The Role of Sleep for Age-Related Differences in Neurobehavioral Performance.

This study investigated developmental changes from childhood to adulthood in neurobehavioral performance and sleep measures. While many studies have examined age-related changes between childhood and adolescence and from mid-to-late adulthood, young adulthood has been overlooked. The main aim of this study was to investigate the effects of sleep loss on developmental changes in neurobehavioral performance and sleepiness in a natural setting. A total of 119 children, adolescents, and young adults (38 children aged 6-9; 38 adolescents aged 13-19; and 43 young adults aged 20-27) wore an actigraph for a continuous five-weekday night. Subjective sleepiness (Karolinska Sleepiness Scale) and neurobehavioral performance (using the psychomotor vigilance test and the digit symbol substitution test) were measured on five school days. The results showed that adolescents and young adults outperformed children on both the digit symbol substitution test and the psychomotor vigilance test measures. However, adolescents committed more errors of commission on the psychomotor vigilance test and reported higher levels of subjective sleepiness. The results are discussed in relation to brain maturation in various cognitive functions.

Differences in the Factor Structure of the Eating Attitude Test-26 (EAT-26) among Clinical vs. Non-Clinical Adolescent Israeli Females.

In recent years, the diagnostic definitions of eating disorders (EDs) have undergone dramatic changes. The Eating Attitudes Test-26 (EAT-26), which is considered an accepted instrument for community ED studies, has shown in its factorial structure to be inconsistent in different cultures and populations. The aim of the present study was to compare the factor structure of the EAT-26 among clinical and non-clinical populations. The clinical group included 207 female adolescents who were hospitalized with an ED (mean age 16.1). The non-clinical group included 155 female adolescents (mean age 16.1). Both groups completed the EAT-26. A series of factorial invariance models was conducted on the EAT-26. The results indicate that significant differences were found between the two groups regarding the original EAT-26 dimensions: dieting, bulimia and food preoccupation, and oral control. Additionally, the factorial structure of the EAT-26 was found to be significantly different in both groups compared to the original version. In the clinical group, the factorial structure of the EAT-26 consisted of four factors, whereas in the non-clinical sample, five factors were identified. Additionally, a 19-item version of the EAT-26 was found to be considerably more stable and well suited to capture ED symptoms in both groups, and a cutoff point of 22 (not 20) better differentiated clinical samples from non-clinical samples. The proposed shortening of the EAT from 40 to 26 and now to 19 items should be examined in future studies. That said, the shortened scale seems more suited for use among both clinical and non-clinical populations. These results reflect changes that have taken place in ED psychopathology over recent decades.

State Anxiety and Procrastination: The Moderating Role of Neuroendocrine Factors.

Procrastination is prevalent among students, as well as the general population, and has negative impacts on various domains. Several models aimed to understand factors associated with procrastination, with some suggesting that anxiety plays a significant role. Biological factors have been shown to contribute to individual differences in procrastination; however, little attention has been paid to the role of neuroendocrine factors on procrastination. The primary question addressed in the present study is whether neuroendocrine factors (testosterone and cortisol) moderate the association between state anxiety and procrastination. Eighty-eight participants (29 men; 32 women using oral contraceptives; and 27 women not using oral contraceptives and in their luteal phase) were tested for biomarkers and completed questionnaires. Results show that state anxiety is positively correlated with procrastination. Furthermore, testosterone levels moderate the correlation between state anxiety and procrastination. As testosterone levels drop, the positive correlation between state anxiety and procrastination becomes stronger, but when testosterone levels are higher, no significant association between state anxiety and procrastination is found. Cortisol levels do not moderate the relationship between state anxiety and procrastination. The role of neuroendocrine factors for psychological outcomes is discussed.

The Role of Sleep Patterns from Childhood to Adolescence in Vigilant Attention.

