed this gap through the application of attachment theory; attachment security has been shown to promote prosocial behavior in early childhood, and emotion regulation may be an important intervening variable in this association. A sample of 199 children (aged 6-12 years) reported on their attachment internal working models for the mother-child and father-child relationships, parents reported on child emotion regulation and emotional lability/dysregulation, and children completed a sticker donation task to assess their prosocial behavior. Child emotional lability/dysregulation served as an intervening variable in the association between father-child attachment security (communication and trust) and greater sticker donation. Mother-child and father-child attachment security was also associated with child emotion regulation, but emotion regulation was not associated with sticker donation. Findings suggest that secure attachment may foster prosocial behavior toward peers in middle childhood primarily by reducing dysregulated responses to the distress of others.

Ethnic/racial discrimination and academic grades among adolescents: moderation by sleep regularity

This study investigates how sleep regularity moderates the association between ethnic/racial discrimination and academic grades among diverse adolescents. The study included a 14-day, daily diary and actigraphy study of ninth-grade adolescents in the United States (N = 265; mean [SD] age 15.26 [0.62] years, 41.51% Asian, 21.13% Black, 37.35% Latinx, 71.32% female) who completed measures of demographic information and ethnic/racial discrimination (Daily Life Experiences Racism and Bother subscale). Sleep data were collected for 14 consecutive days with wrist actigraphy, and sleep regularity was calculated using the Sleep Regularity Index (SRI). Academic grades were provided by the Department of Education. Discrimination frequency was associated with lower academic grades, and the SRI moderated this association. Compared to adolescents who had moderate and regular SRI profiles, adolescents with irregular SRI (i.e., lower sleep regularity) had stronger negative associations between discrimination and grades. On the other hand, for adolescents who had moderate to high sleep regularity, there was no significant association between discrimination and grades. This study underscores the importance of sleep regularity for adolescents' academic achievement.

Bidirectional associations between nightly sleep and daily happiness and negative mood in adolescents

This study examined bidirectional associations between daily happiness and negative mood and subjective and objective sleep measures. Participants were 311 adolescents (M_age = 17.37 years; 51.8% female; 59.2% White/European American, 38.6% Black/African American, 1% Hispanic/Latinx American, 1.4% multi‐racial; 19.3% below poverty line) observed over a 7‐day period (2017–2018) using sleep diaries and actigraphy. Daily negative mood was related to greater subjective sleep/wake problems, and happiness was related to lower subjective sleep/wake problems. Conversely, shorter self‐reported sleep duration was related to higher negative mood the next day. For actigraphy measures, daily negative mood was related to greater sleep duration and efficiency, whereas happiness was related to lower sleep efficiency. Differences in associations based on subjective versus objective sleep measures are discussed.

Adolescents' sleep and adjustment: Reciprocal effects

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.

Longitudinal associations between adolescents' sleep and adjustment: Respiratory sinus arrhythmia as a moderator

Sleep and autonomic nervous system functioning are important bioregulatory systems. Poor sleep and low baseline respiratory sinus arrhythmia (RSA), a measure of parasympathetic nervous system activity, are associated with externalizing behaviors and depressive symptoms in youth. Rarely, however, have measures of these systems been examined conjointly. The present study examined baseline RSA (RSA-B) as a moderator of longitudinal relations between adolescent sleep and adjustment. Participants were 256 adolescents (52% girls, 66% White/European American, 34% Black/African American) from small towns and surrounding rural communities in the southeastern United States. Sleep (minutes, efficiency, variability in minutes and efficiency) was assessed at age 15 via actigraphs across seven nights. RSA-B was derived from electrocardiogram data collected at rest. Adolescents self-reported externalizing problems and depressive symptoms at ages 15 and 17. Controlling for age 15 adjustment, findings generally demonstrated that sleep predicted age 17 adjustment particularly at higher (rather than lower) levels of RSA-B, such that adolescents with good sleep (more minutes and lower variability) and high RSA-B were at lowest risk for maladjustment. The results highlight the value of examining multiple bioregulatory processes conjointly and suggest that promoting good sleep habits and regulation of physiological arousal should support adolescent adjustment.

Plasma brain-derived neurotrophic factor (BDNF) in Egyptian children with attention deficit hyperactivity disorder

Background

To date, researchers do not fully understand what the aetiology of attention deficit hyperactivity disorder (ADHD) is. As a neurotrophin, the brain-derived neurotrophic factor (BDNF) contributes to the growth of neurons as well as to the efficiency and plasticity of the neuronal synapse, which suggests that it may be a contributing aetiological factor in ADHD. Therefore, we sought to investigate the relationship between ADHD and plasma BDNF, including whether there is an association between BDNF and the degree of severity of ADHD and with ADHD subtypes.

Results

We found significantly elevated plasma BDNF in ADHD subjects in comparison with healthy subjects, but differences among the three subtypes of ADHD did not reach statistical significance.

