British Journal of Clinical Psychology最新文献

Objectives: Exposure therapy is a well-established treatment for anxiety disorders in children; however, many young people do not fully respond to treatment. Advances in strategies to enhance extinction learning from exposure therapy are urgently needed. Emerging adult research suggests that sleep could be used to augment exposure therapy outcomes. To the best of our knowledge, the current study is the first published pilot evaluation of the potential benefits of sleep to enhance extinction learning in anxious children.

Methods: Eighteen children aged 7-12 years (M = 9.11; 38.9% Male) with a primary diagnosis of an anxiety disorder were randomized to either a period of sleep immediately following a single session of exposure (SLEEP group), or a day of wakefulness following exposure (WAKE group).

Results: Both groups improved on clinician-rated anxiety severity and children's danger severity expectancies from pre-treatment to post-treatment and 1-week follow-up. Child- and parent-rated target symptom fear ratings also improved from pre-treatment to 1-week follow-up. However, there was no evidence that children in the SLEEP group improved significantly more than the WAKE group.

Conclusions: The current pilot study failed to demonstrate an augmentation effect of post-exposure sleep in children. Practical and methodological challenges are reported for consideration in future investigations.

Background: There has been increasing attention to sleep disturbances such as insomnia in psychosis, due to its impact on symptoms, well-being, and recovery. However, excessive sleep and extended sleep duration are common in psychosis (partly linked to sedating antipsychotic medication) and have been relatively neglected, despite plausible interactions with symptoms, functioning, and broader well-being.

Aim: This study aimed to explore the experience of extended sleep duration and excessive sleepiness, or their combination (hypersomnia) in people with psychotic disorders through a qualitative interview around the experience, impacts, contributors, and role of treatment.

Method: Ten patients experiencing excessive sleep (defined as excessive daytime sleepiness >3 days a week; extended sleep duration of > 11 h in 24 h or >9 h at night; or a combination of these) alongside a diagnosed psychotic disorder were recruited. They met with the researcher online to participate in a semi-structured interview, which was analysed using thematic analysis.

Results: Five major themes were developed: (1) The Exhausting Everyday, (2) Medication is the story? (3) Indescribable Tiredness, (4) Overruled by Sleep and (5) An Unfair Fight. Excessive sleep impacts multiple domains of individual well-being and recovery - for example, limiting patients in everyday tasks and socializing. Cycles of emotional avoidance and inactivity were identified as potential maintainers or exacerbators of excessive sleep, in addition to medication side effects. Patients reported difficulty conveying the impact of their sleepiness symptoms to clinicians or others.

Conclusion: The results support that excessive sleep requires further attention as a problematic and impactful sleep presentation in this group. Further research is needed to improve recognition and assessment of problematic excessive sleep, and how existing practices or novel treatments may be applied to reduce its impact on recovery.

Background: Anxiety disorders frequently co-occur with sleep disturbances, and social anxiety disorder (SAD) is no exception (Journal of affective disorders, 2020, 260, 200).

Aims: The present study examined differences in sleep dysfunction between individuals with and without SAD as well as the temporal relationship between reported sleep quality and anxiety in individuals' daily lives.

Materials & methods: Eighty-seven participants took part in the study: 44 met diagnostic criteria for SAD and 43 did not. Both groups completed a daily diary measurement to assess the levels of experienced anxiety and sleep quality every day for 21 consecutive days.

Results: Individuals with SAD reported significantly poorer sleep across all measured variables compared with those without SAD. Hierarchical linear modelling (HLM) analyses showed reciprocal effects between sleep duration and anxiety, with both variables predicting each other on subsequent days. In addition, sleep quality and time to fall asleep predicted subsequent anxiety but not vice versa.

Discussion: The findings suggest that sleep could play an important role in the maintenance of social anxiety.

Conclusion: Sleep interventions targeting duration, quality, and time to fall asleep may be beneficial for improving SAD symptoms.