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ObjectiveThis study examined sleep disorders and sleep medication use rates, nighttime tics, and sleep and chronotype in relation to tic and co-occurring symptoms in adults with persistent tic disorders (PTDs), including Tourette's disorder (TD).MethodsOne hundred twenty-five adult internet survey respondents rated sleep history, sleep, chronotype, tic severity, impairment, attention deficit hyperactivity disorder, obsessive-compulsive symptoms, anxiety, depression, and emotional and behavioral dyscontrol.ResultsBruxism, insomnia, tic-related difficulty falling asleep, and melatonin use were commonly endorsed. Sleep disturbance correlated with impairment, obsessive-compulsive symptoms, and emotional and behavioral dyscontrol. Eveningness correlated with vocal and total tic severity only in TD. Controlling for age and sex, age, impairment, and obsessive-compulsive symptoms predicted sleep disturbance, and age and tic severity predicted chronotype.ConclusionsImpairment and obsessive-compulsive symptoms play a role in sleep disturbance in adults with PTDs, and may be intervention targets. Eveningness relates to tic severity, which may suggest the utility of interventions to advance chronotype.

BackgroundSleep disturbance is common among individuals with Tourette's Disorder (TD). Given that sleep is influenced by the circadian system, this study examined circadian rhythms and sleep in adults with TD, and explored the possible benefit of short-wavelength wearable morning light therapy.MethodsParticipants were 34 adults with TD (n = 14) and age- and sex-matched healthy controls (HC; n = 20). Participants were screened using clinician-rated diagnostic and tic severity interviews, and procedures lasted 3 consecutive weeks. Participants completed a baseline week of actigraphy. Adults with TD completed 2 weeks of Re-Timer™ morning light therapy and continued actigraphy monitoring. Dim light melatonin-onset (DLMO) phase assessment, tic severity interview, and measures of chronotype, sleep disturbance, daytime sleepiness, disability, depression, anxiety, and stress were completed at baseline and post-intervention.ResultsAdults with TD reported significantly greater eveningness and sleep disturbance relative to controls. Per wrist actigraphy, adults with TD exhibited significantly longer sleep-onset latency, lower sleep efficiency, and greater sleep fragmentation than HC. Following morning light therapy, there was a significant advance in DLMO phase, but not self-report or actigraphy sleep variables. There were small, statistically significant decreases in tic severity and impairment. There were also significant reductions in daytime sleepiness, and self-reported anxiety, but not depression, stress, or disability. Participants reported minimal side effects and rated light therapy as acceptable and comfortable.ConclusionsFindings showed some benefits following brief light therapy in TD; further exploration of the impact of spectral tuning the photic environment as part of treatment for TD subjects is warranted.

Recently, there has been increasing recognition that individuals with heightened repetitive negative thinking and anxiety often experience disruptions in their sleep and circadian rhythms. However, the mechanisms of this relation require further study. The primary aim of this study is to identify whether emotional reactivity is related to sleep in individuals with repetitive negative thinking. Fifty-two individuals selected for high levels of transdiagnostic repetitive negative thinking and varying amounts of sleep disruption were included in the study sample. Participants passively viewed emotionally-valenced (positive and negative) and neutral images. Some of these images had been previously-seen by participants and others were novel. Participants' pupil diameter was measured as they viewed the images and they also rated their subjective reaction to these images. Poorer sleep quality was significantly associated with less pupil dilation in response to all novel stimuli (i.e., collapsing across emotion). Shorter habitual sleep duration and longer sleep onset latency were associated with lower subjective unpleasantness when viewing all study stimuli (i.e., collapsing across novelty and emotion). These findings were consistent with the possibility that sleep disturbance may be related to repetitive negative thinking through differences in emotional reactivity. Sleep disturbance has been associated with blunted responses to emotional stimuli in other samples. Future studies examining mechanisms and moderators of increased and blunted emotional response related to sleep disturbance are needed., Author(s): Jacob A. Nota [sup.1] [sup.2] , Jeremy V. Hermanson [sup.3] , Meredith E. Coles [sup.1] Author Affiliations: (1) grid.264260.4, 0000 0001 2164 4508, Department of Psychology, Binghamton University, , [...]