Conclusion

Compared with the control group, elevated plasma BDNF levels were found in the ADHD group, which suggests it may contribute to the aetiology of ADHD.

Longitudinal relations between parents' sleep problems and harsh parenting

Toward better understanding the determinants of harsh parenting, the present study assessed prospective associations between mothers' and fathers' sleep problems and their harsh parenting toward their child using two waves of data. Children's gender was examined as a moderator of these associations. At the first wave, 257 families participated. Mean age was 36.15 years (SD = 5.70 years) for mothers, 39.78 years (SD = 7.54 years) for fathers, and 10.41 years (SD = 7.85 months) for children. The sample was diverse in terms of race/ethnicity and socioeconomic status with approximately 68% identifying as White/European American and 29% identifying as Black/African American. After approximately 1 year, families participated in a second study wave. Parents' sleep was assessed using actigraphy (sleep minutes, sleep efficiency, and long wake episodes) and mothers and fathers reported on the occurrence of their psychological and physical forms of harsh parenting toward their child. After controlling for autoregressive effects, fewer sleep minutes, reduced sleep efficiency, and more frequent long wake episodes among fathers predicted greater harsh parenting among fathers 1 year later. Child gender moderated some of these associations such that relations between fathers' poorer-quality sleep and higher levels of harsh parenting were more pronounced for boys. Sleep problems among mothers did not predict mothers' harsh parenting over time. Findings build on a growing literature that has considered sleep in the family context and provide novel insight into the influence of parents' sleep on their parenting practices. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Linear and nonlinear associations between the sleep environment, presleep conditions, and sleep in adolescence: moderation by race and socioeconomic status

OBJECTIVE/BACKGROUND

The role of the sleep environment and presleep conditions that may influence adolescents' sleep are understudied. The aims of the current study were to examine linear and nonlinear associations between the sleep environment and presleep conditions and adolescents' daytime sleepiness and sleep/wake problems.

METHOD

Participants included 313 adolescents (M_age = 17.39 years, SD = 10.38 months; 51.4% girls, 48.6% boys; 59.1% White/European American, 40.3% Black/African American) from a wide range of socioeconomic backgrounds living in the southeastern United States. Adolescents completed surveys assessing the sleep environment (eg, light, bedding), four presleep conditions (ie, general worries, family concerns, arousal, somatic complaints), and sleep (daytime sleepiness, sleep/wake problems).

RESULTS

Sleep environment disruptions and worse presleep conditions were positively associated with sleepiness and sleep/wake problems in a linear fashion. Nonlinear associations emerged such that levels of sleepiness increased rapidly between low and average levels of the sleep environment and two presleep conditions (worries, arousal); the slope leveled off between average and high levels. Moreover, linear effects of environmental disruptions, family concerns, somatic complaints, and presleep arousal on sleep/wake problems were moderated by race and/or SES, indicating that positive associations between some presleep conditions and sleep/wake problems were more pronounced for Black and lower SES youth.

CONCLUSIONS

Results support the importance of the sleep environment and multiple presleep conditions and assessments of both linear and nonlinear effects for a better understanding of factors that may contribute to sleep. Additionally, results indicate the sleep environment and some presleep conditions may be more consequential for disadvantaged youth.

Usage and risk with phosphodiesterase type 5 inhibitors in male patients with chronic ischemic heart disease on oral organic nitrates

Background

Combining oral organic nitrates (OON) with phosphodiesterase type 5 (PDE5) inhibitors is contraindicated. Growing and liberal use of PDE5 inhibitors for erectile dysfunction among patients with ischemic heart disease (IHD) could pose serious health consequences especially among patients with IHD on OON.

Purpose

We hypothesize that concomitant prescription of OON and PDE5 inhibitors is prevalent and has increased in recent years, and further that possible co-exposure could be associated with an increased risk of ischemic stroke, myocardial infarction (MI) or acute coronary angiography (CAG).

Methods

During 2000–2018, we included all male patients with history of IHD between 18 and 85 years of age from nationwide Danish health registers. Patients with a history of pulmonary hypertension were excluded and not followed up afterwards if they developed the condition during follow-up. From this cohort, we identified an OON treated subgroup defined by two consecutively redeemed prescriptions of OON within 180 days from each other. Further, to become a case or control, patients had to redeem a prescription of OON within 180 days prior to the event or corresponding date among controls.

Temporal trends during 2001–2018 of PDE5 inhibitor use were calculated among all male patients with IHD and the subgroup on OON. Among OON treated patients, we examined associations between PDE5 inhibitor use and risk of ischemic stroke, MI or CAG using a case-crossover design where each individual serves as his/her own control thereby controlling for time-invariant confounding. The case-crossover design compares an individual's exposure in an index period just before the event occurred to a reference period prior to the index period. We investigated periods of varying length (7, 14, 21 and 28 days). To account for possible temporal trends in the use of PDE5 inhibitors, we also conducted a case-time-control analysis using a control group matched on age and calendar year.

