Longitudinal Association of Sleep Problems and Distress Tolerance During Adolescence

Abstract

The mechanism by which sleep problems adversely impacts adolescent health is poorly understood. Distress tolerance—a multifactorial trait indicative of one’s ability to withstand negative emotions and persist toward long-term goals—is implicated in numerous emotional psychopathologies and an important target for research and practice. We hypothesized that the adverse psychobiological effects of sleep problems could disrupt the development of distress tolerance during adolescence. This longitudinal study examined whether sleep problems predicted changes in four facets of distress tolerance during adolescence: (1) absorption—feeling attention is captured by negative emotions, (2) appraisal—experiencing distress as unacceptable, (3) regulation—engaging in behaviors to terminate distress, and (4) tolerance—low perceived ability to tolerate distress. High school students (M baseline age?=?15.5?years, N?=?2,309, 56.1% female), completed self-report measures of sleep problems and distress tolerance at baseline and 1-year follow-up. In linear regression models adjusting for baseline distress tolerance, sleep problems predicted poorer distress tolerance at 1-year follow-up for each distress tolerance facet (βs?=?–0.10 to –0.24, ps?≤?0.02). After additionally controlling for sociodemographics and emotional psychopathology, sleep problems were associated with poorer distress tolerance for absorption (β?=?-0.13, p?=?0.004) and appraisal (β?=?–0.09, p?=?0.049) facets, but not regulation or tolerance (ps?≥?0.35) facets. Interventions targeting healthy sleep habits warrant consideration for improving adolescent development of certain facets of distress tolerance, and in turn various positive health outcomes improved by distress tolerance.     

Peer Victimization and Harsh Parenting Predict Cognitive Diatheses for Depression in Children and Adolescents

The current study examined peer victimization and harsh parenting as longitudinal predictors of broadband and narrowband cognitions associated with the etiology of depression in children and adolescents. The sample consisted of 214 elementary and middle school students. At the start of the study, their average age was 12.2 years (SD = 1.0). The sex ratio was 112 girls to 102 boys. The sample was ethnically diverse (58.9% Caucasian, 34.1% African American, 10.7% Hispanic, 3.3% Asian, and 5.2% other). Children and their parents completed measures of peer victimization and harsh parenting. At two waves 1 year apart, children also completed questionnaire measures of negative and positive broadband cognitive style (e.g., personal failure, global self-worth) and narrowband self-perceptions (e.g., perceived social threat, social acceptance). Every Wave 2 cognitive variable was predicted by peer victimization or harsh parenting or both, even after controlling for a Wave 1 measure of the same cognitive variable. Peer victimization more consistently predicted narrowband social/interpersonal cognitions, whereas harsh parenting more consistently predicted broadband positive and negative cognitions. Furthermore, controlling for positive and negative self-cognitions eliminated a statistically significant effect of harsh parenting and peer victimization on depressive symptoms. Support emerged for the social learning of negative self-cognitions. Support also emerged for negative self-cognitions as a mediator of depressive symptoms. Implications for theory and practice are discussed.     

Cardiac Vagal Control and Depressive Symptoms: The Moderating Role of Sleep Quality

Lower cardiac vagal control (CVC) has been linked to greater depression. However, this link has not been consistently demonstrated, suggesting the presence of key moderators. Sleep plausibly is one such factor. Therefore, we investigated whether sleep quality moderates the link between CVC (quantified by high-frequency heart rate variability, HF-HRV) and depressive symptoms (assessed using established questionnaires) in 29 healthy women. Results revealed a significant interaction between HF-HRV and sleep quality in predicting depressive symptoms: participants with lower HF-HRV reported elevated depressive symptoms only when sleep quality was also low. In contrast, HF-HRV was not associated with depressive symptoms when sleep quality was high, suggesting a protective function of high sleep quality in the context of lower CVC.     

Context-Specific Associations Between Harsh Parenting and Peer Rejection on Child Conduct Problems at Home and School

Although harsh parenting and peer rejection are independently associated with childhood conduct problems (CP), these patterns are often informant specific, suggesting that their associations across contexts (i.e., home and school) should be considered. In a sample of 142 children with and without attention-deficit/hyperactivity disorder (ADHD; ages 5–10; 66% male), we used structural equation modeling to evaluate the structure of multi-informant (parent, teacher) and multimethod (semi-structured interview, questionnaire) rated aggressive, rule-breaking, and oppositional behavior. Next, we explored context-specific associations by modeling harsh parenting and peer rejection as simultaneous and independent predictors of home and school CP. We observed several key findings: (a) the structure of parent- and teacher-reported CP was best accounted by context-specific CP (i.e., home vs. school) and a second-order general CP factor; (b) harsh punishment and peer rejection each independently predicted the second-order general CP factor; and (c) peer rejection was uniquely associated with school CP, whereas harsh punishment was associated only with the second-order general CP factor and did not exhibit specificity with home CP. Whereas harsh parenting and peer rejection were each independently associated with generalized CP, peer rejection showed an additional, unique context-specific association with CP exclusively expressed at school. We discuss potential explanatory mechanisms underlying context-specific associations of CP, as well as address etiological and clinical implications for understanding informant-discrepancies in CP.     

