Do lonely days invade the nights? Potential social modulation of sleep efficiency

Loneliness predicts morbidity and mortality from broad-based causes, but the reasons for this effect remain unclear. Few differences in traditional health behaviors (e.g., smoking, exercise, nutrition) have been found to differentiate lonely and nonlonely individuals. We present evidence that a prototypic restorative behavior—sleep—does make such a differentiation, not through differences in time in bed or in sleep duration, but through differences in efficacy: In the study we report here, lonely individuals evinced poorer sleep efficiency and more time awake after sleep onset than nonlonely individuals. These results, which were observed in controlled laboratory conditions and were found to generalize to the home, suggest that lonely individuals may be less resilient than nonlonely individuals in part because they sleep more poorly. These results also raise the possibility that social factors such as loneliness not only may influence the selection of health behaviors but also may modulate the salubrity of restorative behaviors.     

Dimensionality,identity and security: finding a home through psychoanalysis

This paper suggests that Meltzer’s understanding of the development of inner space can be thought about in relation to how a state of ‘being at home’ can be impaired through early trauma and developmental failure. It shows how a very young child developed a greater capacity for recognising inner and outer experience and consequently a greater awareness of inner space through intensive psychotherapy. Clinical material is presented in which this two-year-old boy moves from profound disorientation and disconnection, through physical containment and moments of communication, to some shared expression and symbolisation of his preoccupations. The author uses episodes from the psychotherapy to illustrate links between Meltzer’s thoughts on impaired interior dimensionality and a resulting terror of the ‘breaking of surfaces’ with Winnicott’s understanding of the necessary ‘gravitational pull’ of a good internal object and the negative retreat which may be caused by overwhelming anxiety. The paper suggests that a developmental approach to psychotherapy with young children has some technical ramifications which might include physical containment, emphasised attunement, simple observational commentary and developmental interpretation. The relationship between interior and exterior spatial awareness is discussed and brief reference is made to a study of psychotherapy with homeless adults regarding their capacity to make use of a physical home. Finally, Bion’s encouragement to abandon memory and desire is discussed in relation to the need traumatised children may have for environmental hope and hopefulness in the person of their therapist.     

Social cognition is not associated with cognitive reserve in older adults

Social and general cognitive abilities decline in late life. Those with high cognitive reserve display better general cognitive performance in old age; however, it is unknown whether this is also the case for social cognition. A total of 115 healthy older adults, aged 60–85 years (m = 44, f = 71) were assessed using The Awareness of Social Inference Test (TASIT-R; social cognition), the Lifetime of Experiences Questionnaire (LEQ; cognitive reserve), and the Wechsler Abbreviated Scale of Intelligence (WASI-II; general cognitive ability). The LEQ did not predict performance on any TASIT-R subtest: Emotion Evaluation Test (β = -.097, p = .325), Social Inference – Minimal (β = -.004, p = .972), or Social Inference – Enriched (β = -.016, p = .878). Sensitivity analyses using two alternative cognitive reserve measures, years of education and the National Adult Reading Test, supported these effects. Cognitive reserve was strongly related to WASI-II performance. Unlike general cognitive ability, social cognition appears unaffected by cognitive reserve. Findings contribute to the emerging understanding that cognitive reserve differentially affects individual cognitive domains, which has implications for the theoretical understanding of cognitive reserve and its brain correlates. Cognitive measures unbiased by cognitive reserve may serve as best indicators of brain health, free of compensatory mechanisms.     

Schlafstörung – Symptom der Depression?

Sleep disorders are an interdisciplinary health issue. Among western industrialized countries, many people suffer from poor quality of sleep. Especially, psychiatric patients have a high prevalence of sleep disorders. The treatment of sleep disorders should follow a detailed sleep history and polysomnographic work-up, which is often not possible in daily work. Thus, patients with sleep disorders are often not treated accurately. Mobile inhospital polysomnography is an attractive alternative that allows tests to be performed already during normal hospitalization on any ward. The following case report shows that the diagnostic work-up of sleep disorders can significantly affect further treatment decisions.