Only a few studies addressed age-related changes from childhood to adolescence in sleep patterns, sleepiness, and attention. Vigilant attention plays a key role in cognitive performance. While its nature and course have been investigated broadly among adults, only limited research has been conducted on its development between childhood and adolescence. The main aim of the current study was to replicate previous findings about the effects of sleep loss on age-related changes in vigilance attention performance and sleepiness in a natural setting. A total of 104 children and adolescents (46 children aged 6-9 and 58 adolescents aged 13-19) wore an actigraph for a continuous five to seven nights, including weekdays and weekends. Subjective sleepiness (Karolinska Sleepiness Scale) and a Psychomotor Vigilance Test (PVT-B) were measured on two school days and one non-school day. Findings showed that PVT-B performance differed by age group, with adolescents outperforming children in PVT-B measures in spite of their elevated subjective sleepiness. Adolescents demonstrated less sleep time and increased sleepiness. Although PVT-B performance was better among adolescents, a within-subject analysis revealed that adolescents performed better on PVT measures on weekends than on weekdays. The results are discussed in relation to the synaptic elimination model.

Lifestyle Changes, Emotional Eating, Gender, and Stress during COVID-19 Lockdown.

Emotional eating poses health risks. It is associated with adverse weight gain and a higher body mass index and is frequently triggered by stressful situations such as pandemics. The COVID-19 pandemic was found to cause stress as well as lifestyle changes of different magnitudes. This study examined the relationship between lifestyle changes and emotional eating by focusing on the moderating effect of gender and COVID-19-related stressors. A total of 1969 respondents completed online questionnaires during the first COVID-19 lockdown in Israel. The questionnaires assessed COVID-19-related lifestyle changes concerning eating habits, alcohol consumption, sleep quality, physical activity, and cigarette smoking, COVID-19-related stressors, and emotional eating (Dutch Eating Behavior Questionnaire). People with positive and negative COVID-19-related lifestyle changes demonstrated higher emotional eating compared to people with no lifestyle changes. The relationship between lifestyle changes and emotional eating was moderated by gender and COVID-19-related stressors. In conclusion, health officials should consider recommendations about lifestyle changes given to the public in times of unpredictable changes, with special attention to populations at risk of emotional eating. As emotional eating is related to poor emotional regulation skills, public nutrition recommendations should focus on improving these skills rather than adopting better diets.

Difference between Minorities and Majorities in the Association between COVID-19-Related Stress and Psychological Distress: A Socio-Ecological Perspective and the Moderating Role of Parenthood.

This study introduces a socio-ecological perspective of differences in psychological distress between the Palestinian minority and Jewish majority citizens of Israel during lockdown due to COVID-19. The study examines the association between COVID-19-related stress and psychological distress, and the moderating effect of parenthood. Online questionnaires, completed by 1934 participants (1391 Jews, 552 Palestinians; 1306 parents, 637 without children; 54.86% female, 45.13% male; M age = 40.38, SD = 13.77) assessed COVID-19-related stressors and depression, anxiety, and stress. The Palestinian minority showed a higher level of COVID-19-related stress and psychological distress than the Jewish majority. Parenthood showed a moderating effect on the association between COVID-19-related stress and distress for the Jewish majority but not the Palestinian minority. The results emphasize the significance of considering social status when seeking to understand the differences between minorities and majorities in terms of distress and resilience during pandemic events, and the need for cultural sensitivity and awareness when issuing instructions in such circumstances. Additionally, the results highlight the potential role of parenthood as a resilience factor, depending upon social status.

The Association Between Men's Mental Health During COVID-19 and Deterioration in Economic Status.

This study investigated associations among economic status deterioration, mental health, and gender during the COVID-19 pandemic. A total of 1,807 participants completed an online questionnaire that included demographic variables and questions measuring three mental health variables: psychological distress (as measured by symptoms of depression, anxiety, and stress), adjustment disorder, and emotional eating. Results indicated that women reported higher mental health impairment than men. Men and women whose economic status significantly deteriorated because of the COVID-19 pandemic reported greater mental health impairment than those whose economic status did not significantly deteriorate. However, men whose economic status significantly deteriorated reported high mental health impairment (emotional eating and adjustment difficulties) similar to women in the same situation. This change in men's reporting pattern suggests that the economic impact of COVID-19 severely impacted their mental health and affected how they view their masculinity, which, in turn, further impaired their mental health. As the COVID-19 outbreak has had a significant impact on mental health worldwide, it is important to identify individuals and groups who are at high risk of mental health impairment. The current study demonstrates that men's distress, which is frequently complex to identify, can be detected using standardized measures and analyzing these according to changes in reporting patterns as opposed to simply examining means and frequencies. The results suggest that the COVID-19 crisis may provide an opportunity to understand more about mental health, in particular, that of men.

