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The present study aims to investigate the influence of 24-hr sleep deprivation on implicit emotion regulation using the emotional conflict task. Twenty-five healthy young adults completed a repeated-measures study protocol involving a night of at-home normal sleep control and a night of in-laboratory sleep deprivation. Prior to the experimental session, all participants wore an actigraph watch and completed the sleep diary. Following each condition, participants performed an emotional conflict task with electroencephalographic recordings. Emotional faces (fearful or happy) overlaid with words ("fear" or "happy") were used as stimuli creating congruent or incongruent trials, and participants were instructed to indicate whether the facial expression was happy or fearful. We measured the accuracy and reaction time on the emotional conflict task, as well as the mean amplitude of the P300 component of the event-related potential at CPz. At the behavioural level, sleep-deprived participants showed reduced alertness with overall longer reaction times and higher error rates. In addition, participants in the sleep deprivation condition made more errors when the current trial followed congruent trials compared with when it followed incongruent trials. At the neural level, P300 amplitude evoked under the sleep-deprived condition was significantly more positive compared with the normal sleep condition, and this effect interacted with previous-trial and current-trial congruency conditions, suggesting that participants used more attentional resources to resolve emotional conflicts when sleep deprived. Our study provided pioneering data demonstrating that sleep deprivation may impair the regulation of emotional processing in the absence of explicit instruction among emerging adults.
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BACKGROUND: The Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population. METHODS: Healthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test-retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI. RESULTS: We identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953-0.989, Tucker-Lewis index = 0.931-0.984, root means square error of approximation = 0.040-0.092, standardized root mean square residual = 0.039-0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach's alpha = 0.811-0.835, McDonald's omega = 0.805-0.832), and test-retest reliability (intraclass correlation coefficient = 0.829). CONCLUSION: The SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.
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Psicometría , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Femenino , Masculino , Estudios Longitudinales , Reproducibilidad de los Resultados , China , Adulto Joven , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Encuestas y Cuestionarios , Adulto , Estudiantes del Área de la Salud/psicología , Adolescente , Estudios TransversalesRESUMEN
In caring for patients with stroke, the leading cause of death and disability affecting over 80 million people worldwide, caregivers experience substantial psychological and physical burdens and difficulties in help-seeking owing to physical and time-constraints. Social distancing measures imposed during the coronavirus disease 2019 (COVID-19) pandemic further restricted them from using caregiver support services. While the use of telehealth emerged as a global prevailing trend during the COVID-19 pandemic, evidence for utilising instant messaging (IM) applications for psychological intervention is scanty. This study aimed to explore stroke caregivers' perceived potential utility of IM-delivered psychological intervention. Between January and August 2020, 36 adult family stroke caregivers in Hong Kong were recruited to individual telephone semi-structured interviews using purposive sampling. The interviews were audio-recorded, transcribed verbatim and analysed using an interpretive description approach. Three themes of caregivers' perceptions towards IM-delivered psychological intervention emerged: perceived high convenience and ease of use, perceived advantages that overcome existing barriers to services and message delivery tailored to individual needs. Our findings suggested that there is an imminent need among stroke caregivers for personalised psychological interventions and that IM is a potential modality for overcoming existing barriers in delivering accessible support to caregivers in real-time, real-world settings. Our study highlighted caregivers' acceptance and perceived benefits of IM-delivered psychological intervention and provided practical insights into the design of IM-delivered psychological interventions.
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COVID-19 , Cuidadores , Investigación Cualitativa , Accidente Cerebrovascular , Envío de Mensajes de Texto , Humanos , Cuidadores/psicología , Femenino , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/psicología , Hong Kong , Adulto , Anciano , Intervención Psicosocial/métodos , Telemedicina , Aplicaciones MóvilesRESUMEN
Mental ill health is more common among juvenile offenders relative to adolescents in general. Little is known about individual differences in their long-term psychological adaptation and its predictors from multiple aspects of their life. This study aims to identify heterogeneous trajectories of probable psychiatric conditions and their predictors. Participants included 574 juvenile offenders who were first convicted for serious crimes and without detention history. The participants were assessed at 11 timepoints over seven years (2000-2010). Growth mixture modeling revealed the same three trajectories for both probable anxiety and probable depression: stable low trajectory (75.96%; 75.78%), stable high trajectory (15.16%; 10.98%), and recovery (8.89%, 13.24%). Least absolute shrinkage and selection operator (LASSO) logistic regression identified three multilevel predictors for memberships of different trajectories. Risk factors against stable low trajectory lay within personal (e.g., neuroticism), relationship (e.g., parental hostility), and contextual levels (e.g., chaotic neighborhood). Resilience factors for stable low trajectory included strong work orientation and low education level of father. Recovery was predicted by Black race, self-identity, high education level of father, and nonincarcerated sentencing. Our findings suggest that both psychopathology and psychological resilience could be predicted by multiple personal, relationship, and contextual factors in the social ecology of juvenile offenders.
