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This study investigated the impact of Problematic Internet Use (PIU) on Iranian adolescents' Psychological Well-Being (PWB), focusing on the mediating roles of sleep quality and self-regulation. Data was collected from a sample of students (n = 228, girl = 197, boy = 31) aged 12 to 19 years. Participants completed four online questionnaires, including the PIU questionnaire, the Psychological Well-Being Scale (PWBS), the Pittsburgh Sleep Quality Index (PSQI), and the Short Self-Regulation Questionnaire (SSRQ). Results confirmed that while PIU was not directly effective on PWB, it was indirectly effective through the mediation of sleep quality and self-regulation. By gaining such understanding, we can devise interventions to enhance individuals' sleep quality and self-regulatory capacities, thereby improving their PWB.

This empirical cross-sectional study explored the effect of chronotypes on classroom behaviour. One hundred and forty young Portuguese children, from 1st to 4th grades, were examined regarding their chronotype and disruptive behaviours occurring in the classroom. Three groups of chronotypes (i.e., morning, intermediate and evening) were identified. The Chronotype Questionnaire for Children evaluated the chronotype of children, and the Conners Scale -- reduced version for teachers (self-report) identified the frequency of the following behaviours in the classroom: psychomotor agitation, inattention, and opposition. Multivariate analysis of variance and analysis of regression parameters showed that morning children are more agitated and impulsive compared to evening peers. Concerning academic achievement, students did not differ in the subjects Portuguese and Mathematics for both semesters when considering chronotype and controlling for covariates such as age and gender. Parental qualifications appeared as an influential covariate for the chronotype effect in disruptive behaviour. This evidence addresses the contributions of school policies and family supervision regarding young children: children have earlier evening chronotypes; chronotypes impact specific disruptive behaviours in the classroom; parents' education influences the sleep habits and behaviours of children in school; parents and schools need more support and evidence to correctly identify children's chronotypes, to understand how chronotype and sleep habits affect behaviours in the classroom, and to recognise that more studies should be replicated attending to the contextual factors of health outbreaks and war conflict. With reliable data, this study highlights concerns and novelties for education and psychology.

This paper explores the negative impact of the shutdown of contact-based learning on learners' mental health as a result of COVID-19 and provides recommendations to promote learners' mental health during and post COVID-19. A qualitative research method was used to guide the collection and analysis of the data. Data was collected from a sample of 20 learners from Cape Town and analysed through thematic analysis. The study findings revealed that with the shutdown of contact-based learning as one of the COVID-19 containment measures by the government learners experienced social anxiety disorder and sleeping disorder. Youth policymakers need to design interventions that promote mental health in after-school programmes implemented by qualified youth workers and social workers. Youth workers should take the courses of action in a non-formal education to promote youth mental health.

Understanding the factors that influence students' results in hybrid learning environments is becoming increasingly important in today's educational environment. The goal of this research is to examine factors that influence students' academic performance as well as their level of participation in blended learning environments. A comprehensive study was conducted with 330 interested participants from the prestigious government polytechnics of the state of Karnataka in order to achieve this goal. Our data acquisition approach relied on the administration of a meticulously crafted survey questionnaire. The conceptual framework underpinning this study seamlessly integrates Transactional Distance Theory (TDT) principles with valuable insights derived from prior research. The Welch test and one-way ANOVA (Analysis of Variance) are two statistical approaches that we used selectively to reinforce our research which produced surprising results. These findings underscore the pivotal role played by certain specific factors. The geographical location of learners and the medium through which they pursue their studies have emerged as critical determinants significantly influencing academic performance. Aspects like the frequency of login activities and active engagement in forum discussions have been found to exert a positive influence on learners' academic performance. In contrast, the duration of sleep did not show a significant impact on performance. These insights bear tangible implications for teachers and policymakers who are dedicated to the enhancement of the quality of BL programs with the ultimate goal of enriching the overall educational experience.

Objective: Sleep deprivation is common among children and schools are ideal settings in which to influence children's sleep. Children spend a significant amount of time at school during key developmental periods, and programmes that influence students' well-being also benefit academic achievement. Comprehensive School Health (CSH) is an approach that prioritises school, home and community partnerships by supporting the development of health behaviours. However, sleep is often unaddressed in the school environment. The objective of this study was to integrate multiple partner perspectives to inform how to strengthen school-based sleep promotion using a CSH approach. Design: A secondary qualitative analysis of student aged 9-11 (n = 45), parent/guardian (n = 24) and teacher (n = 19) interviews from participants representing elementary (Kindergarten -Grade 6) schools and communities in Alberta, Canada was conducted. Data were examined using an a priori framework in alignment with the four components of the CSH approach: social and physical environment, teaching and learning, policy and partnerships and services. Inductive content analysis was used to develop categories followed by subthemes within each CSH component. Results: Subthemes identified within each component were as follows: social and physical environment (culture of healthy sleep habits; students influence each other); teaching and learning (formally integrate sleep-specific learning into curricula; school, teacher and parents/guardian collaboration); policy (sleep-positive classroom policies) and partnerships and services (community partnerships; school-home collaboration). Conclusion: This research identifies recommendations from student, parent/guardian and teacher interviews to inform and strengthen school-based sleep promotion when taking a CSH approach. Findings can support school partner efforts to foster a school culture (or ethos) of healthy sleep habits leading to improvements in student sleep behaviours.

Sleep problems are common in children with autism spectrum disorder. Although previous research has shown the positive effects of parent-based sleep intervention, it was mainly focused on face-to-face modality, which might limit accessibility. This study aimed to examine the efficacy of a telehealth-delivered parent-based sleep-focused intervention in treating insomnia in preschool children with autism spectrum disorder. A total of 62 parents/caregivers with a child with autism spectrum disorder and comorbid insomnia (aged 3-6 years) were randomized to receive either three weekly group sessions of sleep-focused intervention via Zoom with telephone support (n = 30) or treatment as usual (n = 32). The intervention group had significantly greater improvements in overall sleep problems (Children's Sleep Habit Questionnaire total score; p < 0.05), bedtime resistance (p < 0.05), and sleep-onset delay (p < 0.05) at post-treatment as compared to the treatment as usual group. The intervention group also showed significant improvements in overall behavioral and emotional problems (p < 0.05), especially externalizing problems (p < 0.05) as measured by Strengths and Difficulties Questionnaire, and parental stress level (p < 0.05) as measured by Depression, Anxiety and Stress Scale-21 as compared to the treatment as usual group (partial [eta][superscript 2] = 0.081-0.101). The findings supported the feasibility and promising effects of a brief parent-based sleep intervention delivered via telehealth.

