bluuebunny/crossref_metadata_2025_split huggingface dataset:
0681 The Relationship between Safety Behaviors and Insomnia in individuals with Post-Traumatic Stress Disorder
Authors: Bui Brendan , Mills Audrey , Krouse Ryan , Hayes Kimberly , Pardes Adam , McGeoch Ellen , Chakravorty Subhajit 
Published: May 2023

Abstract

Introduction
Safety behaviors may perpetuate anxiety, maintain an individual’s perception of threats, and may lead to psychosocial impairment. Safety behaviors are commonly seen in those suffering from insomnia and post-traumatic stress disorder (PTSD). Despite their prevalence and associated impairments, there exists no data on the relationship between insomnia and safety behavior in those suffering from PTSD. The aim of this study is to evaluate the relationship between safety behavior and insomnia in those with PTSD. If such a relationship is seen, does the severity of nightmares or overall PTSD mediate this relationship between insomnia and safety behaviors?

Methods
The study extracted data from baseline assessments of a treatment study conducted at the VA Medical Center at Philadelphia. The subjects were treatment-seeking patients with PTSD (N =43). Safety behavior was evaluated using the 12-item brief Safety Behavior Assessment Form (SBAF), PTSD was evaluated using the PTSD checklist for DSM-5 (PCL-5), and insomnia with Insomnia Severity Index (ISI) scales. Bivariate analyses evaluated the relationship between SBAF total score and age, education, income, PCL-5, and ISI total scores. Nightmare severity was evaluated using item number 2 from the PCL-5 questionnaire. An analysis evaluated the role of the severity of nightmares or PTSD (PCL-5 total score after excluding the sleep and safety items) as independent mediators in the relationship between SBAF and ISI total scores.

Results
The mean±standard deviation of their age was 56.1±11.6 years and 13.1±2.1 years of education. They were mostly males (86.0%), black (61.9%) and unemployed over the past month (76.8%). The mean total score was 17.1±5.7 on the SBAF, 17.3±7.4 on the ISI, and 52.5±14.5 on the PCL-5. Bivariate analysis demonstrated that SBAF total score was associated with the ISI (β=0.32, p=0.0005 and PCL-5 (β=0.22, p=0.0004) total scores. Mediation analysis demonstrated a significant mediation effect of nightmares (R2=24.6%) and PTSD severity (R2=33.3%) on the association between safety behaviors and insomnia.

Conclusion
About sixty percent of the variance in safety behaviors was explained by insomnia and its association with PTSD or nightmare severity. Treatment of underlying insomnia, PTSD, or nightmares may improve the safety behaviors associated with PTSD.

Support (if any)
1IK2CX000855 (S.C.), and 1 I01 CX001957 (S.C.).
0683 Sleep disturbance, social functioning, and suicidal ideation among preadolescent children admitted to intensive psychiatric care
Authors: Buitron Victor , Gianukakis Ariel , Saletin Jared , Spirito Anthony , Walters Anne , Parent Justin 
Published: May 2023

Abstract

Introduction
Research on preadolescent childhood suicidality is sparse, with recent population-based studies providing support for sociodemographic and diagnostic correlates of preadolescent suicidal ideation. Sleep disturbance is of particular interest in the examination of preadolescent suicidal ideation because sleep health is interlinked with childhood psychosocial functioning; further, there are changes in preadolescent homeostatic regulation of sleep-wake and intrinsic circadian rhythm (i.e., delayed sleep onset), and psychosocial pressures in preadolescence, such as bedtime autonomy, that are increasingly manifested. There is a need to test models that begin to delineate associations between sleep disturbance and childhood suicidal ideation, specifically among youth with early-onset psychopathology. One possible explanatory factor in the association between sleep disturbance and suicidal ideation, grounded in existing theoretical frameworks of suicide, is social functioning (e.g., developmentally appropriate peer interactions and connectedness). The current study tested an indirect effects model in which sleep disturbance is associated with suicidal ideation via social functioning.

Methods
223 children (ages 7–12) with severe psychopathology who presented for intensive hospital-based treatment and their caregivers completed an assessment battery at admission, including the parent-reported sleep disturbances via the Children’s Sleep Habits Questionnaire, and child-reported dysregulated negative affect, social functioning, and suicidal ideation. Indirect effects were examined via the PROCESS macro for SPSS Version 4.0. Binary logistic regression was used when suicidality served as the dependent variable. All models controlled for youth age and dysregulated negative affect.