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OBJECTIVE: Accumulating evidence has suggested bidirectionality between sleep problems and depression, but the underlying mechanism is unclear. We assessed the role of sleep in inhibitory control ability with emotional stimuli, which has been shown to be suboptimal among individuals with depression and proposed to perpetuate depressive symptoms. METHODS: Emerging adults (aged 18-25 years, 64.6% female) were screened for depressive and other mental disorders by structured clinical interview and questionnaire. Individuals with depressive disorders were assigned to have a polysomnography-monitored daytime sleep opportunity (Sleep-Dep, n = 20), whereas nondepressed individuals were randomized to either have daytime sleep (Sleep-Ctrl, n = 27) or stay awake (Wake-Ctrl, n = 18). Participants completed the Affective Go/No-Go Task two times, separated by experimental conditions. RESULTS: A factorial model with a between-subject factor (Sleep-Dep/Sleep-Ctrl/Wake-Ctrl) and a within-subject factor (test 1/test 2) was used to assess if the groups differed in inhibitory control across test sessions, as inferred by changes in d-prime and false alarm rates (FA). Results from mixed factorial models showed a significant interaction effect between time and group on FA in the block with neutral faces as the target and happy faces as the nontarget (F(2,61) = 5.15, pfdr = .045). Although Sleep-Dep had decreased FA after sleep (t(19) = 2.94, pfdr = .050), Sleep-Ctrl and Wake-Ctrl had no significant between-session changes (p values > .05). Postsleep improvement in FA in Sleep-Dep correlated with longer stage 2 sleep (r(20) = 0.788, pfdr < .001) and stage 2 fast spindle number at O1 (r(18) = 0.692, pfdr = .015). CONCLUSIONS: Sleep gain, particularly stage 2 sleep and related physiology, potentially enhances inhibitory control ability responding to emotional information among individuals with depressive disorders.
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Trastorno Depresivo , Trastornos del Sueño-Vigilia , Adolescente , Adulto , Afecto , Depresión/psicología , Emociones , Femenino , Humanos , Masculino , Polisomnografía , Sueño , Trastornos del Sueño-Vigilia/psicología , Adulto JovenRESUMEN
Despite the critical role of sleep in memory and emotion processing, large remains unknown regarding how sleep influences trauma-related symptoms arising from maladaptive memory/emotional processes, such as those among patients with post-traumatic stress disorder. Employing a trauma film paradigm, we investigated how post-trauma sleep versus sleep deprivation influenced involuntary intrusions and voluntary recognition of traumatic memories. Sixty participants were randomly assigned to sleep or total sleep deprivation group following experimental trauma induction. Participants were assessed with: (a) lab-based and 7-day diary-based involuntary intrusions; (b) voluntary recognitions of traumatic memories 12-hr and 7-day post-trauma induction; and (c) post-traumatic stress disorder-like symptoms measured by the Impact of Event Scale-Revised. We found that compared with sleep deprivation, slept participants experienced fewer traumatic intrusions across 7â days, reported lower emotional hyperarousal, and showed more accurate recognition of trauma-related stimuli. Moreover, higher subjective sleep quality was associated with fewer intrusions only in the sleep group, while a reversed pattern emerged in the sleep deprivation group. These results provide novel evidence supporting the therapeutic benefits of sleep in protecting mental well-being from trauma exposure. To the extent that sleep modulates trauma-related symptoms, sleep can be conceived as the potential target for early interventions among trauma victims.
