Sleep problems as a transdiagnostic hub bridging impaired attention control, generalized anxiety, and depression

2022 ◽  
Vol 296 ◽  
pp. 305-308
Author(s):  
Charlotte Coussement ◽  
Alexandre Heeren
2015 ◽  
Vol 74 (3) ◽  
pp. 119-127 ◽  
Author(s):  
Martine Bouvard ◽  
Anne Denis ◽  
Jean-Luc Roulin

This article investigates the psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS). A group of 704 adolescents completed the questionnaires in their classrooms. This study examines potential confirmatory factor analysis factor models of the RCADS as well as the relationships between the RCADS and the Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-R). A subsample of 595 adolescents also completed an anxiety questionnaire (Fear Survey Schedule for Children-Revised, FSSC-R) and a depression questionnaire (Center for Epidemiological Studies Depression Scale, CES-D). Confirmatory factor analysis of the RCADS suggests that the 6-factor model reasonably fits the data. All subscales were positively intercorrelated, with rs varying between .48 (generalized anxiety disorder-major depression disorder) and .65 (generalized anxiety disorder-social phobia/obsessive-compulsive disorder). The RCADS total score and all the RCADS scales were found to have good internal consistency (> .70). The correlations between the RCADS subscales and their SCARED-R counterparts are generally substantial. Convergent validity was found with the FSSC-R and the CES-D. The study included normal adolescents aged 10 to 19. Therefore, the findings cannot be extended to children under 10, nor to a clinical population. Altogether, the French version of the RCADS showed reasonable psychometric properties.


2019 ◽  
Vol 30 (4) ◽  
pp. 524-531
Author(s):  
Taylor E. Purvis ◽  
Brian J. Neuman ◽  
Lee H. Riley ◽  
Richard L. Skolasky

OBJECTIVEIn this paper, the authors demonstrate to spine surgeons the prevalence and severity of anxiety and depression among patients presenting for surgery and explore the relationships between different legacy and Patient-Reported Outcomes Measurement Information System (PROMIS) screening measures.METHODSA total of 512 adult spine surgery patients at a single institution completed the 7-item Generalized Anxiety Disorder questionnaire (GAD-7), 8-item Patient Health Questionnaire (PHQ-8) depression scale, and PROMIS Anxiety and Depression computer-adaptive tests (CATs) preoperatively. Correlation coefficients were calculated between PROMIS scores and GAD-7 and PHQ-8 scores. Published reference tables were used to determine the presence of anxiety or depression using GAD-7 and PHQ-8. Sensitivity and specificity of published guidance on the PROMIS Anxiety and Depression CATs were compared. Guidance from 3 sources was compared: published GAD-7 and PHQ-8 crosswalk tables, American Psychiatric Association scales, and expert clinical consensus. Receiver operator characteristic curves were used to determine data-driven cut-points for PROMIS Anxiety and Depression. Significance was accepted as p < 0.05.RESULTSIn 512 spine surgery patients, anxiety and depression were prevalent preoperatively (5% with any anxiety, 24% with generalized anxiety screen-positive; and 54% with any depression, 24% with probable major depression). Correlations were moderately strong between PROMIS Anxiety and GAD-7 scores (r = 0.72; p < 0.001) and between PROMIS Depression and PHQ-8 scores (r = 0.74; p < 0.001). The observed correlation of the PROMIS Depression score was greater with the PHQ-8 cognitive/affective score (r = 0.766) than with the somatic score (r = 0.601) (p < 0.001). PROMIS Anxiety and Depression CATs were able to detect the presence of generalized anxiety screen-positive (sensitivity, 86.0%; specificity, 81.6%) and of probable major depression (sensitivity, 82.3%; specificity, 81.4%). Receiver operating characteristic curve analysis demonstrated data-driven cut-points for these groups.CONCLUSIONSPROMIS Anxiety and Depression CATs are reliable tools for identifying generalized anxiety screen-positive spine surgery patients and those with probable major depression.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
F. De Angeli ◽  
C. Lovati ◽  
L. Giani ◽  
C. Mariotti D'Alessandro ◽  
E. Raimondi ◽  
...  