Results
Higher levels of parent-reported youth sleep disturbances were related to lower levels of youth-report social functioning. Further, lower levels of social functioning and higher levels of sleep disturbances were associated with higher odds of endorsing suicidal ideation. Indirect effects analyses indicated that higher levels of sleep disturbances was associated with increased odds of reporting suicidal ideation via the detrimental impact of sleep disturbances on social functioning.

Conclusion
The findings support the novel extension of explanatory models of suicide to children and highlight the possible role of sleep disturbance in the etiology of early suicidality. Documenting these associations provides the impetus for fine-grained examination of sleep health and social functioning among children who experience suicidal ideation and severe psychopathology.

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0685 Emotion Regulation Moderates the Relationship between Sleep and Social Participation
Authors: Hammer Lillian , Springfield Cassi , Tighe Caitlan , Bonfils Kelsey 
Published: May 2023

Abstract

Introduction
While poor sleep quality has been tied to worse social functioning, this relationship is complex and other variables likely play a role. For instance, emotion regulation and alexithymia are both related to sleep quality and to social functioning. Yet, the impact of these emotional processes on the relationship between sleep and social functioning remains unexplored. This study aimed to fill this gap by assessing whether alexithymia or two emotion regulation strategies –reappraisal and suppression—moderate the relationship between sleep and one aspect of social functioning (participation in social activities). We hypothesized that the relationship between sleep and social participation would be stronger for those who had greater difficulties in these emotional processes (high alexithymia, high suppression, or low reappraisal).

Methods
Data for this study came from the Pittsburgh Cold Study 3, a publicly available dataset (N = 213). Participants completed measures of self-reported sleep, emotion regulation, alexithymia, and social participation. Objective sleep data was also collected via actigraphy.

Results
The Reappraisal subscale significantly moderated the relationship between sleep quality and social participation. For participants with high reappraisal scores, worse sleep quality was related to lower social participation scores. Additionally, the Suppression subscale significantly moderated the relationship between actigraphy sleep duration and social participation. For participants with lower suppression scores, greater sleep duration was related to higher social participation. Alexithymia did not significantly moderate these relationships.

Conclusion
Our results suggest that the ability to effectively regulate one’s emotions may be important to consider in the link between sleep and social participation, as the relationship varies depending upon one’s use of emotion regulation strategies. Importantly, this sample included only individuals who had no recent mental health treatment. Future work should extend these findings by including a wider range of participants, including those with relevant diagnoses– such as borderline personality and schizophrenia-spectrum disorders.

Support (if any)
The data were collected by the Laboratory for the Study of Stress, Immunity, and Disease at the Carnegie Mellon University under the directorship of Sheldon Cohen, PhD; and were accessed via the Common Cold Project website (www.commoncoldproject.com; grant number NCCIH AT006694).
0686 High prevalence of sleep apnea in mental disorders – a need for use of sleep evaluation tools in psychiatric health care
Authors: Wichniak Adam , Sikorska Olga , Szaulińska Katarzyna , Wierzbicka Aleksandra , Smułek Daria , Gustavsson Katarzyna 
Published: May 2023

Abstract

Introduction
Sleep apnea is a prevalent disorder but it is frequently overlooked in diagnosing mental disorders. The aim of the present study was to screen for sleep apnea in a group of patients referred for diagnosing mental disorders or non-restorative sleep and to assess the accuracy with which such testing can be replaced with commonly used screening questionnaires for sleep apnea.

Methods
104 patients were investigated – 58 with mental disorders (26 with affective disorders, 26 with schizophrenia spectrum disorders, 3 with anxiety disorders, 3 with neurocognitive disorders; mean age 37.5±9.5 years, 24% females, BMI 32.8±6.5 kg/m2) and 46 with non-restorative sleep (mean age 41.2±14.6, 39% females, BMI 26.3±4.8 kg/m2). The patients were screened for sleep apnea with a home sleep apnea test (HSAT) based on peripheral arterial tonometry (PAT) and were asked to fill in the Sleep Apnea Scale from Sleep Disorders Questionnaire (SDQ-SA), the STOP-BANG and the Berlin questionnaires (BQ), and the Epworth Sleepiness Scale (ESS).