Background: Sleep problems are common in adults with ADHD and may be bidirectionally associated with ADHD severity and other psychiatric symptoms. We investigated the prevalence of positive screenings for various sleep disorders, and their association with psychiatric comorbidities in a large sample of adults with ADHD from a specialized outpatient clinic. Methods: We included data of 3,691 adult patients diagnosed with ADHD, who had filled out a screener for sleep disorders (Holland Sleep Disorders Questionnaire (HSDQ)) as part of routine diagnostic assessment. The HSDQ screens for the sleep disorders insomnia, parasomnia, hypersomnia, circadian rhythm sleep disorders (CRSD), restless legs syndrome (RLS)/periodic limb movement disorder (PLMD), and sleep-related breathing disorders (SBD). As delayed sleep phase syndrome (DSPS) is very frequent in ADHD, we additionally screened for DSPS. Psychiatric comorbidities were diagnosed through clinical assessment and the Mini International Neuropsychiatric Interview (M.I.N.I.) Plus, which assesses 26 psychiatric disorders following the classification of the DSM-5. All data were retrieved from the electronic patient files. Results: Mean age was 35.4 and 49.4% of the patients were female. About 60% of the adults with ADHD screened positive for any sleep disorder. Highest prevalences were found for symptoms of DSPS (36%), insomnia (30%), and RLS/ PLMD (29%). Sleep problems in adults with ADHD were associated with comorbid depression, anxiety, substance use disorder, personality disorder, and post-traumatic stress disorder. Conclusion: Adults with ADHD often report sleep problems, which are associated with specific psychiatric comorbidities. Systematic screening for sleep disorders in adult patients with ADHD can contribute to a better understanding of their complaints and may aid improved and integrated treatment for the sleep and psychiatric problems.

Background: ADHD is highly comorbid with Delayed Sleep Phase Syndrome (DSPS). Both are associated with obesity and diabetes, which can be caused by long-term dysregulations of appetite and glucose metabolism. This study explores hormones involved in these processes and the effects of chronotherapeutic interventions in a small sample of adults with ADHD and DSPS. Methods: Exploratory, secondary analysis of data from the PhASE study, a three-armed randomized clinical trial, are presented, including 37 adults (18-53 years) with ADHD and DSPS receiving three weeks of 0.5 mg/day (1) placebo, (2) melatonin, or (3) melatonin plus 30 minutes of bright light therapy (BLT). Leptin (appetite-suppressing), ghrelin (appetite-stimulating), insulin, insulin-like growth factor-1 (IGF-1), and glucose were measured from blood collected at 08:00 hours. Salivary cortisol was collected during the first 30 minutes after awakening and self-reported appetite was assessed. Results: Baseline leptin and IGF-1 levels were higher than reference ranges, and ghrelin and cortisol levels were lower, while insulin and glucose were normal. Melatonin treatment decreased leptin and insulin. Other outcomes remained unchanged and melatonin + BLT had no effects. Conclusion: Due to the small sample size and exploratory nature of the study, results should be interpreted with caution. Overall, these results show no strong indications for dysregulation of appetite and glucose metabolism to suggest high risk of obesity and diabetes in this small sample of adults with ADHD and DSPS. However, baseline appetite was suppressed, likely because measurements took place in the early morning which could be considered the biological night for this study population. Melatonin treatment seemed to cause subtle changes in appetite-regulating hormones suggesting increased appetite. Chronotherapeutic treatment may affect appetite-regulating hormones by advancing the biological rhythm and/or altering eating behaviors, but this remains to be investigated in larger samples using detailed food diaries.

Background: The wellbeing of college students today is at risk because of rising occurrences of mental health issues in higher education. Concurrently, undergraduate students perceive engineering courses and programs to be among the most arduous, and least welcoming and accommodating, in higher education. Although research related to mental health and wellbeing (MHW) in engineering is growing, a systematic review of this research has yet to be conducted. Purpose: This systematic literature review identifies and synthesizes empirical scholarship related to the MHW of undergraduate engineering students. Scope/Method: Specified search terms and inclusion criteria were used to identify 34 empirical studies related to engineering undergraduates' MHW. Content and qualitative thematic analyses were conducted to characterize and synthesize trends in research quality and outcomes across studies. Results: Undergraduate engineering students experience a variety of mental health issues that negatively affect their experiences in engineering education. Stress is the most prevalent mental health issue identified; anxiety, depression, and post-traumatic stress disorder (PTSD) are also reported. Heavy academic workloads, sleep issues, and the nature of engineering education culture are identified as impediments to MHW in engineering education. Conclusions: Although MHW in engineering is a growing area of research internationally, current MHW research in engineering is nascent and focused on the characterization of student mental health issues. Researchers underutilize qualitative and mixed-methods approaches, longitudinal and experimental designs, guiding frameworks, and robust sampling techniques. Academic and mindfulness interventions, as well as the use of mental wellness constructs from positive psychology, show promise for supporting MHW in engineering.

Autistic children are at higher risk of experiencing adverse childhood experiences, which lead to negative health outcomes such as sleep difficulties. In the general population, family resilience can help reduce the negative impact of adverse childhood experiences on child functioning. The aim of this study was to examine the impact of adverse childhood experiences on sleep duration, and whether family resilience moderates this impact in autistic children. With data from 2882 caregivers of children with autism from the National Survey of Children's Health, we examined the role of family resilience on the relationship between adverse childhood experiences and sleep duration. As shown in previous findings, there was a main effect of adverse childhood experiences on sleep duration. There was no significant main effect of family resilience on sleep duration. Results also show that family resilience moderates the relationship between adverse childhood experiences and sleep duration, possibly serving as a protective factor.