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Memoria/fisiología , Reconocimiento en Psicología/fisiología , Privación de Sueño/complicaciones , Trastornos por Estrés Postraumático/psicología , Adulto , Femenino , Humanos , Masculino , Privación de Sueño/psicología , Adulto JovenRESUMEN
BACKGROUND: Nonrestorative sleep is a common sleep disorder with a prevalence ranging from 1.4 to 35%, and is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to nonrestorative sleep. This study aimed to examine the relationships among noise, noise sensitivity, nonrestorative sleep, and physiological sleep parameters in Chinese adults. METHODS: A cross-sectional household survey was conducted with randomly selected Chinese adults based on a frame stratified by geographical districts and types of quarters in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale, the Weinstein Noise Sensitivity Scale, the ENRICHD Social Support Instrument, the Patient Health Questionnaire, and the Perceived Stress Scale to assess nonrestorative sleep, noise sensitivity, social support, somatic symptoms and stress, respectively. Anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale while sociodemographic and lifestyle characteristics were assessed with an investigator-developed sheet. Nocturnal noise level and physiological sleep parameters were measured during nighttime for a week by noise dosimetry and actigraphy, respectively. A structured multiphase linear regression was conducted to estimate associations. RESULTS: A total of 500 adults (66.4% female) with an average age of 39 years completed this study. Bivariate regressions showed that age, marital status, occupation, family income, season, exercise, cola and soda consumption, social support, somatic symptoms, stress, depression, noise sensitivity, total sleep time, and awakenings were associated with nonrestorative sleep. In the multivariable analysis, family income, season, exercise, social support, somatic symptoms, stress, and depression remained associated with nonrestorative sleep. Specifically, a one-unit increase of noise sensitivity was associated with 0.08 increase in nonrestorative sleep (95% confidence interval [CI]: 0.01, 0.15, p = 0.023). Nocturnal noise was negatively associated with time in bed (b = - 1.65, 95% CI: - 2.77, - 0.52, p = 0.004), total sleep time (b = - 1.61, 95% CI: - 2.59, - 0.62, p = 0.001), and awakenings (b = - 0.16, 95% CI: - 0.30, - 0.03, p = 0.018), but was not associated with nonrestorative sleep. CONCLUSIONS: Nonrestorative sleep was predicted by noise sensitivity in addition to family income, season, exercise, social support, somatic symptoms, stress, and depression.
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Trastornos del Sueño-Vigilia , Sueño , Adulto , Ansiedad , China/epidemiología , Estudios Transversales , Depresión , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
BACKGROUND: Studies have demonstrated that noise is associated with various health problems, such as obesity and hypertension. Although the evidence of the associations of noise with obesity and hypertension is inconsistent, there seems to be a stronger association of the latter. This study aimed to investigate the associations of noise with body mass index (BMI) and blood pressure in adults living in multi-story residential buildings. METHODS: A cross-sectional study was conducted in Hong Kong from February 2018 to September 2019. The Weinstein Noise Sensitivity Scale, Pittsburgh Sleep Quality Index, ENRICHD Social Support Instrument, Patient Health Questionnaire, Perceived Stress Scale, and Hospital Anxiety and Depression Scale were administered to the participants. BMI and blood pressure were assessed. Nocturnal noise exposure and total sleep duration were measured for a week. RESULTS: Five hundred adults (66.4% female), with an average age of 39 years (range: 18-80), completed the study. The average levels of nocturnal noise, BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were 51.3 dBA, 22.2 kg/m2, 116.0 mmHg, and 75.4 mmHg, respectively. After adjusting for sociodemographic characteristics, nocturnal noise was associated with BMI (b = 0.54, 95% CI: 0.01 to 1.06, p = 0.045) and SBP (b = 2.90, 95% CI: 1.12 to 4.68, p = 0.001). No association was detected between nocturnal noise and DBP (b = 0.79, 95% CI: - 0.56 to 2.13, p = 0.253). Specifically, higher nocturnal noise was associated with higher BMI (b = 0.72, 95% CI: 0.07 to 1.38, p = 0.031) and SBP (b = 3.91, 95% CI: 2.51 to 5.31, p < 0.001) in females but only higher SBP (b = 3.13, 95% CI: 1.35 to 4.92, p < 0.001) in males. The association between noise and SBP remained significant (b = 2.41, 95% CI: 0.62 to 4.20, p = 0.008) after additionally adjusting for lifestyle, diagnosis of hypertension, psychometric constructs, and sleep. CONCLUSIONS: Indoor nocturnal noise was associated with BMI and blood pressure in females but only blood pressure in males. It is important to control nocturnal noise or use soundproofing materials in buildings to reduce noise exposure.