The Effects of Parental Intervention on Sleep Patterns and Electronic Media Exposure in Young Adolescents.

Objective: This study evaluated the effectiveness of a parent-focused intervention aimed at the promotion of healthy sleep patterns and controlled exposure to electronic media (EM) in young adolescents. Participants: The sample included 70 dyads of parents (68 mothers and 2 fathers) and adolescents. Intervention and control groups each consisted of 35 young adolescents with a mean age of 10.7 (0.9) years old. Methods: Three waves of data collection included baseline, post-intervention, and 3 month follow-up. In each wave, adolescents reported habitual electronic media exposure and sleep patterns for a week and wore an actigraph for five nights. Parents in the intervention group participated in a six-session interactive workshop, while parents in the control group received equivalent written information by mail. Results: The intervention led to earlier bedtimes (p < 0.001), increased sleep efficiency (p < 0.01), increased sleep duration (p < 0.001) and reduced video games exposure (p < 0.01). Benefits were maintained at the follow-up. Conclusion: Interventions tailored for parents can create lasting positive changes in sleep patterns and EM exposure in young adolescents.

The connection between childhood maltreatment and eating disorder psychopathology: a network analysis study in people with bulimia nervosa and with binge eating disorder.

PURPOSE: Childhood maltreatment (CM) experiences are associated with heightened risk of Eating disorders (EDs). The psychopathological pathways promoting this association in people with Bulimia nervosa (BN) and in those with Binge eating disorder (BED) are under-investigated. METHODS: One hundred and eighty-one people with BN and 144 with BED filled in the Eating Disorder Inventory-2, to measure ED psychopathology, and the Childhood Trauma Questionnaire, to assess their early traumatic experiences. Network analysis was conducted to investigate the interplay between those variables. The shortest pathways function was employed to investigate the shortest out of all routes conveying the association between CM and ED-specific symptoms. RESULTS: In both people with BN and with BED, all CM types were connected to the ED psychopathology through the emotional abuse node. The association between emotional abuse and ED-specific symptoms (bulimia and body dissatisfaction) differed in the two groups: in people with BN, it included ineffectiveness, while in people with BED, it involved impulsivity. Interoceptive awareness, an indirect measure of emotion regulation, was included in these pathways in both groups. CONCLUSION: In the light of literature showing that emotional abuse has a connecting role between CM and ED psychopathology also in anorexia nervosa, the present findings support the idea that emotional abuse conveys such association in all the main ED diagnoses. Ineffectiveness and impulsivity may represent the specific psychopathological dimensions connected to emotional abuse and promoting the maintenance of ED-specific symptoms in BN and in BED, respectively. These findings are worth of attention by clinicians. LEVEL OF EVIDENCE: Level III: evidence obtained from well-designed cohort or case-control analytic studies.

Adolescents at risk of eating disorders: The mediating role of emotional distress in the relationship between differentiation of self and eating disorders.

Introduction: Adolescents may feel dissatisfied with their bodies, which may lead to a risk of eating disorders (EDs) due to several factors, with emotional distress being one of the most important. Evidence suggests that family might be one of the most significant factors that may increase or decrease emotional distress. An important family pattern found to contribute to mental and physical health is the differentiation of self (DoS). The primary purpose of the current study was to map the complex relationships between DoS, emotional distress, and EDs among adolescents. We hypothesized that emotional distress would mediate the relationship between DoS and the risk of EDs among adolescents. Moreover, based on findings indicating a higher risk of EDs among females, we expected sex differences in the research indices and the mediation model. Methods: The sample included 194 non-clinical adolescents (mean age 15.15; mean BMI 21.66). Preliminary analyses examined differences between males and females using t-tests. In addition, Pearson correlations were run to assess the association between background variables and the study metrics among males and females. To examine the mediation effect, we ran SEM. Results: Due to a sex moderation effect, two mediation models were run (SEM), one for females and one for males. Results indicated that emotional distress partially mediated the relationships between DoS and the risk of EDs. In addition, sex differences were found in the mediated indices, showing that among female adolescents, perfectionism is the only dimension of EDs that was associated with DoS through the mediation of emotional distress. While the relationship between emotional distress and the risk of EDs is well documented. Conclusions: It is concluded that high DoS may reduce emotional distress, which may, in turn, decrease the risk of EDs. In addition, the results enable an in-depth understanding of specific risk factors of EDs that characterize each sex.

