Phillips Eric M, Goldberg Emily L, Brock Rebecca L, Hamburger Emily R, Nelson Jennifer Mize, Mason W Alex, Espy Kimberly Andrews, Nelson Timothy D
University of Nebraska-Lincoln, Lincoln, Nebraska.
Wayne State University School of Medicine, Detroit, Michigan.
JAACAP Open. 2024 Jul 4;3(3):701-712. doi: 10.1016/j.jaacop.2024.06.001. eCollection 2025 Sep.
This study examined associations between actigraphy-derived sleep metrics (ie, intraindividual sleep variability, average sleep duration, bedtime, and waketime) and psychopathology to discern their roles as potential transdiagnostic factors related to psychiatric problems during adolescence.
In a sample of 238 adolescents (aged 14-18 years; 0.4% Asian American, 4.0% Black, 22.0% Multiracial, and 73.5% White; 53.4% female) oversampled for socioeconomic risk, we used a bifactor s-1 model of psychopathology, with emotion dysregulation as the reference indicator, to model the general factor of dysregulation and psychopathology (GF-DP) as well as specific internalizing and externalizing factors. We used multilevel structural equation modeling with the Markov chain Monte Carlo procedure to model latent means and intraindividual variability in nightly sleep duration, bedtime, and waketime over 14 nights, and to test whether they had general or specific associations with psychopathology. Furthermore, we examined whether sociodemographic variables moderated the associations between psychopathology and the various sleep metrics.
Results indicated a significant positive association between the GF-DP and intraindividual variability in sleep duration (β = 0.18, 95% CI = 0.013, 0.335). This association was consistent across multiple demographic characteristics, highlighting its broad relevance. The study did not find significant associations with specific internalizing or externalizing problems or other sleep metrics.
Findings emphasize intraindividual variability in sleep duration as a key transdiagnostic factor in adolescent psychopathology. Targeting sleep variability could lead to more effective interventions, potentially reducing the prevalence of a broad spectrum of psychiatric disorders. Future research using diverse samples and longitudinal designs is warranted to build on these insights.
• Clinicians should assess for consistency of adolescent sleep in addition to the amount of time an adolescent is sleeping. Sleep inconsistency may be more relevant to adolescents' mental health problems than total sleep time.• Interventions aimed at improving the consistency of young people's sleep, such as the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C), may be beneficial in reducing diverse forms of mental health problems (eg, depression, anxiety, attention problems, oppositionality, and conduct problems).• Improving consistency of sleep may be particularly beneficial for adolescents with comorbid mental health problems.
本研究探讨了基于活动记录仪得出的睡眠指标（即个体内睡眠变异性、平均睡眠时间、就寝时间和起床时间）与精神病理学之间的关联，以确定它们作为与青少年期精神问题相关的潜在跨诊断因素的作用。
在一个238名青少年（年龄14 - 18岁；0.4%为亚裔美国人，4.0%为黑人，22.0%为多种族，73.5%为白人；53.4%为女性）的样本中，该样本因社会经济风险进行了过度抽样，我们使用了一个以情绪失调为参考指标的精神病理学双因素s - 1模型，来构建失调和精神病理学的一般因素（GF - DP）以及特定的内化和外化因素。我们使用马尔可夫链蒙特卡罗程序的多级结构方程模型来构建14个晚上夜间睡眠时间、就寝时间和起床时间的潜在均值和个体内变异性，并测试它们与精神病理学是否存在一般或特定的关联。此外，我们还研究了社会人口统计学变量是否调节了精神病理学与各种睡眠指标之间的关联。
结果表明，GF - DP与睡眠时间的个体内变异性之间存在显著正相关（β = 0.18，95% CI = 0.013，0.335）。这种关联在多种人口统计学特征中是一致的，突出了其广泛的相关性。该研究未发现与特定的内化或外化问题或其他睡眠指标存在显著关联。
研究结果强调睡眠时间的个体内变异性是青少年精神病理学中的一个关键跨诊断因素。针对睡眠变异性可能会带来更有效的干预措施，有可能降低广泛的精神障碍的患病率。有必要开展未来研究，使用多样化的样本和纵向设计来基于这些见解进行深入研究。
• 临床医生除了评估青少年的睡眠时间外，还应评估其睡眠的一致性。睡眠不一致性可能比总睡眠时间与青少年的心理健康问题更相关。
• 旨在改善年轻人睡眠一致性的干预措施，如睡眠和昼夜节律功能障碍的跨诊断干预（TranS - C），可能有助于减少多种形式的心理健康问题（如抑郁、焦虑、注意力问题、对立性和行为问题）。
• 改善睡眠一致性可能对患有合并心理健康问题的青少年特别有益。
