A comparison of trichotillomania and obsessive-compulsive disorder

The validity of conceptualizing trichotillomania (TCM) and obsessive-compulsive disorder (OCD) as separate and distinct diagnoses was examined in a study of 20 patients with each disorder. A comparison of demographic, psychometric, and clinical features between the two groups revealed a number of statistically significant differences. Patients meeting the criteria for OCD scored higher on measures of psychiatric symptomatology including ratings of obsessions and compulsions, depression, interpersonal sensitivity, general anxiety, phobic anxiety, and psychoticism. Patients meeting the criteria for TCM reported an earlier age at onset than those with OCD. Stressors associated with onset were also significantly different between groups. These results support the validity of conceptualizing TCM and OCD as differing behavioral disorders.Portions of this paper were presented at the annual meeting of the Anxiety Disorders Association of America (March 1992) in Dallas, TX, and at the annual meeting of the American Psychiatric Association (May 1992) in Washington, DC.     

Temperament and sleep–wake behaviour from infancy to toddlerhood

Sleep–wake behaviours and temperament were examined longitudinally for trait stability and relationship to behavioural state regulation from infancy to early childhood. Subjects were 120 low‐risk, full‐term infants from a middle class sample. At 6 weeks, parents completed three consecutive days of the Baby's Day Diary which measures sleep, wake, fuss, feed and cry states and the Infant Characteristics Questionnaire. At 16 months, parents assessed sleep behaviours with the Sleep Habits Inventory and temperament with the Toddler Symptom Checklist. At 24 months, parents repeated 3 days of the Baby's Day Diary. Structural Equation Modelling was used to examine the cross‐age hypotheses for sleep–wake and temperament associations. From early infancy to toddlerhood, sleep–wake behaviours and irritable temperament were notably stable but independent in this cohort. Copyright © 2011 John Wiley & Sons, Ltd.     

Sleep and Aging: Challenges and Recommendations for Middle‐Aged and Older Adults

Understanding and alleviating sleep problems for middle‐aged and older adults is addressed through discussion of the following topics: age‐related sleep changes; gender considerations; interactions among sleep, mental health, and physical illness; lifestyle and sleep; and assessment and treatment recommendations.     

The effectiveness of function‐based interventions to treat sleep problems,including unwanted co‐sleeping,in children with autism

This study investigated the effectiveness of functional behavioral assessment (FBA)—informed interventions for sleep problems, particularly co‐sleeping, in children with autism spectrum disorder (ASD). Seven children, who exhibited multiple sleep problems including unwanted co‐sleeping, participated. FBA, based on information derived from interviews and parent‐recorded sleep diaries, was used to develop individualized case formulations upon which multicomponent, parent‐implemented interventions were based. These were evaluated using a single‐case, non‐concurrent multiple‐baseline‐across‐participants design. Improvements were observed across all sleep problems, including the elimination of co‐sleeping. Gains were maintained at follow‐up for five out of seven children, though two children did not complete intervention. Parents reported high levels of satisfaction with the program. FBA‐based interventions for sleep problems in children with ASD and their clinical implications are further discussed.     

“Ghosts in the Nursery:” Infant sleep and sleep‐related cognitions of parents raised under communal sleeping arrangements

In an experiment of nature, a normal cohort of parents who were raised under communal sleeping arrangements (CSA) in Israeli kibbutzim are raising their infants at home under home‐based family sleeping arrangements. The present study focused on exploring the links between the early sleep experiences of CSA parents and their present sleep‐related beliefs and behaviors. In particular, the study assessed whether the cognitions of CSA parents regarding infant sleep differ from cognitions of parents who were raised under home‐based family sleeping arrangements. Furthermore, parental soothing methods and infant sleep patterns were compared. One hundred forty‐one families participated in this study. The children's ages ranged between 4.5 to 30 months. Parental cognitions were evaluated by two questionnaires. Infant sleep was assessed by a questionnaire and by daily parental reports. As expected, CSA parents were more likely than were control parents to: (a) interpret infant night wakings as a sign of distress and (b) actively soothe their infants at bedtime, co‐sleep with them, and report more night wakings of their infants. These findings support the hypothesis that early childhood sleep‐related experiences of parents (“Ghosts in the Nursery”) influence their parental sleep‐related cognitions that in turn affect infant sleep patterns.     

