Repetitive Thought Impairs Sleep Quality: An Experience Sampling Study

Although previous research has suggested that presleep negative cognitive activities are associated with poor sleep quality, there is little evidence regarding the association between negative thoughts and sleep in real-life settings. The present study used experience sampling and long-term sleep monitoring with actigraphy to investigate the relationships among negative repetitive thought, mood, and sleep problems. During a 1-week sampling period, 43 undergraduate students recorded their thought content and mood eight times a day at semirandom intervals. In addition to these subjective reports, participants wore actigraphs on their wrists in order to measure sleep parameters. Analyses using multilevel modeling showed that repetitive thought in the evening was significantly associated with longer sleep-onset latency, decreased sleep efficiency, and reduced total sleep time. Furthermore, impaired sleep quality was significantly associated with reduced positive affect the next morning, and decreased positive affect was indirectly associated with increased repetitive thought in the evening. These findings suggest the existence of a self-reinforcing cycle involving repetitive thought, mood, and impaired sleep quality, highlighting the importance of cognitive and emotional factors in enhancement and maintenance of good-quality sleep.     

Worry and Sleep Length Revisited: Worry,Sleep Length,and Sleep Disturbance Ascribed to Worry

The author administered university students (N = 222; 152 women, 70 men) the Worry Domains Questionnaire (F. Tallis, G. C. L. Davey, & A. Bond, 1994) and a newly constructed scale (the Sleep Disturbance Ascribed to Worry Scale) to measure sleep disturbance attributed to worry. To revisit previous studies (i.e., E. Hartmann, F. Baekeland, & G. R. Zwilling, 1972; S. J. H. McCann & L. L. Stewin, 1988) that suggested that sleep length was positively related to worry, the author also asked the students a question about habitual sleep length. The results indicated that worry and sleep disturbance attributed to worry were negatively related to sleep length. A regression analysis revealed that worry was significantly negatively related to habitual sleep length irrespective of sleep disturbance ascribed to worry.     

Effects of Rumination and Worry on Sleep

Recent research suggests that the stress-sleep relationship is mediated by pre-sleep arousal (PSA) and that cognitive arousal has a stronger mediating effect than somatic arousal; however, this has not been directly tested. Using multilevel moderated mediation, we compared the effects of cognitive arousal and somatic arousal within the stress-sleep relationship. We also assessed whether two forms of repetitive negative thought—rumination and worry—are similarly involved in the stress-sleep relationship. Data was collected from 178 participants across the United States via an online platform. Participants completed baseline self-report surveys examining rumination tendencies and worry tendencies. Over the course of 2 weeks, participants completed daily questionnaires assessing daily stress, PSA, and sleep quality. Results indicated that indirect effects from stress to sleep quality via PSA were statistically significant at low and high levels of rumination and worry, and people at high levels of rumination and worry had stronger relationships between stress and PSA. Across all models, cognitive arousal consistently accounted for more of the variance in the stress-sleep relationship as compared to somatic arousal. Implications for the cognitive behavioral treatment of insomnia are discussed.     

Prospective Associations Between Sleep Disturbance and Repetitive Negative Thinking: The Mediating Roles of Focusing and Shifting Attentional Control

Although considerable evidence has linked sleep disturbance to symptoms of psychopathology, including repetitive negative thinking, few studies have examined how sleep disturbance may predict repetitive negative thinking over time. Further, no study to date has examined specific mechanisms that may account for this relationship. The present study sought to address these gaps in the literature by testing focusing and shifting attentional control as two potential mediators of the relationship between sleep disturbance and repetitive negative thinking over a 6-month period. A final sample of 445 unselected community participants completed measures of sleep disturbance and repetitive negative thinking at Time 1, measures of focusing and shifting attentional control 3 months later, and measures of repetitive negative thinking again 6 months later. Results revealed that focusing, but not shifting, attentional control mediated the relationship between sleep disturbance and repetitive negative thinking, specifically, worry, rumination, and obsessions. These findings provide preliminary evidence for focusing attentional control as a candidate mechanism that may explain the causal role of sleep disturbance in the development of repetitive negative thinking observed in various disorders.     

