The Effects of Mood and Anxiety Sensitivity on Attentional Engagement and Disengagement in Sleep Disturbance

Insomnia is a highly prevalent, chronic disorder that is associated with adverse psychological, physical, and psychosocial outcomes. Harvey’s (2002) cognitive model of insomnia and Espie’s (2006) attention-intention-effort pathway model highlight two critical processes believed to play a role in the onset and persistence of insomnia: (a) emotional distress and physiological arousal and (b) selective attention and monitoring. However, investigations examining attentional bias in sleep disturbance have produced mixed results and have exclusively used paradigms that are limited in their ability to differentially examine the two unique components of attentional bias (i.e., facilitated engagement, impaired disengagement). Discrepant findings in the attentional bias literature may be explained by (a) the need for more nuanced measures of attentional bias and (b) the presence of moderators (i.e., anxiety sensitivity) that operate between emotional distress and physiological arousal and attentional bias processes. The current investigation examined (a) the causal effects of distress and arousal on attentional bias to sleep-related threat, (b) the nature of attentional bias in sleep disturbance by using a novel paradigm that allows for the orthogonal measurement of facilitated attentional engagement toward versus impaired attentional disengagement from sleep-related threat, (c) the degree to which anxiety sensitivity is a predictor of such attentional biases, (d) the degree to which anxiety sensitivity and attentional bias interact to predict severity of sleep disturbance. A sample of undergraduate college students (n = 166) were identified as good and poor sleepers as per the Pittsburgh Sleep Quality Index (Buysse et al., 1989). Participants were randomly assigned to a distress/arousal mood-inducing condition or a relaxation mood-inducing condition and then completed two attentional bias tasks composed of sleep-related threat (i.e., Attentional Response to Distal vs. Proximal Emotional Information task, Focused Attention Task). Results indicated that (a) poor sleepers remained highly attentive to body sensations and functional consequences of sleep disturbance regardless of whether they were distress/aroused or relaxed; (b) monitoring for the functional consequences of sleep disturbance was associated with poor sleep outcomes; (c) ASI cognitive concerns was associated with both attentional bias to sleep-related threat and poor sleep outcomes; and (d) anxiety sensitivity did not moderate the relationship between emotional distress and physiological arousal and attentional bias. These results highlight potential targets for therapeutic interventions such as decreasing attentional focus on sleep-related threat and reducing cognitive concerns associated with anxiety sensitivity

Feasibility and acceptability of cognitive behavioral therapy for insomnia (CBT-I) or acupuncture for insomnia and related distress among cancer caregivers.

ObjectiveInsomnia is a common, distressing, and impairing psychological outcome experienced by informal caregivers (ICs) of patients with cancer. Cognitive behavioral therapy for insomnia (CBT-I) and acupuncture both have known benefits for patients with cancer, but such benefits have yet to be evaluated among ICs. The purpose of the present study was to evaluate the feasibility, acceptability and preliminary effects of CBT-I and acupuncture among ICs with moderate or greater levels of insomnia.MethodParticipants were randomized to eight sessions of CBT-I or ten sessions of acupuncture.ResultsResults highlighted challenges of identifying interested and eligible ICs and the impact of perception of intervention on retention and likely ultimately outcome.Significance of the resultsFindings suggest preliminary support for non-pharmacological interventions to treat insomnia in ICs and emphasize the importance of matching treatment modality to the preferences and needs of ICs

Feasibility and acceptability of cognitive behavioral therapy for insomnia (CBT-I) or acupuncture for insomnia and related distress among cancer caregivers.

ObjectiveInsomnia is a common, distressing, and impairing psychological outcome experienced by informal caregivers (ICs) of patients with cancer. Cognitive behavioral therapy for insomnia (CBT-I) and acupuncture both have known benefits for patients with cancer, but such benefits have yet to be evaluated among ICs. The purpose of the present study was to evaluate the feasibility, acceptability and preliminary effects of CBT-I and acupuncture among ICs with moderate or greater levels of insomnia.MethodParticipants were randomized to eight sessions of CBT-I or ten sessions of acupuncture.ResultsResults highlighted challenges of identifying interested and eligible ICs and the impact of perception of intervention on retention and likely ultimately outcome.Significance of the resultsFindings suggest preliminary support for non-pharmacological interventions to treat insomnia in ICs and emphasize the importance of matching treatment modality to the preferences and needs of ICs

Emotion regulation therapy for cancer caregivers—an open trial of a mechanism-targeted approach to addressing caregiver distress

Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious treatment principles (e.g., cognitive behavior therapy [CBT]) show disappointing results in reducing anxiety and depression in ICs. This may reflect failure of these interventions to specifically target crucial mechanisms underlying the central feature of distress caused by the patient's illness-notably, perseverative negative thinking (PNT). Emotion Regulation Therapy (ERT) is an efficacious CBT developed to explicitly target mechanisms underlying PNT and the emotional concomitants that arise in response to stressful situations. This open trial was conducted to evaluate the acceptability and initial efficacy of ERT adapted to the experience of cancer ICs (ERT-C). Thirty-one ICs provided informed consent and completed eight weekly individual sessions of ERT-C. Participants completed self-report measures of depression and anxiety symptoms, PNT, emotion regulation deficits, and caregiver burden before and after treatment. ERT-C was well tolerated as indicated by 22 treatment completers and feedback provided in exit interviews. ICs demonstrated reduced depression and anxiety symptoms, PNT, and emotion regulation deficits with moderate to large effect sizes (Hedge's g range: 0.36-0.92). Notably, caregiver burden was not reduced but ICs expressed more ability to confront caregiving-related challenges. Findings offer promising but preliminary support for ERT-C as a conceptual model and treatment modality for distressed cancer ICs

The LHCb upgrade I

The LHCb upgrade represents a major change of the experiment. The detectors have been almost completely renewed to allow running at an instantaneous luminosity five times larger than that of the previous running periods. Readout of all detectors into an all-software trigger is central to the new design, facilitating the reconstruction of events at the maximum LHC interaction rate, and their selection in real time. The experiment's tracking system has been completely upgraded with a new pixel vertex detector, a silicon tracker upstream of the dipole magnet and three scintillating fibre tracking stations downstream of the magnet. The whole photon detection system of the RICH detectors has been renewed and the readout electronics of the calorimeter and muon systems have been fully overhauled. The first stage of the all-software trigger is implemented on a GPU farm. The output of the trigger provides a combination of totally reconstructed physics objects, such as tracks and vertices, ready for final analysis, and of entire events which need further offline reprocessing. This scheme required a complete revision of the computing model and rewriting of the experiment's software