Chronotypes and trauma reactions in children with ADHD in home confinement of COVID-19: full mediation effect of sleep problems

Abstract

This study aimed to investigate the relationship between chronotype preference/sleep problems and symptom severity of children with Attention Deficit Hyperactivity Disorder (ADHD) during the COVID-19 outbreak and to assess the chronotype preference/sleep problems that may play a mediating role in the relationship between the reactions to trauma and severity of ADHD symptoms. The sample of this single-center cross-sectional study consisted of 76 children with ADHD and their parents. Trauma symptoms were evaluated with the Children's Impact of Event Scale (CRIES-8); sleep habits were assessed using the Children's Sleep Habits Questionnaire (CSHQ); and chronotype was assessed using the Children's Chronotype Questionnaire (CCQ). There were significant differences in CRIES-8 and CSHQ scores between the eveningness type group and the non-eveningness type group. The CRIES-8 scores of children with ADHD were related to the CCQ and CSHQ scores and severity of ADHD symptoms. In mediation analyses, sleep problems were found to be the full mediating factor in the relationship between CRIES-8 scores and severity of ADHD symptoms and the relationship between CCQ scores and the severity of ADHD symptoms. Our findings indicate that chronotype plays an important role on the negative effects of home confinement of ADHD children during the COVID-19 outbreak. The role of the full mediator of sleep problems in the path from cognition to the behavior of young ADHD and non-ADHD children confined to the home environment during the pandemic period requires further assessment.

Demographic, psychological, chronobiological, and work-related predictors of sleep disturbances during the COVID-19 lockdown in Italy

“…The present results pointed to a particular vulnerability of the ET group, although the lockdown was a favourable period to reduce the mismatch between internal and social clocks. Of note, the present results are consistent with those obtained during the pandemic period in an adolescent clinical population 50 .…”

Sleeping During the First Wave: Demographic, Psychological, Chronobiological, and Work-Related Predictors of Sleep Disturbances Throughout the COVID-19 Lockdown

“…The present results pointed to a particular vulnerability of the ET group, although the lockdown was a favourable period to reduce the mismatch between internal and social clocks. Of note, the present results are consistent with those obtained during the pandemic period in an adolescent clinical population [49].…”

The impact of COVID-19 lockdown on child and adolescent mental health: systematic review

“…Those who felt lonelier were more likely to use social media to deal with the lack of social contact ( p = 0.004). Humorous coping was found to be positively related to feelings of happiness and not influenced by anxiety or loneliness ( p = 0.008) Cetin et al 2020 [ 17 ] Turkey Cross-sectional 76 30% 10.1 ± 2.2 Y ★★ Sleep problems mediated the relationship between PTSD symptoms and severity of ADHD symptoms and the relationship between chronotype and the severity of ADHD symptoms Chen et al 2020a [ 19 ] China Longitudinal 543 51% 10.9 ± 0.7 Y N.A At follow-up there were greater levels of psychological distress for school children. A significant predictor of psychological distress at baseline and follow up was seen to be problematic internet-related behaviours.…”

“…A proportion of studies ( n = 10, 2,321) utilised interviews, of which some were parent interviews ( n = 2, 535), some were child interviews (n = 5, 2,629), and some interviewed both parents and children ( n = 3, 261). Duration of lockdown was 52.3 ± 21.3 days in the included studies (range 30 [ 1 , 4 , 12 , 17 , 25 , 27 , 34 , 39 , 41 , 57 , 82 ]—100 days [ 80 , 100 ]). The characteristics of the included studies and their findings are summarised in Table 1 .…”