Shirley Xin Li

Shirley Xin Li
The University of Hong Kong | HKU · Department of Psychology

PhD, DClinPsy

About

147
Publications
12,636
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3,027
Citations
Citations since 2017
99 Research Items
2222 Citations
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20172018201920202021202220230100200300400500
20172018201920202021202220230100200300400500
20172018201920202021202220230100200300400500

Publications

Publications (147)
Article
Acute insomnia is common and a substantial proportion of people with acute insomnia (i.e. 3 days to 3 months) transit into chronic insomnia (i.e. 3 months or longer). Therefore, early intervention for acute insomnia is vital to prevent chronicity. Previous trials with small sample sizes have shown that brief versions of both individual and group-ba...
Article
Objectives: The current study aimed to examine the neurodegenerative implication of isolated REM sleep without atonia (RSWA) among first-degree relatives of patients with REM sleep behaviour disorder (RBD). Methods: This cross-sectional case-control study recruited three groups of subjects: First-degree relatives of RBD patients with isolated RS...
Article
Humans experience multiple biological and emotional changes under acute stress. Adopting a multi-systemic approach, we summarized 61 studies on healthy people’s endocrinological, physiological, immunological and emotional responses to the Trier Social Stress Test. We found salivary cortisol and negative mood states were the most sensitive markers t...
Article
Recurrent dream‐enactment behaviours (DEB) and rapid eye movement (REM) sleep without atonia (RSWA) are two diagnostic hallmarks of REM sleep behaviour disorder (RBD), a specific prodrome of α‐synucleinopathy. Whilst isolated RSWA (without DEB) was suggested as a prodrome of RBD, the implication of ‘isolated’ recurrent DEB remains under‐investigate...
Article
Study objectives This study aimed to examine the effect of sleep-corrected social jetlag (SJLsc) on mental health, behavioral problems, and daytime sleepiness in adolescents. Methods This was a cross-sectional study which included 4787 adolescents (Mean age: 14.83±1.6y, 56.0% girls) recruited from 15 secondary schools in Hong Kong. SJLsc was defin...
Article
Full-text available
Many experimental sleep deprivation (SD) studies were conducted to clarify the causal relationship between sleep and pain. This systematic review and meta-analysis aimed to update the evidence regarding the effects of different experimental SD paradigms on various pain outcomes. Five databases were searched from their inception to June 2022. Separa...
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The current study examined the possible predictors of dropout during a five-week light treatment (LT) with a gradual advance protocol in 93 patients with unipolar non-seasonal depression and evening chronotypes by comparing their clinical characteristics and performing a logistic regression analysis. Nineteen out of ninety-three (20%) subjects (80%...
Article
Full-text available
Patients with Parkinson’s disease (PD) were described less extraverted and more neurotic. It remained unclear whether similar personality traits could be found in idiopathic rapid eye movement sleep behavior disorder (iRBD), a prodromal stage of PD, and could predict phenoconversion to neurodegenerative disorders. We aimed to investigate the person...
Article
Study objectives: The current study aimed to examine the association of insomnia symptoms with daytime behavior and cognitive functioning in children with attention deficit hyperactivity disorder (ADHD). Methods: Thirty-six children with ADHD and insomnia symptoms, 27 children with ADHD without insomnia symptoms and 21 age-matched healthy contro...
Article
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Background Electronic media use (EMU) becomes one of the most common activities in adolescents. The present study investigated the deleterious influence of excessive EMU and EMU before bedtime on social, emotional, and behavioral difficulties (SEBD) in adolescents. The role of sleep and circadian problems in mediating the association of EMU with SE...
Article
Introduction Although depression has shown a strong familial aggregation tendency, there are some moderators between parental and offspring’s depression. Meanwhile, it is known that evening chronotype is a risk factor for depression. Therefore, this study aimed to evaluate the moderating role of chronotype in the relationship between maternal and a...
Article
Full-text available
Background and objectives: Individuals with a history of recurrent dream-enactment behaviors, but with subthreshold REM sleep without atonia levels for REM sleep behavior disorder (RBD) diagnosis, are currently classified to have prodromal RBD (pRBD). However, the REM sleep elevated EMG diagnostic cut-off, progression trajectory, and long-term neu...
Article
Full-text available
Purpose We conducted an exploratory study to identify risk factors of dropout in an 8-week e-mail-based cognitive-behavioral therapy for insomnia (REFRESH) to improve sleep among university students with insomnia symptoms. Methods University and graduate students in Hong Kong and Korea who scored higher than 10 on the Insomnia Severity Index parti...
Article
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This study examined whether cognitive behavioral therapy (CBT) for insomnia (CBT-I) improved insomnia severity, by changing sleep-related mediating factors. It also examined whether an improvement in insomnia led to enhanced mental health. This study was a secondary analysis of a randomized controlled trial of e-mail-delivered CBT-I for young adult...
Article
Sleep complaints are common among children. These include both night-time and daytime symptoms, such as trouble falling asleep, problems in maintaining sleep, snoring, and unusual events during sleep and daytime functioning impairment. However, sleep complaints in children are often overlooked and undertreated in clinical practice. Untreated sleep...