Results

We identified 249,541 male patients with IHD (median age 65 years [IQR 56–73]), and a subgroup of 42,073 (17%) on OON treatment (median age 70 years [IQR 62–77]). From 2001 to 2018, the use of PDE5 inhibitors saw a 6-fold increase among all male IHD patients and a 10-fold rise in the subgroup on OON (Figure 1). The risk of ischemic stroke, MI or CAG following exposure to PDE5 inhibitors was not increased in the OON subgroup in neither the case-crossover nor the case-time-control analyses (Figure 2).

Conclusions

The use of PDE5 inhibitors has increased 6-fold since 2001 among male patients with IHD, and 10-fold among patients on OON–notwithstanding an established absolute contraindication. However, we did not find any evidence of an increased risk of ischemic stroke, MI or acute CAG following exposure to PDE5 inhibitors in the OON subgroup. This suggests that patients on OON are adequately informed and comply with the recommended pause in OON medication prior to PDE5 inhibitor use.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Ib Mogens Kristiansens Almene FondandHelsefonden

Gastrointestinal bleeding risk following concomitant treatment with oral glucocorticoids in patients with atrial fibrillation on direct-acting oral anticoagulants

Background

Oral glucocorticoids and direct-acting oral anticoagulants (DOAC) have both been associated with a risk of gastrointestinal (GI) bleeding. However, drug safety, especially regarding the risk of bleeding, in relation to concomitant treatment with oral glucocorticoids and DOACs is insufficiently explored.

Purpose

We aimed to investigate the short-term risk of GI bleeding in patients with atrial fibrillation (AF) following concomitant treatment with DOACs and oral glucocorticoids.

Methods

Register-based, retrospective and nationwide Danish study including patients with AF and on DOAC treatment during 2012–2018. Patients were defined as exposed to oral glucocorticoids from the date of a redeemed prescription and 60 days forward. We associated concomitant treatment with GI bleeding and reported hazard ratios (HR) via a nested case-control design and standardized 60-day absolute risk adjusted for comorbidities using a cohort design. In both analyses, exposed were compared to non-exposed controls matched on age, sex, calendar year, follow-up time and DOAC agent.

Results

We included 98,376 patients (age [interquartile range]: 75 [68– 82], 44% females) with AF on DOAC treatment. The use of oral glucocorticoids among included patients was widespread with 16% redeeming at least one prescription within three years, 4% redeeming at least five (Figure 1A). Lung disease was the most frequent indication (Figure 1B). Concomitant treatment with DOACs and oral glucocorticoids was associated with an increased incidence of GI bleeding (total n=4,946) compared with only DOAC treatment, including a dose-response trend (&lt;20mg daily dose, HR [95% confidence interval (CI)]: 1.64 [1.38–1.95]; ≥20mg daily dose, HR [95% CI]: 2.29 [1.90–2.77]). Likewise, the standardized 60-day absolute risk of GI bleeding from first oral glucocorticoid exposure was increased compared with non-exposed (Figure 2).

Conclusion

Caution should be exercised when prescribing even short-term oral glucocorticoid treatment for DOAC treated patients, most notably in high doses and for patients with elevated bleeding risk.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Ib Mogens Kristiansens Almene FondandHelsefonden

Changes in Depressive Symptoms, Physical Symptoms, and Sleep-Wake Problems from before to during the COVID-19 Pandemic among Emerging Adults: Inequalities by Gender, Socioeconomic Position, and Race

The impact of the COVID-19 pandemic on emerging adults is of global concern. We examine changes in depressive symptoms, physical symptoms, and sleep-wake problems from before to during the pandemic among college students, and examine inequalities by gender, socioeconomic status (SES), and race (N=263, 52% Black, 48% White, 53% female). As compared to pre-pandemic levels, increases were evident in depressive symptoms, physical symptoms, and sleep problems. Females had greater increases than males in depressive symptoms, sleep problems, and physical symptoms. Students from disadvantaged SES backgrounds had greater increases in physical symptoms. Among White students, those from disadvantaged backgrounds also had greater increases in sleep problems. Lastly, daytime sleepiness increased more among Black male than White male students. Overall, findings suggest notable shifts in sleep and health during the early phase of the pandemic among emerging adults, and that attention to inequality by gender, SES, and race is warranted.

