Publication year
2018
Citation Title
Associations among adolescent sleep problems, emotion regulation, and affective disorders: Findings from a nationally representative sample.
Journal Name
Journal of Psychiatric Research
Journal Volume
96
Page Numbers
1-8
DOI
10.1016/j.jpsychires.2017.09.015
Summary
Sleep problems during childhood and adolescence are associated with higher instances of anxiety and mood disorders in later years. This study examined the association between sleep problems, emotion regulation strategies, and the risk of psychiatric disorders in adolescents. Findings suggested that sleep problems were positively associated with an increased likelihood for a mood or anxiety disorder and poorer emotion regulation.
Key Findings
Youth with greater sleep problems were more likely to engage in more rumination and lower problem solving, both of which were associated with higher likelihood to meet criteria for a mood or anxiety disorder.
Sleep problems were positively related to maladaptive emotion regulation strategies, such as avoidance, suppression, rumination, and negatively associated with adaptive strategies, such as problem-solving and acceptance.
Sleep problems were positively associated with acceptance, which is an adaptive emotion regulation strategy meaning a non-judgmental awareness of emotional experience. Acceptance was also positively related to experiencing a mood disorder.
Implications for Military Professionals
Collaborate with organizations connected with children, youth, and families to disseminate information about adaptive and maladaptive strategies for emotion regulation
Enhance activities and programming with emotion regulation strategies to equip youth with ways to positively deal with emotional and mental health concerns
Implications for Program Leaders
Promote the development of leisure activities for youth to help alleviate anxiety and stress and build stronger bonds with peers
Provide workshops to help parents learn about available community resources for youth mental health services
Implications for Policy Makers
Promote the development and implementation of evidence-based programs aimed to teach emotional regulation strategies to youth
Recommend training for youth development professionals to educate them about challenges faced by youth with mood or anxiety issues
Methods
Participants were drawn from the National Comorbidity Survey-Adolescent Supplement, which is a nationally representative epidemiological survey conducted in the United States of America.
Mood and anxiety disorders were assessed using the DSM-IV criteria. Sleep problems and emotion regulation were measured using the sleep module and items from the National Comorbidity Survey-Adolescent Supplement. A 16-item checklist was used to measure current life stress.
Analyses examined the associations between sleep problems, emotion regulation strategies, and likelihood of psychiatric disorders.
Participants
A total of 10,148 adolescents were included in the study.
The participants' age ranged from 13 - 18 years (M=15.18 years, SD=1.51).
Gender distribution was 51.1% female and 48.9% male.
Racial/ethnic distribution was 55.7% White, 19.3% Black, 18.9% Latino, and 6.1% from other races/ethnicities.
Limitations
Assessment of some anxiety and mood disorders included sleep difficulty questions, creating an overlap in assessment. This may have resulted in inflated associations.
Participants' self-assessment of their response to social stressors are subject to social desirability bias, and may result in lower estimates of stress than they actually experience.
The data were collected only at a single time point, limiting the ability to make inference about patterns of sleep and emotion regulation over time.
Avenues for Future Research
Conduct further research on the association between emotional regulation strategies and other sleep characteristics (e.g., sleep latency)
Expand this study by collecting longitudinal data to examine the trajectories of the association between sleep and emotion
Use other methods to measure sleep problems (e.g., polysomnogram) rather than relying solely on self-report data
Focus
Civilian
Target Population
Population Focus
Abstract
Sleep problems in youth reliably forecast the development of anxiety and mood disorders, presumably due to increased emotional difficulties. However, precise emotional mechanisms have yet to be delineated. The current study investigated how sleep problems in adolescence are associated with different emotion regulation strategies, and how sleep and psychiatric risk may be indirectly associated via poor emotion regulation. This study utilized data from the National Comorbidity Survey-Adolescent Supplement, a nationally representative sample from the United States (N ¼ 10,148; age range 13e18 years). A diagnostic interview determined if adolescents qualified for a mood or anxiety disorder within the past year. Participants provided reports of their sleep, emotion regulation, and current life stress. Adolescents who reported greater sleep problems were more likely to qualify for a mood or anxiety disorder and generally reported poorer emotion regulation strategy use, even when accounting for demographic characteristics and current stress. Specifically, adolescents with greater sleep problems reported less problem solving, and greater avoidance, suppression, rumination, and acceptance. Sleep problems were indirectly associated with anxiety disorders through greater suppression and rumination, and indirectly associated with mood disorders through greater rumination and lower problem solving. Although crosssectional, this study extends current research by suggesting that certain emotion regulation strategies may be more difficult for youth struggling with sleep problems, and provides initial evidence that poor emotion regulation may be one factor contributing to sleep-based psychiatric risk. These findings can inform more efficacious intervention efforts.
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