The reciprocal relation between sleep and memory in infancy: Memory‐dependent adjustment of sleep spindles and spindle‐dependent improvement of memories

Sleep spindle activity in infants supports their formation of generalized memories during sleep, indicating that specific sleep processes affect the consolidation of memories early in life. Characteristics of sleep spindles depend on the infant's developmental state and are known to be associated with trait‐like factors such as intelligence. It is, however, largely unknown which state‐like factors affect sleep spindles in infancy. By varying infants’ wake experience in a within‐subject design, here we provide evidence for a learning‐ and memory‐dependent modulation of infant spindle activity. In a lexical‐semantic learning session before a nap, 14‐ to 16‐month‐old infants were exposed to unknown words as labels for exemplars of unknown object categories. In a memory test on the next day, generalization to novel category exemplars was tested. In a nonlearning control session preceding a nap on another day, the same infants heard known words as labels for exemplars of already known categories. Central–parietal fast sleep spindles increased after the encoding of unknown object–word pairings compared to known pairings, evidencing that an infant's spindle activity varies depending on its prior knowledge for newly encoded information. Correlations suggest that enhanced spindle activity was particularly triggered, when similar unknown pairings were not generalized immediately during encoding. The spindle increase triggered by previously not generalized object–word pairings, moreover, boosted the formation of generalized memories for these pairings. Overall, the results provide first evidence for a fine‐tuned regulation of infant sleep quality according to current consolidation requirements, which improves the infant long‐term memory for new experiences.     

Dispositional resilience in treatment‐seeking patients with obsessive‐compulsive disorder and its association with treatment outcome

There is a lack of research on the relation between obsessive‐compulsive disorder (OCD) and resilience. Dispositional resilience, as described and defined in literature on hardiness, consists of three facets, namely beliefs about having control in everyday living, having a sense of purpose or commitment, and a positive attitude toward challenges. This study explores associations between dispositional resilience (measured with the Dispositional Resilience Scale (DRS‐15‐R)), symptom severity, and treatment outcome in a sample of 89 patients treated with concentrated exposure therapy (cET), and compares the findings with scores from two reference groups (students and soldiers). The patient group had significantly lower resilience scores than the two reference groups. Weak correlations were observed between dispositional resilience and OCD symptoms. Differences in dispositional resilience were weakly related to remission status at follow‐up (odds ratio of 1.11). Furthermore, resilience improved from pre‐ to post‐treatment (Cohen's d of 0.65). Our results imply that patients’ initial resilience score does not hinder nor facilitate treatment effects to a great extent in this format of ERP treatment.     

Sleep disturbances in treatment‐seeking OCD‐patients: Changes after concentrated exposure treatment

Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD‐treatment. Thirty‐six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow‐up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre‐treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD‐symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow‐up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre‐treatment had better outcome on OCD‐symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment.     

Cross‐cultural comparison of seven morningness and sleep–wake measures from Germany,India and Slovakia

Morningness–eveningness or circadian typology can be viewed as an interesting aspect of individual differences. Morningness–eveningness is a preference for a given time of day for physical or mental performance, but also reflects aspects of affect. Here, we used seven different measures to assess differences in morningness–eveningness between Germany, Slovakia and India. The hypothesis was that Indians should be earliest chronotypes, followed by Slovakia and then Germany, because of higher temperatures in India, and the fact that Slovakia is located farther east compared to Germany. We applied the Composite Scale of Morningness (CSM), the Circadian Energy Scale (CIRENS), the CAEN Chronotype Questionnaire (CCQ), and habitual sleep–wake variables to calculate sleep duration, midpoint of sleep and social jetlag. Sample sizes were N = 300 (Germany), N = 482 (Slovakia) and N = 409 (India). Country had the strongest influence on morningness–eveningness. Germans were latest chronotypes and differed in all seven measures from Indians but differed from Slovakians only in the energy level at the evening and midpoint of sleep. Slovakians and Indians differed in all measures but the energy level (CIRENS). Women scored higher on the CSM, lower on CIRENS, lower on the morningness–eveningness (ME) scale, but higher on distinctness (DI) scale. Women slept longer and had an earlier midpoint of sleep.     