Exposure to peer aggression and adolescent sleep problems: Moderation by parental acceptance

Many adolescents experience or witness aggression by peers at school. The purpose of the current study was to examine associations between exposure to peer aggression (i.e., peer victimization and witnessing school violence) and sleep problems and whether these associations are moderated by parental acceptance. Participants included 272 adolescents attending high school (M age = 17.27 years; 49% female; 59% White/European American, 41% Black/African American). Adolescents reported on exposure to peer aggression, parental acceptance, and two key sleep domains: sleep quality problems and daytime sleepiness. Results indicated that exposure to peer aggression was directly associated with poor sleep quality and sleepiness. Furthermore, peer victimization and witnessing school violence interacted with parental acceptance to predict sleep quality. Specifically, exposure to peer aggression was associated with sleep quality problems at higher (but not lower) levels of parental acceptance. The lowest levels of sleep quality problems were apparent at low levels of peer aggression and high levels of parental acceptance, but parental acceptance did not protect adolescents with high exposure to peer aggression against sleep problems. Findings illustrate the importance of considering moderators of effects and the conjoint roles of family and peer processes when considering individual differences in adolescents' sleep. Future research should examine whether parental strategies targeted to address peer victimization are protective against the detrimental effects of exposure to peer aggression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Discrimination and adjustment in adolescence: The moderating role of sleep

STUDY OBJECTIVES

We examined multiple actigraphy-based sleep parameters as moderators of associations between experiences of general and racial discrimination and adolescent internalizing symptoms (anxiety, depression) and externalizing behavior (rule-breaking). Adolescent sex and race were examined as additional moderators.

METHODS

Participants were 272 adolescents (Mage = 17.3 years, SD = 0.76; 51% male; 59% White/European American, 41% Black/African American). Sleep was assessed using actigraphs for 7 consecutive nights from which sleep duration (minutes), efficiency, and variability in minutes over the week were derived. Youth reported on their experiences of general discrimination, racial discrimination, anxiety, depressive symptoms, and rule-breaking behavior.

RESULTS

Both types of discrimination were associated with poorer adjustment outcomes. Longer sleep duration, greater sleep efficiency, and less variability in sleep duration were protective in associations between race-specific and general discrimination and internalizing symptoms. Findings for duration and efficiency were more pronounced for females such that the adverse effects of discrimination were minimized among females with longer and more efficient sleep. Greater variability in sleep exacerbated rule-breaking behavior among adolescents experiencing general or racial discrimination. Associations did not differ by adolescent race.

CONCLUSIONS

Short and poor-quality sleep may exacerbate internalizing symptoms for adolescents experiencing discrimination, particularly females. Variability in sleep duration was a key moderator of associations between discrimination and internalizing symptoms as well as rule-breaking behavior. Findings illustrate that actigraphy-assessed sleep parameters play a key role in ameliorating or exacerbating adjustment problems associated with discrimination.

The Impact of Daily Discrimination on Sleep/Wake Problem Trajectories Among Diverse Adolescents

This study examines how everyday discrimination is associated with 6-day trajectories of sleep/wake problems, operationalized as sleep disturbance and daytime dysfunction, among 350 diverse adolescents (M_age  = 14.27, SD = 0.61, 69% female; 22% African American, 41% Asian American, 37% Latinx; 24% multiethnic/racial; across participating schools, 72% of students eligible for free/reduced price lunch) in the Northeastern United States. Adolescents encountering discrimination experienced changes in sleep/wake problem trajectories (i.e., significant increases in same-day sleep/wake problems), whereas adolescents reporting no discrimination experienced no changes in trajectories (Cohen's ds = .51-.55). Multiethnic/racial (compared to monoethnic/racial) adolescents experiencing everyday discrimination reported greater same-day sleep/wake problems, yet steeper decreases in sleep/wake problems suggesting stronger impact coupled with faster return to baseline levels.

Linking autonomic nervous system reactivity with sleep in adolescence: Sex as a moderator

The purpose of the present study was to investigate relations between autonomic nervous system (ANS) reactivity across the parasympathetic and sympathetic branches and multiple sleep parameters in adolescence. Participants were 244 adolescents (Mage  = 15.79 years old, SD = 9.56 months; 67.2% White/European-American, 32.8% Black/African-American). Parasympathetic activity was indexed by respiratory sinus arrhythmia (RSA) withdrawal and sympathetic activity was indexed by skin conductance level reactivity (SCL-r), which were examined in response to a laboratory-based stressor (star-tracing task). Sleep was assessed with actigraphs in adolescents' homes for seven consecutive nights. Two sleep parameters were examined: sleep duration indexed by actual sleep minutes and sleep quality indexed by sleep efficiency from sleep onset to wake time. Regression analyses showed that more RSA withdrawal (lower RSA during task than baseline) was associated with shorter sleep, and more SCL-r (higher SCL during task than baseline) was associated with poorer sleep efficiency. Moderation analyses showed that associations linking RSA withdrawal with fewer sleep minutes and poorer sleep efficiency, and SCL-r with fewer sleep minutes were significant only for boys. Results illustrate that higher daytime physiological reactivity (increased RSA withdrawal and SCL-r) is negatively associated with sleep duration and efficiency for adolescents, especially boys.

Trajectories of sleep problems in childhood: associations with mental health in adolescence

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.

