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1.
J Affect Disord ; 267: 203-210, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32217220

RESUMO

BACKGROUND: Recent research has linked emotion dysregulation with increases in subjective ratings of negative affect (NA reactivity) to trauma reminders, a central symptom of posttraumatic stress disorder (PTSD). The current study adds to this burgeoning line of research by exploring elicited PTSD symptoms as a mechanism explicating the relation between emotion dysregulation and NA reactivity following trauma cue exposure. METHODS: Participants were 60 treatment-seeking marijuana users with insomnia symptoms who reported exposure to a traumatic event. Participants were administered questionnaires assessing emotion dysregulation, PTSD symptoms, and NA prior to and/or after listening to a personalized trauma script, and subsequently completed a diagnostic interview. RESULTS: Results demonstrated that greater emotion dysregulation was associated with heightened NA reactivity through re-experiencing symptoms, but not avoidance or dissociation symptoms, even after accounting for past 30-day PTSD symptom severity and pre-trauma script NA. These effects were driven by the dimensions of emotion dysregulation characterized by nonacceptance of negative emotions and limited access to effective emotion regulation strategies. LIMITATIONS: This study requires replication among other clinical samples, and is limited by use of self-report measures. CONCLUSIONS: Findings provide novel empirical support for one mechanism through which emotion dysregulation may confer vulnerability to PTSD symptomology, and offer implications for refining PTSD treatments.

2.
J Anxiety Disord ; 71: 102198, 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32109828

RESUMO

Posttraumatic stress disorder (PTSD) has empirically-established associations with positive emotion dysregulation. Extending existing research, we utilized a network approach to examine relations between PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], alterations in arousal and reactivity [AAR]) and positive emotion dysregulation dimensions (nonacceptance, impulse control, goal-directed behavior). We identified (1) differential relations of PTSD symptom clusters with positive emotion dysregulation, and (2) central symptoms accounting for the PTSD and positive emotion dysregulation inter-group interconnections. Participants were 371 trauma-exposed community individuals (Mage = 43.68; 70.9 % females; 34.5 % white). We estimated a regularized Gaussian Graphic Model comprising four nodes representing the PTSD symptom clusters and three nodes representing positive emotion dysregulation dimensions. Study results indicated the key role of AAR and intrusions clusters in the PTSD group and impulse control difficulties in the positive emotion dysregulation group. Regarding cross-group connectivity patterns, findings indicate the pivotal role of (1) AAR in its link with positive emotion dysregulation dimensions, and (2) nonacceptance of positive emotions and impairment in goal-directed behavior in the context of positive emotions in their link to PTSD symptom clusters. Thus, the current study indicates the potentially central role of particular PTSD symptom clusters and positive emotion dysregulation dimensions, informing assessment and treatment targets.

3.
Behav Ther ; 51(1): 149-161, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32005332

RESUMO

Anxiety and insomnia disorders are two of the most common and costly mental health conditions. They are frequently comorbid, but current treatments do not target both. To streamline treatment, we developed a computerized intervention targeting a transdiagnostic factor, safety aids (cognitive or behavioral strategies used to cope with distress that paradoxically exacerbate symptoms). We conducted a randomized controlled trial to determine the acceptability and efficacy of this brief one-session intervention. Young adult undergraduates (N = 61) with elevated subclinical anxiety and insomnia were randomized to receive the anxiety-insomnia intervention or a physical health control condition. Participants were followed for 1 month and completed self-report measures. Analyses indicated that participants found the intervention acceptable, credible, and engaging. Analyses revealed the active intervention reduced sleep- and anxiety-related safety aids, with medium to large effect sizes. Findings suggest that targeting safety aids for anxiety and insomnia is acceptable and effective in reducing the target mechanism, safety aids, as well as worry. Future research should replicate these findings within a clinical sample and with a longer-term follow-up.

