Kenneth Macmahon

Who is pre-occupied with sleep? A comparison of attention bias in people with psychophysiological insomnia, delayed sleep phase syndrome and good sleepers using the induced change blindness paradigm

Cognitive models of insomnia suggest that selective attention may be involved in maintaining the disorder. However, direct assessment of selective attention is limited. Using the inducing change blindness (ICB) paradigm we aimed to determine whether there is attentional preference for sleep‐related stimuli in psychophysiological insomnia (PI) relative to delayed sleep phase syndrome (DSPS) and good sleepers (GS). In the ICB task, a visual scene, comprising both sleep‐related and neutral stimuli, ‘flickers’ back and forth with one element (sleep or neutral) of the scene changing between presentations. Therefore, a 2u2003×u20033 totally between‐participants design was employed. The dependent variable was the number of flickers it took for the participant to identify the change. Ninety individuals (30 per group) were classified using ICSD‐R criteria, self‐report diaries and wrist actigraphy. As predicted, PI detected a sleep‐related change significantly quicker than DSPS and GS, and significantly quicker than a sleep‐neutral change. Unexpectedly, DSPS detected a sleep‐related change significantly quicker than GS. No other differences were observed between the two controls. These results support the notion that there is an attention bias to sleep stimuli in PI, suggesting that selective attention tasks such as the ICB may be a useful objective index of cognitive arousal in insomnia. The results also suggest that there may be an element of sleep preoccupation associated with DSPS. Results are discussed with reference to other experiments on attentional processing in insomnia.

Interpersonal Sources of Conflict in Young People with and without Mild to Moderate Intellectual Disabilities at Transition from Adolescence to Adulthood

BACKGROUNDnInterpersonal conflict is a source of stress and contributes to poor mental health in people with mild to moderate intellectual disabilities. Understanding the contexts in which conflict typically occurs can better equip services to help people with such difficulties. However, existing studies into the contexts of conflict have included participants with wide-ranging ages and may not reflect the experiences of young adults in particular.nnnMATERIALS AND METHODSnTwenty-six young adults (16-20 years) with intellectual disabilities and 20 non-disabled young adults completed a semi-structured interview about a recent experience of interpersonal conflict. Participants were asked to describe their beliefs and feelings about the event and their subsequent response.nnnRESULTSnParticipants with intellectual disabilities were more likely to encounter conflict with strangers or peers outside their friendship group and to describe incidents of aggression than non-disabled participants. They were also more likely to characterize the other person globally as bad and to perceive the others actions as being personally directed at them. Young women with intellectual disabilities were less likely to describe responding aggressively to incidents.nnnCONCLUSIONSnFindings suggest that young adults with intellectual disabilities are often the target of overt aggression from those outside their inner social sphere, while their non-disabled peers are more likely to experience conflict with people close to them. Young adults with intellectual disabilities may also be more likely to feel victimized by interpersonal conflict. Implications of these findings and limitations of the study are discussed.

The Social Information Processing Model as a Framework for Explaining Frequent Aggression in Adults with Mild to Moderate Intellectual Disabilities: A Systematic Review of the Evidence

BACKGROUNDnThere is an established evidence base con-cerning the use of anger management interventions with violent offenders who have intellectual disabilities. However, there has been limited research investigating the role of social cognitive factors underpinning problems of aggression. Psychosocial sources of agg-ression in the non-disabled population are generally discussed using Social Information Processing (SIP) models.nnnMETHODnA systematic review of the available evidence was carried out to establish whether SIP offers a useful explanatory model for understanding the contribution of social cognitive factors to problems of aggression presented by people with intellectual disabilities.nnnRESULTS AND CONCLUSIONSnWhilst research relating to the SIP model remains sparse for this population, there was evidence for different patterns of processing between aggressive and non-aggressive individuals. Group diff-erences included interpretation of emotional cues, inter-personal attributions and beliefs about the outcomes of aggressive behaviour. The future direction of SIP research with people who have intellectual disabilities is discussed, along with the possibility of using this framework to help build on current initiatives to develop individually tailored interventions to work at a cognitive level with those who are aggressive and offend.

From Causes of Aggression to Interventions: The Importance of Context

Abstract This chapter reviews several strands from recent research concerning the causes of aggression, including neurological and psychosocial factors. There is some support for the commonly held assumptions linking aggressiveness and social-cognitive problems associated with people’s cognitive deficits. However, this explanation fails to account for the fact that most people with intellectual disabilities are not aggressive. There is a significant danger in simplifying the aggressive behavior of people with intellectual disabilities to a single causative factor. Even if one factor was found to predispose an individual to be aggressive, it is improbable that the other aspects of a person’s life (such as the social and environmental context in which they live) would not also influence the individual’s actions. Moreover, there are different kinds of aggression, including acts that are categorized as reactive and instrumental or planned. An interaction of cognitive, communicative, genetic, and sociocultural factors may influence aggressive behavior. However, aggression is usually a social act and concerns the dynamic relationship between the person and his or her social environment. This means taking seriously how more able people negotiate their social identities in the world and how those with more significant impairments communicate their needs and wishes. Although there is limited evidence for the effectiveness of pharmacological treatments, there are promising findings for the use of behavioral approaches for people with more severe impairments and anger management treatments for those with milder disabilities. In addition to individual interventions, recent attempts have also been made to foster positive change in individuals’ wider lives. It is proposed that promoting a formulation-based approach to interventions might help professionals to take account of the range of intrapsychic and interpersonal factors that can contribute to the person’s difficulties.

