Fibromyalgia: The role of sleep in affect and in negative event reactivity and recovery.

Objective: Fibromyalgia (FM) syndrome is a chronic pain condition characterized by diffuse muscle pain, increased negative mood, and sleep disturbance. Until recently, sleep disturbance in persons with FM has been modeled as the result of the disease process or its associated pain. The current study examined sleep disturbance (i.e., sleep duration and sleep quality) as a predictor of daily affect, stress reactivity, and stress recovery. Design and Measures: A hybrid of daily diary and ecological momentary assessment methodology was used to evaluate the psychosocial functioning of 89 women with FM. Participants recorded numeric ratings of pain, fatigue, and positive and negative affect 3 times throughout the day for 30 consecutive days. At the end of each day, participants completed daily diary records of positive and negative life events. In addition, participants reported on their sleep duration and sleep quality each morning. Results: After accounting for the effects of positive events, negative events, and pain on daily affect scores, it was found that sleep duration and quality were prospectively related to affect and fatigue. Furthermore, the effects of inadequate sleep on negative affect were cumulative. In addition, an inadequate amount of sleep prevented affective recovery from days with a high number of negative events. Conclusions: These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Associations among perceptions of social support, negative affect, and quality of sleep in caregivers and noncaregivers.

The authors used structural equation modeling to examine associations among perceptions of negative affect, social support, and quality of sleep in a sample of caregivers (n = 175) and noncaregiver control participants (n = 169). The authors hypothesized that caregiver status would be related to sleep quality directly and also indirectly by way of negative affect and social support. This hypothesis was partially supported in that caregiving was found to be indirectly related to sleep quality. However, after accounting for the indirect effects of negative affect and social support, the direct effect of caregiving on sleep quality was no longer statistically significant. The structural model accounted for approximately 43% of the variance in sleep quality. The present findings may be useful in the development of successful sleep interventions for caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between child sleep disturbances and maternal sleep, mood, and parenting stress: A pilot study.

Although sleep disturbances in children are common, little is known about the relationship between children's sleep disruptions and maternal sleep and daytime functioning. Forty-seven mothers completed measures of sleep, depression, parenting stress, fatigue, and sleepiness. Significant differences in maternal mood and parenting stress were found between mothers of children with and without significant sleep disturbances. Regression analyses showed that the quality of the children's sleep significantly predicted the quality of maternal sleep. In addition, maternal sleep quality was a significant predictor of maternal mood, stress, and fatigue. Results from this pilot study support the need for future research examining the relationship between child sleep disturbances and maternal daytime functioning, and they highlight the importance of screening for and treating pediatric sleep disruptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examinations of chronic pain and affect relationships: Applications of a dynamic model of affect.

Two studies of the relationship between pain and negative affect are presented in this article: a study of weekly fluctuations in pain and negative affect among those with arthritis and a study of daily fluctuations in pain and negative affect for participants with fibromyalgia. The roles of positive affect and mood clarity (or the ability to distinguish between different emotions) in modifying the size of the relationship between pain and negative affect were examined in both studies as a means of testing the predictions of a dynamic model of affect regulation. In both studies, the presence of positive affect reduced the size of the relationship between pain and negative affect. Also, for arthritis participants with greater mood clarity, there was less overlap in ratings of negative and positive affective states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association between sleep duration and intelligence scores in healthy children.

We examined the association between sleep behavior and cognitive functioning in 60 healthy children between 7 and 11 years of age under nonexperimental conditions. Intellectual abilities were assessed by the Wechsler Intelligence Scale for Children (4th edition) and sleep variables by questionnaires, actigraphy, and sleep diaries. Correlation analysis revealed a negative association between sleep duration on weekends and measures of intelligence (full-scale IQ, r = ?.29; fluid IQ, r = ?.36). The regression coefficient for sleep duration on weekends was ?6.11 (SE = 2.09), indicating an increase of 6.11 points on fluid IQ scores for each hour of shorter sleep duration. Attention measures did not correlate with cognitive or sleep variables. Daytime sleepiness as a potential moderator of the relationship between sleep duration and cognitive performance was not related to cognitive or sleep variables. We conclude that children with higher daytime cognitive efficiency (reflected by higher intelligence scores) show increased nighttime efficiency (reflected by shorter sleep duration). In the light of the neural efficiency hypothesis, the current results argue for an extension of the original theory—referring not only to daytime but also to nighttime behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affect intensity and phasic REM sleep in depressed men before and after treatment with cognitive-behavioral therapy.

