Helping Clinicians Conceptualise Behavioural Insomnia in Children: Development of the Manifestations and Vulnerabilities of Behavioural Insomnia in Childhood Scale (MAVBICS).

This paper outlines the development and psychometric evaluation of the Manifestations and Vulnerabilities of Behavioural Insomnia in Childhood Scale (MAVBICS), an instrument intended to assess the manifestations of, and factors underpinning, child behavioural insomnia. The MAVBICS comprises two sections: a more general sleep and bedtime information section (Section 1), and a psychometric measure of six theoretically derived factors that underlie, contribute to, and are manifestations of, child sleep problems (Section 2), that is the focus of this research. Study 1 comprised an exploratory factor analysis of Section 2 items (EFA; n = 328 parents of children aged 3-12 years), with a final 25 items found to load highly onto 6 factors; Sleep Maintenance Problems (4 items, α = 0.88), Co-Sleeping Behaviours (4 items, α = 0.93), Bedtime Routines (5 items, α = 0.82), Bedtime Resistance (5 items, α = 0.88), Bedtime Worries (3 items, α = 0.85) and Bedtime Fears (4 items, α = 0.86). Study 2 comprised a confirmatory factor analysis (CFA) of Section 2 items and tests of convergent validity (n = 313), with results confirming the factor structure and providing evidence for convergent validity through correlations in expected directions between MAVBICS scores and other sleep, anxiety and behaviour measures. Study 3 tested the test-retest reliability of Section 2 items (n = 53), and found support for the temporal stability of the MAVBICS over a 2-week period. Overall, the results provide strong preliminary evidence for the validity of the MAVBICS total score and its subscales, although the Bedtime Routines subscale may be less useful.

Treating sleep problems in young children: A randomised controlled trial of a group-based, parent-focused behavioural sleep intervention.

This study tested the efficacy of a 5 × 1.5 h/session, group-based, parent-focused, behavioural intervention (BI) targeting sleep problems in preschool children. Parents were randomised to either the BI (N = 62) or care as usual (CAU; N = 66) conditions. Outcomes included sleep, anxiety, behavioural problems, internalising and externalising symptoms, transition to school and academic achievement. Assessments were conducted at pre- and post-BI intervention (in the year prior to formal schooling), and then at follow-ups 1 and 2 in the first year of formal schooling. Relative to the CAU, the BI condition demonstrated significantly greater improvements in sleep, anxiety, behaviour problems and internalising and externalising symptoms from pre-to post-intervention. Improvements in sleep, anxiety, and internalising symptoms were maintained, while behaviour and externalising symptoms were further improved upon at school follow-up 2. For the BI group, improvements in sleep at post-intervention were found to mediate improvements in anxiety, internalising, and externalising symptoms, but not behaviour problems, at school follow-ups 1 and 2. There were no significant effects of condition on school transition or academic outcome measures. The results suggest that the BI is effective for sleep, anxiety, behaviour, internalising and externalising symptoms, but not for school transition or academic outcomes. ANZCTR NUMBER: ACTRN12618001161213.

Body dissatisfaction in midlife women: The applicability of the tripartite influence model.

Body image issues and disordered eating are relatively under-researched areas within midlife populations. Accordingly, this study investigated the applicability of the Tripartite Influence Model (TIM) to midlife women. In an online survey, predominately Australian female participants (N = 206) aged 40-55 years (M = 46.75, SD = 4.54) completed measures related to sociocultural pressures, thin-ideal internalisation, appearance comparison, body dissatisfaction, bulimic symptoms, restrained eating, and psychological distress. Path analysis was used to evaluate the model. Greater peer and media pressure were associated with greater appearance comparison, which in turn was associated with greater thin-ideal internalisation, and through this greater body dissatisfaction. Similarly, greater body dissatisfaction was associated with greater restrained eating and bulimic symptoms, which in turn were associated with greater psychological distress. Unexpectedly, family pressure also emerged as an important direct predictor of outcomes, while sociocultural influences were not associated with thin-ideal internalisation, nor was family pressure associated with appearance comparison. Furthermore, appearance comparison was not associated with body dissatisfaction. Overall, the findings provide partial support for applicability of the TIM for midlife women and suggest practical implications such as targeted interventions that may assist body image disturbance and associated outcomes for midlife women.

Recharge: a preliminary evaluation of an emotion regulation enhanced CBT-i intervention for insomnia in early adolescence.

BACKGROUND: Insomnia disorder in adolescence is prevalent, persistent and associated with adverse outcomes, including reduced quality of life. Cognitive behavioural therapy for insomnia (CBT-i) has shown promise as an effective treatment for adolescents. Recent research has highlighted the role of emotion regulation in insomnia, suggesting that the inclusion of emotion regulation techniques may enhance CBT-i. AIMS: To evaluate the feasibility and preliminary effectiveness of a CBT-i treatment program for insomnia in early adolescence, augmented with emotion regulation strategies, using a case-series design. METHOD: Three participants (mean 11.67 years) completed the program that consisted of seven, weekly individual therapy sessions and parental participation. Participants monitored their sleep daily during the intervention, and insomnia diagnostic status and severity, use of emotion regulation strategies and quality of life were assessed at baseline, post-intervention and at 6-week follow-up. RESULTS: At post-treatment, none of the participants met criteria for insomnia and all reported statistically reliable reductions in symptoms. Improvements were maintained at follow-up for two participants. Sleep onset latency was reduced and improvements in quality of life were evident. There were no changes in the use of emotion regulation strategies following treatment. Adolescents and parents reported high program satisfaction. CONCLUSIONS: This preliminary evaluation provides support for the effectiveness of the CBT-i program tested. However, given that emotion regulation did not change and yet improvements in sleep were evident, the usefulness of augmenting the program with emotion regulation strategies requires further evaluation.