4.
J Sleep Res ; 29(1): e12909, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31569285

RESUMO

Insomnia symptoms prior to traumatic event exposure predict the development of post-traumatic stress symptoms. However, potential mechanisms underlying the association between insomnia and risk for post-traumatic stress disorder symptoms have not been prospectively tested. The current study used the trauma film paradigm to test whether insomnia symptoms prior to analogue trauma exposure predict subsequent analogue post-traumatic stress disorder symptoms, and potential mediators of this relationship, among an at-risk sample of 108 participants. Results indicated that, after covarying for negative affectivity, insomnia symptoms in the 2 weeks prior to analogue trauma exposure significantly predicted increased post-traumatic stress disorder symptoms 3 days and 1 week post-exposure. Moreover, distress immediately after exposure and post-traumatic avoidance mediated the association between insomnia symptoms and post-traumatic stress disorder symptoms 1 week after exposure. Effect sizes were small. The current study uses an analogue trauma and analogue post-traumatic stress disorder symptoms to model clinical symptoms, includes an additional intervention prior to analogue trauma, and lacks a control film. Findings suggest increased reactivity to trauma exposure and subsequent reminders, and attempts to suppress trauma memories may be mechanisms in the association between insomnia symptoms and risk for post-traumatic stress disorder symptoms.

5.
J Affect Disord ; 262: 344-349, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31740111

RESUMO

OBJECTIVE: Posttraumatic stress disorder (PTSD) is a prevalent and impairing condition that often involves difficulties with interpersonal functioning. Targeting interpersonal difficulties may be a promising alternative approach to reducing PTSD symptoms, particularly given the relatively low rates of treatment engagement and efficacy for first-line treatments for PTSD. Recent research has identified perceived burdensomeness (i.e., feelings of being a burden on others) and thwarted belongingness (i.e., feeling isolated and as if one does not belong) as two specific interpersonal factors related to increased PTSD symptoms. Thus, the current study tested whether a brief, computerized intervention would reduce PTSD symptoms via reductions in perceived burdensomeness and thwarted belongingness, vs. a repeated contact control condition. METHOD: Hypotheses were tested among 250 trauma-exposed participants who were randomized to receive one of two active computerized interventions designed to target interpersonal factors (i.e., perceived burdensomeness or thwarted belongingness) or anxiety sensitivity, or participate in a repeated contact control condition, as part of a larger randomized clinical trial. Participants were then followed over six-months. RESULTS: Results indicated a direct effect of the active interventions on PTSD symptoms at month-one, that was not detected at months three or six. However, there was a significant indirect effect of condition at all-time points, such that reductions in perceived burdensomeness mediated condition effects on PTSD symptoms. CONCLUSIONS: Findings identify perceived burdensomeness as a potential etiological factor in the maintenance of PTSD symptoms, and suggest that targeting perceived burdensomeness may be an effective approach to reducing PTSD symptoms.

6.
BMJ Open ; 9(11): e031087, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31753875

RESUMO

INTRODUCTION: Worldwide, an estimated 10%-27% of women are sexually assaulted during their lifetime. Despite the enormity of sexual assault as a public health problem, to our knowledge, no large-scale prospective studies of experiences and recovery over time among women presenting for emergency care after sexual assault have been performed. METHODS AND ANALYSIS: Women ≥18 years of age who present for emergency care within 72 hours of sexual assault to a network of treatment centres across the USA are approached for study participation. Blood DNA and RNA samples and brief questionnaire and medical record data are obtained from women providing initial consent. Full consent is obtained at initial 1 week follow-up to analyse blood sample data and to perform assessments at 1 week, 6 weeks, 6 months and 1 year. These assessments include evaluation of survivor life history, current health and recovery and experiences with treatment providers, law enforcement and the legal system. ETHICS AND DISSEMINATION: This study is approved by the University of North Carolina at Chapel Hill's Institutional Review Board (IRB) and the IRB of each participating study site. We hope to present the results of this study to the scientific community at conferences and in peer-reviewed journals.

7.
Behav Ther ; 50(5): 886-897, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31422845

RESUMO

Suicide is a growing public health crisis among military veterans. Despite recent attention to this area, there are few empirically supported preventative interventions for suicidality among veterans. In the context of an empirically supported theoretical framework, the Interpersonal Theory of Suicide, the current study targeted suicide risk factors (i.e., perceived burdensomeness and thwarted belongingness) among a sample of 46 veterans selected from a larger clinical trial. Participants were randomized to receive either a newly developed computerized intervention aimed at decreasing perceived burdensomeness and thwarted belongingness, or participate in a repeated contact control condition. Results indicated a direct effect of the intervention on both perceived burdensomeness and thwarted belongingness. Temporal mediation analyses also revealed an indirect effect of condition on suicidality at Month 1 follow-up via reductions in perceived burdensomeness. The current results are the first to indicate that factors from the interpersonal theory of suicide can be reduced among veterans, and to demonstrate that these reductions in perceived burdensomeness lead to reductions in suicidality. Because of the brevity and computer delivery system, this intervention could be widely and rapidly disseminated among military veterans to reduce the public health burden of suicide in this population.