Explored the relationship between daytime affect and REM sleep in 45 depressed men before and after treatment with cognitive-behavioral therapy and in a control group of 43 healthy Ss. The intensity of daytime affect (as measured by the sum of positive and negative affects) in depressed men correlated significantly and positively with phasic REM sleep measures at both pre- and posttreatment. This relationship was not found in healthy control Ss. In depressed men, both affect intensity and phasic REM sleep measures decreased over the course of treatment. The results suggest a relationship between phasic REM sleep and intensity of affect reported by depressed men. On the basis of this preliminary observation, it was hypothesized that abnormalities in phasic REM sleep in depressed patients are related, in part, to fundamental alterations in the intensity of their affective experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the within-person coupling of sleep and cognition in older African Americans.

This study examined the within-person relationship between sleep and cognitive functioning. Fifty community-dwelling African Americans (age range = 50–80 years) were asked to report their sleep duration and quality the previous evening and to complete cognitive measures over 8 occasions within a 2–3 week period. A within-person daily change in sleep duration was significantly associated with worse global cognitive performance. The greater an individual deviated away from his or her average sleep duration on a particular day, the more likely his or her performance would decline. These results demonstrate that the sleep-cognition relationship can be observed at a within-person level of analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unfair treatment is associated with poor sleep in African American and Caucasian adults: Pittsburgh SleepSCORE project.

Objective: To test the association between self-reported unfair treatment and objective and self-reported sleep characteristics in African American and Caucasian adults. Design: Cross-sectional study of 97 African American and 113 Caucasian middle-aged adults. Main Outcome Measures: Participants completed: (a) two-night in-home, polysomnography (PSG) sleep study, (b) sleep diaries and actigraph assessments across 9 days and nights, and (c) self-report measures of sleep quality in the past month, and daytime sleepiness in the past 2 weeks. Results: Greater unfair treatment was associated with reports of poorer self-reported sleep quality and greater daytime sleepiness, shorter sleep duration, and lower sleep efficiency as measured by actigraphy and PSG, and a smaller proportion of rapid eye movement (REM) sleep. Racial/ethnic differences were few. Exploratory analyses showed that nightly worry partially mediated the associations of unfair treatment with sleep quality, daytime sleepiness, sleep efficiency (actigraphy), and proportion of REM sleep. Conclusion: Perceptions of unfair treatment are associated with sleep disturbances in both African American and Caucasian adults. Future studies are needed to identify the pathways that account for the association between unfair treatment and sleep. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The social environment and health in rheumatoid arthritis: marital quality predicts individual variability in pain severity

OBJECTIVE: To examine prospective relations between a wide array of measures of social functioning and pain, while controlling for disease duration and activity and functional grade. METHODS: As part of a larger study on health care utilization, longitudinal data were collected from 136 Dutch and 98 German outpatients on clinical status and pain. Social data included information on sexual handicap, spouse behavior, loneliness, daily emotional support, and the maintenance of pleasurable life domains. Pain severity was assessed at baseline and 12 months later with standard measures of pain and analyzed with hierarchical regressions. RESULTS: Social measures obtained at baseline were consistently associated with pain at followup. Depression was a moderate correlate of pain in the Dutch and German samples. The regressions revealed that patient reports of negative spouse behavior (such as avoidance and critical remarks) and baseline depression predicted worse pain outcome, and this association remained significant in analyses controlling for baseline pain. The level of formal education was a weak correlate of disability, emotional support, and pain. Daily emotional support and social life domains associated with positive affect had an indirect influence on outcome. The absence of strong rather than weak social ties was the component of the loneliness construct linked to pain. These associations between social prognostic factors and pain severity, however, were mediated by psychological functioning at baseline. CONCLUSION: The social environment was found to operate on the core health outcome, pain severity, via several pathways. Social functioning may be affected by rheumatoid arthritis (RA) progression, but it also appears to form a determinant of future health outcome. Not only the status of being married but also the quality of the relationship in terms of long-term stress and emotional support may be useful prognostic factors in RA.     

Low life purpose and high hostility are related to an attenuated decline in nocturnal blood pressure.

Objective: An attenuation of the nighttime decline in blood pressure (BP) predicts cardiovascular disease and cardiovascular-related mortality, beyond daytime BP levels. We investigated whether positive and negative psychological attributes were associated with sleep–wake BP ratios and examined sleep parameters as potential mediators of these relationships. Design: Two hundred twenty-four participants (50% men; 43% Black; mean age = 60 years) underwent ambulatory BP monitoring for 2 days and nights. Self-reports of positive and negative psychological attributes were collected. In-home polysomnography was conducted for 2 nights, and a wrist actigraph was worn for 9 nights. Main Outcome Measures: Sleep–wake mean arterial pressure (MAP) ratios. Results: After adjustment for demographics, body mass index, and hypertensive status, low life purpose and high hostility were associated with high sleep–wake MAP ratios. Depression, anxiety, and optimism were not related to MAP ratios. Sleep latency, fragmentation, architecture, and the apnea–hypopnea index were examined as potential mediators between psychological attributes and MAP ratios; only long sleep latency mediated the relationship between hostility and MAP ratios. Conclusion: Low life purpose and high hostility are associated with high sleep–wake BP ratios in Black and White adults, and these relationships are largely independent of sleep. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's objective and subjective sleep disruptions: Links with afternoon cortisol levels.

