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转诊至儿科睡眠障碍中心的儿童认知节奏迟缓:探究与睡眠问题的可能重叠以及与功能损害的关联。

Sluggish cognitive tempo in children referred to a pediatric Sleep Disorders Center: Examining possible overlap with sleep problems and associations with impairment.

作者信息

Becker Stephen P, Garner Annie A, Byars Kelly C

机构信息

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 10006, Cincinnati, OH 45056, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave., MLC 10006, Cincinnati, OH 45056, USA.

Department of Psychology, Saint Louis University, 3700 Lindell Blvd., St. Louis, Missouri 63108, USA.

出版信息

J Psychiatr Res. 2016 Jun;77:116-24. doi: 10.1016/j.jpsychires.2016.03.005. Epub 2016 Mar 16.

Abstract

Research supports the distinctness of sluggish cognitive tempo (SCT) (e.g., mental confusion and slowed behavior/thinking) from other psychopathologies. However, the relation between SCT and sleep functioning has not been adequately studied. We examined the association between SCT and sleep functioning in 325 children (62% male) ages 6-10 years referred to a pulmonary-based, accredited Sleep Disorders Center. Correlations between caregiver ratings of SCT, other psychopathologies (i.e., inattention/hyperactivity, oppositionality, depression, anxiety), sleep functioning (both behavioral and organic symptoms), as well as sleep disorder diagnoses, were examined. Unique effects of SCT and other psychopathologies on sleep problem severity controlling for child demographics were assessed using regressions. Regression analyses were also conducted to examine the unique effects of SCT on impairment (i.e., academic difficulties, parenting stress, and other psychopathologies) controlling for child demographics, sleep problem severity, and other psychopathology symptoms. SCT was weakly to moderately correlated with most measures of sleep (rs = .07-.39) and moderately to strongly correlated with measures of daytime sleepiness (rs = .33 and .53). In the regression analyses, SCT was uniquely associated with greater sleep functioning severity and impairment in academic functioning. SCT was also uniquely associated with higher levels of depression and inattention/hyperactivity, but not anxiety, and negatively associated with oppositionality. Finally, SCT symptoms were uniquely associated with greater parent-child dysfunctional interaction. Findings demonstrate that SCT is related to, but not redundant with, sleep problems and daytime sleepiness specifically. Further, SCT remained associated with several domains of functional impairment in sleep-disordered children after controlling for clinically-relevant variables, highlighting the potential value in assessing SCT symptoms in children with sleep problems.

摘要

研究支持迟缓认知节奏(SCT)(例如,思维混乱和行为/思维迟缓)与其他精神病理学的区别。然而,SCT与睡眠功能之间的关系尚未得到充分研究。我们在一家经认可的、以肺部疾病为基础的睡眠障碍中心,对325名6至10岁儿童(62%为男性)进行了SCT与睡眠功能之间关联的研究。我们考察了照料者对SCT、其他精神病理学(即注意力不集中/多动、对立性、抑郁、焦虑)、睡眠功能(行为和器质性症状)以及睡眠障碍诊断的评分之间的相关性。使用回归分析评估了在控制儿童人口统计学因素的情况下,SCT和其他精神病理学对睡眠问题严重程度的独特影响。还进行了回归分析,以考察在控制儿童人口统计学因素、睡眠问题严重程度和其他精神病理学症状的情况下,SCT对损害(即学业困难、养育压力和其他精神病理学)的独特影响。SCT与大多数睡眠指标呈弱至中度相关(r值范围为0.07至0.39),与日间嗜睡指标呈中度至高度相关(r值分别为0.33和0.53)。在回归分析中,SCT与更高的睡眠功能严重程度以及学业功能损害存在独特关联。SCT还与更高水平的抑郁和注意力不集中/多动存在独特关联,但与焦虑无关,且与对立性呈负相关。最后,SCT症状与更大程度的亲子功能失调互动存在独特关联。研究结果表明,SCT与睡眠问题和日间嗜睡存在关联,但并非冗余。此外,在控制临床相关变量后,SCT在睡眠障碍儿童的几个功能损害领域中仍然存在关联,这凸显了在评估有睡眠问题儿童的SCT症状方面的潜在价值。

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