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Hipertensión , Adulto , Presión Sanguínea , Índice de Masa Corporal , Estudios Transversales , Femenino , Hong Kong/epidemiología , Humanos , Hipertensión/epidemiología , Hipertensión/etiología , MasculinoRESUMEN
Sleep deprivation is suggested to impact emotion regulation, but few studies have directly examined it. This study investigated the influence of sleep deprivation on three commonly used emotion regulation strategies (distraction, reappraisal, suppression) in Gross's (1998) process model of emotion regulation. Young healthy adults were randomly assigned to a sleep deprivation group (SD; n = 26, 13 males, age = 20.0 ± 1.7) or a sleep control group (SC; n = 25, 13 males, age = 20.2 ± 1.7). Following 24-h sleep deprivation or normal nighttime sleep, participants completed an emotion regulation task, in which they naturally viewed or applied a given emotion regulation strategy towards negative pictures, with electroencephalographic (EEG) recordings. A reduction in the centroparietal late positive potential (LPP) amplitudes towards negative pictures from the naturally viewing condition to a regulated condition was calculated as an index of regulatory effects. Comparisons between the two groups indicated that sleep deprivation significantly impaired the regulatory effects of distraction and reappraisal on LPP amplitudes. Suppression did not reduce LPP amplitudes in either group. In addition, habitual sleep quality moderated the effect of sleep deprivation on subjective perception of emotional stimuli, such that sleep deprivation only made good sleepers perceive negative pictures as more unpleasant and more arousing, but it had no significant effect on poor sleepers' perception of negative pictures. Altogether, this study provides the first evidence that sleep deprivation may impair the effectiveness of applying adaptive emotion regulation strategies (distraction and reappraisal), creating potentially undesirable consequences to emotional well-being.
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Encéfalo/fisiología , Regulación Emocional/fisiología , Privación de Sueño/fisiopatología , Adulto , Nivel de Alerta , Electroencefalografía , Potenciales Evocados , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
Resting-state spontaneous neural activities consume far more biological energy than stimulus-induced activities, suggesting their significance. However, existing studies of sleep loss and emotional functioning have focused on how sleep deprivation modulates stimulus-induced emotional neural activities. The current study aimed to investigate the impacts of sleep deprivation on the brain network of emotional functioning using electroencephalogram during a resting state. Two established resting-state electroencephalogram indexes (i.e. frontal alpha asymmetry and frontal theta/beta ratio) were used to reflect the functioning of the emotion regulatory neural network. Participants completed an 8-min resting-state electroencephalogram recording after a well-rested night or 24 hr sleep deprivation. The Sleep Deprivation group had a heightened ratio of the power density in theta band to beta band (theta/beta ratio) in the frontal area than the Sleep Control group, suggesting an affective approach with reduced frontal cortical regulation of subcortical drive after sleep deprivation. There was also marginally more left-lateralized frontal alpha power (left frontal alpha asymmetry) in the Sleep Deprivation group compared with the Sleep Control group. Besides, higher theta/beta ratio and more left alpha lateralization were correlated with higher sleepiness and lower vigilance. The results converged in suggesting compromised emotional regulatory processes during resting state after sleep deprivation. Our work provided the first resting-state neural evidence for compromised emotional functioning after sleep loss, highlighting the significance of examining resting-state neural activities within the affective brain network as a default functional mode in investigating the sleep-emotion relationship.
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Electroencefalografía/métodos , Emociones/fisiología , Privación de Sueño/fisiopatología , Adulto , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
This study aimed to examine the sleep-dependent memory consolidation of verbal declarative memory in Chinese adolescents in a naturalistic experimental setting. Thirty-nine healthy boarding school students (ages 15-18, 70% female) were randomized to either a one-hour afternoon nap or wake group between the baseline and the retest sessions of three verbal declarative memory tasks: a Prose Stories Recall task, a Word Pair Associates task, and Rey Auditory Verbal Learning Test. Results showed that the nap group performed better than the no-nap group on both the Prose Stories Recall task and the Word Pair Associates task, but not on list learning. Our findings suggest that napping is beneficial to verbal declarative memory in adolescents, providing ecologically-valid empirical support for the sleep-dependent memory consolidation hypothesis using a napping paradigm in participants' naturalistic habitat. Our results demonstrate the potential importance of napping as a practical mnemonic intervention/compensatory strategy for student populations.
