A RAPID METHOD FOR EVALUATING THE NECESSITY FOR BOTH A BEHAVIORAL INTERVENTION AND METHYLPHENIDATE

We examined the effects of a behavioral intervention and methylphenidate (MPH) on inappropriate behavior and sleep disturbance displayed by a 6-year-old boy who had been diagnosed with attention deficit hyperactivity disorder. Results showed that the behavioral intervention was effective in reducing inappropriate behaviors to near-zero levels regardless of the presence or absence of MPH.     

Treatment of Young Children's Bedtime Refusal and Nighttime Wakings: A Comparison of “Standard” and Graduated Ignoring Procedures

Young children with sleep problems received either standard or graduated ignoring treatment. Both brief treatments were superior to a wait-list control condition and resulted in comparable improvements in bedtime and nighttime sleep problems. At bedtime, the treatments did not differ with respect to maternal compliance and stress. For nighttime wakings, mothers in the graduated ignoring group reported higher rates of compliance and less treatment-related stress. Maternal characteristics predicted treatment outcome in the standard ignoring condition. Following treatment, only positive side effects were observed. When compared to the wait-list group, mothers in the standard ignoring group reported less verbose discipline and decreased stress in parenting, while mothers in the graduated ignoring group reported improved parent–child relationships. Treatment gains were maintained over a 2-month follow-up period.     

A FADED BEDTIME WITH RESPONSE COST PROTOCOL FOR TREATMENT OF MULTIPLE SLEEP PROBLEMS IN CHILDREN

The sleep-wake cycles of 4 developmentally delayed individuals with longstanding severe sleep disturbances were regulated using a faded bedtime procedure with response cost. Bedtimes were systematically delayed for each individual, thus increasing the probability of short latency to sleep onset. The response cost component, consisting of removing the individual from bed for 1 hour, was implemented when an individual did not experience short latency to sleep onset. A fading procedure was then applied successfully to advance the bedtimes and to gradually increase durations of sleep. Specifically, all 4 individuals had decreased amounts of nighttime sleep that increased following treatment. Two of the 4 individuals showed excessive daytime sleep that decreased following treatment. Three of the 4 individuals experienced decreases in night wakings following treatment. Both environmental and biological manipulations of the sleep-wake cycle are hypothesized as mechanisms of treatment. The relative advantages of this procedure over other procedures for the treatment of pediatric sleep disorders are discussed, as are directions for future research.     

Discrimination training facilitates pigeons' performance on one-trial-per-day delayed matching of key location

Six pigeons were tested on a one-trial-per-day variant of delayed matching of key location. In one condition, a trial began with the illumination of a pair of quasi-randomly selected pecking keys in a large 10-key test box. Pigeons' pecks to one key (the sample) were reinforced with 8-second access to grain on a variable-interval 30-second schedule, whereas pecks to the other key (the distractor) had no scheduled consequences. In the second condition, the nonreinforced distractor was not presented. In both conditions, subjects were removed from the apparatus after 15 minutes and placed in a holding cage. Subjects were subsequently replaced in the box after a delay (retention interval) of 30 seconds and were reexposed to the illuminated sample and distractor keys for 1 minute. If a pigeon made more pecks to the sample during this interval, the distractor was extinguished and subsequent pecks to the sample were reinforced on the previous schedule for an additional 15 minutes. If, however, a pigeon made more pecks to the distractor, both keys were extinguished and the subject was returned to its home cage. For all subjects, matching-to-sample accuracy was higher in the first condition. In a second experiment, the retention interval was increased to 5, 15, and 30 minutes, and then to 1, 2, 4, 8, 12, and 24 hours. Most subjects remembered the correct key location for up to 4 hours, and in one case, up to 24 hours, demonstrating a spatial-memory proficiency far better than previously reported in this species on delayed matching tasks. The results are discussed in terms of the commonly held distinction between working and reference memory.     

The effects of sleep disruption on the treatment of a feeding disorder

We evaluated the effects of sleep disruption on the mealtime behavior of a young boy with developmental disabilities. Results showed that bite acceptance was less likely to persist during meals following disrupted sleep, but only when escape extinction was not implemented. Findings are discussed in terms of establishing operations and the effects of sleep disruption on the assessment and treatment of feeding problems.     