Article
Purpose: The purpose of the study was to compare the efficacy of group-based therapy (GT) and email-delivered self-help (ESH) cognitive behavioral therapy for insomnia (CBT-I) with the wait-list (WL) control group in youths. Methods: The study involved an assessor-blind, parallel group randomized controlled trial in youths meeting the diagnostic...
Article
Chronotype, referred to as an individual's diurnal preference of timing for rest and activity, can be subjectively measured using the Munich Chronotype Questionnaire (MCTQ). However, the validity of MCTQ has yet to be tested in the youth population. In addition, it remains uncertain if MCTQ is a good measure of chronotype in individuals with insomn...
Article
Full-text available
This study examined the effects of an e-mail-delivered cognitive behavioral therapy for insomnia (CBT-I), validated in Western countries, on insomnia severity, anxiety, and depression in young adults with insomnia in Eastern countries, particularly Japan. This prospective parallel-group randomized clinical trial included college students with Insom...
Article
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The coronavirus disease (COVID-19) has brought significant social and economic disruptions and devastating impacts on public health, and vaccines are being developed to combat the disease. Timely vaccination may prevent complications and morbidity but may also potentially result in unforeseen outcomes in some special clinical populations. We report...
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Objective To investigate the prevalence and clinical correlates of video polysomnography (vPSG)-confirmed rapid eye movement sleep behaviour disorder (RBD) in patients with major depressive disorder (MDD). Methods This is a clinic-based two-phase epidemiological study. In phase 1, patients with MDD were screened by a validated questionnaire, RBD Q...
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Objectives Research in recent years has shown that mindfulness-based interventions can enhance teachers’ mental and physical health. However, the existing studies were predominantly conducted in Western, educated, industrialized, rich, and democratic (WEIRD) societies. As a randomized controlled trial in a non-WEIRD society, the present study exami...
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Study Objectives Insomnia and depression are common comorbid conditions in youths. Emerging evidence suggests that disrupted reward processing may be implicated in the association between insomnia and the increased risk for depression. Reduced reward positivity (RewP) as measured by event-related potential (ERP) has been linked to depression, but h...
Article
Study objectives: Eveningness is associated with worse outcomes in depression. It remained unclear if eveningness could be altered with chronobiological therapy and whether such a change would predict long-term outcomes of depression. Methods: Data from a randomized controlled trial of 5-week adjunctive bright light therapy with a gradual advanc...
Article
Background Eveningness and insomnia are highly comorbid and closely related to psychopathology in adolescents. We aimed to prospectively investigate the trajectories and associations of eveningness and insomnia with daytime functioning, depression and suicidal risk in adolescents. Methods A 3-year longitudinal study conducted among 414 Chinese ado...
Article
Background The relationship between sleep and frailty in older age is complex. Most previous studies focused on sleep duration, while insomnia, a common sleep problem in older adults, has not been adequately examined and the factors implicated in its association with frailty were under-explored. Methods A community-based sample of 345 prefrail and...
Article
Insomnia has been shown to negatively affect one's cognitive functioning. While there has been some evidence suggesting sleep disruption in relation to impaired inhibitory control, a major component of executive function, little is known about the underlying neural processing in insomnia. The current study aimed to examine the differences in the be...
Article
Study objectives: To examine the associations of circadian characteristics (ie, chronotype and social jetlag) with insomnia symptoms and emotional and behavioral problems among school-age children. Methods: A total of 620 primary school children (medianage = 10.06, standard deviation = 1.16, 58.7% boys) were recruited and assessed by a set of pa...
Article
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Introduction As dropout from treatment potentially diminishes its therapeutic effect and poses clinical concern, it is important to find out which characteristics of participants are suitable for online-based treatment. Therefore, we aimed to identify factors that predicted a dropout in the e-mail based cognitive behavioral therapy (REFRESH) develo...
Article
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Introduction Although delayed sleep-wake phase disorder (DSWPD) shares phenomenological experiences with chronic insomnia disorder, previous research on the conceptual understanding of DSWPD has been limited, with a predominant focus on its chronobiological basis. The present study examined several insomnia-related cognitive and behavioural factors...
Article
Introduction Drop out during treatment hampers therapeutic effect of interventions. The current study examines the possible predictors of drop out during the five-week light treatment in patients with unipolar non-seasonal depression and evening-chronotype. Methods Baseline characteristics including demographics, sleep diary parameters, light trea...
Article
Introduction Disrupted circadian rhythms is associated with impaired cognitive function. Although circadian rhythm disturbances are commonly seen in individuals with attention-deficit hyperactivity disorder (ADHD), whether their cognitive functioning is thus affected remains unclear. This study aimed to examine the associations of circadian-related...
Article
