Shyness, social anxiety, social anxiety disorder, and substance use among normative adolescent populations: A systematic review.

Researchers have increasingly studied shyness, social anxiety, and social anxiety disorder (SAD) as potential precursors of substance use. OBJECTIVES: The objective of this study was to review the relationships between these variables and tobacco use, alcohol use, and cannabis/drug use in normative adolescent populations and the extent to which these associations differ by gender. METHODS: A systematic search in PsycINFO and PubMed was conducted, reference screening was performed, and five experts were consulted. RESULTS: Fifty articles published between 1980 and 2016 were included for review. Shyness was frequently associated with lower use of tobacco, alcohol, and cannabis/drug. Similar findings emerged for social anxiety. In contrast, SAD tended to be associated with higher use of tobacco and cannabis/drug, although the association between SAD and the use of alcohol appeared inconclusive. Furthermore, limited evidence suggests that shy females use less tobacco than shy males and that males with social anxiety use less drugs than socially anxious females. CONCLUSIONS: In conclusion, these results highlight that shyness, social anxiety, and SAD may exert different effects on substance use. Higher use of substances among adolescents suffering from a SAD may be explained, among other possibilities, by a self-medication mechanism. While all adolescents should benefit from prevention efforts targeted at substance use, a systematic screening for substance use disorders during the clinical evaluation that precedes SAD treatments is advised.

The Relationship Between Tobacco and Cannabis Use: A Review.

BACKGROUND: Based on the prevalence and health implications of tobacco and cannabis use, aiming to reduce their use, especially among youth, is a sound objective at both the individual and public health level. A proper understanding of the relationships between tobacco and cannabis use may help to achieve this goal. OBJECTIVES: To review the relationships between tobacco and cannabis use. METHODS: A selective review of the literature. RESULTS: We present an overview of the motivations for tobacco and cannabis use, and their perceived harmfulness. The article then reviews the gateway theory, reverse gateway theory, route of administration theory, and common liability theory. We describe the link between co-use and dependence symptoms, and the substitution phenomenon between tobacco and cannabis use. Three forms of simultaneous use-mulling, blunt smoking, and chasing-and their impacts are explained. We summarize the impact of tobacco use on cannabis (and vice versa) treatment outcomes, and, finally, review new treatments that simultaneously target tobacco and cannabis dependence. Most of the literature reviewed here relates to substance use among adolescents and young adults. CONCLUSIONS: The use of tobacco and cannabis-two of the most widely used substances around the world-are strongly intertwined in several respects. Both health professionals and researchers should have well-informed views on this issue to better evaluate, understand, inform, and provide care to their patients.

The relationships between insomnia, nightmares, and dreams: A systematic review.

Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and nightmares in individuals without a concomitant psychopathology. The relationships between insomnia and dreams are also addressed. PsycINFO and Medline were searched for papers published in English or French from 1970 to March 2023. Sixty-seven articles were included for review. Most results support positive relationships between insomnia variables and nightmare variables in individuals with insomnia, individuals with nightmares, the general population, students, children and older adults, and military personnel and veterans. These positive relationships were also apparent in the context of the COVID-19 pandemic. Some psychological interventions, such as Imagery Rehearsal Therapy, might be effective in alleviating both nightmares and insomnia symptoms. Regarding the relationships between insomnia and dreams, compared with controls, the dreams of individuals with insomnia are characterized by more negative contents and affects. The results show that insomnia and nightmares are connected and may be mutually aggravating. A model is proposed to explain how insomnia might increase the likelihood of experiencing nightmares, and how nightmares can in turn lead to sleep loss and nonrestorative sleep.

Prospective effects of peer support and gender roles on the mental health and work functioning of child protection workers exposed to potentially traumatic events.

BACKGROUND: Child protection workers (CPWs) are regularly exposed to potentially traumatic events (PTEs), especially, aggressive behaviors from the service users. OBJECTIVES: This study aimed to evaluate the effects of a peer support program on the mental health and work functioning of CPWs exposed to a PTE, while considering the moderating effect of gender roles. PARTICIPANTS AND SETTING: Participants were recruited in two youth social services centers (YSS) in Canada and assessed one month (n = 176), two months (n = 168), six months (n = 162), and 12 months (n = 161) following exposure to a PTE. Three groups were formed: workers from the first YSS who received peer support (intervention group), workers from the first YSS who did not receive peer support (first control group), and workers from the second YSS where no peer support program was available (second control group). METHODS: Linear mixed models were used to compare the three groups across time. RESULTS: The intervention group did not differ from the control groups on any outcome variables at any time points. Gender roles did not moderate any effect. However, compared with the first control group, the intervention group scored lower on masculine gender roles, suggesting that lower masculinity may facilitate help seeking behaviors. CONCLUSION: The results point toward the need to improve the peer support intervention, to complement this intervention with other forms of support, and to promote organizational changes that would favor the workers' well-being and facilitate their recovery following a PTE.

