Objective sleep disturbance is associated with poor response to cognitive and behavioral treatments for insomnia in postmenopausal women

Study objectivesTo determine whether insomnia patients with objective sleep disturbance are less responsive to cognitive and behavioral treatments than those without objective sleep disturbance, characterize effects of insomnia therapy on objective sleep, and determine whether reductions in nocturnal cognitive arousal correspond to changes in objective sleep.MethodsSecondary analysis of a single-site, randomized controlled trial. 113 postmenopausal women (56.40 ± 5.34 years) with menopause-related insomnia disorder were randomized to three treatment conditions: cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy (SRT), or sleep education control. Primary outcomes were the Insomnia Severity Index (ISI) and polysomnography (PSG) sleep parameters and were collected at pretreatment, posttreatment, and six-month follow-up.ResultsPatients with lower pretreatment PSG sleep efficiency had lower rates of insomnia remission after active treatment relative to those with higher sleep efficiency (37.8% vs 61.8%). Neither CBTI and SRT produced clinically meaningful effects on PSG sleep. Exploratory analyses revealed that reductions in nocturnal cognitive arousal were associated with decreases in PSG sleep latency, but not wake after sleep onset.ConclusionsOur findings support an emerging literature suggesting that insomnia patients with objective sleep disturbance may have blunted response to insomnia therapy. Research is needed to enhance treatments to better improve insomnia in patients with objective sleep disturbance. A lack of observed CBTI and SRT effects on PSG sleep suggests that these therapies may be presently ill-designed to improve objective sleep. Nocturnal cognitive arousal may represent an entry point to improve objective sleep latency in insomnia.NameBehavioral Treatment of Menopausal Insomnia: Sleep and Daytime Outcomes. URL: clinicaltrials.gov. Registration: NCT01933295.     

Relationship between coping,rumination and posttraumatic growth in mothers of children with autism spectrum disorders

This study examined the relationship between coping, rumination and posttraumatic growth in mothers of children with autism spectrum disorders (ASD). One hundred and two mothers of autistic children in China were surveyed using Post-traumatic Growth Inventory, Trait Coping Style Questionnaire, and Event Related Rumination Inventory. Mothers reported mediate level of PTG, mostly on the growth of personal strength. Hierarchal regression analysis indicated that positive coping positively predicted PTG and growth on “relating to others”; deliberate rumination was positively correlated with growth on “appreciation of life”; and intrusive rumination negatively predicted growth on “personal strength”, “new possibilities” and “spiritual change”. No statistically significant relationship between negative coping and PTG was found. The results may be used to provide mothers with a better understanding of the underlying growth process and assist service providers in facilitating this progress.     

文本交互办公场景中蔑视对攻击与绩效的影响:反刍的调节作用

目的:对文本交互办公场景下的蔑视及其影响进行探索,为企业管理与个人职业生涯决策提供依据。方法:通过Tower软件平台,设计基于文本交互办公场景的多轮商业产品决策任务,对蔑视/失败反馈的影响进行研究。结果:实验一中蔑视组与失败组的攻击(t=3.806,P0.001)与绩效(t=5.989,P0.001)都存在显著差异。实验二中蔑视与攻击(F=55.588,P0.001,η~2=0.042)和绩效(F=12.776,P=0.001,η~2=0.061)的关系再次证实了实验一的结果,同时反刍在蔑视对攻击(F=14.094,P0.001,η~2=0.011)与绩效(F=25.286,P0.001,η~2=0.121)的影响中交互效应显著;绩效(t=6.421,P0.001)与攻击(t=2.763,P=0.007)的简单斜率分析差异显著。结论:在文本工作场景中蔑视将同时导致接受者绩效和攻击的提高;但相对于低反刍特质的个体而言,高反刍特质的个体接受到蔑视会使他们产生更强的攻击,且并不会提高其绩效。     

Rumination,Social Problem Solving and Suicide Intent Among Egyptians With a Recent Suicide Attempt

The more complex influences of social problem-solving abilities and rumination—specifically brooding and reflection—on suicide intent is not well understood. We hypothesized that social problem solving would moderate the association between reflection and suicide intent, and mediate the influence of brooding on suicide intent. A convenience sample (N = 186) of individuals hospitalized for recent suicide attempt was interviewed, assessing suicide intent, social problem solving, brooding, reflection and depression. Brooding and reflection were positively associated with suicide intent. The mediating, but not the moderating, hypothesis was supported. Brooding was not significant (β = 0.15, t = 1.92, p = 0.06) with social problem solving controlled. Interventions to disengage rumination and improve social problem-solving skills are underscored.     

