Sleep-amount differentially affects fear-processing neural circuitry in pediatric anxiety: A preliminary fMRI investigation.

Insufficient sleep, as well as the incidence of anxiety disorders, both peak during adolescence. While both conditions present perturbations in fear-processing-related neurocircuitry, it is unknown whether these neurofunctional alterations directly link anxiety and compromised sleep in adolescents. Fourteen anxious adolescents (AAs) and 19 healthy adolescents (HAs) were compared on a measure of sleep amount and neural responses to negatively valenced faces during fMRI. Group differences in neural response to negative faces emerged in the dorsal anterior cingulate cortex (dACC) and the hippocampus. In both regions, correlation of sleep amount with BOLD activation was positive in AAs, but negative in HAs. Follow-up psychophysiological interaction (PPI) analyses indicated positive connectivity between dACC and dorsomedial prefrontal cortex, and between hippocampus and insula. This connectivity was correlated negatively with sleep amount in AAs, but positively in HAs. In conclusion, the presence of clinical anxiety modulated the effects of sleep-amount on neural reactivity to negative faces differently among this group of adolescents, which may contribute to different clinical significance and outcomes of sleep disturbances in healthy adolescents and patients with anxiety disorders

Normative developmental trajectories of actigraphic sleep variables during the preschool period : a three-wave longitudinal study

Important changes in sleep are believed to occur in the preschool years, but studies that have documented these changes were generally cross‐sectional or based on subjective sleep measures. The current longitudinal study modeled the developmental trajectories followed by five sleep variables objectively assessed during the preschool period. Children (N = 128) wore an actigraph over 3 days at 2, 3, and 4 years of age and change in sleep variables was assessed with growth curves. The results showed a linear decrease of daytime, total, and nighttime sleep duration, and a linear increase of sleep efficiency and proportion of nighttime to total sleep. For all sleep variables, the rhythm of change was relatively uniform across children, but there was significant inter‐individual variation around the initial status for most variables. To our knowledge, this study is the first to model the developmental trajectories followed by several sleep variables during the preschool period

Longitudinal associations among asthma control, sleep problems, and health-related quality of life in children with asthma: a report from the PROMIS® Pediatric Asthma Study

Few studies have investigated the complex relationship among asthma control, sleep problems, and health-related quality of life (HRQOL) among children with asthma. This study aimed to test the longitudinal effect of asthma control status on asthma-specific HRQOL through the mechanism of nighttime sleep quality and daytime sleepiness

Does Child Sex Moderate Vulnerability to Postpartum Risk among Infants of Mothers at Risk for Psychopathology?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110024/1/infa12065.pd

Breastfeeding Duration Is Associated with Regional, but Not Global, Differences in White Matter Tracts

Extended breastfeeding through infancy confers benefits on neurocognitive performance and intelligence tests, though few have examined the biological basis of these effects. To investigate correlations with breastfeeding, we examined the major white matter tracts in 4–8 year-old children using diffusion tensor imaging and volumetric measurements of the corpus callosum. We found a significant correlation between the duration of infant breastfeeding and fractional anisotropy scores in left-lateralized white matter tracts, including the left superior longitudinal fasciculus and left angular bundle, which is indicative of greater intrahemispheric connectivity. However, in contrast to expectations from earlier studies, no correlations were observed with corpus callosum size, and thus no correlations were observed when using such measures of global interhemispheric white matter connectivity development. These findings suggest a complex but significant positive association between breastfeeding duration and white matter connectivity, including in pathways known to be functionally relevant for reading and language development

Identification of predictors and moderators of weight-related behaviors in college students.

