RESUMEN
STUDY OBJECTIVES: To examine the relationship between pre-sleep cognitions and sleep-onset difficulties in an adolescent sample. METHODS: Participants comprised 385 students (59% male) from grades 9 to 11, aged between 13 and 18 years (M = 15.6, SD = 1.0), from eight co-educational high schools of varied socio-economic status in metropolitan Adelaide, South Australia. The cross-sectional study used a questionnaire battery including the Sleep Anticipatory Anxiety Questionnaire -Adolescent Version (SAAQ-A), completed during school time, followed by eight days of sleep diary completion and wearing wrist actigraphy to obtain subjective and objective sleep onset latency (SOL). RESULTS: Significant relationships were found between somatic arousal (SAAQ-A subscale) and objective SOL and also between sleep-related cognitions (SAAQ-A subscale) and subjective SOL and SOL overestimation (sleep misperception). No relationships were found between subjective SOL and somatic or rehearsal and planning cognitions. Objective SOL was not related to rehearsal and planning and to sleep-related cognition scores, and sleep misperception had no relationship with somatic as well as rehearsal and planning cognition scores. CONCLUSIONS: These findings are not only similar to those in clinical adult populations but also notably different, for example, the lack of association between negative sleep-related pre-sleep cognitions and objective sleep difficulty. The results of this study provide a basis for a more detailed causal study on the existing relationships between negative pre-sleep cognitions and subjective and objective sleep difficulties in this population.
Asunto(s)
Nivel de Alerta/fisiología , Cognición/fisiología , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Adolescente , Ansiedad/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Latencia del Sueño , Australia del Sur , Encuestas y CuestionariosRESUMEN
Cognitive processes play an important role in the maintenance, and treatment of sleep difficulties, including insomnia. In 2002, a comprehensive model was proposed by Harvey. Since its inception the model has received >300 citations, and provided researchers and clinicians with a framework for understanding and treating insomnia. The aim of this review is two-fold. First, we review the current literature investigating each factor proposed in Harvey's cognitive model of insomnia. Second, we summarise the psychometric properties of key measures used to assess the model's factors and mechanisms. From these aims, we demonstrate both strengths and limitations of the current knowledge of appropriate measurements associated with the model. This review aims to stimulate and guide future research in this area; and provide an understanding of the resources available to measure, target, and resolve cognitive factors that may maintain chronic insomnia.
Asunto(s)
Cognición , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Nivel de Alerta , Humanos , Modelos Psicológicos , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Estrés Psicológico/complicaciones , Estrés Psicológico/psicologíaRESUMEN
STUDY OBJECTIVES: To establish the extent to which the developmental changes in sleep timing experienced by Australian adolescents meet the International Classification of Sleep Disorders (ICSD-2) diagnostic criteria for delayed sleep phase disorder (DSPD), and whether adolescents with DSPD engage in poorer lifestyle choices, and are more impaired compared to good sleeping adolescents. METHODS: Three-hundred seventy-four Australian adolescents (mean age 15.6 years, SD 1.0) participants completed a 7-day sleep diary, wore wrist actigraphy, and completed a battery of questionnaires to assess DSPD criteria. RESULTS: The ICSD-2 criteria for DSPD were met by 1.1% (N = 4) of the adolescents sampled. The majority of adolescents (51.9%, N = 194) met one criterion, 14% (N = 52) of the adolescents met 2 criteria, while 33.2% (N = 124) did not fulfill any DSPD criteria. Despite having significantly delayed sleep timing, adolescents who met all criteria for DSPD reported similar lifestyle habits and daytime functioning. However, there were trends for greater alcohol and caffeine consumption, less sport participation, yet more time spent on extracurricular activities (i.e., learning to play a musical instruments for adolescents with DSPD. CONCLUSIONS: Despite the majority of adolescents reporting DSPD symptoms, only a small minority met full diagnostic criteria. Adolescents with DSPD reported similar lifestyle habits and daytime functioning to those with some or no symptoms. Future investigations of non-school-attending DSPD adolescents are needed to confirm the trends for lifestyle behaviors found in the present study.