Objective: The purpose of this study was to determine possible relations between the quality and amount of children's sleep and cortisol in healthy children. Design: Children's sleep was monitored with actigraphs for 7 nights. Children came to the laboratory to provide saliva samples, which were used to assess cortisol. Children reported on their sleepiness and sleep/wake problems. Sixty-four healthy children participated (M = 8.75 years; SD = .55). Main Outcome Measures: Self-reported sleepiness and sleep/wake problems, actigraphy-measured total sleep minutes, sleep efficiency, minutes awake after sleep onset, and sleep activity, and afternoon cortisol levels. Results: After controlling for demographic variables and child characteristics, higher levels of cortisol were related to increased subjective sleep problems and objective measures of shorter sleep duration and poorer sleep quality. Conclusion: These findings are of importance for understanding critical facets of children's health and well-being, and are noteworthy given the high prevalence of sleep disruptions in otherwise normally developing children in the United States. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The two-factor structure of sleep complaints and its relation to depression and anxiety.

Although sleep complaints are common in depression and anxiety, there is little agreement as to how they should be organized and assessed. It is also unclear whether sleep complaints show specificity with certain disorders or whether they are nonspecific symptoms. The authors examined the structure of sleep complaints and the relations of these complaints to depression and anxiety in 3 samples: college students, older adults, and psychiatric patients. Exploratory and confirmatory factor analyses indicated that sleep complaints consistently defined 2 distinct dimensions: Insomnia and Lassitude. The Insomnia factor included indicators of early, middle, and late insomnia, as well as poor sleep quality. The Lassitude factor included measures of hypersomnia, fatigue, and sleepiness. Both factors were significantly related to symptoms and diagnoses of depression and anxiety. However, Lassitude was more strongly related to symptoms of depression and anxiety than was Insomnia. In addition, Lassitude showed specificity to measures and diagnoses of depression compared with anxiety disorders. This specificity can be explained by Lassitude's relation with negative and positive emotionality, both of which are components of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reported exposure and emotional reactivity to daily stressors: The roles of adult age and global perceived stress.

A central goal of daily stress research is to identify resilience and vulnerability factors associated with exposure and reactivity to daily stressors. The present study examined how age differences and global perceptions of stress relate to exposure and emotional reactivity to daily stressors. Sixty-seven younger (Mage = 20) and 116 older (Mage = 80) adults completed a daily stress diary and measures of positive and negative affect on 6 days over a 14-day period. Participants also completed a measure of global perceived stress. Results revealed that reported exposure to daily stressors is reduced in old age but that emotional reactivity to daily stressors did not differ between younger and older adults. Global perceived stress was associated with greater reported exposure to daily stressors in older adults and greater stress-related increases in negative affect in younger adults. Furthermore, across days on which daily stressors were reported, intraindividual variability in the number and severity of stressors reported was associated with increased negative affect, but only among younger adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive Affect as a Source of Resilience for Women in Chronic Pain.

A sample of 124 women with osteoarthritis or fibromyalgia, or both, completed initial assessments for demographic data, health status, and personality traits and 10-12 weekly interviews regarding pain, stress, negative affect, and positive affect. Multilevel modeling analyses indicated that weekly elevations of pain and stress predicted increases in negative affect. Both higher weekly positive affect as well as greater positive affect on average resulted in lower negative affect both directly and in interaction with pain and stress. Finally, increases in weekly negative affect and higher average negative affect related to greater levels of pain in subsequent weeks. In contrast, higher levels of overall positive affect predicted lower levels of pain in subsequent weeks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: A quantitative review of 30 years of investigations.

[Correction Notice: An erratum for this article was reported in Vol 135(5) of Psychological Bulletin (see record 2009-12487-006). There is an error in Table 1. On p. 840 the entry for Hill et al. 1987 should be Masters et al. 2004.] This meta-analysis included 729 studies from 161 articles investigating how acute stress responsivity (including stress reactivity and recovery of hypothalamic-pituitary-adrenal [HPA] axis, autonomic, and cardiovascular systems) changes with various chronic psychosocial exposures (job stress; general life stress; depression or hopelessness; anxiety, neuroticism, or negative affect; hostility, aggression, or Type-A behavior; fatigue, burnout, or exhaustion; positive psychological states or traits) in healthy populations. In either the overall meta-analysis or the methodologically strong subanalysis, positive psychological states or traits were associated with reduced HPA reactivity. Hostility, aggression, or Type-A behavior was associated with increased cardiovascular (heart rate or blood pressure) reactivity, whereas anxiety, neuroticism, or negative affect was associated with decreased cardiovascular reactivity. General life stress and anxiety, neuroticism, or negative affect were associated with poorer cardiovascular recovery. However, regarding the sympathetic nervous system and parasympathetic nervous system, there were no associations between the chronic psychosocial factors and stress reactivity or recovery. The results largely reflect an integrated stress response pattern of hypo- or hyperactivity depending on the specific nature of the psychosocial background. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Calcium and signal transduction in granulocytes

