Northwestern University, Department of Psychology, Evanston, IL, USA.
Northwestern University, School of Education and Social Policy, Evanston, IL, USA.
J Psychiatr Res. 2022 May;149:194-200. doi: 10.1016/j.jpsychires.2022.02.038. Epub 2022 Mar 2.
Stress and sleep have been implicated in the etiology of psychosis, and literature suggests they are closely related. Two distinct domains of stress associated with sleep dysfunction in the general population are responsivity to environmental stressors and stress sensitivity. However, to date, no research has examined relationships between these stress domains and sleep dysfunction in individuals at clinical high-risk (CHR) for psychosis. A total of 57 CHR (mean age = 18.89, SD = 1.82) and 61 healthy control (HC; mean age = 18.34, SD = 2.41) adolescents and young adults completed a measure of emerging stress intolerance. A subset of participants (CHR = 50, HC = 49) completed a measure indexing responsivity to family stressors - an integral context for this developmental stage overlapping with the psychosis-risk period. Sleep efficiency, continuity, and duration were objectively assessed by actigraphy (CHR = 38, HC = 36). Partial correlations with age and sex as covariates were conducted in both groups separately to examine relationships between stress and sleep. Results indicated that automatic maladaptive responsivity to family stressors was associated with disrupted sleep in the CHR but not HC group. Specifically, greater involuntary engagement was associated with poorer sleep efficiency (r = -.42) but not sleep continuity (r = 0.31) and duration (r = .-19). Interestingly, both adaptative and maladaptive voluntary responses to stressors (engagement and disengagement coping) were not associated with sleep. Finally, impaired stress tolerance was associated with sleep efficiency (r = -0.47), continuity (r = 0.37), and duration (r = -0.43). Taken together, findings provided important groundwork for understanding the role of the relationship between involuntary maladaptive responsivity to family stressors and stress sensitivity with sleep in psychosis etiology.
压力和睡眠与精神病的病因有关，并且文献表明它们密切相关。在普通人群中，与睡眠功能障碍相关的两个不同的压力领域是对环境压力源的反应性和压力敏感性。然而，迄今为止，尚无研究在精神病临床高风险（CHR）个体中检查这些压力领域与睡眠功能障碍之间的关系。共有 57 名 CHR（平均年龄 18.89，SD 1.82）和 61 名健康对照组（HC；平均年龄 18.34，SD 2.41）青少年和年轻人完成了一项新兴压力不耐受性的测量。一部分参与者（CHR=50，HC=49）完成了一项家庭压力源反应性指标的测量，这是一个与精神病风险期重叠的这个发展阶段的重要背景。通过活动记录仪（CHR=38，HC=36）客观评估睡眠效率、连续性和持续时间。分别在两组中进行了与年龄和性别作为协变量的偏相关，以检查压力与睡眠之间的关系。结果表明，对家庭压力源的自动适应性反应与 CHR 但不是 HC 组的睡眠中断有关。具体来说，更大的无意识参与与较差的睡眠效率（r=-.42）相关，但与睡眠连续性（r=0.31）和持续时间（r=.-19）无关。有趣的是，对压力源的适应性和不适应性自愿反应（参与和脱离应对）都与睡眠无关。最后，压力耐受能力受损与睡眠效率（r=-.47）、连续性（r=0.37）和持续时间（r=-.43）有关。总之，这些发现为理解精神病病因中对家庭压力源的无意识适应性反应和压力敏感性与睡眠之间的关系提供了重要的基础。