Asunto(s)
Trastornos del Sueño del Ritmo Circadiano/epidemiología , Actigrafía , Adolescente , Factores de Edad , Australia/epidemiología , Femenino , Humanos , Estilo de Vida , Masculino , Trastornos del Sueño del Ritmo Circadiano/diagnóstico , Trastornos del Sueño del Ritmo Circadiano/etiología , Encuestas y CuestionariosRESUMEN
AIM: Adolescent sleep patterns vary between countries, and these differences influence adolescent functioning and well-being. The present study provides data on the sleep and well-being of Australian adolescents. METHODS: 385 adolescents aged 13-18 years were recruited from 8 South Australian schools spanning the socio-economic spectrum. Adolescents completed survey battery during class time at school, followed by a 7-day sleep diary. RESULTS: Australian adolescents, on average, obtained inadequate sleep across the school week. Adolescents commonly reported difficulty initiating sleep, unrefreshing sleep, and the subjective feeling of restless legs. Problematic levels of sleepiness, fatigue, depressed mood and anxiety were highly prevalent. Later bedtimes, longer sleep onset latencies, and shorter sleep duration were significantly associated with aspects of poor daytime functioning. CONCLUSION: These results add to our knowledge of adolescent sleep and well-being worldwide. They also highlight the need for greater attention to sleep during this phase of development, when future behaviors and outcomes are being shaped.
Asunto(s)
Sueño , Adolescente , Conducta del Adolescente , Afecto , Ansiedad/epidemiología , Australia/epidemiología , Femenino , Humanos , Masculino , Síndrome de las Piernas Inquietas/epidemiología , Sueño/fisiología , Trastornos del Sueño-Vigilia/epidemiología , Población UrbanaRESUMEN
STUDY OBJECTIVES: Many studies of adolescent insomnia use experience of insomnia-like symptoms to categorize "caseness." This is likely to lead to inflated prevalence and may have important ramifications for the research using individual symptoms to operationalize insomnia. The aim of the present study was to contrast the occurrence of insomnia symptoms with cases of insomnia diagnosed using criteria from the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and the second edition of the International Classification of Sleep Disorders (ICSD-II) in a sample of Australian adolescents. METHODS: Data were collected from 384 representative Australian adolescents aged 13-18 years old (59% male). During school hours, adolescents completed a comprehensive questionnaire battery targeting insomnia criteria and then completed a sleep diary for 7 days. RESULTS: Insomnia symptoms were frequently reported by adolescents (e.g., 34.6% for frequent sleep-related daytime consequences). The proportion of adolescents meeting the diagnositc criteria for insomnia was much smaller: 10.9% of adolescents were classified as having General Insomnia using ICSD-II criteria, and 7.8% were classified as having Primary Insomnia according to DSM-IV criteria. ICSD-II Psychophysiological Insomnia was observed in 3.4% of adolescents. Insomnia diagnoses did not vary according to age, gender, school grade, or socioeconomic status. Using the ICSD-II criteria for General Insomnia resulted in a significantly higher number of insomnia diagnoses than did DSM-IV criteria for Primary Insomnia (p < 0.001) and ICSD-II Psychophysiological Insomnia (p < 0.001). CONCLUSIONS: These results reveal that approximately 3 adolescents in the average classroom of 30 are likely to meet the diagnostic criteria for insomnia, while many more will have insomnia symptoms. There were significant differences in prevalence rates, depending on how insomnia was operationalized.
Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Adolescente , Australia/epidemiología , Femenino , Humanos , Clasificación Internacional de Enfermedades , Masculino , Sueño , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To evaluate cognitive-behavior therapy plus bright light therapy (CBT plus BLT) for adolescents diagnosed with delayed sleep phase disorder (DSPD). DESIGN: Randomized controlled trial of CBT plus BLT vs. waitlist (WL) control with comparisons at pre- and post-treatment. There was 6-month follow-up for the CBT plus BLT group only. SETTING: Flinders University Child & Adolescent Sleep Clinic, Adelaide, South Australia. PATIENTS: 49 adolescents (mean age 14.6 ± 1.0 y, 53% males) diagnosed with DSPD; mean chronicity 4 y 8 months; 16% not attending school. Eighteen percent of adolescents dropped out of the study (CBT plus BLT: N = 23 vs. WL: N = 17). INTERVENTIONS: CBT plus BLT consisted of 6 individual sessions, including morning bright light therapy to advance adolescents' circadian rhythms, and cognitive restructuring and sleep education to target associated insomnia and sleep hygiene. MEASUREMENTS AND RESULTS: DSPD diagnosis was performed via a clinical interview and 7-day sleep diary. Measurements at each time-point included online sleep diaries and scales measuring sleepiness, fatigue, and depression symptoms. Compared to WL, moderate-to-large improvements (d = 0.65-1.24) were found at post-treatment for CBT plus BLT adolescents, including reduced sleep latency, earlier sleep onset and rise times, total sleep time (school nights), wake after sleep onset, sleepiness, and fatigue. At 6-month follow-up (N = 15), small-to-large improvements (d = 0.24-1.53) continued for CBT plus BLT adolescents, with effects found for all measures. Significantly fewer adolescents receiving CBT plus BLT met DPSD criteria at post-treatment (WL = 82% vs. CBT plus BLT = 13%, P < 0.0001), yet 13% still met DSPD criteria at the 6-month follow-up. CONCLUSIONS: CBT plus BLT for adolescent DSPD is effective for improving multiple sleep and daytime impairments in the immediate and long-term. Studies evaluating the treatment effectiveness of each treatment component are needed. CLINICAL TRIAL INFORMATION: Australia-New Zealand Trials Registry Number: ACTRN12610001041044.
Asunto(s)
Terapia Cognitivo-Conductual/métodos , Fototerapia/métodos , Trastornos del Sueño del Ritmo Circadiano/terapia , Adolescente , Depresión/psicología , Fatiga/psicología , Femenino , Humanos , Masculino , Registros Médicos , Sueño , Resultado del TratamientoRESUMEN
STUDY OBJECTIVES: To determine the proportion of adolescents whose bedtime is set by their parents and to evaluate whether parent-set bedtimes are associated with earlier bedtimes, more sleep, and better daytime functioning. PARTICIPANTS: 385 adolescents aged 13-18 years (mean = 15.6, SD = 0.95; 60% male) from 8 socioeconomically diverse schools in South Australia. MEASUREMENTS AND METHODS: Adolescents completed the School Sleep Habits Survey during class time and then completed an 8-day Sleep Diary. The Flinders Fatigue Scale was completed on the final day of the study. RESULTS: 17.5% of adolescents reported a parent-set bedtime as the main factor determining their bedtime on school nights. Compared to adolescents without parent-set bedtimes, those with parent-set bedtimes had earlier bedtimes, obtained more sleep, and experienced improved daytime wakefulness and less fatigue. They did not differ significantly in terms of time taken to fall asleep. When parent-set bedtimes were removed on weekends, sleep patterns did not significantly differ between groups. CONCLUSIONS: Significant personal and public health issues, such as depression and accidental injury and mortality, are associated with insufficient sleep. Converging biological and psychosocial factors mean that adolescence is a period of heightened risk. Parent-set bedtimes offer promise as a simple and easily translatable means for parents to improve the sleep and daytime functioning of their teens.