Assuntos
Relações Interpessoais , Trauma Psicológico/prevenção & controle , Suicídio/psicologia , Terapia Assistida por Computador/métodos , Veteranos/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Teoria Psicológica , Trauma Psicológico/psicologia , Fatores de Risco , Ideação Suicida , Suicídio/prevenção & controle
8.
Arch Suicide Res ; : 1-13, 2019 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-30955483

RESUMO

The current study tested whether emotion dysregulation predicts suicidal ideation over the course of 6 months. Community members (N = 298) with elevated suicide risk completed a clinical interview and self-report questionnaires at baseline and month-6 follow-up appointments. Elevated general emotion dysregulation but not subscales significantly predicted increases in suicidal ideation at month-6 follow-up after accounting for initial suicidal ideation, treatment condition, and negative affectivity. Furthermore, general emotion dysregulation as well as lack of awareness and lack of clarity subscales were significantly associated with prior suicide attempts at baseline after accounting for negative affectivity. Findings support the establishment of emotion dysregulation as a risk factor for suicidal ideation and provide evidence for a role in suicide attempts. Findings call for the development of interventions targeting emotion dysregulation in effectively predicting and preventing suicidality.

9.
Drug Alcohol Depend ; 199: 35-41, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30981047

RESUMO

BACKGROUND: Despite evidence that insomnia symptoms exacerbate alcohol use disorder symptoms, there is a dearth of prospective research testing bidirectional associations between these variables. Furthermore, no studies have prospectively examined these associations among military personnel, a vulnerable population for sleep- and alcohol-related problems. Thus, the current study examined whether insomnia symptoms prospectively predicted increased alcohol use disorder symptoms among a sample of military service members and veterans over a 6-month follow-up period, as well as whether alcohol use disorder symptoms led to increases in insomnia. METHOD: Hypotheses were tested among a sample of 274 current and past military service members who participated in a baseline and 6-month assessment using self-report measures. RESULTS: Path analyses revealed that insomnia symptoms significantly prospectively predicted increased month-6 heavy drinking and alcohol-related problems, but not days drinking or being bothered by drinking. None of the alcohol variables significantly predicted insomnia. CONCLUSION: Results support a model in which insomnia symptoms exacerbate alcohol use disorder symptoms, specifically heavy drinking and alcohol-related problems. Future research should seek to examine these findings in diverse populations and test potential mechanisms and clinical implications of these results.


Assuntos
Alcoolismo/epidemiologia , Alcoolismo/psicologia , Militares/psicologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Veteranos/psicologia , Adulto , Alcoolismo/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Adulto Jovem
10.
Psychiatry Res ; 267: 400-408, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29960937

RESUMO

Low distress tolerance, the perceived or actual inability to tolerate negative emotional states, is a transdiagnostic risk marker associated with greater PTSD symptoms and poorer treatment outcomes. However, the role of distress tolerance in PTSD symptom trajectories has not yet been explored. This study examined the mediating role of distress tolerance in PTSD symptom change among outpatients participating in a trial of computerized interventions for anxiety-related and mood-related risk factors. It was hypothesized that pre- to post-intervention change in distress tolerance would predict PTSD symptoms at three- and six-month follow-up, and mediate the effect of condition on PTSD symptoms above and beyond the effects of a competing mediator, anxiety sensitivity. Although condition differences in distress tolerance change were non-significant, distress tolerance change predicted month-three PTSD symptoms and mediated the direct effect of condition on month-three PTSD symptoms. After accounting for the direct effect of condition on month-six PTSD symptoms, distress tolerance change did not predict month-six PTSD symptoms. Findings suggest distress tolerance does play a longitudinal role in PTSD symptom change, and distress tolerance interventions may benefit certain samples who may otherwise not be able to immediately access, or remain in PTSD treatments.