Results
Apnea-Hypopnea Index of &gt; 5/h was found in 57 (55%) patients: 36 (62%) patients with mental disorders and 21 (45%) patients with non-restorative sleep. An increased risk for sleep apnea was found in 45 patients (43.3%) using SDQ-SA, 64 (61.5%) using BQ, 80 (76.9%) patients using STOP-BANG with the cut-off of 3 points and 30 (28.8%) with the cut-off of 5 points. Positive predictive values were: 65.9% for SDQ-SA, 71.0% for BQ, 68.8% for STOP-BANG with the cut-off of 3 point and 75.9% with the cut-off of 5 points. Negative predictive values were 49.1%, 63.0%, 83.3% and 51.4% respectively. Diagnostic accuracy was highest for STOP-BANG with the cut-off of 3 points – 72.3% and lowest for SDQ-SA – 56.6%. Excessive Daytime Sleepiness was found in 44 (42.3%) of patients. Three patients (2.9%) refused or did not complete the HSAT.

Conclusion
Inclusion of HSAT in the diagnostic process revealed high prevalence of sleep apnea in patients with mental disorders. Psychiatrists should be encouraged to include HSAT in evaluation of patients. Such testing is patient-friendly and using only screening questionnaires does not provide high enough diagnostic accuracy.

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0687 Loneliness, Sleep, and High Risk Alcohol Use in College Students Before and During the COVID-19 Pandemic
Authors: Cutrer Caleb , Prichard J Roxanne 
Published: May 2023

Abstract

Introduction
The aim of this study is to determine what behavioral and psychological factors were predictive of high-risk drinking in students with and without a Substance Use Disorder (SUD) diagnosis. We also compared how these relationships differed between Fall 2019, before the COVID-19 pandemic, and Fall 2020, a period of increased financial stress, distance learning, and social isolation.

Methods
We used factor analysis to extract a wide range of behavioral and psychological predictor variables from the Fall 2019 and Fall 2020 American College Health Association’s National College Health Assessment III (ACHA-NCHA). Next, we used structural equation modeling to identify significant drivers of high-risk alcohol use (ASSIST alcohol subscale) in students with (n = 577) and without (n = 50,926) SUD diagnosis.

Results
When compared to 2019, both students with and without SUD diagnosis showed lower levels of high-risk drinking, more difficulties falling asleep, and longer sleep duration. In students without SUD, short sleep duration and loneliness were the primary predictors of past year high risk alcohol use. In students with SUD, long sleep latencies and loneliness (UCLA Loneliness Scale) were the primary predictors, and sleep factors predicted more variance in high-risk alcohol use than in the general college population. Students with SUD diagnosis who also had sleep latencies &gt;30 minutes were significantly more likely to report binge drinking (&gt;5 drinks in one sitting) than those with shorter sleep latencies.

Conclusion
Sleep factors and loneliness are large predictors of problematic alcohol use in both students with and without diagnoses of Substance Use Disorder. In the first year of the COVID-19 pandemic, students sleep patterns changed with students reporting longer sleep, but also greater symptoms of insomnia.

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0688 Nocturnal pain and its association with quality of life in women: data from the Epidemiologic Sleep Study (EPISONO)
Authors: Lucena Leandro , Lavigne Gilles , Fabbro Cibele , Andersen Monica , Tufik Sergio , Hachul Helena 
Published: May 2023

Abstract

Introduction
It is known that poor sleep is related to pain, even though this relationship is not fully understood. Women with pain present alterations in sleep pattern and reduced quality of life, but little is known about the negative effects of nocturnal pain on these outcomes. This study aimed to evaluate and compare the levels of anxiety, depression, and fatigue in women with pain during the night with those without pain. We hypothesize that pain perception is associated with worsening fatigue and mood outcomes.

Methods
This cross-sectional study used data from the 2007’s Epidemiological Study of Sleep (EPISONO). A total of 574 women aged 20-80 years participated in the EPISONO, and 244 women met the inclusion criteria of our study, 85 in the pain group and 171 in the control group. Participants were categorized into the pain group if they responded positively to the following questions: i) they generally had pain, according to the Pre-Sleep Questionnaire (PSQ), and ii) pain usually interfered with sleep 3 or more times a week, according to the Pittsburg Sleep Quality Index (PSQI). Participants who responded negatively to these questions were allocated to the control group. All of them underwent a full night laboratory polysomnography, and answered questionnaires related to fatigue, depression, anxiety, and quality of life.