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Conducta del Adolescente/fisiología , Conducta del Adolescente/psicología , Fatiga/epidemiología , Padres , Sueño/fisiología , Adolescente , Lechos , Estudios de Casos y Controles , Ritmo Circadiano , Fatiga/prevención & control , Femenino , Humanos , Masculino , Australia del Sur , Factores de Tiempo , VigiliaRESUMEN
Adolescent sleep health is becoming increasingly recognized internationally as a significant concern, with many countries reporting high incidences of sleep disturbance in our youth. Notwithstanding the value of findings obtained from each large-scale survey of adolescent sleep performed within individual countries, the field lacks synthesis and analysis of adolescent sleep studies into a single review. This review presents findings from a meta-analysis of 41 surveys of worldwide adolescent sleep patterns and problems published in the last decade (1999-2010). Sleep patterns tended to delay with increasing age, restricting school-night sleep. Notably, Asian adolescents' bedtimes were later than peers from North America and Europe, resulting in less total sleep time on school nights and a tendency for higher rates of daytime sleepiness. Weekend sleep data were generally consistent worldwide, with bedtimes 2+ hours later and more total sleep time obtained. We note a worldwide delayed sleep-wake behavior pattern exists consistent with symptoms of Delayed Sleep Phase Disorder, which may be exacerbated by cultural factors. Recommendations for future surveys of adolescent sleep patterns are discussed and provided in light of current methodological limitations and gaps in the literature.
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Salud Global , Trastornos del Sueño-Vigilia/epidemiología , Sueño , Adolescente , Distribución por Edad , HumanosRESUMEN
STUDY OBJECTIVES: Video-game use before bedtime has been linked with poor sleep outcomes for adolescents; however, experimental evidence to support this link is sparse. The present study investigated the capacity of presleep video-game playing to extend sleep latency and reduce subjective feelings of sleepiness in adolescents. The arousing psychophysiologic mechanisms involved and the impact of presleep video-game playing on sleep architecture were also explored. METHOD: Thirteen male adolescent "evening types" (mean age = 16.6 years, SD = 1.1) participated in a counterbalanced, within-subjects design with experimental (active video gaming) and control (passive DVD watching) conditions. The experiment was conducted in the Flinders University Sleep Research Laboratory. RESULTS: Relative to the control condition, presleep video-game playing increased sleep-onset latency (Z= 2.45, p= .01) and reduced subjective sleepiness (Z = 2.36, p = .02)-but only slightly. Video gaming was related to changes in cognitive alertness (as measured by a power: p < 0.01) but not physiologic arousal (as measured by heart rate: p > 0.05). Contrary to previous findings, sleep architecture was unaffected (both rapid eye movement and slow wave sleep: p > 0.05). CONCLUSIONS: Results suggest the direct effect of presleep video-game playing on adolescent sleep may be more modest than previously thought, suggesting that surveys linking stimulating presleep activities to poor sleep need substantiating with empirical evidence.
Asunto(s)
Conducta del Adolescente/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Sueño , Juegos de Video/psicología , Juegos de Video/estadística & datos numéricos , Adolescente , Análisis de Varianza , Nivel de Alerta , Australia/epidemiología , Cognición , Electroencefalografía , Electromiografía , Electrooculografía , Frecuencia Cardíaca , Humanos , Masculino , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Fases del Sueño , VigiliaRESUMEN
The link between sleep hygiene and adolescent sleep is well documented, though evidence suggests contributions from other factors, particularly the family environment. The present study examined whether sleep hygiene mediated the relationship between family disorganization and self-reported sleep onset latency, total sleep time, and daytime sleepiness in adolescents. Participants were 217 adolescents, aged 13 to 18 (M = 14.9, SD = 1.0) years, (43% male), recruited from four high schools in South Australia. Sleep hygiene fully mediated the relationship between family disorganization and sleep onset latency (z = 2.77, p < .01) and daytime sleepiness (z = 3.47, p < .01). Only partial mediation was evident for total sleep time (z = 2.50, p < .05). These findings suggest that consideration should be given to the family environment when assessing sleep disturbance in adolescents, and subsequently implementing interventions.