Purpose: To investigate serum levels of VEGF, IGF-1 and FGF-2, and relationships with several clinical characteristics in children and adolescents with autism spectrum disorder (ASD) with and without bipolar disorder (BD). Method: 40 subjects with ASD + BD as study group, and 40 subjects with ASD as control group were included. Serum levels of VEGF, IGF-1, and FGF-2 were measured using commercial enzyme-linked immunosorbent assay kits. Results: The study group was significantly higher than the control group in terms of ASD severity, self-harming behavior and sleep disturbance. Serum VEGF and FGF-2 levels were significantly higher in the ASD + BD group than in the control group. There was no significant difference in serum IGF-1 levels between the two groups. There was no correlation between VEGF, IGF-1 and FGF-2 serum levels and ASD severity in the study group. However there was a negative correlation between VEGF levels and age at first diagnosis of BD, and a positive correlation between IGF-1 levels and the number of bipolar episodes in the study group. Conclusion: Growth factors like VEGF and FGF-2 may be potential biomarkers of bipolar disorder in young subjects with ASD. Given the difficulty of clinical management of BD in young subjects with ASD, potential biomarkers would help clinicians in the diagnosis and follow up of BD in this special population. Further research is needed whether VEGF and FGF-2 can be potential biomarkers in the clinical management of young subjects with ASD and BD.

The COVID-19 lockdown affected children, especially those with autism spectrum disorder, due to the disruption in rehabilitation and educational activities. We conducted a cross-sectional study of 315 preschool-aged children, 35 of which had autism, to investigate this impact. A questionnaire was administered to explore socio-demographic status, familiar/home environment, and COVID-19 exposure. The clinical features of autistic subjects were also examined. Seven variables were considered to describe the effect of pandemic: "Remote learning, Behavior changes, Home activities, Sleep habits, Night awakenings, Physical activity, Information about the virus." The lockdown had a significant impact on Remote learning, Behavior changes, and Information about the virus in participants with autism. Moreover, we found a worsening in repetitive movements, echolalia, restricted interests, and aggressive behaviors.

This study examined the relationship between the accuracy of parental reporting of children's sleep duration compared to objectively measured child sleep and tested whether any discrepancies were related to childhood obesity prevalence in a sample of Latinx families (N = 119). A paired sample t-test revealed that parents significantly overestimated their child's sleep duration by 1.33 hours, t(86) = 6.69, p < 0.001. Using a one-way ANOVA, no significant differences were found in children's BMI percentile when grouped by the parent's accuracy of their child's sleep duration F(3, 83) = 0.76, p = 0.52. A potential, although non-significant, trend regarding parent accuracy and child BMI may merit further examination. Future research should seek to determine if the discrepancy in parent reported child sleep duration is indeed linked with increased child BMI and if this knowledge could be used in targeted intervention efforts to reduce childhood obesity.

Several meta-analyses have demonstrated that bullying prevention programs are successful in reducing bullying. However, scant research addresses if and how such anti-bullying efforts affect long-term internalizing health problems and even less on later use of pharmacotherapy and psychotherapy. This study explores how the school-based Olweus Bullying Prevention Program (OBPP) affects the likelihood of being prescribed antidepressant drugs, anxiolytics, hypnotics, and sedatives, using a difference-in-difference design with population-wide Norwegian register data, including the Norwegian Prescription Database. Generally, we find that student cohorts from schools with a higher proportion of victimized students have more prescribed drugs at ages 17-22. Although OBPP substantially reduces victimization, and, hence, assumedly internalizing problems, our results indicate that the OBPP increased the likelihood of being prescribed drugs for internalizing problems between ages 17 and 19. Our interpretation of these findings is that the OBPP had increased awareness of bullying in school and its damaging consequences, and thereby reduced the mental and attitudinal barriers that often prevent students from seeking help for internalizing problems. It should be noted, however, that the victimization data in our study were linked to schools only and not to register data for individual students. Accordingly, we were restricted to studying average program effects at the school level. The power to detect long-term effects would have been better with student-linked data for both the victimization and register variables.

Achievement goal orientations have a significant impact on students' self-regulation and development. An individual's achievement goal orientations may change at some critical stages. The sample of this study came from a survey of college students conducted in China for four consecutive years. The study used a growth mixture model to identify the longitudinal trajectories of achievement goal orientations during the college years, constructed a logistic regression model to analyze the related factors of students in different classes, and further examined the effects on academic performance. The results indicate that the longitudinal trajectories of all the 2 × 2 achievement goal orientations can be divided into decreasing class and increasing class. Taking the increasing class as the reference, extroversion, high BMI, high sleep duration, and major are related factors of students in the decreasing class of performance-approach goals. Extroversion and father's education level are associated with students in the decreasing class of mastery-avoidance goals. Extroversion, high sleep duration, father's education level, family economic status, and family social status correlate with students in the decreasing class of mastery-approach goals. In addition, there are significant differences in the academic performance of students in different trajectory classes.

Children and adolescents (henceforth "children") with both attention-deficit/hyperactivity disorder (ADHD) and anxiety experience greater difficulties than children with either alone, though qualitative methodologies are yet to be used to understand the challenges this population experiences. We aimed to explore parent-reported daily impacts of co-occurring anxiety in children with ADHD (ages 8-13 years). Participants were enrolled in an Australian trial evaluating an adapted anxiety intervention and were eligible if their child met diagnostic criteria for ADHD plus separation, social, and/or generalized anxiety disorder. A baseline measure of life impacts associated with child anxiety captured situations parents reported were difficult, due to their child's anxiety. Reflexive thematic analysis of free-text responses (N = 203) facilitated new insights via inductively generating key themes. Three overarching themes highlighted (1) child difficulties with everyday situations and processes due to their anxiety; (2) the nature of the child's anxiety being pervasive and unrelenting; and (3) the strain placed on the child's family system. This study enhances understanding of daily impacts associated with co-occurring anxiety and ADHD and may contribute to an improved understanding of support needs. Results reiterate the need to identify co-occurring difficulties in children with ADHD and support both children and their families.