Assuntos
Negociação/psicologia , Escalas de Graduação Psiquiátrica , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Negociação/métodos , Distribuição Aleatória , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/diagnóstico
11.
Behav Ther ; 49(3): 323-330, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29704963

RESUMO

A growing number of studies identify insomnia symptoms as a potential risk factor for the development of anxiety disorders. However, little research has examined potential mechanisms through which insomnia could confer increased risk for anxiety. A separate line of literature suggests sleep is necessary for adaptive emotional and behavioral responding to stressors, a potential mechanism linking insomnia symptoms to anxiety risk. To test whether insomnia symptoms affect emotional and behavioral responding to an anxiety-relevant stressor, the current study recruited a sample of 99 undergraduates with varying levels of insomnia symptoms. Participants completed self-report and psychophysiological measures before, during, and after an impromptu speech task. Results indicated that, after covarying for negative affectivity, increased insomnia symptoms were significantly associated with elevated anticipatory anxiety and skin conductance response prior to the speech, and increased skin conductance response, emotion regulation difficulties, and safety aid use during the speech. Taken together, results provide evidence for the notion that insomnia symptoms are associated with maladaptive emotional and behavioral responding to an anxiety-relevant stressor.


Assuntos
Ansiedade/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Fala , Estresse Psicológico/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Autorrelato , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Adulto Jovem
12.
Cogn Behav Ther ; 47(5): 397-411, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29508645

RESUMO

Rates of suicide and major depressive disorder (MDD) are currently at the highest point in the history of the United States (US). However, these rates are not distributed evenly among the population and Latinos show disproportionately high rates of both suicide and MDD. Yet, past research has infrequently explored factors related to suicide and MDD in primary care settings that serve as the major community portal for mental health among the Latino population. Thus, the current study investigated sociodemographic variables (marital status, nativity, education, employment, primary language, age, and gender) in terms of their relations with suicidal ideation, suicide risk, MDD, and MDD symptom severity among Latino primary care patients in a Federally Qualified Health Center (N = 634, M age = 39.46, SD = 11.46, 87.1% female). Results indicated that gender and Nativity were associated with suicidal ideation, older age was associated with suicide risk, and higher education and having a partner were negatively associated with MDD and depressive symptom severity. These results provide novel insight into the role of sociodemographic factors predicting suicide and MDD among Latinos in primary care, and suggest greater scientific and clinical attention can be focused on certain sociodemographic factors to offset mental health disparities among this group.


Assuntos
Transtorno Depressivo Maior/etnologia , Hispano-Americanos/psicologia , Ideação Suicida , Suicídio/etnologia , Adulto , Fatores Etários , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Suicídio/psicologia
13.
Psychiatry ; 81(1): 71-84, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29565729

RESUMO

OBJECTIVE: High anxiety sensitivity (AS) and poor attention control (AC) are established risk factors for posttraumatic stress symptoms (PTSS), but little is known about the combined influence of these variables. Consistent with dual-systems models suggesting facets of executive function (e.g., AC) will modulate the effects of other risk factors (e.g., AS), the current study evaluated the singular and interactive effects of these variables on posttraumatic stress disorder (PTSD) symptoms. METHOD: In Study 1, latent variable modeling was used to examine the unique and interactive effects of AS and AC on PTSS, controlling for trauma history, sex, and age, in a sample of trauma-exposed community adults (N = 670). In Study 2, latent variable modeling was used to replicate these effects in a sample of trauma-exposed treatment-seeking adults (N = 207). RESULTS: Findings from both studies demonstrated a significant and negative interaction between AS and AC predicting PTSS when controlling for trauma history, sex, and age. Moreover, results revealed that AS more strongly predicts PTSS among those with poor AC. CONCLUSIONS: These findings suggest that impaired AC, one facet of executive function, may potentiate the effects of AS on PTSS, and increasing levels of AS may enhance the effects of AC on PTSS. Results are discussed within the context of a dual-systems model of PTSS.


Assuntos
Ansiedade/psicologia , Atenção , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Idoso , Ansiedade/complicações , Feminino , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Características de Residência , Transtornos de Estresse Pós-Traumáticos/complicações , Adulto Jovem
14.
J Affect Disord ; 230: 77-83, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29407542

