Kristen C. Stone

Anhedonia and amotivation in psychiatric outpatients with fully remitted stimulant use disorder.

This study evaluated whether psychiatric outpatients with a past stimulant use disorder in full remission for >/= 2 months (STIM+, n = 204) and those with no history of stimulant use disorder (STIM-, n = 2070) differed in the prevalence of current anhedonia and amotivation. Results showed that a significantly greater proportion of STIM+ participants reported anhedonia and amotivation than STIM- participants. The relation between stimulant use disorder history and anhedonia remained robust after controlling for other relevant clinical and demographic factors. These findings suggest that anhedonia may be a preexisting risk factor or protracted effect of stimulant misuse.

Psychometric evaluation of the Beck anxiety inventory: a sample with sleep-disordered breathing.

This study aimed to document the psychometric properties of the Beck Anxiety Inventory (BAI) within a population with sleep-disordered breathing (SDB), given concerns about overlapping symptomatology between anxiety and sleep apnea. Results supported good internal consistency and convergent and discriminant validity for the BAI and a single-factor solution for men, women, and the total sample. Women had higher scores than men, and discriminant analyses differentiated men from women based on item responses. The BAI has acceptable reliability and validity within a SDB population, supporting its use as a gauge of anxiety severity in individuals with SDB. This is a preliminary study to measure anxiety severity in SDB; future research is needed to determine the utility of the BAI as a diagnostic screener.

Sleep problems in children with prenatal substance exposure: the Maternal Lifestyle study.

OBJECTIVE To examine the associations between sleep problems and prenatal exposure to cocaine, opiates, marijuana, alcohol, and nicotine in children aged 1 month to 12 years. DESIGN Sleep data were collected by maternal report in a prospective longitudinal follow-up of children participating in the Maternal Lifestyle multisite study. SETTING Hospital-based research centers in Providence, Rhode Island; Miami, Florida; Detroit, Michigan; and Memphis, Tennessee. PARTICIPANTS There were 808 participants, 374 exposed to cocaine and/or opiates, and 434 comparison subjects. MAIN EXPOSURE Prenatal cocaine, opiate, marijuana, alcohol, and/or nicotine exposure. OUTCOME MEASURE Sleep problems in early, middle, and/or late childhood, assessed as composites of maternal report items. RESULTS Of the 5 substances, prenatal nicotine exposure was the only unique predictor of sleep problems (B = 0.074, R(2) change = 0.008, P = .01), with adjustment for covariates, including socioeconomic status, marital status, physical abuse, prenatal medical care, and postnatal cigarette smoke exposure. CONCLUSIONS Prenatal exposure to nicotine was positively associated with childrens sleep problems persisting throughout the first 12 years of life. Targeting of this group of children for educational and behavioral efforts to prevent and treat sleep problems is merited given that good sleep may serve as a protective factor for other developmental outcomes.

Longitudinal study of maternal report of sleep problems in children with prenatal exposure to cocaine and other drugs.

Sleep data were collected by maternal report in a prospective longitudinal follow up of cocaine-exposed and unexposed children. There were 139 participants: 23 with no prenatal drug exposure, 55 exposed to cocaine alone or in combination with other drugs, and 61 exposed to drugs other than cocaine. Characteristics differed between exposure groups including birth size, caretaker changes, maternal socioeconomic status, and postnatal drug use. Compared to those with no drug exposure, children with prenatal drug exposure other than cocaine experienced greater sleep problems (p = .026). Prenatal nicotine exposure was a unique predictor of sleep problems (p = .048). Early sleep problems predicted later sleep problems (all ps < .01). Together, these preliminary findings suggest possible neurotoxic sleep effects that persist over time. Larger studies, however, need to be conducted that better control for potential postnatal confounding factors.

Poor actigraphic and self-reported sleep patterns predict delinquency and daytime impairment among at-risk adolescents

OBJECTIVE To evaluate associations between actigraphic sleep patterns, subjective sleep quality, and daytime functioning (ie, sleepiness, symptoms of depression, and delinquency and other conduct problems) in at-risk adolescents. DESIGN Prospective, observational cohort study. SETTING Providence, RI, predominantly home and school and 2 visits to the Brown Center for the Study of Children at Risk. PARTICIPANTS A diverse group of low-income 13-year-olds (n = 49) with and without prenatal drug exposure. INTERVENTIONS None. MEASUREMENTS Actigraphy, sleep diaries, and sleep and health questionnaires. RESULTS Above and beyond the effects of prenatal drug exposure and postnatal adversity, actigraphic daytime sleep was a significant predictor of daytime sleepiness and delinquency. Subjective sleep quality was a significant predictor of daytime sleepiness, delinquency, and depressive symptoms. Later bed times predicted increased delinquency. CONCLUSIONS There was a unique effect of actigraphic daytime sleep duration, subjective nighttime sleep quality, and bedtime on daytime functioning (ie, sleepiness, symptoms of depression, and delinquency and other conduct problems) of at-risk adolescents. In these vulnerable youth, these problematic sleep patterns may contribute to feeling and behaving poorly. Intervention studies with at-risk teens should be conducted to further explore the role of these sleep parameters on daytime functioning.