Results
Significantly higher levels of fatigue (5.4 times), anxiety and depression were observed in the pain group, as well as significantly lower values in all domains of quality of life, compared to the control group. The presence of pain at night was also correlated with levels of anxiety and depression in the psychological (Rs=-0.463, -0.607, respectively) and social (Rs=-0.423, -0.438, respectively) domains of quality of life.

Conclusion
The presence of pain at night in women is related to a decrease in quality of life and can lead to worsening mood disorders and fatigue. Our results show the importance of investigating pain and its consequences, as well as the interference in women's sleep patterns.

Support (if any)
Associação Fundo de Incentivo à Pesquisa (AFIP), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Finance Code 001, and Conselho Nacional de Pesquisa (CNPq).
0689 Nurses and Sleep: The Relationship Between Patient-Related Stressors and Sleep Quality
Authors: Sedano Brandon Fernandez , Shurovi Sumayya , David Michelle , Cornelius Talea , Schwartz Joseph , Abdalla Marwah 
Published: May 2023

Abstract

Introduction
Poor sleep quality in nurses is linked to worse psychological health. Identifying which occupational stressors may impact nurses’ sleep quality and psychological health may provide an opportunity for intervention. Patient-related stressors such as worrying about and/or an inability to help patients recover or survive hospitalization have a negative impact on a nurses’ psychological health. It remains unclear if patient-related stressors also impact nurses’ sleep quality. We examined if more patient-related stressors are associated with lower sleep quality in nurses.

Methods
The Worksite Blood Pressure Study is a multi-site study investigating psychosocial factors and ambulatory blood pressure. The study recruited 472 participants from 10 New York City worksites including 105 nurses during 3 waves over 11 years. The current analysis was restricted to 82 nurses at Wave 3. Participants completed the Nurses’ Stress Inventory Questionnaire which assessed the frequency and severity of stressful situations at work and a sleep questionnaire. Items on patient-related stressors and sleep quality were examined with higher scores indicating more stress and worse sleep quality, respectively. A linear regression model was specified predicting sleep quality from stressful patient interactions; participants answering at least 8 of the 16 items querying these interactions were included in the analysis. Age, race/ethnicity, religion, personal income, employment tenure, and years of education were included as covariates.

Results
Participants (N=82) were 96.3% female, 30.5% Black, 4.8% Hispanic/Latinx, 75.6% Christian. Mean age was 40.2 years (SD = 7.5), mean years of education was 15.4 (SD = 2.2), mean employment tenure was 8.3 years (SD = 6.7), and median personal income was $55,000 (Range $17,500, $95,000). Mean sleep quality was 8.9 (SD = 2.6). Nurses who reported greater frequency and severity of patient-related stressors had significantly worse sleep quality, B = 1.79, 95% CI 0.20, 3.37, p = 0.028. Sensitivity analyses restricting the analysis to nurses with no missing data on stressful interactions replicated these results, B = 2.22, 95% CI 0.34, 4.09, p = 0.022.

Conclusion
Patient-related stressors were associated with lower sleep quality in nurses. Efforts to increase support to nurses who experience patient-related stressors may help improve nurses’ sleep quality and possibly psychological health.

Support (if any)
P01HL47540
0690 People without any sleep complaints achieve results that exceed the cut-off thresholds in standardized sleep assessment
Authors: Smułek Daria , Gustavsson Katarzyna , Wichniak Adam 
Published: May 2023

Abstract

Introduction
With increasing prevalence of sleep problems in the general population, a question arises on whether standardized clinical sleep assessment shows results exceeding the cut-off thresholds in healthy subjects who do not report any sleep complaint. The aim of this ongoing study is to assess a sample of healthy subjects who report good sleep quality, for each gender in age groups 18-30, 31-40, 41-50, 51-60, 61-75 years old.

Methods
Up to now 70 healthy subjects have taken part in the project (38 females, 32 males, mean age 39.5 ±12.5, median 37 years). Assessment of sleep, and mental health related symptoms was performed using actigraphy, sleep diaries and clinical ratings scales: the Insomnia Severity Index (ISI), Epworth Sleepiness Scale(ESS), Morningness Eveningness Questionnaire(MEQ), Ford Insomnia Response to Stress Test (FIRST), International Physical Activity Questionnaire (IPAQ), STOP-Bang Questionnaire, Sheehan Disability Scale (SDS), Quick Inventory of Depressive Symptoms (QIDS-16SR), Generalized Anxiety Disorders Scale (GAD7), World Health Organization Quality of Life Scale (WHOQOL-BREF).