自我控制对睡眠质量的影响:反刍思维与就寝拖延的中介作用

本研究主要考察了自我控制对睡眠质量的影响作用,以及反刍思维和就寝拖延的中介作用。采用相关量表对1104名大学生进行问卷调查。研究结果表明:(1)自我控制可以负向预测睡眠质量问题、反刍思维和就寝拖延。(2)自我控制还通过反刍思维和就寝拖延的单独中介及序列中介,间接影响睡眠质量。     

Preliminary Evaluation of Sleepwise Program for Children With Sleep Disturbance and Developmental Delay

Sleep disturbances are very prevalent in children with developmental delay. Parental-assisted behavioral strategies have been used effectively in school-aged children; however, multimodal treatment for preschool-aged children is lacking. The current study is a preliminary investigation of the effectiveness of a parent group program called Sleepwise designed for young children with developmental delay and incorporating behavioral, communicative, and sensory strategies. Six parents attended three workshop sessions and implemented individualized treatment plans. Initial results revealed significant posttreatment reductions in child sleep disturbances and behavioral problems, with high treatment acceptability ratings by parents. Outcomes were generally maintained at 1-month follow-up.     

Worry and Rumination in Generalized Anxiety Disorder and Obsessive Compulsive Disorder

Ample work has already been conducted on worry and rumination as negative thought processes involved in the etiology of most of the anxiety and mood related disorders. However, minimal effort has been exerted to investigate whether one type of negative thought process can make way for another type of negative thought process, and if so, how it subsequently results in experiencing a host of symptoms reflective of one or the other type of psychological distress. Therefore, the present study was taken up to investigate whether rumination mediates the relationship between worry and generalized anxiety disorder (GAD), and between worry and obsessive compulsive disorder (OCD) in two clinical groups. Self-report questionnaires tapping worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) were administered to a clinical sample of 60 patients aged 30–40. Worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) correlated substantially with each other, however, rumination did not mediate the relationship between worry and generalized anxiety disorder (GAD) and between worry and obsessive compulsive disorder (OCD). We also analyzed differences of outcome variables within two clinical groups. These results showed that worry and rumination were significantly different between GAD and OCD groups.     

原发性失眠患者的主客观睡眠特征研究

目的：了解原发性失眠患者的睡眠特点,探讨其主客观睡眠的异同点。方法：对15例原发性失眠患者、20例正常人的主观睡眠（PSQI）和客观睡眠（PSG）特点进行比较,对原发性失眠患者进行主观睡眠（PSQI）和客观睡眠（PSG）的比较。结果：原发性失眠的PSG多项指标（睡眠总时间、睡后觉醒次数、觉醒总时间、睡眠潜伏期、睡眠效率、觉睡比、睡眠维持率、REM睡眠时间和REM百分比、REM睡眠潜伏期和REM活动密度）等方面与正常对照有显著差异（p〈0.05或p〈0.01）;原发性失眠的PSQI多项指标（PSQI总分、睡眠效率、睡眠时间、睡眠潜伏期）方面与正常组对照差异显著（p〈0.01）。原发性失眠的PSQI和PSG在睡眠效率、实际睡眠时间、睡眠潜伏期方面存在显著差异（p〈0.01）。结论：原发性失眠患者的PSQI和PSG均存在一定程度的异常,原发性失眠患者有高估自己睡眠障碍的倾向。     

Can self-compassion improve sleep quality via reduced rumination?

ABSTRACT

Poor sleep quality is highly prevalent in modern societies and can be associated with a multitude of problems for individuals and organizations, and also for society at large. Thus, there is a demand for efficient treatments. We suggest that short self-compassion interventions will improve sleep quality via reducing ruminative thoughts, a key variable associated with poor sleep quality. We ran three studies to test this hypothesis. In Study 1 (correlational data), a positive relationship between self-compassion and sleep quality emerged in students’ self-reports. This effect was mediated by rumination. In Study 2, students in two different self-compassion intervention conditions reported higher sleep quality compared to a control condition. Again, rumination mediated this effect. In Study 3, patients with major depressive disorder reported a significant increase in sleep quality and a significant decrease of ruminative thoughts after one week in a daily self-compassion intervention (compared to patients in a control condition). Limitations and implications for future research, such as the need of placebo control groups, objective sleep quality measures, and person–intervention fit designs are discussed.     