Work-related predictors of mental health, presenteeism, and professional quality of life following exposure to a potentially traumatic event in child protection workers.

BACKGROUND: Exposure to potentially traumatic events (PTEs) at work can have a negative impact on the psychological health and work life of child protection workers (CPWs). The most common form of work-related PTE experienced by CPWs consists of aggressive behaviours from the youths or their parents. OBJECTIVE: This study aims to identify modifiable work-related variables that might influence the probability of experiencing impaired mental health and professional adjustment following a PTE. METHOD: The participants were CPWs from two youth social services organizations in Canada. A survey was administered to CPWs within one month of a work-related PTE (Time 1; n = 176), two months after the PTE (Time 2; n = 168), six months after the PTE (Time 3; n = 162), and 12 months after the PTE (Time 4; n = 161). Lagged linear mixed models allowed for the independent variables measured at Time 1, Time 2, and Time 3 to predict the outcome variables as measured on the next assessment (Time 2, Time 3, and Time 4, respectively). The outcomes of interest were insomnia symptoms, depressive symptoms, anxiety symptoms, and post-traumatic stress symptoms, as well as presenteeism (inadequate work performance) and professional quality of life. RESULTS: Confidence in one's own ability to cope with service user aggression negatively predicted depressive, anxiety, and post-traumatic stress symptoms as well as presenteeism, and positively predicted professional quality of life. The perception of job safety negatively predicted depressive, anxiety, and post-traumatic stress symptoms, and positively predicted professional quality of life. Finally, psychological demands from work positively predicted all mental health outcomes as well as presenteeism, and negatively predicted professional quality of life. CONCLUSIONS: This study identified work-related variables that could be modified in an attempt to prevent the negative impacts of exposure to work-related PTEs, especially, aggressive behaviours from the service users.

Antecedentes: La exposición a eventos potencialmente traumáticos (PTEs por sus siglas en inglés) en el trabajo pueden tener un impacto negativo en la salud psicológica y la vida laboral de trabajadores dedicados a la protección de la infancia (CPWs por sus siglas en inglés). La forma más común de PTE relacionada con el trabajo experimentada por los CPWs consiste en comportamientos agresivos de los niños, niñas y adolescentes o sus padres.Objetivo: El estudio pretende identificar variables modificables relacionadas con el trabajo que puedan influir un deterioro de la salud mental y en el ajuste laboral posterior a una PTE.Método: Los participantes fueron CPWs de dos organizaciones de servicios sociales para niños, niñas y adolescentes en la provincia de Quebec, Canadá. Una encuesta fue administrada a los CPWs un mes posterior a un PTE relacionado con el trabajo (Tiempo 1; n = 176), 2 meses posterior a la PTE (Tiempo 2; n = 168), seis meses posterior a la PTW (Tiempo 3; n = 162) y 12 meses posterior a la PTE (Tiempo 4; n = 161). Los modelos mixtos lineares desfasados permitieron que las variables independientes medidas en Tiempo 1, Tiempo 2 y Tiempo 3 predijeran las variables de resultado medidas en la siguiente evaluación (Tiempo 2, Tiempo 3 y Tiempo 4, respectivamente). Los resultados de interés fueron síntomas de insomnio, síntomas depresivos, síntomas ansiosos, y síntomas de estrés postraumático, así como presentismo (rendimiento laboral inadecuado) y calidad de vida profesional.Resultados: La confianza en la propia capacidad de lidiar con la agresión de un usuario predijo negativamente la depresión, la ansiedad y los síntomas de estrés postraumático así como el presentismo, y predijo positivamente la calidad de vida profesional. La percepción de seguridad en el trabajo predijo negativamente síntomas depresivos, ansiosos y postraumáticos, y predijo positivamente la calidad de vida profesional. Finalmente, las demandas psicológicas del trabajo predijeron positivamente todos los resultados de salud mental así como el presentismo, y negativamente la calidad de vida.Conclusiones: Este estudio identificó variables relacionadas con el trabajo que pudiesen ser modificadas en un intento de prevenir los impactos negativos de los PTEs laborales, especialmente comportamientos agresivos de los usuarios del servicio.

Insomnia in personality disorders and substance use disorders.