Socioeconomic Status and Sleep among Couples

Objective/Background: Lower socioeconomic status (SES) is generally associated with poor sleep but little is known about how different SES indices are associated with sleep duration and quality, or about these relations longitudinally or in cohabiting couples. The main objective was to examine longitudinal associations between multiple SES and sleep parameters in cohabiting adults. Participants: Participants were cohabiting couples (N = 135) of women (M age = 37.2 years, SD = 5.93; 76% White/European American, 18% Black/African American) and men (M = 39.9 years, SD = 7.33; 78% White, 18% Black). Methods: Men and women participated twice with a 1-year lag. At Time (T1), participants reported on multiple SES indices including their income, perceived economic well-being, education, employment status, and occupation. Sleep at T1 and T2 was assessed with self-reports and actigraphs (sleep duration from onset to wake time, %sleep from onset to wake, long wake episodes). Results: Actor effects on actigraphy-assessed sleep parameters were evident for both men and women; low SES was associated with shorter duration and poor quality (%sleep, long wake episodes) sleep. These associations were most pronounced for income-to-needs ratio (men and women) and perceived economic well-being (women only). Partner effects were also evident such that men's employment status was associated with women's longer sleep duration and greater sleep quality (%sleep) whereas women's employment predicted increased subjective sleep problems for men. Conclusion: Findings illustrate the need to consider multiple SES and sleep indices, as well as the family context in studies addressing linkages between SES and sleep.

Racial disparities in adolescent sleep duration: Physical activity as a protective factor

Objectives: Short sleep duration compromises adolescents' functioning across many domains, yet risk for short sleep is not evenly distributed among youth in the United States. Significant Black-White disparities in sleep duration have been observed, with Black/African American youth on average sleeping fewer minutes per night than their White/European American peers. However, not all Black adolescents have short sleep, and identification of moderators of effects, including protective and vulnerability factors in the association between race/ethnicity and sleep duration, is warranted. We examined whether engagement in physical activity attenuates the gap in sleep duration between Black and White teenagers. Method: A sample of 246 adolescents (M_age = 15.79 years; 32.9% Black, 67.1% White) reported on their physical activity and participated in 1 week of at-home actigraphic sleep assessment, which was used to derive sleep duration (minutes scored as asleep from sleep onset to wake time). Results: At higher levels of physical activity, relatively long sleep duration was observed for all youth regardless of their race/ethnicity. However, at lower levels of physical activity, an association emerged between race and sleep minutes, illustrating that youth most at risk for shorter sleep were Black adolescents with lower physical activity. Conclusions: Findings suggest that for Black adolescents, physical activity is a protective factor against short sleep duration and, conversely, low physical activity is a vulnerability factor. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

40 Administration of 0.1µM melatonin during invitro maturation of bovine oocytes regulates autophagy levels in produced embryos

Melatonin, the antioxidant pineal hormone, is a strong regulator for various cellular processes essential for reproduction. Although the protective role of 0.1µM melatonin against the toxicity of different anti-developmental compounds has been elucidated in numerous studies, its effect on the autophagy level in invitro-produced blastocysts has not been entirely clarified. In this study, oocytes were incubated for 24h in the presence and absence of melatonin, administered during IVM, to investigate the effect of 0.1µM melatonin on the developmental competence of bovine oocytes and pre-implantation embryos, autophagy, and quality of embryos. The developmental potential of embryos were basically the stages from oocytes fertilization to blastocyst production. Gene expression levels were evaluated in matured oocytes, whereas blastocysts were used for immunofluorescence experiments. The differences between treated and control groups were analysed using Student’s t-test (GraphPad Prism version 6; GraphPad Inc.), where P-values &lt;0.05 were considered significant. Results showed that oocyte maturation, Day-4 total cleavage, and Day-8 blastocyst development rates were not significantly improved (melatonin: 72±2 vs. control: 69±2 for cleavage rate, and melatonin: 33±1 vs. control: 31±2 for control for Day-8 blastocyst; P&gt;0.05), whereas the level of reactive oxygen species (ROS) was reduced (P&lt;0.05) with addition of melatonin. Using RT-qPCR, cumulus cells-related (HAS2) and apoptosis-related (Bcl2 and SOD2) genes were upregulated, whereas BAX was downregulated in melatonin-treated oocytes. Using immunofluorescence, apoptosis (caspase-3) and autophagy (Beclin-1 and LC3) markers were underexpressed, whereas the PI3K survival protein (P&lt;0.05) and matrix metalloproteinases (MMP-2 and MMP-9; P&gt;0.05) were overexpressed, in Day-8 embryos of melatonin-treatment. Additionally, the total number of cells per blastocysts, inspected via nuclei-based 4′,6-diamidino-2-phenylindole (DAPI) staining was higher in the melatonin-treated group (P&lt;0.05). Taken together, our study demonstrates that 0.1µM melatonin treatment during IVM does not interfere with developmental competence, but improves the quality of IVF-produced embryos by lowering the incidence of autophagy.

