These results set the stage for further research on computer-based treatment targeting interpretation bias of angry faces in DMDD. Such treatment may decrease irritability and alter neural responses to subtle expressions of happiness and anger.
Objectives
Using a social learning model, the aim of the Sleep Smart Program was to primarily improve sleep health behaviors and secondarily improve academic performance and behavioral well-being.
Design
Randomized control trial for a social learning-based preventive intervention program.
Participants
A diverse group of seventh graders from 2 urban, middle schools were randomly assigned, according to school, to an 8-session Sleep Smart Program (SS = 70) or a comparison group (comparison = 73).
Measurements
Sleep patterns, sleep hygiene, and sleep health efficacy; academic performance; and behavioral well-being were assessed at 4 times of measure (baseline, postintervention, 2 follow-up times in eighth grade).
Results
SS seventh graders experienced significantly greater sleep health efficacy, improved physiological and emotional sleep hygiene, more time in bed, and earlier bedtimes vs comparison group. SS (vs comparison) participants also reported a significant decrease in internalizing behavior problems and sustained academic performance. Finally, although not maintained at time 4, SS participants continued to report improved sleep health efficacy at time 3, whereas the comparison group participants' sleep health efficacy declined.
Conclusion
The Sleep Smart preventive intervention was effective in improving sleep health efficacy, sleep hygiene, time in bed, and bedtimes; in maintaining grades; and in reducing internalizing behavior problems, yet these changes were not sustained at follow-up.
Reproducibility of results is important in improving the robustness of conclusions drawn from research, particularly in functional magnetic resonance imaging (fMRI). In this study, we aim to replicate a previous study on the neural correlates of face emotion processing above and below awareness level using an independent sample of youth with severe mood dysregulation (SMD) and healthy volunteers (HV). We collected fMRI data in 17 SMD and 20 HV, using an affective priming paradigm with masked (17 ms) and unmasked (187 ms) faces (angry, happy, neutral, blank oval). When processing masked and unmasked angry faces, SMD patients exhibited increased activation in the parahippocampal gyrus (PHG) and superior temporal gyrus relative to HV. When processing masked and unmasked happy faces, SMD patients showed decreased activation in the insula, PHG and thalamus compared with HV. During masked face processing in general across emotions, youth with SMD showed greater ventromedial prefrontal cortex (vmPFC) activation relative to HV. Perturbed activation in emotion processing areas (e.g. insula, PHG, superior temporal gyrus and thalamus) manifests as hyper-sensitivity toward negative emotions and hypo-sensitivity toward positive emotions may be important in the etiology and maintenance of irritability, aggression and depressive symptoms in SMD. vmPFC dysfunction may mediate over-reactivity to face emotions associated with irritability.
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