Fibromyalgia: the role of sleep in affect and in negative event reactivity and recovery

OBJECTIVE: Fibromyalgia (FM) syndrome is a chronic pain condition characterized by diffuse muscle pain, increased negative mood, and sleep disturbance. Until recently, sleep disturbance in persons with FM has been modeled as the result of the disease process or its associated pain. The current study examined sleep disturbance (i.e., sleep duration and sleep quality) as a predictor of daily affect, stress reactivity, and stress recovery. DESIGN AND MEASURES: A hybrid of daily diary and ecological momentary assessment methodology was used to evaluate the psychosocial functioning of 89 women with FM. Participants recorded numeric ratings of pain, fatigue, and positive and negative affect 3 times throughout the day for 30 consecutive days. At the end of each day, participants completed daily diary records of positive and negative life events. In addition, participants reported on their sleep duration and sleep quality each morning. RESULTS: After accounting for the effects of positive events, negative events, and pain on daily affect scores, it was found that sleep duration and quality were prospectively related to affect and fatigue. Furthermore, the effects of inadequate sleep on negative affect were cumulative. In addition, an inadequate amount of sleep prevented affective recovery from days with a high number of negative events. CONCLUSIONS: These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning.     

Psychiatric Hospital Treatment of Suicidal Children

ABSTRACT: Three phases of psychiatric hospital treatment of children, ages 6 to 12 years, admitted to the hospital because of suicidal threats or suicidal attempts are described. Suicidal behavior in young children must always be taken seriously. Although suicidal behavior usually ceases upon hospitalization, suicidal ideas may continue to be expressed in play and fantasy. In addition to individual and milieu therapy, treatment must also include concomitant assistance of the parents. The treatment procedures are illustrated by suicidal case examples of a depressed girl, an acting-out boy, and a psychotic boy.     

Interpersonal Psychotherapy—Adolescent Skills Training With Youth From Asian American and Immigrant Families: Cultural Considerations and Intervention Process

Although research has identified effective evidence-based depression prevention interventions for diverse youth, little is known about how the intervention process unfolds with immigrant family youth. This study utilized a qualitative approach to explore cultural and clinical differences in the implementation of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) in two schools, one serving youth from primarily immigrant, Asian American families and the second, youth from mostly nonimmigrant, non-Hispanic White families. A total of 131 IPT–AST sessions were audio recorded, transcribed, and coded for presence and patterns of cultural and clinical constructs. Results revealed that sessions with immigrant family youth were more likely to contain discussions of interpersonal problems characterized by estrangement, goals of spending time together with important others, mentions of emotion suppression and academic achievement expectations, conversations about acculturation, differences in value orientation, and discomfort with implementing new intervention skills. Dialogue from interventionist and youth exchanges is presented to illustrate how these themes emerged and were addressed by interventionists in a culturally responsive manner. The study highlights how IPT–AST with immigrant family and Asian American youth may unfold differently compared to youth from nonimmigrant families. Implications of findings for providers are discussed.     

Theorizing the Temporal Aspect of Ikigai or Life Worth Living among Japanese University Students: a Mixed-Methods Approach

Although cross-cultural and non-Western studies have advanced our knowledge on well-being, many studies have adopted English words including ‘happiness’ as their guiding concepts, which may have limited and biased their insight. The current study is part of a larger mixed-methods project that theorizes how Japanese university students pursue ikigai or a life worth living. The first qualitative study, based on 27 photo-elicitation interviews, generated a grounded theory of houkousei, or life directionality. Our qualitative findings suggested that when students formed explicit associations among the past, present, and future, they gained strong ikigai feelings. These associations were developed either cognitively by mentally associating existing present experiences with the past or future, or behaviourally by strategically choosing current experiences more pertinent to the past or future than alternatives. These actions resulted in two subjective states: life legacy and life momentum. Life legacy was the perception that one’s past had meaningfully contributed to his or her present experiences, life, and self. Life momentum meant the belief that one’s present experiences were helping him or her achieve the desired future. Lastly, having defining past experiences and setting clear goals both facilitated the associative actions. To further validate this theory, we collected online survey data from a national sample of 672 Japanese students. Our quantitative results, based on partial least squares structural equation modelling (PLS-SEM), largely supported our theoretical model. Our findings are discussed in light of the ikigai and eudaimonic well-being literatures.