RESUMO

BACKGROUND: Although a burgeoning line of research identifies emotion regulation difficulties as a potential maintenance factor for posttraumatic stress disorder (PTSD), little is known in regard to what emotion regulation strategies individuals with PTSD use in their daily lives, their predictors, and their consequences on later PTSD symptoms. METHOD: The current study utilized ecological momentary assessment (EMA) design to explore prospective relationships between maladaptive and adaptive emotion regulation strategy use and PTSD symptoms in participants with PTSD (N = 30). Participants completed 4 EMAs per day over 8 days, assessing stressors, emotional response, and emotion regulation strategy use. RESULTS: Individuals with PTSD most commonly used avoidance as an emotion regulation strategy. Multilevel modeling indicated that baseline PTSD symptoms predicted maladaptive emotion regulation strategy use. After covarying for morning PTSD symptoms, maladaptive emotion regulation prospectively predicted increased PTSD symptoms later in the day. Adaptive emotion regulation strategies did not uniquely predict later PTSD symptoms. CONCLUSION: In line with conceptualizations of difficulties in emotion regulation as a transdiagnostic maintenance factor in PTSD, findings indicate that maladaptive emotion regulation strategies in response to stressors exacerbate PTSD symptoms. The use of adaptive emotion regulation strategies had no positive or negative impact on subsequent PTSD symptoms. LIMITATIONS: Future studies should utilize longer-term prospective designs.


Assuntos
Adaptação Psicológica , Emoções , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
15.
J Anxiety Disord ; 53: 91-99, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28807519

RESUMO

Within a hierarchical framework for depressive and anxiety disorders, negative affect (NA) is posited to be indirectly related to social anxiety and depression through cognitive vulnerabilities, including intolerance of uncertainty (IU) and anxiety sensitivity (AS). However, few prior studies have considered whether the lower-order dimensions of IU (i.e., prospective and inhibitory IU) and AS (i.e., physical, cognitive, and social concerns) better explain the indirect relation between NA and social anxiety and depression. The indirect relations between NA and social anxiety and depression through these cognitive vulnerabilities were examined using structural equation modeling in a clinical sample (N=298). NA and social anxiety symptoms were indirectly related through AS social concerns and inhibitory IU, although a direct effect of NA was also found. Only AS social concerns explained the relation between NA and a social anxiety disorder diagnosis. AS cognitive concerns was the only cognitive vulnerability factor to indirectly explain the relation between NA and depressive symptoms, although a direct effect of NA was also found. These findings suggest that the lower-order dimensions of AS and IU demonstrate more specific and less transdiagnostic associations with social anxiety and depression.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Modelos Psicológicos , Fobia Social/psicologia , Incerteza , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
16.
J Sleep Res ; 27(1): 64-72, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28771875

RESUMO

Despite the high levels of comorbidity between post-traumatic stress disorder (PTSD) and sleep disturbance, little research has examined the predictors of insomnia and nightmares in this population. The current study tested both PTSD-specific (i.e. PTSD symptoms, comorbid anxiety and depression, nightmares and fear of sleep) and insomnia-specific (i.e. dysfunctional beliefs about sleep, insomnia-related safety behaviours and daily stressors) predictors of sleep quality, efficiency and nightmares in a sample of 30 individuals with PTSD. Participants participated in ecological momentary assessment to determine how daily changes in PTSD- and insomnia-related factors lead to changes in sleep. Multi-level modelling analyses indicated that, after accounting for baseline PTSD symptom severity, PTSD-specific factors were associated with insomnia symptoms, but insomnia-specific factors were not. Only daytime PTSD symptoms and fear of sleep predicted nightmares. Both sleep- and PTSD-related factors play a role in maintaining insomnia among those with PTSD, while nightmares seem to be linked more closely with only PTSD-related factors.


Assuntos
Sonhos/psicologia , Avaliação Momentânea Ecológica , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Comorbidade , Sonhos/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto Jovem
17.
Addict Res Theory ; 25(1): 17-23, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29104521

RESUMO

Insomnia symptoms are associated with smoking, and may interfere with smoking cessation. Specifically, studies have shown that smoking-related sleep problems are associated with long-term smoking relapse, and longer sleep duration is associated with successful smoking cessation. However, it is currently unclear whether pre- or post-quit insomnia symptoms are associated with smoking cessation outcomes. As such, the current study aimed to extend previous findings by using a measure of insomnia symptoms as a predictor of smoking cessation failure by month 3 following smoking cessation treatment. Additionally, we examined whether post-quit insomnia symptoms predicted cessation outcomes. Results indicated that pre-, but not post-quit insomnia, predicted smoking cessation failure by 3 months post-cessation, after covarying for depressive symptoms, anxiety sensitivity, alcohol use disorder severity, treatment condition, and number of cigarettes per day. These findings add to the literature on insomnia symptoms as a risk factor for difficulties with smoking cessation, and suggest it may be a worthy clinical target for smoking populations who are interested in quitting smoking.