Longitudinal relations between sleep and cognitive functioning in children: Self-esteem as a moderator

Short and poor-quality sleep disrupt cognitive functioning, yet associations vary across studies, underscoring the importance of examining individual differences and moderators of risk. Utilizing a multi-method, two-wave longitudinal design, we examined self-esteem as a moderator of relations between actigraphy-derived sleep duration (minutes) and quality (efficiency, long-wake episodes) and children's cognitive functioning 1 year later. During the first study wave (T1), participants were 243 children (47% female) with a mean age of 10.4 years (SD = 8.0 months). The sample was representative of its community, with 37% identifying as Black/African American and 63% White/European American. Children completed a self-esteem measure and wore actigraphs for seven consecutive nights. Participants returned to the lab 1 year later and completed a standardized assessment of cognitive functioning. Results indicated that self-esteem moderated longitudinal associations between sleep quality and cognitive functioning. Specifically, children with both better sleep quality and higher self-esteem performed better relative to other children in the sample.

Linear and Nonlinear Associations between Sleep and Adjustment in Adolescence

BACKGROUND & OBJECTIVES

A growing body of work supports linear associations between sleep and socioemotional adjustment in adolescence. However, associations between sleep and adjustment are not necessarily linear and investigations of nonlinear effects are scarce. This study examined linear and nonlinear relations between several sleep-wake parameters and externalizing behavior and internalizing symptoms in adolescence, and assessed the role of adolescent sex as a moderator of effects.

PARTICIPANTS

Participants were high school students (N = 180; M age = 17.49, SD = .62; 59% female; 68% White/European American, 32% Black/African American) from a wide range of socio-economic backgrounds living in semirural communities and small towns in Alabama.

METHODS

Sleep-wake parameters were indexed by actigraphy-derived sleep minutes and adolescents' reports on morningness-eveningness (circadian preference), sleep-wake problems (sleep quality), and sleepiness. Adolescents completed questionnaires on externalizing behaviors and internalizing symptoms.

RESULTS

Controlling for sleep duration, a higher preference for eveningness and poor sleep quality were associated in a linear fashion with increased externalizing and internalizing symptoms. Nonlinear relations between sleepiness and internalizing symptoms emerged with pronounced sex-related effects, including somewhat delayed accelerating relations for males and rapidly accelerating associations that tended to plateau for females.

CONCLUSIONS

Results illustrate the importance of examining multiple sleep-wake and adjustment variables as well as linear and nonlinear associations.

Sleep and development in adolescence in the context of socioeconomic disadvantage

INTRODUCTION

Sleep problems are associated with negative developmental outcomes in youth, and identification of vulnerability and protective factors is needed to explicate for whom and under which conditions adolescents may be most at risk. Towards this end, we examined socio-economic status (SES) as a moderator of associations between multiple sleep parameters and adolescents' socio-emotional adjustment and cognitive functioning.

METHODS

Participants were 272 adolescents (M age = 17.3 years; 49% girls) and their parents, residing in the Southeastern U.S.A. The sample was socioeconomically diverse and included 41% Black/African American and 59% White/European American youth. Using a cross-sectional design, adolescents' sleep was assessed with actigraphy (total sleep minutes; efficiency indicated by % of time asleep from sleep onset to wake time) and self-reports of sleep quality (sleep-wake problems). Mothers reported on youths' internalizing and externalizing symptoms, and cognitive functioning was assessed with a standardized test battery.

RESULTS

Moderation effects were found and illustrated that, for youth from families with lower SES, shorter and less efficient sleep and subjective sleep problems were associated with higher levels of internalizing and externalizing symptoms as well as lower cognitive performance. Conversely, longer and better-quality sleep protected against socio-emotional and cognitive difficulties otherwise observed for socioeconomically disadvantaged youth. Fewer relations between sleep and adjustment emerged for adolescents from families with higher SES.

CONCLUSIONS

Results reinforce a growing literature indicating that the relation between sleep and adjustment is stronger for youth from families with lower SES, who may especially benefit from better sleep.

Socioeconomic status and sleep in adolescence: The role of family chaos

Low socioeconomic status (SES) has been associated with poor sleep in youth, yet mechanisms underlying this association are not well-understood. The present study examined greater chaos as a mediator of associations between low SES and 2 indices of poor sleep. Two hundred fifty-two adolescents (53% girls; 66% White/European American, 34% Black/African American) participated in the 3-wave longitudinal study. The sample was socioeconomically diverse. At age 16, parents reported on 2 indices of SES: family income and perceived economic well-being. Adolescents reported on chaos within their family at age 17 and on 2 key sleep-wake processes-sleep quality and daytime sleepiness-at age 18. Family chaos functioned as a mediating or intervening variable in longitudinal associations between lower SES and both poorer sleep quality and greater daytime sleepiness. The findings suggest the potential utility of targeting family level processes that exemplify chaos, such as unpredictability, noise, and interruptions, to improve sleep among adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Discrimination and Sleep Mediate Ethnic/Racial Identity and Adolescent Adjustment: Uncovering Change Processes With Slope-as-Mediator Mediation

