Jean R. Eagleston

Sleep disturbance in adolescents: Sleep quality, sleep habits, beliefs about sleep, and daytime functioning

This study examined the prevalence and correlates of sleep disturbance in adolescents. Two hundred seventy-seven 9th- and 10th-grade students completed a questionnaire on sleep quality, sleep habits, beliefs about sleep, and daytime mood and functioning. Based on their responses, subjects were classified as good sleepers (66%), occasional poor sleepers (23%), and chronic poor sleepers (11%). Occasional and chronic poor sleepers reported being significantly more depressed, without energy, tense, moody, and irritable and less rested and alert than good sleepers. They were also more likely to describe themselves negatively. However, poor sleepers were not consistently more tired than good sleepers. Rather, they tended to be least tired in the evening, the time when most good sleepers reported feeling tired. There were few differences in the sleep habits and beliefs about sleep of good and poor sleepers. All subjects reported shifts in bedtimes and waketimes from weekdays to weekends, with occasional and chronic poor sleepers showing a tendency toward greater shifts, a possible factor contributing to their sleep disturbance. Occasional and chronic poor sleepers also reported more observable behaviors and feelings of stress than good sleepers. The need for early intervention with particular attention to teaching adolescents about good sleep habits and the need for stable bedtimes and waketimes and the possibility of joint intervention on daytime stress and sleeping problems are discussed.

Counseling for Health

Good health and chronic diseases exist essentially as matters of habit as well as context in how people routinely go about the business of everyday living. Recently the crucial roles of behavioral, cognitive, and environmental factors in health and disease have been recognized, giving rise to the new fields of health psychology and behavioral medicine. The growing complexities involved yield a host of conceptual, methodological, and clinical problems. Examples include narrow definitions of health and disease, abuse of statistical significance testing in research, and confusing conceptualizations of chronic stress. To illustrate treatment possibilities, several ongoing broadly based intervention programs in the cardiovascular disease area are discussed. The many ways in which counseling psychologists might participate in problem areas in the health field clearly offer exciting challenges and opportunities.

Physical health correlates of type A behavior in children and adolescents.

A physical examination including resting blood pressure, heart rate, Tanner scales, height, and weight was administered to 184 students in the fifth, seventh, and ninth grades. They completed the Physical Symptoms of Stress Inventory, Health Habits Inventory, and two self-monitoring logs of physical symptoms. School absenteeism, medical records, physician ratings, and family health history data were collected. No significant differences between high-and low-Type A behavior pattern (TABP) subjects were found on any of the physical measurements. However, retrospective and prospective reports of physical symptoms revealed a consistent pattern: high TABP subjects reported significantly more physical symptoms than low-TABP subjects. Self-ratings of stress and tension were significantly higher for high-TABP subjects. High-TABP subjects, however, neither missed more school because of illness nor used physician services more often than low subjects. Further, expected relationships between physical symptoms and illness behavior, including school absence, were evident only for low subjects.

Chronic Stress in Children and Adolescents.

portant consequences of experiencing prolonged chronic stress for students in the educational system, from preschool to graduate school. A host of health and disease processes as well as outcomes appear to be intimately tied with the experience of prolonged stress, both in terms of short-term effects and long-term, lifetime consequences. After discussing what stress is, we present some consequences of chronic stress for children and adolescents, followed by discussions of demands and resources as they relate to helping students handle demands more effectively.

Brief consultation and stress management treatments for drug-dependent insomnia: Effects on sleep quality, self-efficacy, and daytime stress

Brief consultation and stress management treatments to help insomniacs withdraw from sleep medication were evaluated with 12 drug-dependent women. The effects of treatment were assessed by all-night home polysomnographic recordings and questionnaires. All 12 subjects succeeded in withdrawing from sleep medication and showed a number of improvements independent of the treatment received: (a) decreased latency to sleep onset, (b) increased minutes of Stage 3 sleep and total slow-wave sleep, (c) increased self-efficacy, and (d) reductions in some types of daytime stress. Subjects in the stress management treatment compared to those in the brief consultation program showed (a) significantly greater improvement on latency to sleep onset, total wake time, total dark time, and sleep efficiency, (b) less of an increase in minutes awake after sleep onset, and (c) greater reductions in anger and depression. Results of 6- and 12-month follow-up and partial replication of the brief consultation program are reported.

Approaches to altering the Type A behavior pattern

Abstract The Type A behavior pattern, a risk factor for coronary heart disease, is described in terms of the expanded cognitive social learning model that takes into account the interdependent influences of behavioral, environmental, cognitive, and physiologic components. Six studies aimed at altering the behavior pattern are discussed in light of this conceptual framework. Among the issues involved in designing and conducting treatment programs are the targets of behavior (e.g., impatience or hostility) for change; the type of client populations to treat (e.g., teenagers, post-coronary patients); and treatment techniques (e.g., relaxation procedures, cognitive restructuring, mass media programs).

Emotional and temperamental correlates of Type A in children and adolescents

Emotional and behavioral correlates of Type A behavior in children and adolescents were examined in 184 fifth-, seventh-, and ninth-grade students, classified as high or low Type A, using self-report, teacher ratings (fifth grade only), and structured interview procedures. Measures included the Hunter-Wolf A-B Rating Scale, Behavioral Symptoms of Stress Inventory, Dimensions of Temperament Survey, Desire for Control Scale, Eysenck Personality Inventory, and the Multiple Affect Adjective Checklist. High Type A children reported significantly more stressed-related behaviors, higher levels of depression, anger, anxiety, and cognitive disorganization, and greater reactivity than Low Type A. No differences were found on measures of temperament (activity level, attention span, adaptibility, and rhythmicity), desire for control, or introversion-extroversion. Females, in general, reported significantly more behavioral stress symptoms. However, no other gender differences were found. Possible reasons for reported differences between Type A children and adults are discussed, along with gender differences in behavioral symptoms. Need for multiple measures of Type A across situation is considered along with need for controlled longitudinal studies of Type A components and the influence of contexts.

Developing Measures of Type A Behavior in Children and Adolescents

Development of measures of Type A behavior in children and adolescents is described and the results of two studies to validate these measures are given. Children in the fifth, seventh, and ninth grades (n = 120 in Study I; n = 652 in Study II) were given five measures of the Type A Behavior Pattern (TABP): the Student Type A Behavior Scale (STABS); Student Structured Interviews (SSI), scored separately for content and behavior; Matthews Youth Test for Health (MYTH); and Parent Observation Checklist, as well as measures of state anxiety, trait anxiety, and depression. Descriptive statistics from the two samples were very similar and indicated that boys scored significantly higher than girls on the MYTH, while seventh and ninth grade girls scored significantly higher than fifth grade girls or boys of any grade on Structured Interview Behavior (SSI-Behavior). Correlations suggested separate self-reported perceptual and behavioral components of Type A behavior in children. In both studies, STABS and SSI-Content correlated moderately well (.48 to .49) but had little relationship with SI-Behavior and the MYTH. Measures of anxiety and depression included to assess discriminant validity were correlated with the self-report measures of TABP (.22 to .56), but showed little relationship with the behavioral measures, especially in the larger cross-validation study. Parallels between these results and those of adult studies are discussed, and the use of multiple measures in classifying subjects is suggested.