Biomedical subjects

Allison G Harvey

Publications and source records attributed to Allison G Harvey.

At least 19 recordsLinked to original sources

PubMed2006

Sleeping with the enemy: clock monitoring in the maintenance of insomnia.

Two experiments that aimed to investigate the association between clock monitoring, pre-sleep worry and sleep are presented. In Experiment 1, 30 good and 30 poor sleepers were instructed either to monitor or not to monitor a clock as they were trying to get to sleep. Worry was indexed by self-rating. Sleep was measured by self-report and actigraphy. Compared to non-monitors, clock-monitors reported more pre-sleep worry and they experienced longer sleep onset latency (SOL). These findings held true for both good and poor sleepers. In Experiment 2, following one night of baseline measurement, 38 individuals diagnosed with primary insomnia were instructed to monitor either a clock or a digit display unit (a control monitoring task) as they were trying to get to sleep. The clock-monitoring task was rated to be more worry provoking and sleep interfering than the display unit-monitoring task. Whilst display unit-monitors experienced less pre-sleep worry, the clock-monitors experienced more pre-sleep worry and reported a longer SOL on the experimental night, relative to baseline. Further, compared to the display unit-monitors, the clock-monitors overestimated their SOL more on the experimental night. Together, these findings suggest that clock monitoring may trigger pre-sleep worry and serve to maintain insomnia by fuelling pre-sleep worry and exacerbating misperception of sleep.

Adult↗

PubMed2006

Interpretive biases in chronic insomnia: an investigation using a priming paradigm.

Disorder-congruent interpretations of ambiguous stimuli characterize several psychological disorders and have been implicated in their maintenance. Models of insomnia have highlighted the importance of cognitive processes, but the possibility that biased interpretations are important has been minimally investigated. Hence, a priming methodology was employed to investigate the presence of an interpretive bias in insomnia. A sample of 78 participants, differing in the presence of a diagnosis of insomnia, severity of sleep disturbance, and sleepiness, was required to read ambiguous sentences and make a lexical decision about target words that followed. Sleepiness at the time of the experiment was associated with the likelihood with which participants made insomnia and threat consistent interpretations of ambiguous sentences. The results suggest that there is a general bias towards threatening interpretations when individuals are sleepy and suggests that cognitive accounts of insomnia require revision to include a role for interpretative bias when people are sleepy. Future research is required to investigate whether this interpretive bias plays a causal role in the maintenance of insomnia.

Adolescent↗

PubMed2006

The organisation and content of trauma memories in survivors of road traffic accidents.

We investigated the trauma narratives of 131 road traffic accident survivors prospectively, at 1 week, 6 weeks, and 3 months post-trauma. At 1 and 6 weeks, narratives of survivors with acute stress disorder (ASD) or post-traumatic stress disorder (PTSD) were less coherent and included more dissociation content. By 3 months, their narratives also contained more repetition, more non-consecutive chunks, and more sensory words. Traumatic brain injury was associated with a separate characteristic, confusion, at all three time points. Three aspects of narrative organisation at 1 week--repetition, non-consecutive chunks, and coherence--predicted PTSD severity at 3 months after controlling for initial symptoms. The results suggest both a strong concurrent and predictive relationship between narrative disorganisation and ASD/PTSD but that as people recover from ASD, their narratives do not necessarily become less disorganised.

Accidents, Traffic↗

PubMed2006

Sleep and circadian rhythms in children and adolescents with bipolar disorder.

The aim of this paper is to highlight the importance of the sleep-wake cycle in children and adolescents with bipolar disorder. After presenting an overview of the measurement and function of human sleep, we describe changes in sleep and circadian functioning across the life cycle. We then review evidence that, in adults, sleep and/or circadian rhythms are of considerable influence in the multifactorial causal chain implicated in relapse in bipolar disorder, discussing relevant mechanisms. The latter include abnormalities in the amount and timing of sleep, the role of social zeitgebers, and the importance of sleep in regulating emotional responses and mood. We next present preliminary data indicating considerable sleep disturbance among children and adolescents with bipolar disorder. Given the considerable sleep disturbance evident among children and adolescents with bipolar disorder along with a key role for sleep in emotion regulation and learning, we conclude that sleep among children and adolescents with bipolar disorder is a critical domain for future research. An agenda for future research is presented that includes descriptive studies, investigations of causality, and treatment development research.

Adolescent↗

PubMed2006

Altering misperception of sleep in insomnia: behavioral experiment versus verbal feedback.