The present study examined rates of sleep disorders and sleep medication use, and predictors of sleep disturbance in children with persistent tic disorders (PTD). Sixty-three parents of children aged 10-17 years with PTDs completed an internet survey evaluating sleep patterns and clinical symptoms. Insomnia (19.4%), nightmares (16.1%), and bruxism (13.1%) were the most commonly reported lifetime sleep disorders. Fifty-two percent endorsed current sleep medication use. Higher ADHD severity, overall life impairment, and female sex predicted greater sleep disturbance. Findings suggest the utility of clinical management of co-occurring ADHD and impairment to mitigate sleep disturbance in children with PTDs. [ABSTRACT FROM AUTHOR]

The goal of the current study was to examine environmental and genetic correlates of children's levels of behavioral inhibition (BI). Participants were 100 mother child pairs drawn from the community who were part of a larger study of the intergenerational transmission of depression. Results indicated that higher levels of maternal overprotection, as reported by the child, were associated with elevations in BI among children carrying two copies of the lower expressing 5-HTTLPR alleles (S or LG), but not among those carrying only one copy or those homozygous for the LA allele. In addition, this interaction was specific for the social component of BI, not the nonsocial component. This relation was maintained even after statistically controlling for children's and mother's psychopathology. Together, these findings add to emerging research demonstrating that G x E interactions predict variation in BI during childhood.

Inflated responsibility beliefs are hypothesized to be a central feature of obsessive-compulsive disorder (OCD; Rachman, 1998, 2002; Salkovskis, 1985), but the etiology of these beliefs remains untested. Salkovskis and colleagues (1999) proposed 5 primary pathways to the development of inflated responsibility beliefs (e.g., heightened responsibility as a child, exposure to rigid and extreme codes of conduct as a child). The current paper presents 2 studies developing a self-report measure--the Pathways to Inflated Responsibility Beliefs Scale (PIRBS)--of these hypothesized pathways. In the first study, an initial version of the scale is developed and the number of items are reduced. In the second study, the revised scale is shown to provide a reasonable match to the proposed structure and to have good internal consistency, retest reliability, and convergent and divergent validity. These initial data suggest that the PIRBS may be useful for studying the etiology of inflated responsibility beliefs that are hypothesized to be central to the development of OCD. Limitations and future directions are discussed. (Contains 3 tables and 1 figure.)

Cognitive-behavioral conceptualizations of obsessive compulsive disorder (OCD) have predominantly viewed compulsions as being motivated by harm avoidance. However, sensations of things being incomplete or not "just right" may also underlie compulsions in OCD. Preliminary research suggests that distinguishing between harm avoidance and incompleteness in OCD may have practical utility, but the research on this topic is very limited to date. The current study further addressed the role of incompleteness in OCD. A confirmatory factor analysis provided evidence for harm avoidance and incompleteness as separate constructs in a student sample. Supporting the benefits of considering incompleteness in addition to harm avoidance, self-reported levels of both constructs were significantly correlated with all domains of OCD symptoms and perfectionism assessed. Further, some evidence for unique relationships was found (e.g., incompleteness with ordering and personally prescribed perfectionism; harm avoidance with obsessing). The role of incompleteness in OCD warrants greater attention. (Contains 2 tables.)

Exposure interventions, both imaginal and in vivo, are an integral part of cognitive behavioral treatments for anxiety disorders and have been found to be efficacious when used to treat various fears and phobias. Although most of the literature has focused on the use of exposure with adults, there is increasing interest in the use of these techniques with anxious children and adolescents. The premise underlying exposure's efficacy is that although it is initially uncomfortable, anxiety will eventually diminish and erroneous cognitions will be disconfirmed when one is exposed repeatedly to a feared stimulus in the absence of the feared negative consequence. In this article the use of exposure techniques with children and adolescents will be discussed, focusing particularly on increasing the developmental sensitivity of these techniques to maximize their effects for younger patients. Various exposure techniques in younger patients will be described, core principles of exposure treatment for anxious children will be delineated, and application for specific pediatric anxiety disorders will be discussed.

The Obsessive-Compulsive Inventory (OCI), a new self-report measure for determining the diagnosis and severity of obsessive- compulsive disorder (OCD), was validated with 141 patients with OCD, 58 with social phobia, 44 with posttraumatic stress disorder, and 194 nonpatients. The OCI exhibited satisfactory reliability and validity with all four samples. (SLD)

The dimensions underlying the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (W. Goodman and others, 1989) were examined by performing a confirmatory factor analysis of the scale using responses from 404 patients. Results support a two-factor model of obsessive-compulsive symptoms, reflecting degree of disturbance and severity of symptoms. (SLD)