This study employs slope-as-mediator techniques to explore how the daily association between ethnic/racial discrimination and sleep disturbances serves as an intermediary link between ethnic/racial identity (ERI) and psychological adjustment. In a diverse sample of 264 adolescents (Mage  = 14.3 years old, 70% female, 76% United States born, 25% African American, 32% Asian American, 43% Latinx), discrimination was associated with sleep disturbance. Furthermore, ERI commitment buffered the impact of discrimination on sleep, whereas ERI exploration exacerbated the impact of discrimination. Finally, the daily level association between discrimination and sleep (i.e., daily slope) mediated the association between ERI and adolescent adjustment. Substantive links between discrimination and sleep are discussed as well as broader applications of slope-as-mediator techniques.

What does a good night's sleep mean? Nonlinear relations between sleep and children's cognitive functioning and mental health

STUDY OBJECTIVES

We attempted to identify the duration and quality of sleep associated with the optimal child outcomes in key developmental domains including cognitive functioning, academic performance, and mental health. In doing so, we examined nonlinear associations between the sleep and developmental variables. Based on racial/ethnic disparities in children's sleep, we assessed this variable as a moderator of examined relations.

METHODS

Two hundred eighty-two children participated (Mage = 9.4 years, SD = .72; 52% boys; 65% white/European American, 35% black/African American). Sleep was examined with actigraphy for seven consecutive nights and with self-reports. Actigraphy-based sleep duration (minutes) and quality (efficiency), as well as self-reported sleep quality were derived. Children reported on their mental health and were administered cognitive performance tests. Mothers and teachers reported on children's mental health; teachers also reported on academic functioning. Schools provided academic achievement data.

RESULTS

Sleep duration had an accelerating nonlinear negative association with externalizing behaviors. Nonlinear associations were also detected between both actigraphy-derived and subjective reports of sleep quality and multiple developmental domains including academic functioning and mental health and the best functioning corresponded with the highest levels of sleep quality. Emphasizing the importance of individual differences, several examined associations were moderated by race/ethnicity.

CONCLUSIONS

Sleep duration and quality emerged as nonlinear predictors of multiple domains of child development. Findings illustrate that the benefits of longer and better-quality sleep did not taper off and that assessments of nonlinear relations may enhance understanding of the nature of associations between sleep and child functioning.

Reciprocal Relations Between Parental Problem Drinking and Children's Sleep: The Role of Socioeconomic Adversity

Reciprocal relations between parental problem drinking (PPD) and children's sleep were examined longitudinally, and socioeconomic status was considered as a moderating variable. At Wave 1, 280 children (Mage  = 10.33) and their parent(s) participated, and 275 families returned 1 year later. At both waves, parent(s) reported on PD and children wore actigraphs that measured established sleep parameters. After controlling for autoregressive effects, fathers' PD predicted reduced sleep duration and efficiency in children over time. Supportive of reciprocal effects, more frequent long wake episodes predicted greater PPD. Fathers' PD was a more robust risk factor for lower than higher income children. Results build on a growing literature that has considered children's sleep in a family context.

Dynamic patterns of marital conflict: Relations to trajectories of adolescent adjustment

The deleterious effects of marital conflict on youth outcomes are well-documented in both cross-sectional and longitudinal studies. To date, longitudinal studies have focused on repeated measures of youths' outcomes and the temporal dynamics of marital conflict have largely been ignored. Marital conflict changes over time as contextual and relationship characteristics change, and these patterns of change may provide unique predictive power in accounting for differences in youth outcomes. This study provides a novel exploration of an old idea by focusing on dynamic patterns of marital conflict in predicting trajectories of adolescents' adjustment. All variables were measured at ages 16, 17, and 18 with 252 adolescents (53% female) enrolled in the longitudinal Family Stress and Youth Development Study. Latent growth curve models with latent variable interactions were used to determine whether marital conflict at age 16 (intercept), change over time in marital conflict (slope), and the intercept-slope interaction predicted change over time in adolescent internalizing and externalizing symptoms and levels of internalizing and externalizing symptoms at age 18. Youth exposed to high and increasing levels of marital conflict reported high and stable levels of internalizing and externalizing symptoms across adolescence. Adolescents exposed to low and decreasing levels of marital conflict had consistently fewer symptoms. Furthermore, exposure to initially low but increasing levels of marital conflict was associated with increases in problems across adolescence, which contrasted with findings for youth with initially high marital conflict exposure that decreased over time. Findings are discussed in relation to both conceptual and methodological advances. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Community violence concerns and adolescent sleep: Physiological regulation and race as moderators