Background. Migraineurs brain has shown some functional peculiarities that reflect not only in phonophobia, and photophobia, but also in mood and sleep. Dreaming is a universal mental state characterized by hallucinatory features in which imagery, emotion, motor skills, and memory are created de novo. We evaluated dream contents and associated emotions in migraineurs.Materials and Methods. 412 subjects: 219 controls; and 148 migraineurs (66 with aura, MA; 82 without aura, MO), and 45 tension type headache patients (TTH). A semistructured retrospective self-reported questionnaire was used to evaluate dreams. The Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depression.Results. Migraineurs showed increased levels of anxiety (P=0.0002for MA versus controls,P=0.004for MO versus controls). Fear and anguish during dreaming were more frequently reported by migraine patients compared to controls, independently by anxiety and depression scores.Discussion. The brain of migraineurs seems to dream with some peculiar features, all with a negative connotation, as fear and anguish. It may be due to the recorded negative sensations induced by recurrent migraine pain, but it may just reflect a peculiar attitude of the mesolimbic structures of migraineurs brain, activated in both dreaming and migraine attacks.


2021 ◽  
Author(s):  
Maya Roth ◽  
Lisa King ◽  
Don Richardson

ABSTRACT Introduction Chronic pain (CP) commonly presents alongside psychiatric conditions such as depression, PTSD, and generalized anxiety. The current study sought to better understand this complex relationship by determining whether anxiety and depression symptom severity mediated the relationship between DSM-5 PTSD symptom clusters and pain symptoms in a sample of 663 Canadian Armed Forces (CAF) personnel and veterans seeking treatment for mental health conditions. Materials and Methods Generalized anxiety disorder, depression, and PTSD symptom severity were measured using self-report scales provided as part of a standard intake protocol. Pain symptoms were measured using the Bodily Pain subscale of the SF-36 (SF-36 BPS). Linear regressions were used to explore the relationship between PTSD symptom clusters, depression, anxiety, and pain. Bootstrapped resampling analyses were employed to test mediation effects. Results The average SF-36 BPS score in this sample was 36.6, nearly 1.5 SDs below the population health status, enforcing the salience of pain symptoms as a concern for veterans and CAF seeking treatment for military-related psychiatric conditions. The effects of PTSD symptom clusters avoidance, negative mood and cognitions, and arousal on pain were fully mediated by anxiety and depression severity. However, the effect of intrusion on pain was not mediated by depression and only partly mediated by anxiety. Conclusion Findings emphasize the importance of including anxiety and depression in models of PTSD and pain, particularly in samples where psychiatric comorbidity is high. Clinically, results highlight the need for improved treatment regimens that address pain symptoms alongside common psychiatric comorbidities.


2016 ◽  
Vol 8 (1) ◽  
pp. 83-92 ◽  
Author(s):  
Emre Selcuk ◽  
Sarah C. E. Stanton ◽  
Richard B. Slatcher ◽  
Anthony D. Ong

The present study investigated whether perceived partner responsiveness—the extent to which individuals feel cared for, understood, and validated by their partner—predicted subjective sleep problems and objective (actigraph-based) sleep efficiency through lower anxiety and depression symptoms. A life span sample of 698 married or cohabiting adults (35–86 years old) completed measures of perceived partner responsiveness and subjective sleep problems. A subset of the sample ( N = 219) completed a weeklong sleep study where actigraph-based measures of sleep efficiency were obtained. Perceived partner responsiveness predicted lower self-reported global sleep problems through lower anxiety and depression and greater actigraph-assessed sleep efficiency through lower anxiety. All indirect associations held after controlling for emotional support provision to the partner, agreeableness, and demographic and health covariates known to affect sleep quality. These findings are among the first to demonstrate how perceived partner responsiveness, a core aspect of romantic relationships, is linked to sleep behavior.


