Catherine Schuman

Competencies for psychology practice in primary care.

This article reports on the outcome of a presidential initiative of 2012 American Psychological Association President Suzanne Bennett Johnson to delineate competencies for primary care (PC) psychology in six broad domains: science, systems, professionalism, relationships, application, and education. Essential knowledge, skills, and attitudes are described for each PC psychology competency. Two behavioral examples are provided to illustrate each competency. Clinical vignettes demonstrate the competencies in action. Delineation of these competencies is intended to inform education, practice, and research in PC psychology and efforts to further develop team-based competencies in PC.

Restless legs syndrome in pediatric patients with chronic kidney disease

Sleep disorders have been shown to be more prevalent in adults and children with chronic kidney disease (CKD) and on dialysis. To date, the prevalence and impact of restless legs syndrome (RLS) in various stages of CKD has not been evaluated. The object of this study was to determine the prevalence of RLS in children with CKD in different stages, and to evaluate its impact on sleep and daytime functioning. We conducted a clinic-based or telephone survey of 26 patients in varying stages of CKD to assess for RLS, sleep schedule, and daytime sleepiness. Thirty-five percent of children met criteria for RLS, the majority being in CKD stages 1–4. There were no significant differences seen in sleep schedule and daytime sleepiness between those children with or without RLS. We found that there is an increased prevalence of RLS in children with CKD compared to the general population. This suggests that children with all stages of CKD should be routinely screened for RLS symptoms.

Excessive daytime sleepiness among attending physicians: A pilot survey study at an academic institution

The purpose of this study is to assess excessive daytime sleepiness (EDS) among attending physicians. Emails with an embedded link to an IRB approved questionnaire were sent to attending physicians of two closely affiliated academic institutions. An online hospital directory was used to compile a list of active attending physicians who practiced clinical medicine. Two additional reminder emails, about 2 weeks apart, were also sent. Data were collected anonymously and participation was voluntary. Three hundred fifteen responses out of 506 emails were returned (responder rate of 62.2%). The average age was 47 years and the majority was married with children. The mean Epworth Sleepiness Scale score was six and only 50 (15.9%) physicians were sleepy with a score of >10. Only working longer hours (p=0.014), habitual napping (p=0.01) and the feeling of not getting enough sleep (p=0.01) significantly correlated with daytime sleepiness. Hours at work, however, did not correlate with hours of sleep, and the latter surprisingly did not correlate with sleepiness. Physicians in our sample were slightly more sleep deprived than the general population but not as sleep deprived as resident physicians.

Preparing Psychologists in Academic Health Centers for the Rapidly Changing Health Care Environment

The Association of Psychologists in Academic Health Centers (APAHC) convened its 5th National APAHC Conference in Boston March 3–5 2011. The conference and its theme, “Preparing Psychologists for a Rapidly Changing Health Care Environment,” brought psychologists from academic health centers together to examine how psychology can adapt to and help lead health care efforts in the face of health care reform. This paper reports on the conference and introduces the special issue of JCPMS that is dedicated to the conference. The conference theme is framed in the historical context of the four national conferences that preceded it. In examining the focus and topics of the preceding conferences, recurrent themes are identified and progress in certain areas is highlighted.

Disturbances of sleep perception in a group of multiple sclerosis patients: A case report

Sleep misperception, whether severe enough to qualify as paradoxical insomnia or not, is common in a number of neurological and psychiatric conditions. The objective was to assess sleep perception in a group of multiple sclerosis (MS) patients. As part of an Institutional Review Board (IRB) approved trial designed to assess the efficacy of eszopiclone versus placebo in improving MS patients’ sleep continuity, we observed a pattern of both paradoxical and reverse paradoxical insomnia in a small number of participants. Eight participants (26.7%) had some degree of misperception at some point during the study. Six (20%) had reverse paradoxical insomnia and two (6.7%) had paradoxical insomnia. This is a preliminary observation that we hope will increase awareness of the condition of misperception of sleep in subjects with MS. (Clin. Exp. Neuroimmunol. doi: 10.1111/j.1759‐1961.2010.00012.x, 2010)

Insomnia and Pain Disorders

During the past decade there has been an increasing interest on the impact and interaction of pain and sleep disturbance. This chapter will present an overview of the growing literature on pain and insomnia, as well as a brief review of cognitive behavioral treatment options. In the United States, 15-20% of the population experiences acute pain and 25-30% experiences chronic pain. Almost a third adults experience at least one symptom a few nights or more per week according to the National Sleep Foundation’s 2005 Sleep in America poll It has been conservatively estimated that 28 million Americans experience sleep complaints in the context of a chronically painful condition. The pathophysiology of either condition and especially the comorbidity of the two have been poorly studied so have therapeutic interventions. Given the immense impact of sleep and pain on individual’s and society, there is a need to further understand and explore the pathways of sleep disturbance and pain.