Prior work has demonstrated that greater community violence concerns are associated with poor sleep quality among adolescents. However, these effects may not be uniform across all youth. The present study examined the role of individual difference variables, physiological regulation and race, as moderators of risk in the relation between adolescents' community violence concerns and their sleep. Adolescents (N = 219; 55.3% female; 69.9% White/European American, 30.1% Black/African American) participated in the study when they were 18 years old (M = 17.7 years, SD = 1.0). Physiological regulation was assessed via respiratory sinus arrhythmia, a measure of parasympathetic regulation, at rest and in response to a stressor. Adolescents wore actigraphs for 7 nights to assess their sleep duration and quality, and reported on their community violence concerns via a well-validated questionnaire. Results demonstrated a consistent pattern of interactions, such that African American adolescents who showed less adaptive patterns of regulating physiological arousal experienced shorter sleep duration and poorer sleep quality in the context of greater community violence concerns. Community violence concerns were not associated with sleep for White adolescents. The findings may suggest that race-related stressors exacerbate risk for poor sleep among African American adolescents who experience more community violence concerns and have more difficulty regulating physiological arousal. Coping strategies for managing stress and arousal may be helpful for improving sleep for some youth.

Parenting, deviant peer affiliation, and externalizing behavior during adolescence: processes conditional on sympathetic nervous system reactivity

BACKGROUND

This study examined associations between permissive parenting, deviant peer affiliations, and externalizing behavior across mid to late adolescence in a plausible indirect effects model of change over time with deviant peer affiliation serving as the mediator. We also evaluated potential conditional indirect effects wherein these relationships may be moderated by sex and sympathetic nervous system (SNS) activity, indexed by skin conductance level (SCL) reactivity.

METHOD

Participants included 242 community-sampled adolescents (M = 15.79 years; 48% boys; 66% European American, 34% African American) with two additional longitudinal assessments lagged by 1 year. Permissive parenting, SCL reactivity, and sex were considered as time invariant predictors of repeated measures of deviant peer affiliation and externalizing behavior in latent growth models that tested whether any of the direct or indirect associations were conditional on sex or SCL reactivity.

RESULTS

Evidence was found for indirect effects of permissive parenting on externalizing behavior via deviant peer affiliation, but only for males with lower SCL reactivity to stress. Additionally, these effects were found on latent intercepts, but not slopes indexing change over time, perhaps reflecting established individual differences in relationships among these variables.

CONCLUSIONS

Findings are discussed in the context of biosocial models of adolescent development and risk factors that may inform interventions for vulnerable youth.

Racial Disparities in Sleep: Associations With Discrimination Among Ethnic/Racial Minority Adolescents

This study investigates the same-day associations between discrimination and sleep among 350 adolescents ages 13-15 (M = 14.29, SD = 0.65; Asian = 41%, Black = 22%, Latinx = 37%). Assessing sleep duration, sleep onset latency, and wake minutes after sleep onset using wrist actigraphy, Black adolescents slept 35 min less than Asian and 36 min less than Latinx youth. Black adolescents suffered the most wake minutes after sleep onset, followed by Latinx and Asian youth. Latinx youth reported the highest levels of sleep disturbance, whereas Asian youth reported the highest levels of daytime dysfunction. Daily discrimination was associated with lower levels of same-night sleep onset latency, more sleep disturbance, more next-day daytime dysfunction, and higher next-day daytime sleepiness.

The role of couple sleep concordance in sleep quality: Attachment as a moderator of associations

Despite most American adults sharing a bed with a romantic partner, sleep research has examined sleep primarily as an individual behaviour. A growing body of research indicates that couple bed sharing may have an impact on sleep quality, but the current study is the first to examine whether such associations may differ based on attachment security. A sample of 179 cohabiting heterosexual couples completed daily sleep diaries and surveys of their attachment security, avoidance and anxiety. Data were analysed using multilevel modelling. Greater attachment security and lower attachment avoidance were associated with greater subjective sleep quality. Greater sleep concordance (time in bed with partners) was associated with better subjective sleep quality for women with lower attachment security and higher attachment avoidance. Findings suggest that couple bed sharing may benefit the subjective sleep quality of women who have lower attachment security.

Preschoolers' secure base script representations predict teachers' ratings of social competence in two independent samples

Associations between attachment security, assessed as a secure base script (SBS), and teachers' social competence ratings were examined in two samples (one from the Midwest region and the other from the Southern region of the United States). Consistent with previous reports, significant associations between domains were obtained in both samples and after combining the two samples, r = .33, p < .001. The associations remained significant when child sex, age, and verbal intelligence were controlled. Findings are discussed with reference to relations between SBS scores and the covariates. Regarding sex differences, an existing literature suggests that girls, compared with boys, may be advantaged with respect to skills that could support higher scores on the task used to assess secure base scripts. In both samples, teachers rated girls as somewhat higher on scales of social competence and controlling for sex reduced the magnitude of associations between SBS and social competence, but the results remained significant in all tests.