Longitudinal Relations Between Parenting and Child Adjustment in Young Children

We studied the predictive relations between reports of parenting behavior on the one hand and academic achievement and reported behavior problems of young children on the other hand. Data were gathered for 352 children and their parents from kindergarten to 2nd grade. The results indicated that in the academic domain, low supportive and high controlling parenting practices were modestly related to poor subsequent math achievement. Children's externalizing and attention problem behavior was clearly predictive of high levels of control in mothers and low levels of support in fathers. The combination of high parental support and control was especially associated with high levels of problem behavior. However, when previous parenting and child adjustment were taken into account, the magnitude of the predictive power of parenting for child adjustment, and of child adjustment for parenting, remained limited.     

Sleeping Toward Behavioral Regulation: Relations Between Sleep and Externalizing Symptoms in Toddlers and Preschoolers

The aim of this study was to investigate the concurrent and longitudinal relations between sleep and externalizing symptoms among young children. Sixty-four families (mostly Caucasian; 36 boys) were met twice, when children were 2 (T1) and 4 years of age (T2). At T1, children wore an actigraph monitor for a 72-hr period, and both mothers and fathers completed the Child Behavior Checklist. At T2, both parents as well as the daycare educator filled the Child Behavior Checklist. At T1, longer sleep duration and higher sleep efficiency were associated with fewer externalizing symptoms as assessed by mothers. Results also indicated that higher sleep efficiency at T1 was related to fewer parent-reported externalizing symptoms at T2 (while controlling for prior externalizing symptoms). Relations between sleep efficiency at T1 and externalizing symptoms as assessed by mothers at T1 and by fathers at T2 were moderated by child sex, such that links were significant among boys only. Results pertaining to educators’ reports were inconclusive. The current study highlights the importance of rapidly treating sleep difficulties, which are associated with persistent behavioral maladjustment, perhaps especially for boys.     

The Direction of Longitudinal Associations Between Sleep Problems and Depression Symptoms: A Study of Twins Aged 8 and 10 Years

Study Objectives:

To establish the direction and etiology of longitudinal associations between sleep problems and depression symptoms in children.

Design:

Data on twins aged 8 and 10 years were obtained. At assessments, parents completed the Child Sleep Habits Questionnaire, and twins completed the Children''s Depression Inventory.

Setting:

Participants were mainly interviewed at the Institute of Psychiatry, London.

Patients or Participants:

Three hundred twin pairs initially enrolled in the study.

Interventions:

N/A.

Measurements and Results:

A genetically informative cross-lagged model examined links between sleep and depression. Sleep problems at age 8 predicted depression at age 10 (partial regression coefficient [95% confidence intervals] = 0.10 [0.01-0.18]). The converse was not found. Stability of sleep problems across time was mainly due to genes (46% of the genetic influence on sleep at 10 was due to the same genetic influence on sleep aged 8). Stability of depression was mainly due to nonshared environmental influences (19% of the nonshared environmental influence on depression at 10 was due to the same nonshared environmental influence on depression at age 8). The cross-lagged association between sleep problems at 8 and depression at 10 years was largely due to genes, although this finding was nonsignificant.

Conclusions:

This study adds to our understanding of the temporal precedence of sleep problems and depression and the risks underlying their associations. There are implications regarding the value of specifying genes linked to sleep problems and potential opportunities for informing early intervention strategies in high-risk groups at key points in the progression to developing more serious problems.

Citation:

Gregory AM; Rijsdijk FV; Lau JYF; Dahl RE; Eley TC. The direction of longitudinal associations between sleep problems and depression symptoms: a study of twins aged 8 and 10 years. SLEEP 2009;32(2):189–199.     

父母-子女人格相似性对教养行为与青少年抑郁关系的调节作用

目的:考查父母-子女人格相似性对教养行为与青少年抑郁关系的调节作用。方法:采用中国科学院心理研究所全国青少年心理健康数据库中2009年的横断数据,对其中4474名11岁到22岁的在校学生数据进行分析。父母和子女人格均为自评,教养行为采用父母自评,抑郁由青少年自评。结果:父亲-子女在神经质维度上的相似性与父亲各项教养行为的交互作用均显著;母亲-子女在外向性维度上的相似性与母亲说理的交互作用显著,母亲-子女在神经质维度上的相似性与母亲各项教养行为的交互作用均显著,母亲-子女在精神质维度上的相似性与母亲监控交互作用显著。结论:父母-子女人格相似性对教养行为与青少年抑郁的关系具有显著的调节作用。     