A Multiple Baseline Study of the Marriage Contract Game's Effect on Problem Solving and Affective Behavior

In a multiple-baseline design, four relatively untroubled couples were guided by the Marriage Contract Game and related instructions as they negotiated contracts. The results demonstrated generalization from clinic to home, and suggested that problem solving and affection are independent behavior domains. When problem-solving behavior was the target of intervention, the rate of problem-solving behavior increased significantly over baseline during generalization probes. When affective behavior was added as a target of training, the rate of affective behavior increased significantly over previous phases and the rate of problem solving continued to increase. Evidence about the interdependence of marital attitudes and behaviors also emerged. Subjective ratings of problems improved along with the increase in problem-solving behavior; mood ratings improved along with increases in problem-solving and in affective behavior. Training had no effect on ratings of marital happiness.     

Sleep quality and treatment of social anxiety disorder

Background and Objectives: Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may affect treatment outcome. We examined whether: (1) individuals with SAD differed from healthy controls (HCs) in sleep quality, (2) baseline sleep quality moderated the effects of treatment (Cognitive–behavioral group therapy [CBGT] vs. mindfulness-based stress reduction [MBSR] vs. waitlist [WL]) on social anxiety, (3) sleep quality changed over treatment, and (4) changes in sleep quality predicted anxiety 12-months post-treatment.

Design: Participants were 108 adults with SAD from a randomized controlled trial of CBGT vs. MBSR vs. WL and 38 HCs.

Methods: SAD and sleep quality were assessed pre-treatment and post-treatment; SAD was assessed again 12-months post-treatment.

Results: Participants with SAD reported poorer sleep quality than HCs. The effect of treatment condition on post-treatment social anxiety did not differ as a function of baseline sleep quality. Sleep quality improved in MBSR, significantly more than WL, but not CBGT. Sleep quality change from pre- to post-treatment in CBGT or MBSR did not predict later social anxiety.

Conclusions: MBSR, and not CBGT, improved sleep quality among participants. Other results were inconsistent with prior research; possible explanations, limitations, and implications for future research are discussed. ClinicalTrials.gov identifier: NCT02036658.     

Comparing computer‐based training and lecture formats to teach visual analysis of baseline‐treatment graphs

Accurate analysis of data is vital to the validation of interventions. As such, there has been a recent increase in studies evaluating visual analysis training procedures. However, past investigations have not evaluated direct and indirect visual analysis training methods with matched instructional content that was systematically designed. Furthermore, training has rarely included assessment of generalization and maintenance of visual analysis skills. The purpose of the current dissertation study was to compare the effectiveness and efficiency of (a) computer‐based training, (b) lecture formats with and (c) without the opportunity to pause, and (d) a no‐training group to teach visual analysis of AB graphs to university students. To make these formats directly comparable, the instructional content was equated by ensuring information and examples were identical across the three training procedures. Eighty‐three students were randomly assigned to one of the four groups. Results showed that all three training formats produced increases in accurate responding compared to the no‐training group. Visual analysis skills generalized to novel graphs and maintained approximately 2 weeks following all trainings. These results suggest that structured approaches that are carefully designed to train visual analysis are effective and lead to gains that generalize and maintain in the absence of training.     