Sleep Quality and Eating Disorder-Related Psychopathologies in Patients with Night Eating Syndrome and Binge Eating Disorders.

Night eating syndrome (NES) is an eating disorder (ED) characterized by nocturnal ingestion (NI), evening hyperphagia, morning anorexia, as well as mood and sleep disturbances. This study compared subjective and objective sleep quality and ED-related psychopathologies in patients seeking treatment for ED. Method: The sample was composed of 170 women, aged 18-68, who were referred for an ED assessment from 2011 to 2020. The participants were divided into three subgroups: NES-NI only (n = 30), NES+ binge eating (BE) (including binge eating disorders or bulimia nervosa (n = 52), and BE-only (n = 88). The measures consisted of a psychiatric evaluation, objective sleep monitoring measured by an actigraph for 1 week, a subjective sleep self-report, and ED-related psychopathology questionnaires. Results: Objective sleep monitoring revealed significant group differences, with higher sleep efficiency in participants with BE-only and longer sleep durations for the NES-NI only group. Subjectively, the BE-only group described a significantly lower sleep quality than either the NES-NI only or the NES+BE groups. ED-related psychopathology was lower in the NES-NI-only group. A stepwise linear regression revealed that general psychopathology (the brief symptom inventory total score) was a significant predictor of subjective sleep quality. Conclusion: NES-NI-only was correlated with less psychopathology, but with more subjective and objective sleep disturbances. These results lend weight to the supposition that NES lies on a continuum of ED psychopathologies, and that NES-NI-only appears to be a separate entity from NES+BE and BE-only in terms of its psychopathology.

The Association between Lifestyle Changes and Psychological Distress during COVID-19 Lockdown: The Moderating Role of COVID-Related Stressors.

The COVID-19 pandemic and the accompanying circumstances (lockdown and social distancing) have been found to cause lifestyle habit changes. While negative changes (adopting risky behaviors) are known to be associated with high psychological distress, the effect of positive changes (adopting health-enhancing behaviors) has yet to be investigated. This study examined the association between the nature of changes and psychological distress, in addition to the moderating effect of "COVID-related stressors". Online questionnaires, completed by 1969 participants, assessed the following: lifestyle changes due to COVID-19 with regard to cigarette smoking, alcohol consumption, physical activity, sleep quality, and eating habits; COVID-related stressors; Depression, Anxiety, and Stress Scale. Positive and negative changes were associated with higher psychological distress compared to no lifestyle change, and there was a moderating effect of COVID-related stressors in the association between COVID-related lifestyle changes and distress. In conclusion, to reduce psychological distress in overwhelming circumstances such as the COVID-19 pandemic, people should carefully consider whether to make changes in their lifestyle habits before doing so, even if these changes are perceived as positive and health-enhancing. Furthermore, efforts should be focused on reducing the perception of stress from COVID-19 by working on personal and mental perceptions of the situation.

Differences in the Factor Structure of the Eating Attitude Test-26 (EAT-26) in Different Cultures in Israel: Jews, Muslims, and Christians.

BACKGROUND: In recent years, there has been a shift in the clinical presentation and, hence, diagnostic definitions of eating disorders (EDs), reflected in a dramatic change in the diagnostic criteria of EDs in the DSM-5. The Eating Attitudes Test-26 (EAT-26) is currently considered an accepted instrument for community studies of EDs, although it features an inconsistent factorial structure in different cultures. Therefore, it is essential to investigate whether the EAT-26 can still be considered an adequate instrument for identifying the risk of developing EDs in different cultures. The aim of the present study was to examine the construct validity and internal consistency of the EAT-26. METHOD: The study used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) among different cultural populations in Israel. RESULTS: Findings indicated different factors in different ethnic groups, most of which do not correspond with the original EAT-26 three-factor structure. RESULTS: The analysis yielded two main factors among Israeli Jews, four main factors among Israeli Muslim Arabs, and three main factors among Israeli Christian Arabs. CONCLUSION: These findings shed light on cultural factors affecting perceptions of the EAT-26 items. This calls for a reconsideration of the generalization of the original three-factor structure of the questionnaire in different cultures.