2021 ◽  
Author(s):  
Kathryn E Barber ◽  
Nur Hani Zainal ◽  
Michelle G. Newman

Background: Generalized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Stress reactivity theories of psychopathology posit that patterns of heightened emotional reactions to stressors can result in increased vulnerability to the development of anxiety and depression. However, cross-sectional studies on this topic have hindered causal inferences. Method: The present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults. GAD and MDD symptom severity (Composite International Diagnostic Interview-Short Form) was assessed at two time points (T1 and T3), approximately 18 years apart. Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2. Results: Structural equation mediation modeling demonstrated that higher T1 GAD severity positively predicted more severe T3 MDD symptoms via T2 stress reactivity (d = 0.45–0.50). After controlling for T1 GAD, T2 stress reactivity was not a significant mediator in the relationship between higher T1 MDD symptoms and worse T3 GAD symptoms. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later, and vice versa (d = 1.29–1.65). Limitations: Stress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. behaviorally indexed) stress reactivity. Conclusions: These findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, our results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
M.A. Mychaskiw ◽  
J.M. Alvir ◽  
B.K. Herman ◽  
S. Pallanti ◽  
A. Joshi

Aims:To assess the impact of insomnia on quality of life (QoL) and functioning in patients with generalized anxiety disorder (GAD), and evaluate the efficacy of pregabalin and venlafaxine-XR in improving sleep and QoL.Methods:A double-blind trial in adults who met DSM-IV criteria for GAD, with a HAM-A total score ≥20,randomized to 8-weeks of flexible-dose treatment with pregabalin (300-600 mg/d, N=121), venlafaxine-XR (75-225 mg/d, N=125), or placebo (N=128).Results:At baseline, 64% of all subjects had insomnia (according to the Medical Outcomes Study Sleep scale [MOS]-Sleep Problems Index [SPI] criteria).While HAM-A total scores (minus the insomnia item) were similar for patients with and without baseline insomnia (25.7 vs. 25.0) those with reported significantly more impairment on the Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES-Q; 45.4 vs. 53.6; p< 0.0001) and Sheehan Disability Scale (SDS; 17.5 vs.14.3; p< 0.0001) than those without. At endpoint, there was a significantly greater mean improvement in MOS-sleep disturbance factor and MOS-SPI with pregabalin (-29.0 and -21.1, respectively) than venlafaxine-XR (-14.7 and -11.0) or placebo (-15.2 and -12.5; all p< 0.05). In more pregabalin (64%) than venlafaxine-XR (51%) or placebo (52%) subjects, abnormal baseline sleep had normalized by endpoint. Endpoint change in MOS-SPI significantly correlated with improvement in both Q-LES-Q and SDS-total scores (Spearman r-values, -0.48 and 0.46, respectively; both p< 0.0001; all subjects).Conclusion:Significantly greater impairment in QoL and functioning was observed in patients with high (vs. low) levels of insomnia. Pregabalin produced significantly greater improvement in insomnia than venlafaxine-XR or placebo.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A176-A177
Author(s):  
T Akerstedt ◽  
F Ghilotti ◽  
J Schwarz ◽  
J Theorell-Haglöw ◽  
E Lindberg

Abstract Introduction Insomnia disorder has a very weak link to polysomnography (PSG) and so does sleep problems in the general population. The reason for this is not clear. One possibility is that the perception of disturbed sleep may be related to immune activation or anxiety/depression, without impairment of objective sleep. Methods 400 women participated, constituting a representative sample of the city of Uppsala with oversampling of snorers. Insomniacs (N=41) were compared with normal sleepers in terms of polysomnography (PSG), immune parameters, anxiety and depression Results The results (after adjustment for age and BMI) show that C-reactive protein (CRP) reached a higher level (4.4±.5) in insomniacs (vs 2.3±.2 for normal sleepers) (p=.003) and lower subjective health (p=.000), while anxiety (p=.000) and depression (p=.000) (Hospital Anxiety and Depression Scale (HAD)) showed higher levels. PSG sleep continuity variables lacked association with insomnia, as did all sleep stage variables except for REM%, with a lower level in the insomnia group (p=.021). Interleukin 6 and Tumor Necrosis Factor alpha were not related to insomnia. CRP levels did not correlate significantly with anxiety or depression, but with subjective health (r=-.21, p=.000). A logistic regression analysis (excluding the variable subjective health) with insomnia as outcome (0/1) yielded as predictors CRP (OR=1.14, Ci= 1.05; 1.24, p=.000), depression (OR=1.21, Ci=1.06;1.38, p=.000) and anxiety (OR=1.15, Ci=1.02;1.30, p=.021). Conclusion It was concluded that increased CRP levels may be part of the subjective experience of insomnia. Support No external funding


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