青少年早期网络欺凌/受欺凌对睡眠质量的影响：社交焦虑和抑郁情绪的链式中介作用

基于压力认知失眠模型,采用网络欺凌/受欺凌问卷、青少年社交焦虑问卷、流调中心抑郁问卷和匹兹堡睡眠质量指数问卷,对582名中小学生进行三次追踪测查,每次间隔半年,并运用结构方程模型考察社交焦虑和抑郁情绪在网络欺凌/受欺凌对睡眠质量的影响的中介作用及其性别差异。结果表明：(1)社交焦虑和抑郁情绪在网络欺凌/受欺凌影响睡眠质量的路径中均起到链式中介作用;(2)网络欺凌/受欺凌影响睡眠质量的链式中介模型存在性别差异。这启示要改善网络欺凌者与受欺凌者的睡眠质量,应关注网络欺凌给他们带来的情绪困扰,只有从根本上解决其情绪问题,才能最终有效促进其睡眠质量。     

Patient Responsiveness to a Sleep and Circadian Intervention in a Sample of Adults With Serious Mental Illness

Understanding patient responsiveness, a component of fidelity, is essential as it impacts treatment outcome and ongoing use of treatment elements. This study evaluated patient responsiveness—operationalized as receptivity to treatment modules and ratings of the usefulness and the utilization of treatment elements—to the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in a sample of adults with serious mental illness (SMI) and sleep/circadian dysfunction. Adults with SMI and sleep/circadian dysfunction (N = 104) received TranS-C in a community mental health setting. Independent raters rated TranS-C sessions to assess receptivity. At posttreatment and 6-month follow-up, participants completed a usefulness scale, utilization scale, the PROMIS Sleep Disturbance (PROMIS-SD) and Sleep-Related Impairment (PROMIS-SRI) scales, DSM-5 Cross-Cutting Measure (DSM-5-CC), and Sheehan Disability Scale (SDS). Receptivity was rated as somewhat to fully understood, and predicted a reduction on the DSM-5-CC. On average, participants rated TranS-C as moderately useful and utilized treatment elements occasionally. Ratings of usefulness were associated with the PROMIS-SD, PROMIS-SRI, and DSM-5-CC at posttreatment, but not with the SDS. Ratings of utilization were not associated with outcome. The findings add to the literature on patient responsiveness, an implementation outcome, and provide data on the utility of TranS-C within a community mental health setting.     

Fetal SSRI antidepressant exposure and infant sleep: Findings from the MPEWS pregnancy cohort study

This longitudinal study examines the association between fetal Selective Serotonergic Reuptake Inhibitor antidepressant exposure and infant sleep behaviours at six and 12 months of age and focus on three of the most commonly prescribed antidepressants in pregnancy.This study utilises data on 698 women recruited at less than 20 weeks of pregnancy and are followed up at six and 12 months postpartum. Women were recruited into one of three groups: those taking either sertraline, citalopram or escitalopram antidepressants in pregnancy (n = 85); women with a depressive disorder who were not taking antidepressants (non-medicated depressed, NMD; n = 82); and, and a control group of women (n = 531). At six and 12 months, data were collected on breastfeeding and sleep location and infant sleep was measured using the Brief Infant Sleep Questionnaire. Antidepressants sertraline, escitalopram and citalopram were not associated with increased infant waking or time awake. However, sertraline was associated with longer time for an infant to go to sleep.This study provides reassurance that SSRI antidepressants and, in particular, sertraline, escitalopram and citalopram are not associated with infant sleep behaviours that are commonly regarded as problematic including night waking. Further replication of these findings, including with direct measures of infant sleep, are recommended.     

Sleep: off-line memory reprocessing

Behavioral studies of memory and learning in both humans and animals support a role for sleep in the consolidation and integration of memories. Physiological studies of hippocampal and cortical activity as well as of brainstem neuromodulatory systems demonstrate the state-dependence of communication both between and within the neocortex and hippocampus. These findings are consonant with observed cognition during sleep and immediately following awakening.     

睡眠研究若干现代理论问题

最近十年间睡眠研究日益引起全世界的重视,除我国等纷纷建立“睡眠研究会”外,并新 建“亚洲睡眠研究会”和“世界睡眠研究联合会”。本文探讨睡眠研究的若干现代理论问题,其 中包括睡眠的核心是深度慢波睡眠问题,睡眠如何受制于“２４－ｈ昼夜节律”,异相睡眠和觉醒 的比较分析,世界范围内重新评价午睡的重要性,临床睡眠疾患及其对策和介诏内源性促眠物质等。