Depression and social anxiety mediate the relationship between parenting styles and risk of eating disorders: A study among Arab adolescents.

In multicultural Israel, the prevalence of eating disorders (EDs), a common chronic disorder among Western adolescents (especially females), has risen for Arab adolescents, who belong to an Eastern collectivist society. The study examines family and psychological factors that may increase the risk of EDs among Muslim Arab adolescents. We expected social anxiety and depressive symptoms to mediate the association between parenting styles and risk of EDs, with possible gender differences in the mediation model. Participants were 613 Muslim adolescents (394 females and 219 males); mean age = 15.4 ± 1.6; range = 12-19. The analyses revealed that the severity of depressive symptoms and especially social anxiety mediate the relationship between authoritarian parenting style and risk of EDs. Females reported higher levels of risk of EDs, social anxiety, depression and authoritative parenting style than males; no differences appeared for authoritarian or permissive parenting styles. The research sheds new light on risk factors for EDs and the likelihood of authoritarian parenting style and social anxiety being involved in the aetiology of EDs among Arab adolescents. The outcomes meaningfully add to understanding of specific psychological processes that may be associated with the risk of EDs in this population.

Sleep quality and COVID-19-related stress in relation to mental health symptoms among Israeli and U.S. adults.

OBJECTIVES: The COVID-19 virus has resulted not only in high rates of morbidity and mortality across the globe, but in widespread mental health problems and sleep disruption, likely as a result of pandemic-related stressors. The current study examines associations among COVID-related stress, sleep quality, and mental health. DESIGN: Cross-sectional data were collected via online surveys in May 2020. PARTICIPANTS: were 2541 community adults ages 18-70 from Israel (N = 1969) and the U.S. (N = 572). MEASUREMENT: Participants completed measures of COVID-related stress, sleep quality, and symptoms of anxiety, depression and adjustment disorder. RESULTS: Participants reported high rates of depression and anxiety symptoms, adjustment difficulties, and poor sleep quality. In both countries, COVID-related stressors were associated with both anxiety and depression, and these associations were mediated by sleep disturbances. CONCLUSIONS: These results support the role of sleep in mental health difficulties. Widespread, accessible, evidence-based interventions are urgently needed to improve health and mental health and to promote resilience in preparation for future global crises.

Childhood maltreatment in patients with binge eating disorder with and without night eating syndrome vs. control.

This study compared women with binge eating disorders or bulimia nervosa with and without night eating syndrome regarding childhood maltreatment and psychopathology relative to healthy controls. The 426 participants (aged 18-60) were divided into two groups: eating disorders (n = 158) and healthy controls (n = 268). Eating disorders was divided into bulimia nervosa, binge eating disorder, and night eating syndrome with binge eating. Participants completed questionnaires: childhood trauma, eating disorders, self-esteem, and psychopathology. No significant differences were found for most variables in the eating disorders subgroups except physical neglect, which was more prevalent in night eating syndrome with binge eating. All variables differed significantly between eating disorders and healthy controls. Significant correlations emerged between childhood maltreatment, psychopathology, emotional abuse, and self-esteem in eating disorders. Regression showed that emotional abuse significantly predicted self-esteem in eating disorders, and group significantly moderated the effect of emotional abuse on psychopathology. Results emphasize that in this specific sample and variables, night eating syndrome with binge eating may be a variant of binge eating disorder or bulimia nervosa and not a separate diagnostic entity. The results highlight the importance of early assessment of childhood maltreatment, particularly emotional abuse, in patients with night eating syndrome.

Relationship of smartphone use at night with sleep quality and psychological well-being among healthy students: A pilot study.