The effect of a delayed weekend sleep pattern on sleep and morning functioning

Abstract

It is a common practice for young adults to delay their weekend sleep schedule. The present study was designed to assess the effect of this sleep pattern on the sleep of Sunday night and the functioning of Monday morning. The sleep schedules of 30 young adults were manipulated for 2 consecutive weeks. In the Habitual-Sleep (HS) week, subjects followed their habitual sleep schedule throughout the week; in the Delayed-Sleep (DS) week, subjects' sleep schedule on Friday and Saturday nights were delayed by two hours. Compared to the HS week, subjects showed significantly lower subjective sleepiness near bedtime and trends of longer sleep onset latency on Sunday night in the DS week. In addition, there was both lowered cognitive performance and overall mood rating on Monday morning in the DS week. The delayed weekend sleep pattern contributes to Sunday night insomnia and the Monday morning “blues”.     

Informative sources of math‐related self‐efficacy expectations and their relationship with math‐related self‐efficacy,interest, and preference

In this study, by using the hypotheses of social‐cognitive career theory (SCCT), the relationship between informative sources of math‐related self‐efficacy expectations and self‐efficacy, interest, and math‐weighted major preferences were investigated. The participants in this study were students (N = 590) from high schools in Southern Turkey. Participants completed measures of sources of math‐related self‐efficacy, self‐efficacy, interest, and choice consideration related to math‐weighted majors. While running analyses, sampling was split in half at random and psychometric analyses of the scales were run with the first half (n = 298); the second half (n = 292) was used to test the hypotheses. By doing this, the testing of hypotheses would not be affected by just one specific sampling characteristic. A structural equation model was tested and findings indicated general support for hypotheses that these sources predict self‐efficacy beliefs and these beliefs also predict interest. However, contrary to SCCT's predictions, math‐weighted major preferences are not predicted by math‐related self‐efficacy expectations and interest. In the Discussion, first, the reasons why the measurement of vicarious learning or modelling did not significantly predict self‐efficacy expectations focus on the relationships between personal accomplishments and persuasion and reported physiological arousal and personal accomplishments. Some information is given as to how counsellors and math teachers can work collaboratively to raise perceptions about informative sources. Second, explanations are given about why self‐efficacy and interest did not predict math‐weighted preferences. It is mentioned that this could be the reason for the constrained and complex system of the university entrance exams and placement in Turkey. The importance of investigating environmental variables on SCCT in developing countries was emphasized. Suggestions are also given for further research. It is concluded that this theory should be tested in developing countries like Turkey.     

Using Dynamic Panel Models to Study Age‐related Differences and Time‐related Changes in Personality

Along with an increasing interest in the plasticity and role of personality across the adult lifespan comes the need for a diverse set of innovative statistical approaches to study it. With this paper, we set out to illustrate some of the possibilities and challenges in modelling age‐related differences and time‐related changes in personality psychology by means of dynamic panel models. To this end, we first distinguish between the study of age‐related differences and time‐related changes and demonstrate how the treatment of age and time as either discrete or continuous variables implies important modelling choices. Second, we present a selection of four example cases that address the topic of age moderation in diverse matters and with different objectives. Based on our cross‐tabulation of age and time as discrete and continuous variables, the first two example cases represent fairly well‐established models (cases A and B), whereas the remaining cases are used to illustrate current developments in the field (cases C and D). We close the paper with some final remarks on current limitation and future research directions. © 2019 European Association of Personality Psychology     

Behavioral treatment of insomnia in older adults: an open clinical trial comparing two interventions

Fifty-five insomniacs, 60 years or above, participated in a behavioral treatment program, comparing two interventions (sleep hygiene+stimulus control vs sleep hygiene+relaxation tape). Half of the subjects were randomized to a waiting-list condition prior to treatment. No significant changes were observed during the waiting-list period. During the treatment period however, the subjects improved on several sleep parameters, and treatment gains were maintained at a 6-month follow-up. The effects of treatment were greater for nocturnal measures (e.g. sleep onset latency and total sleep time) as compared to daytime measures (e.g. life satisfaction, daytime alertness) and not-targeted behavior (medication use). There were no differences in treatment effects for the two interventions.