Information processing bias in insomnia: research evidence and implications for therapy

Objective: Does snoring during pregnancy influence development of pre-eclampsia?Method: Five hundred and three pregnant women were presented a questionnaire concerning snoring, daytime sleepiness a ...withdrawn O141 Sleep-wake cycle in ballet dancers M. GLOS, T. PENZEL, J. STRAUCH, C. THEOBALD and I. FIETZE Interdisciplinary Center of Sleep Medicine, Charité-Universitaetsmedizin Berlin, Berlin, Germany and Staatsballett Berlin, Berlin, Germany Introduction: Ballet dancers are top athletes and artists with extreme demands on their body and intellectual functions. In this group a normal work schedule on a weekly basis is absent and moreover, half of the week working days last until late evenings. Methods: We investigated the sleep-wake cycle over a period of three months prior to a premiere of a new performance by using actigraphy in 28 (17w, 11 m) ballet dancers (mean age 27 5 years, BMI 19 2) of the ‘‘Staatsballett Berlin’’, a big independent ballet institution of the three institutionalized opera houses in Berlin, Germany. Before starting the actigraphy recording (Actiwatch, Cambridge Neurotechnology Ltd, Cambridge, UK) which was accompanied by filling in activity diaries and sleep logs on a daily basis, a physical examination as well as a sleep medical examination and ambulatory polygraphy (Embletta PDS, Embla Systems, Broomfield, CO, USA) was performed. Results: Out of the 28 ballet dancers who were included, 24 of them completed the study after three months. Altogether we found a regular sleep-wake cycle but no circaseptan rhythm in this population. In addition a delayed sleep phase was predominant. In the course of three month the sleep efficacy (SE) was reduced significantly (82 to 77 percent, Po0.01) without changes in the amount of movements and total sleep time (TST) during the night. These findings were independent of the gender of the ballet dancers. The parameters SE and TST are generally lower than in the general age matched German population. These results were accompanied by diminished mental health scores (SF12 questionnaire) and diminished concentration capabilities (d2 test). Conclusion: The preparation time of a new performance in the course of three month caused additional stress in the investigated ballet dancers which was apparent in a diminished sleep quality. In order to guarantee a good status of health and the high degree of physical and mental capability a good management of rest and a activity is needed. As a consequence a dedicated room for rest has been installed at the opera for the ballet dancers. r 2008 European Sleep Research Society, JSR 17 (Suppl. 1), 1–271 Spotlight on Circadian Clock Works On and Off Stage 81

From causes of aggression to interventions

Abstract This chapter reviews several strands from recent research concerning the causes of aggression, including neurological and psychosocial factors. There is some support for the commonly held assumptions linking aggressiveness and social-cognitive problems associated with people’s cognitive deficits. However, this explanation fails to account for the fact that most people with intellectual disabilities are not aggressive. There is a significant danger in simplifying the aggressive behavior of people with intellectual disabilities to a single causative factor. Even if one factor was found to predispose an individual to be aggressive, it is improbable that the other aspects of a person’s life (such as the social and environmental context in which they live) would not also influence the individual’s actions. Moreover, there are different kinds of aggression, including acts that are categorized as reactive and instrumental or planned. An interaction of cognitive, communicative, genetic, and sociocultural factors may influence aggressive behavior. However, aggression is usually a social act and concerns the dynamic relationship between the person and his or her social environment. This means taking seriously how more able people negotiate their social identities in the world and how those with more significant impairments communicate their needs and wishes. Although there is limited evidence for the effectiveness of pharmacological treatments, there are promising findings for the use of behavioral approaches for people with more severe impairments and anger management treatments for those with milder disabilities. In addition to individual interventions, recent attempts have also been made to foster positive change in individuals’ wider lives. It is proposed that promoting a formulation-based approach to interventions might help professionals to take account of the range of intrapsychic and interpersonal factors that can contribute to the person’s difficulties.

Attentional bias for sleep-related stimuli and the transition from acute to persistent insomnia: Results from some recent experiments

withdrawn Abstracts of the ESRS, Prague 2004 1 2004 European Sleep Research Society, JSR 13 (Suppl. 1), 1