Children vary in how sensitive they are to experiences, with consequences for their developmental outcomes. In the current study, we investigated how behavioral sensitivity at age 3 years predicts mental health in middle childhood. Using a novel repeated measures design, we calculated child sensitivity to multiple psychological and social influences: parent praise, parent stress, child mood, and child sleep. We conceptualized sensitivity as the strength and direction of the relationship between psychosocial influences and child behavior, operationalized as toothbrushing time, at age 3 years. When children were 5-7 years old (n = 60), parents reported on children's internalizing and externalizing problems. Children who were more sensitive to their parents' praise at age 3 had fewer internalizing (r = -0.37, p = 0.016, p[subscript FDR] = 0.042) and externalizing (r = -0.35, p = 0.021, p[subscript FDR] = 0.042) problems in middle childhood. Higher average parent praise also marginally predicted fewer externalizing problems (r = -0.33, p = 0.006, p[subscript FDR] = 0.057). Child sensitivity to mood predicted fewer internalizing (r = -0.32, p = 0.013, p[subscript FDR] = 0.042) and externalizing (r = -0.38, p = 0.003, p[subscript FDR] = 0.026) problems. By capturing variability in how children respond to daily fluctuations in their environment, we can contribute to the early prediction of mental health problems and improve access to early intervention services for children and families who need them most.

Suicide is a serious public health problem and is the fourth leading cause of death among adolescents. Suicide ideation is the most significant predictor of suicide. However, few empirical studies have examined the relationship between stressful life events, insomnia, depression symptoms, self-esteem, and suicide ideation among college students. This study builds on O'Connor's The integrated motivational-volitional model of suicidal behavior theory will verify the relationship between these five factors through a large data study among college students, and further reveal the mechanisms and interventions of suicide ideation among college students. A total of 2717 (mean age = 19.81 years, 22.49% male) college students from South China participated in this behavioral and health survey. Using self-reported questionnaires which were Adolescent Self Rating Life Events Check-list, MINI-C, Insomnia Severity Index, PHQ-9, and Self-Esteem Scale to assess the subjects' demographic information, suicide ideation, stressful life events, insomnia, depressive symptoms, and self-esteem levels as comprehensively as possible. A moderated chain mediation model was used to validate their relationship. The results showed that stressful life events significant positively predicted insomnia symptoms, depressive symptoms, and suicide ideation. The mediating effect of depression between stressful life events and suicide ideation was significant. The chain mediating effect of insomnia and depression between stressful life events and suicide ideation was significant. However, the mediating effect of insomnia between stressful life events and suicide ideation was not significant. Also, the positive prediction of stressful life events and depression on suicide ideation was weaker when the individual's self-esteem level was higher, and the moderated chain mediating effect was significant. This study developed a moderated chain mediation model, and proposes a new integrated stress coping-self-perception model of suicide ideation to discover the important role of self-esteem levels in adolescent suicide prevention.

Children with autism spectrum disorder (ASD) report high rates of sleep problems. In 2012, the Autism Treatment Network/Autism Intervention Research Network on Physical Health (ATN/AIR-P) Sleep Committee developed a pathway to address these concerns. Since its publication, ATN/AIR-P clinicians and parents have identified night wakings as a refractory problem unaddressed by the pathway. We reviewed the existing literature and identified 76 scholarly articles that provided data on night waking in children with ASD. Based on the available literature, we propose an updated practice pathway to identify and treat night wakings in children with ASD.

This study aimed to explore the potential mediating role of sleep quality in the effect of physical activity (PA) intervention for improving executive functions (EFs) in children with attention-deficit hyperactivity disorder (ADHD). Participants aged 6 to 12 years old with a formal ADHD diagnosis were recruited from a local hospital. A total of 80 eligible children with ADHD were randomized to an intervention group for 12 consecutive weeks of PA training (three times per week, 60 min per session) (n = 40; Mage = 8.37, 75% boys) or a wait-list control group (n = 40; Mage = 8.29, 80% boys). Three core EFs (inhibitory control, working memory, and cognitive flexibility) were assessed by neurocognitive tasks, and sleep quality was measured by the Chinese version of the Pittsburgh Sleep Quality Index. The bootstrapping method was used to test PA intervention effects on EFs and on potential variables of sleep quality after intervention and to test whether there were indirect effects of the intervention on EFs via mediators of sleep. The results showed that the PA intervention had a direct effect on sleep latency reduction ([beta] = - 0.26, 95%CI - 0.47 to - 0.06) and cognitive flexibility improvement (decrease in completion time) ([beta] = - 0.30, 95%CI - 0.50 to - 0.09). Furthermore, change in sleep latency significantly mediated the effects of PA intervention on cognitive flexibility ([beta] = - 0.084, 95%CI - 0.252 to - 0.001). The findings suggest that sleep latency could be a crucial behavioral mediator of PA intervention in improving cognitive flexibility among children with ADHD.

This study examined the links between COVID-19 psychosocial stressors, ethnic discrimination, COVID-19 fears, and their combined effects on mental health outcomes among U.S.-based Latinx college students (N = 148; M[subscript age] = 20.68, SD = 2.53). Findings showed that sleep and eating disturbances, emotional distress, and work disruptions were linked with fear of contamination, fear of social distancing, and fear of pandemic impact. Further, ethnic discrimination was found to uniquely contribute to COVID-19 fears above and beyond COVID-19 psychosocial stressors. Finally, COVID-19 emotional distress and COVID fear of pandemic impact were significantly linked to anxiety and depression symptomatology. Recommendations for practice and future research are provided.