母亲教养方式与幼儿行为问题、同伴交往的关系

目的:探讨母亲教养方式影响幼儿同伴交往的直接和间接效应。方法:以父母教养行为问卷、儿童行为量表和同伴提名法对260名4-6岁儿童及其母亲进行测查。结果:①专制教养方式与幼儿内、外化行为呈显著正相关,权威教养方式与幼儿内、外化行为呈显著负相关。②幼儿外化行为与同伴拒斥呈显著正相关,与同伴接纳相关不显著。③专制教养方式与幼儿同伴接纳、同伴拒斥分别呈显著的负向、正向相关,权威教养方式与幼儿同伴接纳、同伴拒斥相关不显著。④幼儿外化行为在母亲专制教养方式与幼儿同伴拒斥之间起完全中介作用。结论:专制教养方式不直接影响幼儿同伴拒斥,而是通过幼儿外化行为间接影响同伴拒斥。     

Association Between Sleep Problems and Perceived Cognitive Dysfunction Over 12 Months in Individuals with Multiple Sclerosis

Sleep problems are highly prevalent among individuals with multiple sclerosis (MS); however, the relationship between sleep problems and cognitive dysfunction is poorly understood in this population. In the present study, 163 individuals with MS and depression, fatigue, or pain completed self-report measures of sleep, cognitive dysfunction, and relevant demographic and clinical characteristics (e.g., disability severity, depressive symptomatology, pain intensity, fatigue impact) at four time points over 12 months. Mixed-effects regression demonstrated that poorer sleep was independently associated with worse perceived cognitive dysfunction (β = –0.05, p = .001), beyond the influence of depressive symptomatology. Fatigue impact was found to partially mediate this relationship. Results suggest that for individuals with MS and depression, fatigue, or pain, self-reported sleep problems are related to perceived cognitive dysfunction, and that fatigue impact accounts for part of this relationship.     

大学生的同伴依恋与心理健康关系的性别角色效应

目的：探讨大学生同伴依恋与心理健康的关系及性别角色化的作用。方法：采用亲密关系经历量表、症状自评量表、感情和社会孤独量表、Bem性别角色量表对88名大学生进行问卷调查。结果：①同伴依恋、心理健康、性别角色化各维度得分上未见显著的性别差异；②同伴焦虑与心理健康各指标间均呈显著正相关；同伴回避与人际敏感、感情和社会孤独显著正相关；③男性化与抑郁症状显著负相关，女性化与同伴回避及感情和社会孤独显著负相关；④女性化对感情孤独的影响是通过中介变量同伴回避实现的。结论：大学生同伴依恋与性别角色化对心理健康有显著影响．同伴回避是女性化对心理健康影响的中介变量。     

Association Between Stress-Related Sleep Reactivity and Metacognitive Beliefs About Sleep in Insomnia Disorder: Preliminary Results

To evaluate the relation between stress-related sleep reactivity and metacognitive beliefs about sleep in subjects with insomnia disorder (93) and in a group of healthy controls (30) a set of variables, including Ford Insomnia Response to Stress Test (FIRST) and Metacognition Questionnaire–Insomnia (MCQ-I), have been used. Internal consistency of the Italian version of FIRST was studied. Univariate correlation, regression analysis, and principal component analysis were also performed. The Italian version of FIRST showed good internal consistency and discriminant validity. Sleep reactivity was higher in women (p < .05) and correlates positively in both genders with metacognitive beliefs about sleep (p < .01) in insomnia. In insomnia, metacognitive beliefs may play a key role in modulating sleep reactivity. Therapeutic strategies acting selectively on metacognition to reduce stress-related sleep reactivity in insomnia may be useful.     

Relations Between Toddler Sleep Characteristics,Sleep Problems,and Temperament

Two sources of information (parent-reported sleep diaries and actigraph records) were used to investigate how toddler sleep characteristics (bed time/sleep onset, wake time/sleep offset, total nighttime sleep, and total sleep time) are related to sleep problems and temperament. There were 64 toddler participants in the study. Consistent with studies of older children, parent reports differed from actigraph-based records. The findings that parent-reported and actigraph-recorded sleep characteristics varied as a function of parent report of toddler sleep problems and temperament add needed information on toddler sleep. Such information may contribute to improving parents’ awareness of their child’s sleep characteristics and correlates of problem sleep.     

