Department of Psychology, Harvard University, Cambridge, MA, USA.
Australian Childhood Foundation, Ringwood, Vic., Australia.
J Child Psychol Psychiatry. 2020 Oct;61(10):1116-1125. doi: 10.1111/jcpp.13234. Epub 2020 Mar 17.
Adolescence is characterized by substantial changes in sleep behavior, heightened exposure to stressful life events (SLEs), and elevated risk for internalizing problems like anxiety and depression. Although SLEs are consistently associated with the onset of internalizing psychopathology, the mechanisms underlying this relationship remain poorly understood, especially at the within-person level. Here, we leverage a high-frequency longitudinal design to examine sleep as a potential mechanism linking SLEs to increases in anxiety and depression symptoms over a one-year period.
Thirty female adolescents aged 15-17 years completed 12 monthly in-laboratory assessments of exposure to SLEs and symptoms of anxiety and depression (n = 355 monthly assessments), and wore an actigraphy wristband for continuous monitoring of sleep for the duration of the study (n = 6,824 sleep days). Multilevel models examined concurrent and lagged within-person associations between SLEs, sleep duration and timing regularity, and anxiety and depression symptoms.
Within-person fluctuations in SLEs were associated with variability in sleep duration both concurrently and prospectively, such that when adolescents experienced greater SLEs than was typical for them, they exhibited more variable sleep duration that same month as well as the following month. In turn, within-person increases in sleep duration variability predicted greater anxiety symptoms in the same month and mediated the association between SLEs and anxiety.
These findings highlight sleep disruptions as a mechanism underlying the longitudinal associations between SLEs and anxiety symptoms, and suggest that interventions promoting sleep schedule consistency may help mitigate risk for stress-related psychopathology in adolescence.
青春期的睡眠行为会发生重大变化，面临更多的应激性生活事件（SLEs），出现焦虑和抑郁等内在问题的风险也会增加。尽管 SLEs 与内在心理病理的发生始终相关，但这种关系的机制仍知之甚少，尤其是在个体内部水平上。在这里，我们利用高频纵向设计，研究睡眠作为 SLEs 与一年内焦虑和抑郁症状增加相关的潜在机制。
30 名年龄在 15-17 岁的女性青少年完成了 12 个月的 SLE 和焦虑及抑郁症状的每月实验室评估（n=355 次每月评估），并在研究期间佩戴活动记录仪腕带以连续监测睡眠（n=6824 个睡眠日）。多层次模型检验了 SLEs、睡眠持续时间和定时规律与焦虑和抑郁症状的同时和滞后个体内关联。
个体内 SLEs 的波动与睡眠持续时间的变异性同时存在并具有前瞻性，即当青少年经历的 SLEs 比他们通常经历的多时，他们在当月和下个月的睡眠持续时间都会更加多变。反过来，睡眠持续时间变异性的个体内增加预测了当月焦虑症状的增加，并介导了 SLEs 与焦虑之间的关联。
这些发现强调了睡眠中断是 SLEs 与焦虑症状之间纵向关联的机制之一，并表明促进睡眠时间表一致性的干预措施可能有助于减轻青少年与压力相关的心理病理风险。