Self-direction skill (SDS) is an essential 21st-century skill that can help learners be independent and organized in their quest for knowledge acquisition. While some studies considered learners from higher education levels as the target audience, providing opportunities to start the SDS practice by K12 learners is still rare. Further, practicing such skills requires a concrete context and scaffolding during the skill acquisition. This article introduces the Goal Oriented Active Learner (GOAL) system that facilitates SDS acquisition in learners utilizing daily activities as context. The GOAL architecture integrates learning logs from online environments and physical activity logs from wearable trackers to provide a data-rich environment for the learners to acquire and practice their SDS. The GOAL users follow DAPER, a five-phase process model, to utilize the affordances in the system while practicing SDS. We implemented the GOAL system at a K12 public institution in Japan in 2019. Learners used the online environments for extensive reading and smartwatches for tracking walking and sleeping activities. This study analyzes detailed interaction patterns in GOAL while learners planned and monitored their self-directed actions. The results illustrate the strategies for DAPER behaviors that emerge in different activity contexts. We discuss the potentials and challenges of this technology ecosystem that connects learners' learning logs and physical activity logs, specifically in the K12 context in Japan and, more generally, from the learning analytics research perspective to provide a context to practice SDS.

Emphasis on continuous infant sleep overnight may be driven by parental concern of risk to child mental health outcomes. The Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) examined whether infant sleep at 6 and 12 months postpartum predicts anxiety disorders at 2-4 years, and whether this is moderated by maternal depression, active physical comforting (APC) or maternal cognitions about infant sleep. Data included 349 women and infants. Infant sleep was measured using the Brief Infant Sleep Questionnaire and child anxiety disorders by the Preschool Age Psychiatric Assessment. The risk of developing generalised anxiety or social phobia disorders at 3-4 years was reduced by 42% (p = 0.001) and 31% (p = 0.001), respectively, for a one standard deviation increase in total sleep at 12 months. No other infant sleep outcomes were associated. Maternal depression, APC and cognitions about infant sleep did not significantly moderate these relationships. Focus may need to be on total infant sleep, rather than when sleep is achieved.

Purpose: Previous studies have reported the success of distributional learning for adult speakers across segmental and suprasegmental categories immediately after training. On the other hand, second language (L2) perception models posit that the ease with which learners perceive a nonnative speech contrast depends on the perceptual mapping between the contrast and learners' first language (L1) categories. This study examined whether a difference in perceptual mapping patterns for different L2-Mandarin tonal contrasts might result in a difference in distributional learning effectiveness for tonal speakers and whether an interval of sleep enhanced the knowledge through consolidation. Method: Following a pretest-training-posttest design, 66 L1-Cantonese participants with fewer than 9 years of Mandarin training were assigned to either the bimodal or unimodal distribution conditions. The participants of each group were asked to discriminate Mandarin level-falling (T1-T4) and level-rising (T1-T2) tone pairs on novel syllables in a within-subject design. All participants were trained in the evening, tested after training, and returned after 12 hr for overnight consolidation assessment. Results: A significant distributional learning effect was observed for Mandarin T1-T4, but only after sleep. No significant distributional learning effect was observed for Mandarin T1-T2, either after training or after sleep. Conclusions: The findings may imply that distributional learning is contingent on perceptual mapping patterns of the target contrasts and that sleep may play a role in the consolidation of knowledge in an implicit statistical learning paradigm.

Background: Few studies have examined the effects of later class start times in college, even though developmentally driven sleep phase changes persist into the mid-20s. Objective: We hypothesized that sleepiness would be higher in an 8 a.m. versus 10 a.m. section of Introductory Psychology, and grades, engagement, enjoyment, attendance, assignment completion, ease of waking and staying awake, and student evaluations of teaching (SETs) would be lower. Method: Eighty-two students enrolled in an 8 a.m. (n = 39) or 10 a.m. (n = 43) section of Introductory Psychology reported their GPA and completed the Stanford Sleepiness Scale, Likert-scale items from the College's SET form, and other questions. Results: Students in the 8 a.m. section reported lower GPA, class grade, and assignments completed; more sleepiness; and a harder time waking up and staying awake for class. Several findings held when controlling for GPA. Conclusion: Results extend previous research and suggest the importance of offering later classes in college. Limitations include a small sample size, quasi-experimental design, and use of self-report data. Future researchers should test whether findings replicate with other kinds of classes and in other subjects. Teaching Implications: To maximize student success and well-being, later courses should be offered at the college level whenever feasible.

Linguistic categories can impact visual perception. For instance, learning that two objects have different names can enhance their discriminability. Previous studies have identified a typical pattern of categorical perception, characterized by faster discrimination of stimuli from different categories, a neural mismatch response during early visual processing (100-200 ms), and effects restricted to the right visual field. However, it remains unclear whether language affects perception online or through long-term changes to mental representations in memory. To address this, we tested the impact of newly learned object categories with and without memory consolidation during sleep. We replicated the canonical pattern of categorical perception for categories that underwent consolidation. Without consolidation, linguistic categories still influenced early visual processing but with distinct neural dynamics. Therefore, we found evidence of both transient and long-term effects of language on perception and conclude that memory consolidation plays a crucial role in shaping how linguistic categories modulate perception.

Life Course Theory contends that school transitions can interrupt academic and wellbeing trajectories, depending on child, family, and school factors. Hierarchical regression analyses examined how autistic traits were associated with school transition outcomes. Autistic traits explained 12% of the variance in Quality of Life (QOL), 24% of the variance in mental health and 9% of the variance in school belonging. When autistic traits were accounted for, gender was a significant predictor of changes in QOL whereas changes in school belonging were predicted by cognitive functioning, parent education, school attendance and school refusal. Changes in mental health after transition were mostly predicted by family factors including family structure, family functioning and parent education but were also significantly predicted by sleep problems.

In this systematic review, we aimed to identify the impact of the COVID-19 pandemic on children/adolescents with a diagnosis of autism spectrum disorder (ASD). The protocol was registered on PROSPERO CRD42021255848. Articles were selected from PubMed, Embase, and LILACS according to these characteristics: patients from zero to 18 years old, exposed to the COVID-19 pandemic, impact on social communication/interaction and restricted/repetitive behavior domains. The Newcastle-Ottawa Scale was used to assess methodological quality and the risk of bias. Of the 351 articles initially identified, 26 were finally included with information on 8,610 patients. Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ASD were mostly manifested in their behavior and sleep patterns.