Forty-eight individuals with insomnia were asked to wear an actigraph and keep a sleep diary for 2 nights. On the following day, half were shown the discrepancy between the data recorded on the actigraph and their sleep diary via a behavioral experiment, whereas the other half were told of the discrepancy verbally. Participants were then asked to monitor their sleep for 2 further nights to index the effect of these interventions. Although both reduced sleep misperception, the behavioral experiment (effect size: 0.79 to 1.25) led to greater reduction in self-reported sleep impairment, insomnia symptoms, and sleep-related anxiety and distress compared with verbal feedback (effect size: -0.06 to 0.31). Further, the patients regarded the behavioral experiment as a more beneficial and acceptable intervention strategy than verbal feedback.

Adolescent↗

PubMed2006

An investigation of interpretive bias in insomnia: an analog study comparing normal and poor sleepers.

STUDY OBJECTIVES: Cognitive theories state that psychological disorders are associated with, and are possibly maintained by, interpretive biases, which are tendencies to make threatening interpretations of ambiguous stimuli. Recent models of insomnia have highlighted the importance of cognitive processes. The aim of this study was to empirically evaluate whether an interpretive bias is present in poor sleepers. DESIGN: A mixed-design analysis of covariance was employed with group (normal sleepers vs poor sleepers) as a between-subjects variable and sentence type (insomnia-related vs anxiety related) as a within-subjects variable. The dependent variables were the extent to which participants interpreted insomnia-related and anxiety-related sentences as having a threatening meaning. Sleepiness was used as a covariate. SETTING: Treatment and research clinic at a university department of psychiatry. PARTICIPANTS: Forty-one normal and 34 poor sleepers. MEASUREMENTS AND RESULTS: A set of ambiguous scenarios were administered to participants who gave open-ended and forced-choice interpretations of the scenarios. Each scenario could be interpreted in a threat (insomnia or anxiety)-related or neutral manner. Even after controlling for sleepiness, poor sleepers were found to make significantly more threat-related interpretations of ambiguous scenarios than did normal sleepers. CONCLUSIONS: These findings suggest that there is a bias toward threat-related interpretations among poor sleepers and that the exploration of biased interpretations may be an important avenue for future research among individuals who meet full diagnostic criteria for insomnia.

Adolescent↗

PubMed2006

Daytime functioning in primary insomnia: does attentional focus contribute to real or perceived impairment?

A study was conducted to test the proposal that self-focused attention or monitoring exacerbates the perception of poor daytime functioning in the absence of objective deficits among individuals with insomnia. Fifty-one participants meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for primary insomnia were randomly assigned to a self-focus group (viewing themselves on a TV monitor), a monitoring group (instructed to focus on their thoughts, body sensations, mood, and performance), or a no instruction group while completing a battery of neuropsychological tests. The results indicated that all participants performed within published normative ranges on all tests. The groups did not differ on their objective test performance, but the self-focus group perceived their performance on the tests as significantly worse than the no instruction group. These findings suggest that self-focused attention may contribute to perceived impairment in daytime functioning in primary insomnia.

Activities of Daily Living↗

PubMed2005

Traumatic brain injury, dissociation, and posttraumatic stress disorder in road traffic accident survivors.

This study investigated the symptom profiles of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in participants who did and did not sustain traumatic brain injury (TBI), following a road traffic accident. The participants were assessed at three time points: as soon as possible posttrauma as well as at 6 weeks and 3 months posttrauma. At the first assessment, fewer participants from the TBI group recalled feeling fear and helplessness at the time of the trauma, fewer TBI participants reported recurrent intrusive thoughts and images, and more TBI participants reported dissociation since the trauma, relative to the non-TBI group. At the second assessment, fewer participants from the TBI group recalled feeling intense helplessness at the time of the trauma. Fewer TBI participants also reported reliving and physiological reactions on trauma reminders relative to the non-TBI group. At 3 months posttrauma, there was no difference in PTSD symptom profile between non-TBI and TBI groups. Our findings indicate that the presence of TBI is likely to influence the distribution of certain symptoms, but need not be a significant barrier to diagnosing ASD and PTSD.

Accidents, Traffic↗

PubMed2005

Misperception of sleep can adversely affect daytime functioning in insomnia.

This experiment was designed to investigate the relationship between subjective perception of sleep and daytime processes in primary insomnia. Twenty-two individuals with primary insomnia received positive or negative feedback about their sleep, immediately on waking, on three consecutive mornings. The positive feedback was that last night's sleep was good quality. The negative feedback was that last night's sleep was poor quality. Objective sleep on each of the three nights was estimated by actigraphy and did not differ across the three nights or the two feedback conditions. Negative feedback (based on 32 nights of data) was associated with more negative thoughts, sleepiness, monitoring for sleep-related threat, and safety behaviours during the day, relative to positive feedback (based on 34 nights of data). These results indicate that the impaired daytime functioning reported by insomnia patients is maintained, at least in part, by subjective perception of sleep.

Adolescent↗

PubMed2005

Attempts to control unwanted thoughts in the night: development of the thought control questionnaire-insomnia revised (TCQI-R).