Sleep and Immunity: Cytokine Pathways Linking Sleep and Health Outcomes

ABSTRACT— The functions of sleep are enigmatic but are beginning to be delineated. Sleep has been long thought to be important for health, and poor sleep is prospectively associated with worsened health outcomes. Yet the mechanisms accounting for this are only partially understood. In this review, we suggest that the immune system plays a role in the relationship between sleep and health and that sleep processes and immunity show bidirectional interactions, as evidenced in both animal and human studies. Immunological signaling molecules, termed cytokines, are important in coordinating brain–immune system communication, and particular cytokines such as tumor necrosis factor, interleukin-1, and interleukin-6 play a crucial role in sleep regulation. Elevated levels of these cytokines are also associated with a number of chronic diseases and may provide a pathway linking poor sleep with health outcomes.     

Psychometric Properties and the Predictive Validity of the Insomnia Daytime Worry Scale: A Pilot Study

The relationship between presleep worry and insomnia has been investigated in previous studies, but less attention has been given to the role of daytime worry and symptoms of insomnia. The aims of the current study were (a) to assess the psychometric properties of a novel scale measuring insomnia-specific worry during daytime and (b) to examine whether levels of daytime worry predict severity of insomnia symptoms. Participants (N = 353) completed the Insomnia Daytime Worry Scale (IDWS) and the Insomnia Severity Index. An explorative principal-axis factor analysis extracted two factors from the IDWS, accounting for 70.5% of the variance. The IDWS demonstrated good reliability. The total score of IDWS and both factors predicted levels of insomnia severity in two separate hierarchical regression analyses. This preliminary evidence suggests that the IDWS is a valid and reliable scale to measure daytime worry in insomnia.     

Behandling av en ormfobi med fading

En fallstudie av en ormfobi presenteras. Behandlingen skedde med hjälp av fading som innebär att diabilder utnyttjas som stimulusmaterial. Före och efter behandlingen gjordes kontinuerliga mätningar av fobiskt beteende på alia tre responssystemen (overt motoriskt, kognitivt, fysiologiskt). Resultaten visade att de fobiska symtomen utsläcktes på alia tre systemen, dock till olika grad. I diskussionen konstateras att fading verkar vara ett alternativ till mera traditionella metoder vid behandling av smådjursfobier. Slutligen diskuterades begränsningar med studien vad gäller generalitet etc.     

Does worry affect adjustment to bereavement? A longitudinal investigation

Background and objectives: Repetitive thought is a trans-diagnostic risk-factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have been demonstrated following bereavement, surprisingly few studies have aimed to clarify the role of worry, repetitive thinking about potential future negative events, in adjustment to loss. This study sought to fill this gap in knowledge. Methods/Design: One hundred eighty-three bereaved individuals (85.3% women) filled out questionnaires on sociodemographic and loss-related characteristics, worry, and symptom measures of depression, anxiety, and prolonged grief. After six months, 155 participants completed worry and symptom measures again. Using multiple regression analyses, concurrent and longitudinal associations between loss-related variables, worry, and symptoms of psychopathology were examined. Results: Main results were that worry was strongly positively associated with symptoms of anxiety, depression and prolonged grief concurrently and also predicted higher levels of anxiety, depression and prolonged grief longitudinally. Conclusions: Findings suggest that worry influences adjustment to bereavement negatively and may be a potential target in grief therapy, especially when aiming to reduce anxiety.     

论医学思维和法律思维的差异

医学思维和法律思维是两种不同的思维方式。在卫生法律的实施过程中,经常会遇到这两种思维方式相互冲突的现象。究其原因,在于医学思维和法律思维之间存在的差异。认清差异、分析成因、寻求处置思路和办法对于正确处理医疗纠纷、和谐医患关系具有重要意义。