No abstract

Study objectivesTo examine the resting-state functional connectivity (FC) between subcortical regions in relation to whole-brain activity in patients with psychophysiological insomnia (PI) and changes following cognitive–behavioral therapy for insomnia (CBTi).MethodsThe FC between subcortical seed regions (caudate, putamen, pallidum, amygdala, thalamus, and hippocampus) and whole-brain voxels were compared between the PI group (n = 13, mean age: 51.0 ± 10.2 years) and good sleepers (GS, n = 18, mean age: 42.7 ± 12.3 years). Also, in the PI group, FC was compared before and after 5 weeks of CBTi.ResultsCompared to the GS group, the PI group exhibited stronger FC between the thalamus and prefrontal cortex and between the pallidum and precuneus but weaker FC between the pallidum and angular gyrus, the caudate and orbitofrontal cortex, and the hippocampus and fusiform gyrus. After CBTi, the PI group exhibited decreased FC between the thalamus and parietal cortex, the putamen and motor cortices, and the amygdala and lingual gyrus, but increased FC between the caudate and supramarginal gyrus, the pallidum and orbitofrontal cortex, and the hippocampus and frontal/parietal gyri.ConclusionsThe present findings demonstrate different FC in PI patients compared to GS and provide insight into the neurobiological rationale for CBTi.

Psychophysiological insomnia (PI) includes arousal to sleep-related stimuli (SS), which can be treated by cognitive behavioral therapy for insomnia (CBT-I). The present study was an exploratory, prospective intervention study that aimed to explore brain response to visual SS in PI before and after CBT-I. Blood oxygen level dependent (BOLD) signal differences in response to SS and neutral stimuli (NS) were compared between 14 drug-free PI patients and 18 good sleepers (GS) using functional magnetic resonance imaging (fMRI). BOLD changes after CBT-I in patients were also examined. PI patients showed higher BOLD activation to SS in the precentral, prefrontal, fusiform, and posterior cingulate cortices before CBT-I. The increased responses to SS were reduced after CBT-I. The increased response to SS in the precentral cortex was associated with longer wake time after sleep onset (WASO), and its reduction after CBT-I was associated with improvements in WASO. Clinical improvements after CBT-I were correlated with BOLD reduction in the right insula and left paracentral cortex in response to SS. PI showed hyper-responses to SS in the precentral cortex, prefrontal cortex, and default mode network and these brain hyper-responses were normalized after CBT-I. CBT-I may exert its treatment effects on PI by reducing hyper-responses to SS in the precentral cortex and insula.

No abstract

ObjectiveWe investigated the prevalence of insomnia and its clinical characteristics in North Korean refugees.MethodsNorth Korean refugees living in South Korea (48 males, 129 females; mean age 38.22±12.24 years) and South Koreans (112 males, 203 females; mean age 39.48±10.32 years) completed the following questionnaires: the Self-reported Questionnaire on Insomnia, Center for Epidemiological Studies-Depression Scale (CES-D), Trauma Exposure Check List for North Korean Refugees, and the Impact of Event Scale-Revised (IES-R).ResultsNorth Korean refugees had insomnia more often than South Koreans did (38.42% vs. 8.89%). Depression combined with insomnia was also more prevalent in North Korean refugees (28.25% vs. 3.17%). Compared with South Koreans with insomnia, North Korean refugees with insomnia showed higher CES-D scores. The North Korean refugees with insomnia had experienced a larger number of traumatic events, and had higher CES-D and IES-R scores compared to North Korean refugees without insomnia. Insomnia in North Korean refugees was also associated with the presence of significant depressive and post-traumatic stress disorder (PTSD) symptoms.ConclusionInsomnia was common in North Korean refugees and was closely associated with depressive and PTSD symptoms. Our study suggests that complaints of insomnia may indicate more severe psychopathology, especially in refugees.

No abstract

The aim of this study was to investigate the relationships among morningness-eveningness, impulsivity and anger in the general population. A total of 1000 community-dwelling subjects (500 males) aged 20-77 years (mean± SD age: 39.6 ± 11.6 years) completed the morningness-eveningness questionnaire (MEQ), Barratt impulsiveness scale (BIS), Spielberger State-Trait Anger Expression Inventory (STAXI) and Center for Epidemiologic Studies Depression Scale. Moderation and mediation analyses were performed to determine whether the relationship between two variables depended on the third variable, referred to as a moderator, and whether the third variable, known as a mediator, was associated with the other two variables establishing causation. The MEQ scores exhibited significant negative associations with BIS (p < 0.001) and STAXI (p < 0.001) scores, and high scores on the BIS were associated with high scores on the STAXI (p < 0.001). Impulsivity, as measured by the BIS, played a role as a moderator (p < 0.001) in the relationship between MEQ and STAXI, and anger, as measured by the STAXI, acted as moderator (p = 0.030) in the association between MEQ and BIS. However, after controlling for the interaction of the BIS and MEQ, the MEQ scores did not significantly predict STAXI scores (p = 0.070). Additionally, the effect size of the mediating effect of the BIS scores on the relationship between the MEQ and STAXI (percent mediation: 53.2%) was larger than that of the STAXI scores on the association between the MEQ and BIS (percent mediation: 31.8%). The present results demonstrate that morningness-eveningness was closely related with both impulsivity and anger in the general population. Furthermore, these findings suggest that impulsivity may exercise a great influence on the association between morningness-eveningness and anger in two ways: as a moderator by modulating this relationship based on the level of impulsivity and as a mediator by acting as an intermediary factor.

Dysfunctional affective processes are central to the experience of internalizing disorders (e.g., depression, anxiety, and related disorders). Specifically, extreme positive affect and elevated negative affect each have unique and robust patterns of associations with internalizing symptoms This article examines affect as both an individual difference and a within-person dynamic process that unfolds over time. Recent research is reviewed that clarifies the hierarchical structure of affect and facet-level associations with symptoms, affect-laden traits that confer risk for internalizing psychopathology, models of emotion regulation, and how emotion regulation abilities and strategies contribute to or detract from psychological well-being. Several measurement challenges in this literature are identified and discussed, including possible conceptual and content overlap, mood-state distortion, naturalistic assessment in daily life, and the benefits and limitations of self-reported affective experience.