The attempted control of intrusive, uncontrollable thoughts has been implicated in the maintenance of a range of psychological disorders. The current paper describes the refinement of the Thought Control Questionnaire Insomnia (TCQI; Behav. Cogn. Psychoth. 29 (2001)) through its administration to a sample (n=385) including good sleepers and individuals with insomnia. Several items with poor psychometric properties were discarded, resulting in a 35-item revised TCQI. Factor analysis revealed six factors; aggressive suppression, cognitive distraction, reappraisal, social avoidance, behavioural distraction, and worry. The attempted management of unwanted thoughts was compared across individuals with insomnia and good sleepers, and the impact of these strategies on sleep quality, anxiety and depression was investigated. With the exception of cognitive distraction, individuals with insomnia, relative to good sleepers, more frequently used every thought control strategy. The strategies of aggressive suppression and worry, in particular, appeared to be unhelpful, with the use of these strategies predicting sleep impairment, anxiety and depression. The strategy of cognitive distraction appeared to be helpful, with the use of this strategy predicting better sleep quality.

Adaptation, Psychological↗

PubMed2005

Cognitive approaches to insomnia.

Cognition is a broad term that refers to all mental activities and encompasses attention, perception, memory, reasoning, beliefs, attributions and expectations. The aim of the present paper is to draw together the major research findings relating to the importance of cognition in insomnia. Although the research to date has tended to focus on the role of unwanted intrusive thought (also known as worry or cognitive arousal), there is evidence that a broad range of cognitive processes are important for a full understanding of insomnia. These include beliefs, attributions, expectations, perception and attention. The treatment implications of this evidence are discussed, as are priorities for future research.

Anxiety↗

PubMed2005

Sleep-related functioning in euthymic patients with bipolar disorder, patients with insomnia, and subjects without sleep problems.

OBJECTIVE: The authors investigated sleep-related functioning in euthymic patients with bipolar disorder. METHOD: Euthymic patients with bipolar disorder (N=20), patients with insomnia (N=20), and subjects with good sleep (N=20) were compared on data from interviews and questionnaires and on findings from eight consecutive days and nights of sleep diary keeping (subjective sleep estimate) and actigraphy (objective sleep estimate). RESULTS: Seventy percent of the euthymic patients with bipolar disorder exhibited a clinically significant sleep disturbance. Compared with the other groups, the bipolar disorder group exhibited impaired sleep efficiency, higher levels of anxiety and fear about poor sleep, lower daytime activity levels, and a tendency to misperceive sleep. The bipolar disorder group held a level of dysfunctional beliefs about sleep that was comparable to that in the insomnia group and significantly higher than that in the good sleeper group. CONCLUSIONS: Insomnia is a significant problem among euthymic patients with bipolar disorder. Components of cognitive behavior therapy for insomnia, especially stimulus control and cognitive therapy, may be a helpful adjunct to treatment for patients with bipolar disorder.

Adaptation, Psychological↗

PubMed2005

Time estimation ability and distorted perception of sleep in insomnia.

Although it is an established finding that people with insomnia characteristically overestimate the time they have taken to get to sleep and underestimate the total amount of time they have slept, little is known about the mechanisms that underpin this phenomenon. Accordingly, this study sought to investigate whether the tendency to misperceive sleep among patients with insomnia is accounted for by (a) a general deficit in time estimation ability or (b) the context in which the time estimates are made. Twenty individuals with insomnia and 20 individuals who did not have insomnia were asked to perform two time estimation tasks; one in the laboratory during the day and one in the participant's own bedroom during the night. The two groups were compared with respect to the accuracy of their performance in estimating unfilled temporal intervals of various lengths. The results indicated that the performance of the insomnia group was no different from that of the noninsomnia group, regardless of the context in which the time estimates were made. Time overestimation correlated positively with cognitive and physiological arousal experienced during the time estimation tasks. These findings argue against the hypothesis that individuals with insomnia misperceive their sleep simply because they are poor estimators of time. Future research is required to test the hypothesis that increased cognitive arousal (worry) and physiological arousal are candidate mechanisms that underpin sleep misperception.

Adult↗

PubMed2004

Effects of cognitive arousal and physiological arousal on sleep perception.