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Conducta del Adolescente/psicología , Familia/psicología , Salud Mental , Trastornos del Sueño-Vigilia/psicología , Sueño , Adolescente , Anomia (Social) , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Instituciones Académicas/estadística & datos numéricos , Fases del Sueño , Trastornos del Sueño-Vigilia/etiología , Australia del Sur , Factores de TiempoRESUMEN
The aim of the current research was to evaluate Shapesville, a children's picture book designed to promote positive body image in young children. Participants were a convenience sample comprising 84 girls (aged 5-9 years) recruited from four private girls' schools. Girls were randomly allocated to be read either Shapesville or a control book. Individual measures of body image, stereotyping on the basis of weight and media internalisation, as well as knowledge of non-appearance topics, were obtained at pre- and post-intervention, as well as at 6-week follow-up. Relative to the control book, girls' appearance satisfaction increased after reading Shapesville. In addition, stereotyping on the basis of weight and internalisation of media ideals was reduced. Finally, reading Shapesville also increased girls' knowledge base of non-appearance topics, such as recognising their special talents and awareness of healthy eating, at post-intervention. These gains were somewhat reduced at follow-up, yet were largely still significantly greater than at pre-intervention. The present study demonstrates that Shapesville has the potential to be a successful prevention tool for use with young girls. Schools can incorporate Shapesville into their curriculum as early as school entry, in order to help prevent the early development of body dissatisfaction and disordered eating.
Asunto(s)
Imagen Corporal , Trastornos de Alimentación y de la Ingestión de Alimentos/prevención & control , Promoción de la Salud/métodos , Evaluación de Programas y Proyectos de Salud/métodos , Concienciación/fisiología , Libros , Niño , Preescolar , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Estudios de Seguimiento , Conocimientos, Actitudes y Práctica en Salud , Humanos , Control Interno-Externo , Medios de Comunicación de Masas , Satisfacción Personal , Australia del Sur , Conducta Estereotipada/fisiologíaRESUMEN
This study aimed to prospectively examine the role of peer and media influences in the development of body satisfaction (incorporating the desire for thinness and satisfaction with appearance) in young girls, as well as the relationship between body satisfaction and self-esteem. A sample of 97 girls 5-8 years of age completed individual interviews at Time 1 and 1 year later at Time 2. Linear panel analyses found that Time 1 perception of peers' desire for thinness was temporally antecedent to girls' desire for thinness, appearance satisfaction, and self-esteem 1 year later. In addition, the watching of appearance-focused television programs was temporally antecedent to appearance satisfaction. Finally, girls' desire for thinness was found to temporally precede low self-esteem. Thus, as early as school entry, girls appear to already live in a culture in which peers and the media transmit the thin ideal in a way that negatively influences the development of body image and self-esteem.
Asunto(s)
Imagen Corporal , Medios de Comunicación de Masas , Grupo Paritario , Satisfacción Personal , Autoimagen , Niño , Preescolar , Femenino , Humanos , Estudios Longitudinales , Publicaciones Periódicas como Asunto , Estudios Prospectivos , Valores Sociales , Socialización , Australia del Sur , Televisión , Delgadez/psicologíaRESUMEN
To examine longitudinally figure-rating preferences and dieting awareness in young girls a sample of 40 Australian girls, ages 5 to 7 years (M=6.5, SD=0.9), were recruited from two single-sex private schools in Adelaide. Girls were tested at both Time 1 (mid 2002) and Time 2 (late 2003), approximately 16 months apart. Using the Children's Figure Rating Scale of Tiggemann and Wilson-Barrett, girls indicated current and ideal figure preferences. Their understanding of the concept of dieting was assessed using the Dieting Awareness measure, developed by Lowes and Tiggemann. At Time 1, younger girls preferred a larger ideal figure than the current figure, relative to older girls. At Time 2, however, this age difference had decreased, and all girls preferred a thinner ideal figure. In addition, there was a significant increase in Dieting Awareness from Time 1 to Time 2.