Association Between Sleep Problems and Symptoms of Attention Deficit Hyperactivity Disorder in Adolescence: Results From a Large Population-Based Study

Sleep problems and symptoms of ADHD are common in adolescence, but detailed epidemiological assessment of their association is lacking. Using data from a recent population-based study, 9,846 adolescents aged 16 to 19 provided detailed information on sleep and symptoms of ADHD. Results confirmed a large overlap between self-reported symptoms of ADHD and all sleep variables studied. Symptoms of ADHD were linked to shorter sleep duration, longer sleep latency, and nocturnal wake time, as well as larger sleep deficiency. ADHD symptoms also increased the odds of insomnia and delayed sleep phase syndrome. The associations were only partially explained by confounders (mainly depression). The findings suggest that sleep problems should be included as a treatment target in efforts to reduce symptoms of ADHD in adolescence.     

Prevention for Preschoolers at High Risk for Conduct Problems: Immediate Outcomes on Parenting Practices and Child Social Competence

This study investigated the immediate impact of an 8-month center- and home-based prevention program for preschoolers at high risk for conduct problems. We report immediate program effects on observed and self-rated parenting practices and observed child behavior with peers. Ninety-nine preschool-age siblings of adjudicated youths and their families were randomly assigned to an enhanced version of the Incredible Years Series (Webster-Stratton, 1989; n = 50) or to a no-intervention control condition (n = 49). In an intent-to-treat design, the intervention yielded significant effects on negative parenting, parental stimulation for learning, and child social competence with peers. Improvements in negative parenting, stimulation for learning, and child social competence support the potential of the intervention to prevent later conduct problems in high-risk children.     

The Association Between Toddlerhood Self-Control and Later Externalizing Problems

Lower self-control is a significant correlate or predictor of a wide range of adult outcomes, and this association may be due to more general tendencies toward childhood externalizing problems. The present study examined the association between toddlerhood self-control expressed within a “don’t” compliance task (at 14–36 months) and later externalizing problems (parent-reported externalizing problems from age 4 to 12 years, teacher-reported externalizing problems from age 7 to 12 years, and self-reported conduct disorder symptoms at age 17 years) in a longitudinal, genetically informative study. The slope of self-control, but not its intercept, predicted later teacher-reported, but not parent- or self-reported, externalizing problems. That is, increase in self-control during toddlerhood was associated with lower levels of later teacher-reported externalizing problems. The slope of self-control was no longer a significant predictor of teacher-reported externalizing problems after controlling for observed disregard for others, a robust predictor of externalizing problems. Thus, the hypothesis that self-control is the primary predictor of externalizing problems was not supported. Results from genetic analyses suggested that the covariance between the slope of self-control and teacher-reported externalizing problems is due to both genetic and shared environmental influences.     

Association Between Nonrestorative Sleep and Risk of Diabetes: A Cross-Sectional Study

Although insufficient sleep or poor sleep quality has been reported to be associated with the development of type 2 diabetes, the relation of type 2 diabetes with nonrestorative sleep (NRS), a subjective feeling, has been overlooked. We used a large-scale medical checkup database to investigate whether there is a cross-sectional association between NRS and type 2 diabetes risk in Japanese individuals. We extracted data for 14,476 individuals who were not receiving therapeutic drugs for diabetes. About 36.8% of individuals were identified as having NRS. In a multiple logistic regression analysis, NRS was significantly associated with the risk of developing diabetes. Thus, this line of research may have implications for diabetes prevention.     

Early Childhood Internalizing Problems in Mexican- and Dominican-Origin Children: The Role of Cultural Socialization and Parenting Practices

This study examined mother- and teacher-rated internalizing behaviors (i.e., anxiety, depression, and somatization symptoms) among young children using longitudinal data from a community sample of 661 Mexican and Dominican families and tested a conceptual model in which parenting (mother's socialization messages and parenting practices) predicted child internalizing problems 12 months later. Children evidenced elevated levels of mother-rated anxiety at both time points. Findings also supported the validity of the proposed parenting model for both Mexican and Dominican families. Although there were different pathways to child anxiety, depression, and somatization among Mexican and Dominican children, socialization messages and authoritarian parenting were positively associated with internalizing symptoms for both groups.     

The Relation Between Use of Mobile Electronic Devices and Bedtime Resistance,Sleep Duration,and Daytime Sleepiness Among Preschoolers

This study investigated the relation between preschoolers’ mobile electronic device (MED) use and sleep disturbances. A national sample of 402 predominantly college-educated and Caucasian mothers of 3–5-year-olds completed a survey assessing their preschoolers’ MED use, bedtime resistance, sleep duration, and daytime sleepiness. Heavier evening and daily tablet use (and to some extent, smartphone use) were related to sleep disturbances. Other forms of MED use were not consistently related to sleep disturbances. In addition, playing games on MEDs at bedtime was related to compromised sleep duration, although other forms of MED use at bedtime were not related to sleep outcomes. Although the relations between MED use and sleep disturbances were small in size, they were larger than the relations between sleep and other predictors in the models. Continued work should investigate how MED exposure is related to children’s cognitive, psychological, emotional, and physiological development, particularly given the popularity and widespread use of these devices.