Results
In ISI scale 20 subjects (28,6%) reported mild and 2 subject (2,8%) moderate insomnia symptoms. In ESS 7 subjects (10.0%) were found to have mild, 5 (7,1%) moderate and 3 (4,3%) severe excessive daytime sleepiness. Anxiety symptoms reported 15 (21,4%) subjects and depressive symptoms 18 (22,9%) subjects. Moderate for risk for sleep apnea was found in 9 (12,8%) and high in one (1,4%) subject. In sleep diaries sleep latency above 30 minutes was found in 4 (5,6%) subjects, WASO above 30 minutes in 7 (10.0%) subjects, total sleep time below 6,5 hours in 22 (31,4%) subjects. Average time in bed was 474 ±55 minutes and average sleep efficiency 86,8 ±7,5%. ISI correlated with FIRST (r=0.496, p&lt; 0.001), GAD-7 (r=0.445, p&lt; 0,001), QIDS-SR16 (r=0,483, p&lt; 0.001), sleep latency (r=0,313, p&lt; 0,05), WASO (r=0,270, p&lt; 0,05). ESS corelated with FIRST (r=0.316, p&lt; 0,01), GAD-7 (r=0,275, p&lt; 0,05).

Conclusion
Substantial proportion of subjects from the general population who did not initially report any sleep complaints obtained results exceeding suggested threshold in standard clinical scale and sleep parameters below normal valse in sleep diaries. Poor sleep indices are most related to scales measuring stress, anxiety and depressive symptoms.

Support (if any)
0692 Relationships Between Sleep and Social Cognitive Biases in Schizophrenia-Spectrum and Bipolar Disorders
Authors: Springfield Cassi , Hammer Lillian , Pinkham Amy , Moore Raeanne , Ackerman Robert , Harvey Philip , Depp Colin , Bonfils Kelsey 
Published: May 2023

Abstract

Introduction
People with schizophrenia-spectrum disorders (SSDs) and bipolar disorders (BDs) experience difficulty with social cognition, or the mental processes that underlie social interactions, but determinants of social cognitive impairment are still under investigation. Research suggests that poor sleep quality is related to reduced social cognitive ability in BDs, but it is unclear if sleep quality is related to social cognition in SSDs and if sleep may be related to different types of social cognition (e.g., emotion recognition, biases) in different ways. This study aimed to examine relationships between sleep and different types of social cognition in SSDs and BDs. Given known relationships between blaming and untrustworthiness biases and paranoia in these populations, paranoia was also examined as potential mediator of these relationships.

Methods
Participants (SSDs n=91; BDs with psychotic features n=87) completed tasks of social cognitive ability (e.g., facial and multi-modal emotion recognition, attributional bias, untrustworthiness bias). Participants self-reported their sleep quality. Paranoia was assessed via clinical interview.

Results
In the BD group, poor sleep quality (r=-.23, p=.04) and shorter sleep duration (r=-.25, p=.02) were associated with a bias towards untrustworthiness. For those with SSDs, increased use of sleep medication was associated with poorer multi-modal emotion recognition (r=-.22, p=.04). Additionally, poor sleep quality and overall poor sleep were associated with increased blaming (r=.22, p=.03; r=.21, p=.04) and untrustworthiness biases (r=-.24, p=.03; r=-.24, p=.03) in this group. Higher daytime tiredness was also associated with untrustworthiness bias (r=-.23, p=.03) in SSDs. Regarding mediation results, paranoia did serve as a mediator in the relationships between sleep and blaming and untrustworthiness biases across the sample.

Conclusion
Results suggest that poor sleep quality is linked to increased attributional and untrustworthiness biases, and that these relationships may be at least partially explained by paranoia symptoms. Of note, however, is that indirect effect sizes in mediation models were small. Contrary to expectations, poor sleep quality was not consistently associated with reduced social cognitive ability in the current sample. Findings from the current study require further exploration and replication.

Support (if any)
This work was supported by the National Institute of Mental Health (grant number R01 MH116902-04 awarded to C.A.D).