OBJECTIVE: To examine the differences between objective and subjective measures of smartphone use at night as predictors of sleep quality and psychological well-being: anxiety, depression, and fear of missing out (FoMO). METHODS: Smartphone use after sleep onset was measured using objective and subjective measures among 40 college students. The morning after the fourth night, they completed online questionnaires: Pittsburgh Sleep Quality Index (PSQI), Trait Anxiety Inventory (STAI-T), Beck Depression Inventory (BDI-II), and FoMO Scale (FoMOs). RESULTS: Objective measures showed that 40% of the participants actually awoke during the night and checked their smartphone. However, the subjective measures showed that they overestimated this behavior. More frequent nighttime checking of one's smartphone, as recorded by objective measures, was associated with lower sleep quality and psychological well-being. CONCLUSIONS: This study demonstrated differences between objective and subjective measures of smartphone use at night. It also showed that an objective measurement of smartphone use could identify participants at risk for reduced sleep quality and psychological well-being.

The Relation between Sustained Attention and Incidental and Intentional Object-Location Memory.

The role of attention allocation in object-location memory has been widely studied through incidental and intentional encoding conditions. However, the relation between sustained attention and memory encoding processes has scarcely been studied. The present study aimed to investigate performance differences across incidental and intentional encoding conditions using a divided attention paradigm. Furthermore, the study aimed to examine the relation between sustained attention and incidental and intentional object-location memory performance. Based on previous findings, an all women sample was recruited in order to best illuminate the potential effects of interest. Forty-nine women participated in the study and completed the psychomotor vigilance test, as well as object-location memory tests, under both incidental and intentional encoding divided attention conditions. Performance was higher in the incidental encoding condition than in the intentional encoding condition. Furthermore, sustained attention correlated with incidental, but not with intentional memory performance. These findings are discussed in light of the automaticity hypothesis, specifically as it regards the role of attention allocation in encoding object-location memory. Furthermore, the role of sustained attention in incidental memory performance is discussed in light of previous animal and human studies that have examined the brain regions involved in these cognitive processes. We conclude that under conditions of increased mental demand, executive attention is associated with incidental, but not with intentional encoding, thus identifying the exact conditions under which executive attention influence memory performance.

Dietary patterns of patients with binge eating disorders with and without night eating.

OBJECTIVE: This study aimed to compare dietary patterns (timing and frequency of binge episodes, caloric intake and macronutrient composition) of patients with binge eating disorders (BE) with and without night eating syndrome (NES). DESIGN: The study includes 59 women (18-60) who sought treatment for Eating Disorders (EDs) and were diagnosed with BED or BN (BE) with or without NES. They were divided into two groups: NES-BE and BE-only. The participants kept 7-day, 24-h food diaries and completed demographic and depression questionnaires. RESULTS: NES-BE reported significantly a higher frequency of binge days and binge episodes during the week, and more energy and fat consumption than BE-only. CONCLUSIONS: Individuals with NES-BE exhibit higher levels of eating pathology than individuals with BE-only. Thus, NES-BE may not be simply a variant of BED or BN but rather a separate entity that may lead to a more severe disorder and require early assessment and more intensive and suitable treatment. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Disordered Eating Pathology and Body Image Among Adolescent Girls in Israel: The Role of Sense of Coherence.

Disordered eating pathology (DEP) represents a range of behaviors and attitudes, from negative body image to full blown eating disorders, appearing mainly in adolescent females. DEP is related to a plethora of biological and psychological factors, including various coping strategies. Sense of coherence (SOC) is a coping mechanism defined as an external and internal ability to adapt to stress and has been found to be associated with better mental health outcomes. However, SOC has not been examined in relation to DEP. Therefore, the aim of this study is to examine the relationship between SOC, DEP and body image disturbances among adolescent girls. The sample consisted of 248 Israeli girls (12-18), who completed self-reported questionnaires. SOC was negatively associated with DEP and body dissatisfaction. The overall rate of those in the high risk group for EDs was found to be higher than previously seen among samples from a similar population (22.5% vs. 19.5%), and was found to have a significantly lower levels of SOC and more negative body image than those at lower risk. Greater SOC was found to be associated with lower levels of DEP. It is suggested that strengthening SOC be incorporated into eating disorder prevention and treatment. Results emphasize the importance of SOC to well-being and mental health.