Approaching dysphoric mood: State-effects of mindfulness meditation on frontal brain asymmetry

Meditation-based interventions reduce the relapse risk in recurrently depressed patients. Randomized trials utilizing neurophysiologic outcome measures, however, have yielded inconsistent results with regard to a prophylactic effect. Although frontal brain asymmetry, assessed through electroencephalographic (EEG) alpha activity (8–13 Hz), is indicative of approach vs. withdrawal-related response dispositions and represents a vulnerability marker of depression, clinical trials have provided mixed results as to whether meditation has beneficial effects on alpha asymmetry. Inconsistencies might have arisen since such trials relied on resting-state recordings, instead of active paradigms under challenge, as suggested by contemporary notions of alpha asymmetry.     

The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review

This review examined evidence for some core predictions of the response styles theory (RST) concerning the relation between response styles and symptoms of depression and gender differences in the use of response styles in non-clinical children and adolescents. In summarizing the literature, effect sizes (pooled correlation coefficients) were calculated for cross-sectional and longitudinal studies. Stability of the obtained effect sizes was evaluated by means of a fail-safe N analysis. Results indicated that stable and significant effect sizes were found for rumination being associated with concurrent and future levels of depression. When controlling for baseline levels of depression, effect sizes for rumination and distraction were not stable, indicating that these findings should be interpreted with considerable caution. Finally, significant and stable effect sizes for gender differences in response styles were found only for rumination among adolescents. Taken together, the findings partly support the predictions of the response styles theory examined in this meta-analysis and may implicate that rumination is a cognitive vulnerability factor for depressive symptoms among adolescents.     

Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model

While some individuals develop PTSD subsequent to traumatic experiences, many individuals resume prior functioning naturally. Diathesis-stress models suggest that stable individual differences present in individuals prior to trauma may serve as vulnerability factors to symptom development. The high levels of comorbidity and symptom similarity suggest that established vulnerability factors for anxiety and depression may also serve as vulnerability factors for PTSD. The examination of multiple vulnerability factors simultaneously may increase understanding of the etiology of PTSD and comorbid post-trauma symptomatology and account for a greater percentage of variance in PTSD symptoms. In addition, the vulnerability factors may be related to distinct sets of symptoms, with vulnerabilities predicting the PTSD symptoms most similar to their associated disorders. Research examining the relations between attributional style, rumination, anxiety sensitivity, and the looming cognitive style and the development of PTSD after trauma exposure is reviewed and suggestions for future research are provided.     

青少年自尊与抑郁的关系:迷思的中介作用

目的:了解青少年外显自尊、内隐自尊、迷思与抑郁的关系.方法:采用Rosenberg自尊问卷、流调中心用抑郁量表(CES-D)、迷思反应问卷和自尊IAT测量171名青少年.结果:外显自尊与迷思呈显著负相关(r=-O.394.P<0.001),与抑郁呈显著负相关(1=-0.467,P<0.001),迷思与抑郁呈显著正相关(1=0.634,P<0.001).迷思在外显自尊与抑郁之间发挥着部分中介作用,当迷思进入回归方程时,外显自尊对抑郁的预测效应从0.467降低为0.258;中介性-调节分析发现,当迷思进入回归方程时,外显自尊×内隐自尊对抑郁的预测效应从0.169降为-0.090(β=-0.090,t=-1.499,P=0.139).结论:外显自尊×内隐自尊对抑郁的预测效应是通过迷思这一中介变量实现的.