Child and Adolescent Sleep Disturbances and Psychopathology in a Mental Health Clinic Sample

TitleChild and Adolescent Sleep Disturbances and Psychopathology in a Mental Health Clinic Sample
Publication TypeConference Paper
Year of Publication2022
AuthorsBlacher A., McKenzie K., Stewart S., Reid G.
Conference NameSleep Medicine
IssueSupplement 1
Keywords*Depression, *mental disease, *mental health center, *sleep disorder, Adolescent, Adult, Anxiety, attention deficit hyperactivity disorder, bedtime, Canada, Caregiver, Child, child parent relation, conduct disorder, conference abstract, controlled study, data analysis, distress syndrome, externalizing disorder, family functioning, Female, health care quality, Human, human tissue, internalizing disorder, major clinical study, Male, mental health, Ontario, outcome variable, outpatient, pain, Prevalence, wakefulness

Introduction: Children and adolescents (henceforth children) being treated in specialty mental health services are more likely to have sleep disturbances than community samples. However, few studies have investigated the relationship between sleep and psychopathology in a broad sample of children seen at mental health agencies. This study aimed to fill this gap by examining sleep disturbances in relation to internalizing (e.g., depression, anxiety) and externalizing (e.g., attention-deficit/hyperactivity, conduct disorder) symptoms. Material(s) and Method(s): Secondary data analyses were completed on a sample of children (aged 4 to 18; 56.2% male) who completed the interRAI ChYMH- a semi-structured assessment tool- as a part of standard care in residential or outpatient settings from 39 mental health agencies in Ontario, Canada (N = 13, 472). A split-half sample approach was used to control for error and determine if results were reproducible (Sample 1 n = 6,773, Sample 2 n = 6,699). Hierarchical regressions examined the effects of child (i.e., age, sex, sensory sensitivity, pain), family (i.e., family functioning, caregiver distress, lack of parenting strengths), sleep disturbances (i.e., difficultly falling asleep and staying asleep, night waking, bedtime resistance and falling asleep during the day), and age as a moderator for sleep disturbances on both outcome variables: internalizing and externalizing symptoms. Result(s): In both samples, sleep disturbances predicted both internalizing (Sample 1 DELTAR2 = 8.6%, Sample 2 DELTAR2 = 10.0%) and externalizing (Sample 1 DELTAR2 = 1.5%, Sample 2 DELTAR2 = 1.3%) above and beyond child and family variables. Age moderated the relationship between sleep disturbances and internalizing symptoms (Sample 1 s = 0.06, p <.001, Sample 2 s = 0.08, p <.001), but not externalizing symptoms (Sample 1 s = -0.01, p >.05, Sample 2 s = -0.01, p >.05). Conclusion(s): The relationship between sleep and psychopathology may change as children move through developmental phases marked by structural and organizational changes in sleep-wake patterns and psychopathology prevalence.Copyright © 2022

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