The relationship between certain personality disorders (PDs) and insomnia has been the object of few studies in recent years. Even though it is not indicated to use polysomnography to diagnose insomnia, objective measures have shown sleep abnormalities in individuals with a personality disorder and insomnia. Interestingly, there is increasing evidence that emotion dysregulation is involved in a mutually aggravating relationship between Borderline Personality Disorder (BPD) and insomnia. While BPD traits are highly associated with suicide ideation and attempts, these behaviors could be potentiated or enhanced in individuals presenting sleep disturbances. Because BPD and other mental disorders are often linked with the use of medication or other substances, it is also important to review the association between substance use disorders (SUD) and insomnia. SUD can disrupt sleep and foster insomnia, which in turn might increase motivation to use substances. Insomnia has also been shown to precede (i.e., predict) SUD, and can be present during withdrawal as well. These results highlight the need to assess and treat insomnia when working with patients who present a PD or SUD.

Are cognitive variables that maintain insomnia also involved in shift work disorder?

OBJECTIVE: Shift Work Disorder (SWD) is explained mainly by a misalignment between the sleep schedule and the circadian rhythm. However, the possible role of cognitive variables in maintaining SWD remains unknown. Therefore, the objective of this study is to evaluate whether cognitive variables known to maintain insomnia in day workers might also be involved in perpetuating SWD. DESIGN: Cross-sectional. SETTING: Sleep laboratory. PARTICIPANTS: Twenty-five shift workers diagnosed with SWD (84% females; mean age = 35.9) and 22 shift workers who are good sleepers (91% females; mean age = 34.1). MEASUREMENTS: The participants completed a sleep diary for two weeks, answered questionnaires, and underwent the Harvey's semistructured interview and the catastrophizing procedure. Data from the catastrophizing procedure underwent a content analysis. RESULTS: Compared with good sleepers, shift workers with SWD reported experiencing more thoughts that keep them awake, more presleep cognitive arousal, more dysfunctional beliefs related to worries and helplessness, and more selective attention toward worries and noises. However, the two groups did not differ on the tendency to catastrophize about difficulties falling asleep. Furthermore, 12 catastrophizing themes were identified in the entire sample, the most frequently endorsed being "sleepiness and energy" and "performance at work." CONCLUSIONS: The results suggest that cognitive variables may play a role in maintaining SWD. Finally, worries that interfere with sleep in shift workers are related to their work context.

Pre-sleep cognitive activity in adults: A systematic review.

This systematic review focuses on three themes: 1) the nature of pre-sleep cognitive activity in good sleepers and individuals with insomnia, 2) the links between measures of pre-sleep cognitive activity and sleep onset latency (SOL) or insomnia, and 3) the effect of manipulating pre-sleep cognitive activity on SOL or insomnia. Regarding the first theme, mentation reports have been collected in a sleep laboratory, with an ambulatory monitoring device, or using a voice-activated tape-recorder. Normal transition to sleep is characterized by sensorial imagery, deactivation of higher cognitive processes, and hallucinations. Moreover, pre-sleep thoughts in individuals with insomnia frequently relate to planning or problem-solving, and are more unpleasant than in good sleepers. Regarding the second theme, twelve questionnaires and three interviews were identified. Insomnia is associated with more thoughts interfering with sleep, counterfactual processing, worries, maladaptive thought control strategies, covert monitoring, and cognitive arousal. Regarding the third theme, several strategies have been tested: mental imagery, hypnosis, paradoxical intention, articulatory suppression, ordinary suppression, and distraction. Their effect is either beneficial, negligible, or detrimental. Future research should focus on the mechanisms through which some forms of cognitive activity affect sleep onset latency.

Does shyness interact with peer group affiliation in predicting substance use in adolescence?

Cigarette use and binge drinking are risky behaviors emerging during adolescence. Although many beneficial factors are well documented, studies linking shyness to substance use are somehow conflicting, which may be due to the contribution of moderators. Therefore, the present study has 2 objectives: (a) to prospectively analyze the association between shyness and substance use during adolescence, and (b) to test the moderating role of peer group affiliation on the relationship between shyness and substance use. Participants are 1447 adolescents from the Quebec Longitudinal Study of Child Development, a representative cohort of single-birth children born between 1997 and 1998 in the province of Quebec, Canada. Shyness was assessed at age 12 years. Peer group affiliation, as well as past year cigarette use and binge drinking were assessed at age 15 years. Logistic regressions were used to analyze the data. All analyses were carried out using weighted data accounting for the complex multistage sample design. Results show that shyness negatively predicts the use of tobacco and the occurrence of binge drinking while controlling for confounding variables. However, shyness does not interact with peer group affiliation in predicting substance use. This is the first study that confirms the presence of a negative relationship between shyness and substance use during adolescence over a 3-year period. Results suggest that shyness could exert a beneficial effect against substance use notwithstanding the adolescent's social context. (PsycINFO Database Record