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Recuerdo Mental/fisiología , Sueño/fisiología , Adolescente , Femenino , Humanos , Masculino , Pruebas NeuropsicológicasRESUMEN
BACKGROUND AND OBJECTIVES: In utero exposure to dioxins and related compounds have been associated with adverse neurocognitive development in infants. It is unclear whether neurodevelopmental deficits persist to childhood. We assessed the association of prenatal dioxin exposure with neurocognitive function in 11-year-old children, and to test whether the association is modified by duration of breastfeeding. METHODS: In this prospective study of 161 children born in Hong Kong in 2002, prenatal dioxin exposure was proxied by the dioxin toxicity equivalence (TEQ) in breast milk collected during the early postnatal period as determined by the Chemical-Activated LUciferase gene eXpression (CALUX) bioassay. We used multivariate linear regression analyses to assess the association of prenatal dioxin exposure with the performance on the Wechsler Intelligence Scale for Children-IV, Hong Kong, the Hong Kong List Learning Test, the Tests for Everyday Attention for Children and the Grooved Pegboard Test, adjusting for child's sex, mother's place of birth, mother's habitual seafood consumption, mother's age at delivery and socioeconomic position. RESULTS: Measures of neurocognitive and intellectual function, including full-scale IQ, fine motor coordination, verbal and non-verbal reasoning, learning ability and attention at 11 years old did not show significant variations with prenatal dioxin exposures (proxied by CALUX-TEQ total dioxin load in early breast milk). None of these associations varied by breastfeeding duration or sex. CONCLUSIONS: Neurocongitive function, as measured with psychological tests, in 11-year-old children was not associated with prenatal dioxin exposure to background levels of dioxins in the 2000s in Hong Kong.
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Lactancia Materna , Disfunción Cognitiva/epidemiología , Dioxinas/toxicidad , Contaminantes Ambientales/toxicidad , Exposición Materna , Efectos Tardíos de la Exposición Prenatal/epidemiología , Lactancia Materna/estadística & datos numéricos , Niño , Cognición/efectos de los fármacos , Disfunción Cognitiva/inducido químicamente , Femenino , Hong Kong/epidemiología , Humanos , Pruebas de Inteligencia , Masculino , Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Estudios ProspectivosRESUMEN
Values are guiding principles in our life. While some studies found spiritual values to be "healthier," Sagiv and Schwartz (Eur J Soc Psychol 30:177-198, 2000) showed that people holding non-spiritual values were higher on affective well-being. We examined the predictive power of these two types of values with a longitudinal data set collected from Chinese students mainly in Hong Kong. Structural equation modeling revealed that spiritual values (as well as family income) positively predicted quality of life a year later. Non-spiritual, self-enhancement values, did not show any association. Results suggest that developing spiritual values may promote well-being through enabling individuals to find meaning and purpose in life.
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Calidad de Vida/psicología , Religión y Psicología , Espiritualidad , Adolescente , Adulto , China , Análisis Factorial , Femenino , Humanos , Estudios Longitudinales , Masculino , Satisfacción Personal , Estudiantes/psicología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Marital goals reflect individuals' understanding of the purpose of marriage and could influence the dyadic interactions and satisfaction in intimate relationships. The current study examines how each partner's marital goals and the concordance of marital goals between the partners influence dating couples' relationship satisfaction through dyadic coping. METHOD: The sample consisted of 200 heterosexual dating couples from Hong Kong. Both partners completed a survey that assessed three types of marital goals, dyadic coping, relationship satisfaction, and other background variables. Path analysis was conducted to estimate the Actor-Partner Interdependence Model (APIM) with each partner's three types of marital goals and marital goal concordance between the two partners as the predictors, each partner's dyadic coping as the mediators, and each partner's relationship satisfaction as the outcomes. RESULTS: Women's dyadic coping significantly mediated the effects of women's companionship goals and marital goal concordance on both partners' marital satisfaction. Meanwhile, men's dyadic coping significantly mediated the effects of men's companionship goals and marital goal concordance on their own relationship satisfaction. CONCLUSION: The current study offered the first evidence supporting the importance of marital goals, the goal concordance between the partners, and dyadic coping in dating relationships.