Healthy lifestyle behaviors can improve health-related quality of life (HRQOL) in cancer survivors; but the combination of behaviors most important for HRQOL is not known. This study investigated the patterns of lifestyle behaviors among cancer survivors and differences in HRQOL between behavioral classes. Cancer survivors (n = 2,463) were invited to participate in a cross-sectional survey. Participants (N= 591) were predominately female (63%) and non-Hispanic White (90%). Survey items included self-reported physical activity, diet, smoking, sleep, HRQOL, and demographics. Behavioral classes were estimated by latent class analysis. Differences between classes were assessed by latent class regression. Compared with the "healthy lifestyles" class (higher probabilities of meeting aerobic/strength-based activity guidelines, high fruit/vegetable intake, and no sleep problems; 11% of sample), the "sleep and diet problems with inconsistent physical activity" class (higher probabilities of not meeting strength-based guidelines, low fruit/vegetable intake, some sleep problems; marginally higher probability of meeting aerobic guidelines; 41%) had poorer general and physical HRQOL. The "poor physical activity and diet" class (higher probabilities of not meeting aerobic/strength-based guidelines, low fruit/vegetable intake, and some sleep problems; 48%) had poorer general, physical, and mental HRQOL. Few participants exhibited healthy lifestyle patterns associated with HRQOL. The findings provide opportunities to develop differentiated multiple behavior-change interventions, targeted to two common patterns of behavior. A large subgroup of cancer survivors was susceptible to suboptimal physical activity and diet, warranting interventions exclusively targeting these behaviors. Another subgroup was susceptible to suboptimal physical activity, diet, and sleep, indicating interventions for this group should include strategies targeting these three behaviors.

Sleeping difficulties among adolescents constitute a pressing public health issue, and it is of the utmost importance that these are approached from a health-promotion perspective. This study explores adolescents' suggestions on how their sleep could be supported. Data were collected via eight focus group interviews with 43 adolescents aged 15-16, in Sweden, and analyzed using qualitative content analysis. The results describe the adolescents' suggestions on how their sleep could be supported in three themes: being supported by involved parents--routines, engagement, and warmth are vital; being supported to achieve knowledge on the "whys" and "hows" of sleep--increased knowledge gives the ability to make well-grounded sleep choices; and being guided into finding balance--balance in life is difficult to achieve and adolescents desire support. Parents, school nurses, health professionals, and anyone who has the opportunity to improve and promote sleep should consider adolescents' suggestions.

Sheltered work and leisure activities were locked down in at the Signo centre in March 2020 because of the COVID-19 pandemic. The Signo centre is a Norwegian national centre for adults with multiple, complex needs, including severe sensory loss/impairments. Tension and uncertainty rapidly spread among relatives and workers. To explore the impacts of the pandemic on residents, 24 adults living in Signo Vivo answered a semi-structured interview together with their primary worker. Additionally, reports on staff injuries and PRN medication between April and Aug of 2020 were compared to the period before the lockdown. The reports from the interviews included fewer stressful events for the participants, more rest and sleep, more time spent in their own apartments, and more time with smaller groups of workers. The reports on staff injuries and PRN medication showed decreased occurrence.

Background: Integrated primary care (IPC) can address prevalent behavioral health concerns identified in pediatric office visits, but research on IPC consultation patterns is limited. Objective: This study investigated variation in consultation rates across presenting problems, patient sociodemographic factors, and IPC treatment duration. Method: Retrospective electronic health record data were extracted for 970 patients seen in 12 pediatric primary care sites and for whom behavioral health consultation was requested between June 2018 and December 2019. Logistic regressions were used to examine associations between sociodemographic variables, consultation reasons, and IPC visit type. We used multiple linear regression to assess the association between consultation reason and treatment duration. Results: Anxiety (36.2%) and disruptive behavior (29.7%) were the most common consultation reasons. Consultation requests for internalizing (anxiety, mood) problems were more prevalent in school-aged children and adolescents, whereas consultations for disruptive behavior (tantrums) and health-related issues (toileting, sleep concerns) were common in early childhood. Girls were less likely to receive consultation requests for attention deficit/hyperactivity disorder (ADHD) and autism/developmental concerns compared to boys, but more likely to receive consultation for internalizing problems. Consultation requests varied by patient race, ethnicity, visit type, and insurance type. Treatment duration after consultation was longer among patients with consultation requests for ADHD and for depression/mood concerns. Conclusions: Age-related behavioral health consultation patterns in IPC conform with expected developmental trends; however, sociodemographic findings suggest opportunities for enhancing care. Additional research is needed on IPC consultation given its promise for early identification, prevention, and treatment of pediatric mental health concerns.

Later school start times have emerged as a potential policy to improve the sleep and educational outcomes of teenagers. This study uses a quasi-experimental comparative interrupted time series approach to examine a 90-min delay in start times in an urban district in North Carolina. Results show that the later start time resulted in more sleep for students and improved course grades but limited evidence of benefits to other educational outcomes. In addition, the evidence suggests that disruptions from the change may temporarily decrease some educational outcomes, and that these disruption effects are concentrated among low-income students and students of color.

Autistic adults commonly experience anxiety and worry, although knowledge on how worry presents and the content, extent, and experiences among autistic adults is limited. A convergent parallel mixed-methods approach was used to explore the presentation and experiences of worry in autistic and non-autistic adults. Quantitative surveys were used to compare the content and extent of worry in autistic adults to non-autistic adults, with semi-structured interviews also conducted with autistic adults to gain a deeper understanding of the experiences, impacts and content of worry in autistic adults. Findings indicated that autistic adults demonstrated clinically significant levels of worry which were substantially higher than non-autistic adults. Autistic adults described worry as a cycle of negative thoughts impacting their daily life. Findings indicate that autistic adults may worry more than non-autistic adults, impacting on participation in activities of daily living, sleep, and mental health.