18.
Behav Res Ther ; 99: 108-116, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29035703

RESUMO

Insomnia disorder is impairing and prevalent, particularly among individuals with comorbid anxiety disorders. Despite the availability of effective computerized treatments for insomnia, there are few that target both insomnia as well as co-occurring anxiety symptoms. The current study tests the efficacy of a computerized treatment for anxiety sensitivity cognitive concerns, a transdiagnostic risk factor for anxiety, mood, and insomnia symptoms, against a repeated contact control, on reducing insomnia symptoms. Hypotheses were tested in a mixed clinical sample of community individuals presenting for a treatment study (n = 151) who were followed up 1-, 3- and 6-months after treatment. Results indicated that the anxiety sensitivity intervention resulted in reductions in insomnia symptoms and clinically significant insomnia scores at 3- and 6-month follow-ups. These reductions remained significant when covarying for concurrent reductions in depression and anxiety. Models accounted for 15-54% of the variance in follow-up insomnia symptoms. Current findings add to a growing body of literature suggesting anxiety sensitivity may play a causal role in insomnia symptoms. Results also suggest that targeting anxiety sensitivity may be an effective way to reduce insomnia symptoms in a brief and portable intervention that also reduces symptoms commonly comorbid with insomnia disorder.


Assuntos
Ansiedade/epidemiologia , Terapia Cognitivo-Comportamental , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/terapia , Adolescente , Adulto , Idoso , Ansiedade/terapia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Assistida por Computador , Resultado do Tratamento , Adulto Jovem
19.
Am J Health Behav ; 41(6): 760-774, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29025504

RESUMO

OBJECTIVE: We examined associations between sleep problems, distress intolerance, and perceived stress and health in a convenience sample of homeless adults. METHODS: Participants (N = 513, 36% women, Mage = 44.5 ±11.9) self-reported sleep adequacy, sleep duration, unintentional sleep during the daytime, distress tolerance, urban stress, and days of poor mental health and days of poor physical health over the last month. The indirect effects of sleep problems on stress and health through distress tolerance were examined using a non-parametric, bias-corrected bootstrapping procedure. RESULTS: Sleep problems were prevalent (eg, 13.0 ±11.4 days of inadequate sleep and 4.7 ±7.9 days of unintentionally falling asleep during the preceding month). Distress intolerance partially accounted for the associations of inadequate sleep and unintentionally falling asleep, but not sleep duration, with urban stress and more days of poor mental and physical health. CONCLUSIONS: Many homeless individuals endure sleep problems. Given the connections between sleep and morbidity and mortality, results further support the need for more attention directed toward facilitating improvements in sleep quality to improve the quality of life of homeless adults, potentially including attention to improving distress tolerance skills.


Assuntos
Pessoas em Situação de Rua/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Estresse Psicológico/psicologia , Adulto , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Distúrbios do Início e da Manutenção do Sono/complicações , Estresse Psicológico/complicações , População Urbana , Adulto Jovem
20.
Behav Res Ther ; 97: 146-153, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28772196

RESUMO

Recent research has highlighted the etiological role of sleep disturbance in posttraumatic stress disorder (PTSD); however it is currently unknown how daily changes in sleep are associated with next-day PTSD symptoms. Furthermore, sleep is critical for maintaining appropriate affect, leading some to hypothesize that affective dysfunction may account for the link between sleep disturbances and PTSD symptoms. Thus, the current study tested the relationship between sleep disturbances, affective valence, and PTSD symptoms utilizing an ecological momentary assessment (EMA) design among individuals with PTSD (n=30) who participated in 4 EMA-based assessments daily over 8 days. Multilevel modeling indicated that, after accounting for prior evening's PTSD symptoms, poor sleep quality and reduced sleep efficiency were associated with increased PTSD symptoms and negative affect. Furthermore, results supported the indirect effect of poor sleep quality on elevated PTSD symptoms through increased negative affect in the morning. Findings add to the body of research demonstrating the negative impact of poor sleep for individuals with PTSD by indicating that daily variations in sleep can affect next-day PTSD symptoms, and identifying negative affect as a mechanism of this relationship.


Assuntos
Avaliação Momentânea Ecológica , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Afeto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/complicações , Adulto Jovem
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