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With the growth of social networking, parents are increasingly sharing their experiences and opinions or seeking help with childcare through online platforms. This study explored breastfeeding-related topics that Hong Kong mothers raise on social networking sites and how other mothers respond; and how these sites could be a facilitator or barrier to breastfeeding. An online ethnographic approach was used to collect breastfeeding-related discussions (posts and responses) among mothers from three sources: two closed moderated Facebook groups with more than 1000 members, and one open unmoderated forum (Baby Kingdom) (26 December 2021-26 May 2022). Posts not related to breastfeeding (e.g., about formula feeding only) were excluded. Data were collected by a nonparticipatory approach to avoid disrupting the dynamics of the groups. In total, 131 original posts and their 802 responses were collected, of which the common topics discussed were breastfeeding technique, breastfeeding-related health issues, breastfeeding mothers returning to work, and COVID-19 vaccination/infection during breastfeeding. The responses to the queries on breastfeeding technique and health issues in the closed groups were mostly about sharing breastfeeding knowledge and health information to provide timely emotional support and practical solutions. Although similar responses were observed in the open forum, sharing experiences in using formula milk were frequently observed in the responses to posts related to breastfeeding. Social networking sites could be facilitators and barriers to breastfeeding. The potential for infant formula promotion in open forums requires further monitoring and evaluation. Moderation and support from trained professionals or peers could be important.
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OBJECTIVE: To evaluate the effectiveness of small-group nurse-administered cognitive behavioural therapy for insomnia (CBTI) as an early intervention of mood disorders with comorbid insomnia. METHODS: A total of 200 patients with first-episode depressive or bipolar disorders and comorbid insomnia were randomized in a ratio of 1:1 to receiving 4-session CBTI or not in a routine psychiatric care setting. Primary outcome was Insomnia Severity Index. Secondary outcomes included response and remission status; daytime symptomatology and quality of life; medication burden; sleep-related cognitions and behaviours; and the credibility, satisfaction, adherence and adverse events of CBTI. Assessments were conducted at baseline, 3, 6, and 12-month. RESULTS: Only a significant time-effect but no group-by-time interaction was found in the primary outcome. Several secondary outcomes had significantly greater improvements in CBTI group, including higher depression remission at 12-month (59.7% vs. 37.9%, χ2 = 6.57, p = .01), lower anxiolytic use at 3-month (18.1% vs. 33.3%, χ2 = 4.72, p = .03) and 12-month (12.5% vs. 25.8%, χ2 = 3.26, p = .047), and lesser sleep-related dysfunctional cognitions at 3 and 6-month (mixed-effects model, F = 5.12, p = .001 and .03, respectively). Depression remission rate was 28.6%, 40.3%, and 59.7% at 3, 6, and 12-month, respectively in CBTI group and 28.4%, 31.1%, and 37.9%, respectively in no CBTI group. CONCLUSION: CBTI may be a useful early intervention to enhance depression remission and reduce medication burden in patients with first-episode depressive disorder and comorbid insomnia.
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Terapia Cognitivo-Conductual , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Trastornos del Humor/complicaciones , Trastornos del Humor/epidemiología , Trastornos del Humor/terapia , Calidad de Vida , Resultado del TratamientoRESUMEN
Social unrest, coupled with the outbreak of COVID-19, was a double-hit for Hong Kong in early 2020. Those stressful societal situations not only trigger negative emotions, such as anxiety and/or depression, but also consolidate a person's belief towards oneself (i.e., meaning in life) and society (i.e., social axioms). The study included 2031 participants from the Formation and Transformation of Beliefs in Chinese (FTBC) project dataset. The data were collected in Hong Kong from February 2020 to March 2020 (double-hit). Path analysis and multiple regression were used to examine the mediating and moderating effects of the presence subscale (P) of the Meaning in Life Questionnaire (MLQ) on the relations between social axioms and negative emotions. Results showed that low MLQ-P mediated the associations between cynicism and negative emotions and between low religiosity and negative emotions and moderated the relation between social cynicism and emotional outcomes. Exploratory analyses showed that MLQ-Search (S) mediated the relations between reward for application and negative emotions, between social complexity and negative emotions, and between fate control and negative emotions, and moderated the relation between religiosity and stress. As far as we know, this study reported the first evidence of the role of meaning in life in explaining and modifying the associations between social axioms and mood states. The presence of and search for meaning in life seem to work differently with respect to the relations between social axioms and negative emotions, with important implications for understanding the dynamics of social and personal beliefs in affecting mental health in times of large-scale public crisis.