STUDY OBJECTIVES: Two experiments were conducted to investigate the effect of presleep arousal on sleep perception. Experiment 1 examined the link between presleep cognitive arousal and distorted perception of sleep and compared the relative effect of anxious and neutral cognitive arousal on sleep perception. Experiment 2 compared the relative effect of anxious cognitive arousal and physiological arousal on sleep perception. DESIGN: Participants completed a nap session. Just prior to the nap, the participants were randomly assigned to 1 of 3 groups to receive different arousal manipulations. They were then allowed to go to sleep and were asked to report their sleep perception upon waking. SETTING: Sleep laboratory. PARTICIPANTS: Fifty-four healthy good sleepers in each experiment. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Self-reported sleep, actigraphy-defined sleep, and the discrepancy between them were indexed. In Experiment 1, participants who were experimentally manipulated to experience anxious cognitive arousal during the presleep period reported longer sleep-onset latency. Both the Anxious Cognitive Arousal Group and the Neutral Cognitive Arousal Group exhibited a greater discrepancy between self-reported and actigraphy-defined sleep, relative to participants who received no manipulation. In Experiment 2, participants who were experimentally manipulated to experience anxious cognitive arousal or physiological arousal during the presleep period reported longer sleep-onset latency and shorter total sleep time, and both groups exhibited a greater discrepancy between the self-reported and actigraphy-defined sleep, relative to participants who received no manipulation. CONCLUSIONS: Results suggest that both presleep cognitive arousal and presleep physiological arousal contribute to distorted perception of sleep.

Adolescent↗

PubMed2004

Integration of psychological and biological approaches to trauma memory: implications for pharmacological prevention of PTSD.

Although memory processes play a central role in both psychological and neurobiological accounts of the development of posttraumatic stress disorder (PTSD), there has been little integration of the two literatures. This paper aims to consider the implications of an integrated account of trauma memory for pharmacological treatments that have been proposed for the prevention of PTSD. The idea of reprocessing trauma memories to bring about recovery, central to the psychological account of PTSD, is translated into terms more familiar in the biological literature using the concept of reconsolidation of active memories. It is suggested that physiological arousal enhances the reprocessing of trauma memories. Drugs that influence arousal may have effects after trauma which depend on the psychosocial context, helping to prevent the development of PTSD in some trauma victims, but impeding recovery in others who would do well without treatment.

Arousal↗

PubMed2004

An investigation of monitoring for sleep-related threat in primary insomnia.

In Study 1, individuals with primary insomnia (n=32) and good sleepers (n=38), recruited from a university population, completed a semi-structured interview. The interview assessed monitoring for sleep-related threat, negative thoughts and safety behaviours, at night and during the day. Compared to good sleepers, individuals with insomnia reported more frequent monitoring at night and during the day, more negative thoughts associated with monitoring at night and during the day, and the use of more safety behaviours associated with monitoring at night. A path analysis showed that the total monitoring frequency was significantly positively related to the score for total negative thoughts, which in turn, was significantly positively related to the total number of safety behaviours used. Study 2 aimed to test the generalisability of these findings in a clinical sample of individuals with primary insomnia (n=23). The results indicated that the clinical sample also engaged in monitoring for sleep-related threat, experienced negative thoughts and used safety behaviours. Further, more severe insomnia was associated with more negative thoughts and the use of more safety behaviours associated with monitoring at night. Together, these results are consistent with the proposal that monitoring for sleep-related threat functions to maintain insomnia by triggering negative thoughts and the use of safety behaviours. Future research is required to verify the proposed causal status of monitoring, using prospective designs and experimental manipulations.

Adaptation, Psychological↗

PubMed2004

Correcting distorted perception of sleep in insomnia: a novel behavioural experiment?

Patients with primary insomnia overestimate their sleep onset latency (SOL) and underestimate their total sleep time (TST). The present study aimed to test the utility of a novel behavioural experiment designed to correct distorted perception of sleep among patients diagnosed with primary insomnia. Individuals with primary insomnia were asked to wear an actigraph and keep a sleep diary for three nights. On the following day, half were shown the discrepancy between the data recorded on the actigraph and their sleep diary (Shown-Discrepancy Group), the other half were not shown the discrepancy (No-Demonstration Group). Participants were then asked to wear the actigraph and keep a sleep diary for three further nights. Following the behavioural experiment, the Shown-Discrepancy Group estimated their SOL more accurately and reported less anxiety and preoccupation about sleep compared to the No-Demonstration Group. The theoretical and clinical implications of these findings are discussed.

Adolescent↗

PubMed2003

Catastrophic worry in primary insomnia.

The present study aimed to provide an empirical test of the proposal that catastrophic worry about the consequences of not sleeping is common among patients with primary insomnia and serves to maintain the sleep disturbance. It was predicted that relative to good sleepers, patients with primary insomnia would catastrophize more and that catastrophizing would be associated with increased negative affect and increased perception of threat. A 'catastrophizing interview' was administered to 30 patients with primary insomnia and 30 good sleepers. Consistent with the predictions, the insomnia patients generated more catastrophes about the consequences of not sleeping and gave higher likelihood ratings than good sleepers. For the insomnia group, but not the good sleepers, the catastrophizing interview was associated with increased anxiety and discomfort. The limitations of the study, possibilities for future research, and clinical implications of these findings are discussed.

Adult↗