Toward the development of a new parent-rating for insomnia, this multi-site qualitative study explored sleep problems and related impacts in children with autism spectrum disorder (ASD) and their families. To ensure content validity of the measure, we conducted six focus groups with caregivers (N = 25) of 24 children (age 3 to 18 years) with ASD. Based on parent report, all children had a history of mild or greater insomnia. The focus group transcripts were systematically coded to identify major themes. Verbatim comments from caretakers were used to generate 134 candidate items. Further review by the research team and an expert panel followed by individual cognitive interviews with 12 parents reduced the item bank to 40. The thematic analysis of focus group transcripts identified 7 categories: (1) Trouble falling asleep; (2) trouble staying asleep; (3) early morning waking; (4) bedtime routines; (5) parental strategies for bedtime management; (6) impact of sleep problems on the child; and (7) impact of sleep problems on the family. The Flesch Kincaid Grade Level of the 40-item version was 7.2 (seventh grade reading level). Insomnia in children with ASD shares features in common with insomnia in the general pediatric population. However, perhaps owing to autistic features such as insistence on sameness, sensory sensitivities, communication impairments, insomnia in children with ASD appears to have unique behavioral manifestations. Content validity and item clarity of the 40-item bank were supported by expert panel review and cognitive interviews with caregivers of children with ASD.

This was an exploratory cross-sectional study comparing 45 children with ASD to 24 typically developing drug-naïve controls, group-matched on age, sex, and body mass index. Objective data was obtained using the following: an ambulatory circadian monitoring device; saliva samples to determine dim light melatonin onset (DLMO): and three parent-completed measures: the Child Behavior Checklist (CBCL); the Repetitive Behavior Scale-Revised (RBS-R); and the General Health Questionnaire (GHQ28). The CBCL and RBS-R scales showed the highest scores amongst poor sleepers with ASD. Sleep fragmentation was associated with somatic complaints and self-injury, leading to a higher impact on family life. Sleep onset difficulties were associated with withdrawal, anxiety, and depression. Those with phase advanced DLMO had lower scores for "somatic complaints"; "anxious/depressed" state; and "social problems", suggesting that this phenomenon has a protective role.

At the start of the COVID-19 pandemic, K-12 teachers rapidly implemented new technologies to provide remote education, often with limited technological training and support. We tested whether teachers' satisfaction with their technology training was associated with their perceived stress, depression, anxiety, well-being and sleep. The School Staff Health and Wellness Study has surveyed school staff about their experiences throughout the COVID-19 pandemic. A priori analyses included comparisons of well-being scores among teachers who were satisfied with their technology training, dissatisfied with their technology training and those who had not received technology training. We also explore qualitatively what additional technology-related responsibilities teachers had throughout Fall 2020. Participants included 5,873 K-12 teachers who identified predominately as female, White and Non-Hispanic. Most K-12 teachers (88%) had to learn new technology, and 54% reported being "not at all" or only "a little bit" satisfied with the technology training they received. Teachers who were satisfied with their training in new technology were less anxious, depressed, stressed, scored lower on measures of sleep disturbance and higher on measures of well-being compared to other groups. Understanding the association between training in new technology and teachers' well-being will help school leaders support teachers amid future challenging circumstances.

Exposure to war is known to impact children's physical and mental health. Recent research reveals that war exposure might even affect the developmental outcomes of children who are yet to be conceived. In this study, we sought to extend such prior work by investigating longitudinal associations between pre-conception war exposure and the accompanying maternal emotional distress on child sleep. Israeli mothers, who conceived within a year after the Lebanon war in 2006 (N = 68), were followed until their children reached 10 years of age. At that age, child sleep problems were measured through mother and child reports. Results from analyses of covariances (ANCOVAs) showed that war exposure prior to conception itself did not predict child sleep. However, hierarchical regression analyses showed that higher levels of maternal emotional distress, as a result of pre-conception war exposure, predicted more sleep problems in girls. Further exploratory analyses revealed that these associations showed themselves in both maternal and child reports on various sleep domains. In boys, no evidence was found for associations between maternal emotional distress during wartime and sleep 10 years later. These results indicate that war-related pre-conception stress might have long-term, sex-specific effects on child sleep, though replication with larger samples is needed to corroborate the findings.

This study examined demographic information for current music education faculty (N = 136), the factors that seem to influence music education faculty members' levels of job satisfaction and primary stressors, also by institution type. Simultaneous multiple regression revealed that academic autonomy, collegial support, sleep, parental responsibilities, and certainties of the tenure process affect music education faculty members' reported levels of job satisfaction and stress. Mean job satisfaction and stress scores for each group by Carnegie institution types were compared using a one-way ANOVA. Significant differences in stress scores between groups suggested that the larger institution group (R1) did not report feeling more stressed about professional responsibilities than the smaller institution group (M1). Analyses of open-ended questions also reinforced the notion that the COVID-19 pandemic increased flexibilities in work and parental responsibilities leading to lower stress levels.

Background: Accumulating evidence suggests that sleep disordered breathing (SDB) is under-recognized in youth and adults with ADHD. SDB may contribute to exacerbating pre-existing ADHD symptoms and may play a role in the development of cognitive deficits that may mimic ADHD symptoms. Method: We conducted a focused review of publications on cross-prevalence, overlapping clinical and neurobiological characteristics and possible mechanisms linking SDB and ADHD. Results: Exiting studies suggest that co-occurrence of SDB and ADHD is as high as 50%, with frequent overlap of clinical symptoms such as distractibility and inattention. Mechanisms linking these conditions may include hypoxia during sleep, sleep fragmentation and activation of inflammation, all of which may affect brain structure and physiology to produce disturbances in attention. Conclusions: The relationship between SDB and ADHD symptoms appear well-supported and suggests that more research is needed to better optimize procedures for SDB assessment in youth being evaluated and/or treated for ADHD. "(J. of Att. Dis. 2024; 28(5) 686-698)"

Objective: Short-term RCTs have demonstrated that MPH-treatment significantly reduces ADHD-symptoms, but is also associated with adverse events, including sleep problems. However, data on long-term effects of MPH on sleep remain limited. Methods: We performed a 2-year naturalistic prospective pharmacovigilance multicentre study. Participants were recruited into three groups: ADHD patients intending to start MPH-treatment (MPH-group), those not intending to use ADHD-medication (no-MPH-group), and a non-ADHD control-group. Sleep problems were assessed with the Children's-Sleep-Habits-Questionnaire (CSHQ). Results: 1,410 participants were enrolled. Baseline mean CSHQ-total-sleep-scores could be considered clinically significant for the MPH-group and the no-MPH-group, but not for controls. The only group to show a significant increase in any aspect of sleep from baseline to 24-months was the control-group. Comparing the MPH- to the no-MPH-group no differences in total-sleep-score changes were found. Conclusion: Our findings support that sleep-problems are common in ADHD, but don't suggest significant negative long-term effects of MPH on sleep.