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COVID-19 , Humanos , Hong Kong/epidemiología , COVID-19/epidemiología , Emociones , Ansiedad , Salud MentalRESUMEN
Purpose: The World Health Organization-Five Well-Being Index (WHO-5) is widely used to assess subjective well-being. Nevertheless, measurement invariance and optimal cutoff point of the WHO-5 have not been examined in Chinese samples. We aimed to assess measurement properties of the Chinese version of the WHO-5 (WHO-5-C) among healthcare students. Patients and Methods: A two-wave longitudinal assessment was conducted among 343 Chinese healthcare students from September to November 2022. Measurement properties of the WHO-5-C were assessed through structural validity using confirmatory factor analysis (CFA), measurement invariance using multigroup CFA (MGCFA) and longitudinal CFA (LCFA), convergent validity using correlation analysis with the Self-Rated Health Questionnaire (SRHQ) and Patient Health Questionnaire-4 (PHQ-4), reliability using internal consistency and test-retest reliability, and optimal cutoff point using receiver operating characteristic (ROC) analysis. Results: The WHO-5-C demonstrated satisfactory structural validity with comparative fit index (CFI) of 0.968 at baseline and 0.980 at follow-up, and adequate measurement invariance in different sociodemographic variables at baseline (gender, age, major, home location, being only child, monthly household income, part-time job, physical exercise, hobby, frequency of visiting home, and stress coping strategy) (CFI changes [ΔCFI] = -0.009-0.003) and over a week (ΔCFI = -0.006-0.000). The WHO-5-C also had good internal consistency (Cronbach's α = 0.907-0.934; McDonald's ω = 0.908-0.935) and test-retest reliability (intraclass correlation coefficient [ICC] = 0.803). Convergent validity was supported by moderate correlations of the WHO-5-C with the SRHQ and PHQ-4. The optimal cutoff point of the WHO-5-C was found to be 50, with an area under the ROC curve of 0.882 at baseline data, with sensitivity of 0.803 and specificity of 0.762 at follow-up. Conclusion: The WHO-5-C demonstrated adequate measurement properties, especially concerning cross-sectional and longitudinal measurement invariance, with a recommended optimal cutoff point of ≥ 50 for assessing adequate level of psychological well-being in healthcare students.
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BACKGROUND: The study aimed to assess the measurement properties of a simplified Chinese version of the Sleep Condition Indicator (SCI-SC) in the community. METHODS: A psychometric evaluation through an observational cross-sectional survey design was conducted. Community residents (N = 751) in Hangzhou, China completed the SCI-SC and the simplified Chinese version of the Sleep Quality Questionnaire (SQQ) in July 2021. Data were randomly split into a development sample (N = 375) for model development by exploratory factor analysis (EFA) and a holdout sample (N = 376) for validation by confirmatory factor analysis (CFA). Multi-group CFA (MGCFA) was used to assess configural, metric, scalar, and strict measurement invariance across gender, age, marital status, body mass index (BMI), napping habits, generic exercise, hobby, and administered survey. Moreover, statistical analyses were performed to determine the reliability (alpha and omega) and construct validity of the instrument. RESULTS: Both factor analyses showed a stable solution with two dimensions of Sleep Pattern and Sleep-Related Impact. Good structural validity, robust internal consistency, and construct validity with the SQQ were demonstrated. There was evidence of strict invariance across gender, BMI, napping habits, generic exercise, hobby, and administered survey subgroups, but only metric and scalar invariances were established across age and marital status groups, respectively. CONCLUSIONS: The SCI-SC demonstrated promising psychometric properties, with high SQQ concordance and consistent structure of the original version. The SCI-SC can be used by sleep researchers as well as healthcare professionals in various contexts in detecting risks for insomnia disorder in the community.
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Moderation effects in multiple regression, tested usually by the inclusion of a product term, are frequently investigated in health psychology. However, several issues in presenting the moderation effects in standardized units and their associated confidence intervals are commonly observed. While an old method had been proposed to standardize variables in moderated regression before fitting a moderated regression model, this method was rarely used due to inconvenience and even when used, the confidence intervals derived were biased. Here, we attempt to solve these two problems by providing a tool to conveniently conduct standardization in moderated regression without the step of standardizing the variables beforehand and to accurately form the nonparametric bootstrapping confidence intervals for this standardized measure of moderation effects. Health psychology researchers are now equipped with a tool that can be used to report and interpret standardized moderation effects correctly. (PsycInfo Database Record (c) 2022 APA, all rights reserved).