ИСТИНА |
Войти в систему Регистрация |
|
ФНКЦ РР |
||
Introduction: An extensive research of psychological factors of insomnia in adults demonstrated an important role of anxiety, depression, dysfunctional beliefs and thoughts in illness perpetuation (Morin, 2010, Harvey, Tang, 2012, Spiegelhalder et al., 2008 etc.). Less is known about the cognitive factors of sleep in children and adolescents where family, developmental as well as pubertal factors may play crucial role (El-Sheikh, Kelly, 2011, Erath, Tu, 2011). This lack of studies is specifically prominent in different cultures (Owens, 2004). In Russia sleep-related dysfunctional beliefs and behavior are wide-spread both in general population and patients with insomnia (Rasskazova, Tkhostov, 2012). However, their role in adolescence remains unclear. The aim of the study is to reveal the specific role of beliefs about sleep in sleep quality of Russian female adolescents after adjusting for family cohesion, depression and anxiety. Materials and methods: 59 Russian female adolescents 14 to 16 years were interviewed about their typical sleep schedule (time to fall asleep and awake, sleep latency, number and length of awakes) and filled Insomnia Severity Index (ISI, Morin, 1993), Hospital Anxiety and Depression Scale (HADS, Zigmond, Snaith, 1983), Dysfunctional Beliefs About Sleep Scale (DBAS, Morin, 1993) and the Family Adaptability and Cohesion Scale (FACES-IV, Olson, 2011). Results: Cronbach's alpha for ISI and DBAS were acceptable (.70 and .76, respectively) but lower than in Russian adults. Factor analysis supported 1-factor structure for both scales. Subjective sleep disturbances negatively correlated with family flexibility and cohesion (r=-.31 - -.29, p< .05) and positively - with disengaged and rigid family structure, depression, anxiety and dysfunctional beliefs about sleep (r=.28-.59, p< .05). After adjusting for family adaptability and cohesion anxiety (but not depression) was a significant predictor of poorer sleep quality (R-square change 22.8%, beta=.45, p< .01). Dysfunctional beliefs about sleep had an independent effect on sleep quality predicting further 5.5% of variance (beta=.26, p< .05). Chaotic family structure was the only predictor of subjective sleep latency (beta=.34, p< .05) while the anxiety was the only predictor of the number of awakes at night (beta=.35, p< .05). The length of night awakes was related to poorer family cohesion (beta=.74, p< .01) and after adjusting for family factors - to anxiety (beta=.42, p< .05) but not to dysfunctional beliefs. Conclusions: In line with previous findings (Erath, Tu, 2011), subjective sleep in adolescents is related to family context and emotional factors. In healthy female adolescents anxiety seem to be stronger predictor of poorer sleep than depression. Dysfunctional beliefs remain an important factor of sleep-related complaints demanding psychological intervention even after family and emotional factors are taken into account. Concrete parameters of sleep (sleep latency and night awakes) seem to depend more on family cohesion and anxiety than on cognitive factors. Russian versions of ISI and DBAS could be used in research in adolescents. Acknowledgements: Research is supported by the Russian Foundation for Basic Research, project No. 17-06-00363.