The purpose of this study was to examine the relationships among negative affect (depression, anxiety, and anger), microstressors (hassles), temporomandibular disorder (TMD) pain severity, and life interference, using structural equations modeling. One hundred four subjects were recruited from the Parker Mahan Facial Pain Clinic at the University of Florida. Significant positive direct effects were found for paths between pain severity and life interference; pain severity and negative affect; and negative affect and life interference. These results are consistent with a learning or behavioral model of suffering and suggest that negative affect is an important mediating variable in the relationship between pain and life interference. Microstressors were not a significant predictor and may not be a relevant issue in the TMD population. The results suggest that the impact of chronic pain conditions is influenced by both pain and negative affect, and assessment and treatment of chronic TMD disorders may better benefit from a multidisciplinary approach.     

Diurnal cortisol secretion and 2-year changes in older adults' physical symptoms: The moderating roles of negative affect and sleep.

Objective: This study examined whether the association between cortisol secretion and changes in physical health symptoms would depend on other factors in a person's life. The authors expected that physical health effects would emerge particularly when cortisol disturbances co-occur in the context of high levels of trait negative affect or poor sleep. Design: Physical symptoms, diurnal cortisol secretion, affective tendencies, and sleep efficiency were assessed in a 2-yr longitudinal study of 184 older adults. Main Outcome Measure: Two-year changes in physical symptoms. Results: High cortisol levels were associated with increases in physical symptoms, but only among participants who experienced high negative affect and poor sleep. Conclusion: Elevated levels of cortisol secretion contribute to older adults' physical symptoms if they co-occur in the context of other emotional and behavioral problems. By contrast, cortisol disturbances may not influence physical symptoms among people who are emotionally well or engage in efficient sleep behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness impairs daytime functioning but not sleep duration.

Objective: To assess the prospective association between daily feelings of loneliness and subsequent feelings of daytime dysfunction indicative of poor sleep quality. Design: Three consecutive end-of-day diaries were completed by a population-based sample of 215 adults (mean age = 57.5 years, SD = 4.4). Diary questions probed sleep duration, daytime dysfunction (i.e., fatigue, low energy, sleepiness), loneliness, physical symptoms, and depressed affect experienced that day. Chronic health condition data and body mass index were also obtained. Autoregressive cross-lagged panel models were used to examine the magnitude of reciprocal prospective associations between loneliness and daytime dysfunction. Main Outcome Measures: Unstandardized path coefficients adjusted for race/ethnicity, sleep duration, marital status, household income, chronic health conditions, and health symptom severity. Results: Daily variations in loneliness predicted subsequent feelings of daytime dysfunction (B = 0.16, p     

"Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: A quantitative review of 30 years of investigations": Correction to Chida and Hamer (2008).

Reports an error in "Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: A quantitative review of 30 years of investigations" by Yoichi Chida and Mark Hamer (Psychological Bulletin, 2008[Nov], Vol 134[6], 829-885). There is an error in Table 1. On p. 840 the entry for Hill et al. 1987 should be Masters et al. 2004. (The following abstract of the original article appeared in record 2008-14745-003.) This meta-analysis included 729 studies from 161 articles investigating how acute stress responsivity (including stress reactivity and recovery of hypothalamic-pituitary-adrenal [HPA] axis, autonomic, and cardiovascular systems) changes with various chronic psychosocial exposures (job stress; general life stress; depression or hopelessness; anxiety, neuroticism, or negative affect; hostility, aggression, or Type-A behavior; fatigue, burnout, or exhaustion; positive psychological states or traits) in healthy populations. In either the overall meta-analysis or the methodologically strong subanalysis, positive psychological states or traits were associated with reduced HPA reactivity. Hostility, aggression, or Type-A behavior was associated with increased cardiovascular (heart rate or blood pressure) reactivity, whereas anxiety, neuroticism, or negative affect was associated with decreased cardiovascular reactivity. General life stress and anxiety, neuroticism, or negative affect were associated with poorer cardiovascular recovery. However, regarding the sympathetic nervous system and parasympathetic nervous system, there were no associations between the chronic psychosocial factors and stress reactivity or recovery. The results largely reflect an integrated stress response pattern of hypo- or hyperactivity depending on the specific nature of the psychosocial background. (PsycINFO Database Record (c) 2010 APA, all rights reserved)