College students are at increased risk for weight-gain and obesity compared to their non-student peers. Although many studies have confirmed these findings, few address the underlying causes of weight-related behaviors in college students. Associations between sleep behaviors (sleep duration and sleep quality), stress and weight-related behaviors (physical activity and food choices) have been identified, but studies have not adequately explored these associations among college students. Further, the influence of bioecological determinants of health cannot be overlooked when addressing health-related behaviors in diverse populations. The purpose of this dissertation was to explore factors impacting sleep behaviors and weight-related behaviors in college students. Three manuscripts comprised this dissertation and included: a state of the science review of sleep behaviors in college students; a systematic review of instruments used to assess physical activity in college students; and a cross-sectional study identifying predictors and moderators of weight-related behaviors in college students. A critical review of sleep behaviors in college students revealed that developmental changes occurring in older adolescents and young adults results in delayed sleep times. Decreased sleep duration in this population is associated with poor health outcomes (weight-gain), higher risks for accident related death/disability, and academic underperformance. Findings from this review enforced the need for healthcare providers working with college students to assess for and educate students regarding the risks associated with inadequate sleep. The second manuscript evaluated the psychometric properties of commonly used self-report physical activity measures used with college student populations. Three instruments including: the International Physical Activity Questionnaire; the Leisure Time Exercise Questionnaire; and the National College Health Assessment II, were identified as the most commonly used instruments used with college student populations. Results indicated that researchers must consider the physical activity domains of interest, the completion process, and the reliability and validity of instruments when selecting self-report instruments of physical activity for use in studies examining college students. The third manuscript summarized a cross-sectional, quantitative research study designed to identify predictors and moderators of weight-related behaviors among college students to provide a better understanding of the association between sleep behaviors (sleep duration and sleep quality) and perceived stress and what role they play in predicting weight-related behaviors. The aims of the study were to (1) characterize sleep behaviors, perceived stress and weight-related behaviors in college students stratified by bioecological determinants of health and (2) identify predictors and moderators of weight-related behaviors in college students. Approximately 394 undergraduate nursing students were recruited to complete self-report instruments related to sleep behaviors, perceived stress, physical activity, fruit intake, vegetable intake, sugar sweetened beverage consumption, fast-food consumption, and bioecological determinants of health (n=268). Data were analyzed to determine group differences in sleep behaviors, perceived stress and weight-related behaviors based on bioecological determinants of health. Next, path analysis was conducted to establish correlations and model fit. Finally, multiple group analysis was performed to identify the moderating effect of perceived stress. The findings indicated that having children/step-children and eating the majority of meals at home had significant indirect effects on physical activity and sugar-sweetened beverage consumption when mediated by sleep duration. Perceived stress was also found to moderate the predictive effect of bioecological variables and sleep behaviors on weight-related behaviors. Limitations of the study included limited interpretability of cross-sectional data, exclusive use of self-report data, a homogenous sample that limited generalizability, and a lengthy survey

Bidirectional Associations Between Passive and Active Technology Use and Sleep: A Longitudinal Examination in Young Adolescents with and without ADHD

Many adolescents do not receive recommended amounts of sleep, and prevalence rates of sleep problems are particularly high among adolescents with attention-deficit/hyperactivity disorder (ADHD). One factor that may contribute to these sleep difficulties is technology use, and there is some evidence that the association between technology use and sleep may be bi-directional. Further, type of technology use (i.e., passive versus active) may be differentially associated with sleep. To date, most studies have evaluated these associations cross-sectionally and relied upon global and subjective ratings of technology use and sleep, which masks important day-to-day variability. The present study evaluated bi-directional associations between passive and active technology use and sleep (measured subjectively and objectively), and to determine whether these associations differ between adolescents with and without ADHD. The study involved a large (N=302) sample of eighth grade students, approximately half of whom were comprehensively diagnosed with ADHD. Importantly, a multi-method approach was used to assess sleep, including daily diary and actigraphy data. Results indicated that adolescents with ADHD engaged in greater levels of weekday active technology use than those without ADHD. Weekday passive technology use was positively associated with sleep duration only in adolescents without ADHD. In addition, poorer weekday sleep quality was associated with less passive but more active next-day technology use, regardless of ADHD diagnosis. Overall, the association between technology use and sleep is nuanced but not stronger in adolescents with ADHD, despite a greater amount of weekday active technology use. Clinical implications for adolescents, parents, and healthcare providers are discussed

Identification of Latent Subgroups of Obese Adolescents Enrolled in a Healthy Weight Management Program

In obesity research, it is assumed that the population is homogeneous. While this approach has yielded important insights, testing this supposition might reveal information that could impact our understanding of the phenomena and its treatment. In this study, data from obese teenagers (N = 248, Mean BMI percentile = 99%; Mean age = 13.9, SD = 1.8) who were predominantly minority (n = 182), female (n = 169), and enrolled in a weight loss intervention were analyzed. Latent profile analysis (LPA) was used to segment patients into groups based on their scores on PedsQL 4.0 scales (physical-, emotional-, social-, and school functioning) and the Coopersmith Self-Esteem Scale. A 3-class solution was parsimonious and demonstrated the best statistical fit (Bayesian information criterion = 10596.96; Lo-Mendell-Rubin-adjusted likelihood ratio test = 73.020, p \u3c .05). The 3 groups were ordinal and composed of respondents with high- (HF; n = 72, 29%), medium- (MF; n = 110, 44%), and low functioning (LF; n = 66, 27%). Further analyses (chi squares and linear regressions) showed that the LF group had a significantly higher proportion of Caucasians and males compared to the HF (referent) group. Also, when controlling for demographics and weight, the LF group had significantly higher blood pressure (diastolic and systolic), lower self-reported physical activity (on two different measures), and a higher total score on a scale of depressed mood. Four groups of ordinal regressions (since the pair of self-reported exercise variables and blood pressure variables were correlated, only one from each pair was included in each set) consistently found that self-reported physical activity and blood pressure improved significantly from the LF to HF groups. However, when depressed mood was included, it became the only significant variable. These findings suggest that LF group members are demographically and clinically distinct and that depressed mood may be the critical factor connecting self-report and metabolic dysfunction. Theory suggests depressed mood is both associated with cognitive schemas that affect responses on self-report measures; skewing them negative, and is also manifested metabolically