Objective: The aim of this study was to identify patterns of ADHD care, including factors that guide selection and sequencing of treatments in a large nationwide sample of preschool-aged youth over the past 6 years. Method: A retrospective cohort study utilizing a large electronic health record (TriNetX) of nearly 24,000 children ages 3 to 6 diagnosed with ADHD. Results: One in three preschoolers with ADHD were prescribed psychotropic medication, most commonly methylphenidate and guanfacine. One in 10 had at least one psychotherapy billing code during the entire assessment with most youth starting medication before psychotherapy. Rates of most treatments, including polypharmacy, increased with comorbid psychiatric disorders or sleep problems and over the course of the coronavirus pandemic. Conclusion: Rates of treatment have increased over time but are still largely inconsistent with published care guidelines that advise therapy before medication. Clinicians appear to prioritize psychiatric comorbidity and sleep problems when selecting treatments.

Music education majors across the United States (N = 1029) self-reported indicators of depression, anxiety, personality, and stress. According to the results, music education majors are highly busy, and report elevated levels of stress as compared to their peers. Semester enrollment averages include: 18.5 hours (including 0 credit courses) a semester, rehearsing an average of 9.08 hours a week, and a majority of whom work an average of 13-15 hours a week all while reporting high perceived stress levels. Furthermore, 74% of respondents required additional screening on the DSM-V for depression with over 70% exhibiting symptoms of moderate or severe depression; whereas, 84% of the respondents required additional screening for anxiety with over 74% showing signs of moderate and severe anxiety. Both series of results represent significant increases from the original study. The discussion provides possible explanations and suggestions for future considerations regarding music education majors and mental health. [Research in this manuscript was presented as a presentation at the 2021 Biennial National Conference for the National Association for Music Education in a Virtual Platform.]

The purpose of this research is to explain the effects of the qualitative results obtained from the data which is gathered from the interviews with gifted students and their parents regarding the screen use of gifted students between the ages of 12-18 on the potential screen addictions of gifted students. This study is mixed methods research. The rationale for choosing mixed methods research is complementarity, based on the fact that results from quantitative and qualitative data clarify and detail each other's results. For the research, explanatory sequential/(sequential quantitative [right arrow] qualitative) mixed methods research design was used. Quantitative data of the study were collected through a questionnaire created by the researcher from a group of 160 gifted students aged 12-18 and 100 parents. The data obtained from the questionnaire were analyzed by ratio and frequency analysis. In the light of the findings obtained from the quantitative results, structured interviews were conducted with 16 gifted students and 17 parents with purposeful sampling from the research group. Content analysis technique was used in the analysis of the data obtained from the interviews. Quantitative and qualitative research results were brought together in the mixed methods study and the results were integrated. The findings of the research were explained under subheadings such as the duration of screen use before and during the pandemic, the number of technological devices used, the time spent in front of the screen, the purpose for which this time was used, and the effects of the time spent in front of the screen on students. With the pandemic, the time spent in front of the screen has increased, the duration of sleep has increased, the purposes of using the screen have changed, and the situation of being uncomfortable and unhappy in case of not being able to reach the screen has increased. As a suggestion to this situation, it is suggested to carry out awareness raising activities for families and children.

Surveys indicate that nearly three-fourths of all college students do not get an adequate amount of sleep on most nights and over half report daytime sleepiness. Sleep deficiency impairs cognitive function, diminishes academic performance, and impedes learning. Asynchronous online education, which provides flexibility to participate in learning exercises and complete assignments at a time and pace that better matches a student's sleep schedule, may offer a solution to this problem. In this study, we examine the impact of reported sleep deprivation on learning outcomes for a group of students who took an asynchronous online class versus a similar group of students who took the same class in a face-to-face (F2F) setting (N = 399). Our results indicate that whereas sleep deprivation, all other factors held constant, significantly negatively affects learning for F2F students, no such influence is observed for online learners. Student counselors and school administrators should therefore consider advising sleep-deprived students to take more online classes to enhance student learning outcomes, which in turn may improve student retention and degree completion.

Mothers of school-aged children ages 3 to 17 years with developmental disabilities (DDs) commonly report sleep problems in their children associated with impaired maternal sleep. However, existing research relies heavily on mothers' self-reported sleep. This study aimed to determine the feasibility of objectively measuring child and mother sleep-wake patterns using actigraphy and videosomnography. This was an observational pilot study. Mothers wore actigraphy watches and video-recorded their child's sleep for 7 nights. Mothers also completed a 7-day sleep diary and questionnaires on sleep quality, depressive symptoms, stress, and child sleep problems. Ten mothers (32-49 years) and ten children with DDs (8-12 years) completed this study. Half of the children were boys with autism spectrum disorders. We successfully recruited 77% of eligible mothers for the study during the pandemic. Eight mothers successfully wore the actigraphy, and nine successfully video-recorded their child's sleep. Mothers rated their participation positively and considered the data collection protocol acceptable. While mothers' sleep patterns from actigraphy were mostly within recommendations, self-reported sleep quality was poor. Child's sleep estimates from videosomnography showed children slept substantially less than recommended sleep hours. Mothers also reported a high frequency of child sleep problems. Consistent with this pattern, mothers also endorsed elevated stress and depression. The use of actigraphy and videosomnography is feasible. Objective sleep measurement for mothers' and children's sleep is needed with self-report to measure multidimensional aspects of sleep and discrepancies between objective and self-report sleep measures. Future studies can use multi-methods sleep measures and work toward interventions that can improve family sleep and reduce mothers' stress and depression.