Introduction Circadian rhythm disturbances, including delayed circadian rhythm and increased motor activity, are commonly seen in attention-deficit hyperactivity disorder (ADHD). Previous research suggested a link between circadian rhythm disturbances and poor psychosocial functioning in children, but such a relationship has not been examined in ch...
Article
Introduction Insomnia is often comorbid with depression in youths and both may reciprocally exacerbate clinical outcomes and lead to a constellation of detrimental consequences. The present study aimed to test the efficacy of cognitive behavioral therapy (CBT) for insomnia (CBT-I) and CBT for depression (CBT-D), when compared with waitlist control,...
Article
Insomnia is a prevalent sleep problem associated with a constellation of negative health-related outcomes and significant socioeconomic burden. It commonly co-occurs with psychiatric and medical conditions, which may further exacerbate these comorbid conditions and hinder treatment response. There is much empirical evidence to support the clinical...
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Study objectives We aimed to investigate the prospective associations of sleep phenotypes with severe intentional self-harm (ISH) in middle-aged and older adults. Methods A total of 499,159 participants (mean age: 56.55 ± 8.09 years; female: 54.4%) were recruited from the UK Biobank between 2006 and 2010 with follow-up until February 2016 in this...
Article
Objectives: To prevent the future development of insomnia in at-risk adolescents. Methods: A randomized controlled trial comparing 4 weekly insomnia prevention program with a nonactive control group. Subjects were assessed at baseline, postintervention, and 6 and 12 months after intervention. Assessors were blinded to the randomization. Analyses...
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PurposeWe aimed to investigate the association between sleep disturbance and menstrual problems in female Chinese university students.MethodsA convenience sample of 1006 female university students participated in this study. Sleep duration, sleep quality, and insomnia symptoms were assessed by the Pittsburgh Sleep Quality Index and the Insomnia Sev...
Article
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Despite the critical role of sleep in memory and emotion processing, large remains unknown regarding how sleep influences trauma-related symptoms arising from maladaptive memory/emotional processes, such as those among patients with post- traumatic stress disorder. Employing a trauma film paradigm, we investigated how post-trauma sleep versus sleep...
Article
Background: Unipolar non-seasonal depressed patients with concomitant evening chronotype were associated with poor clinical outcomes and higher non-remission rate. This study aims to examine the efficacy of adjunctive bright light therapy with gradual timing advance in a randomized, assessor and prescriber-blinded controlled trial. Method: Parti...
Article
Background The risk of neurodegenerative disorders in idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with residual injuries symptoms (RIS) after symptomatic treatment with clonazepam and/or melatonin is unclear. Objective The objective of this study was to determine the rate and correlates of RIS and its association with the...
Article
Objective To investigate the differences in actigraphy‐measured rest‐activity patterns (e.g., sleep‐wake cycle, circadian rest‐activity rhythm, and physical activity) across different stages of α‐synucleinopathy. Methods We compared alterations in 7‐day actigraphy‐measured rest‐activity patterns among patients with clinically diagnosed α‐synuclein...
Article
Objectives To investigate the association of insomnia and chronotype preference with daytime impairment and psychopathology in a community sample of adolescents in Hong Kong. Methods This is a cross-sectional study that included seven local secondary schools in Hong Kong. A total of 1667 adolescents (mean age: 14.8 ± 1.6 years old; boys: 56.5%) re...
Preprint
BACKGROUND Mobile technology has been becoming a necessity in life among people in many countries. Its characteristics and advantages also make it a potential medium of intervention for people with Autism Spectrum Disorder (ASD). OBJECTIVE The objective of this review was to evaluate the previous evidence, obtained in randomized control trials (RC...
Article
Background: Mobile technology has become a necessity in the lives of people in many countries. Its characteristics and advantages also make it a potential medium of intervention for people with autism spectrum disorder (ASD). Objective: The objective of this review was to evaluate previous evidence, obtained in randomized controlled trials (RCTs...
Code
SAVE-9 was developed (by Yong-Wook Shin & Seockhoon Chung, ASAN Medical Center, KOREA) to measure anxiety symptoms and work-related stress in response to viral epidemic for front-line Healthcare workers / 医护人员因病毒疫情而产生的压力以及焦虑反应的测量表(Chinese-Cantonese version was done by Shirley Xin Li, Department of Psychology, University of Hong Kong)
Article
Sleep quantity and quality are both important for optimal development and functioning during youth. Yet few studies have examined the effects of insomnia symptoms and objective short sleep duration on memory performance among adolescents and young adults. One‐hundred and ninety participants (female: 61.6%) aged from 12 to 24 years completed this st...
Article
Full-text available
Introduction Previous evidence suggested that online self-guided sleep intervention is efficacious in improving treatment outcomes in patients with persistent insomnia. However, research on online sleep interventions targeting episodic insomnia has been scarce. This study aims to evaluate the effectiveness of brief e-aid cognitive behavioural thera...
Article
Study objectives: To compare the secular trends of sleep/wake patterns in school-aged children in Hong Kong and Shanghai, two major metropolitan cities in China with two different policies that school start time was delayed in Shanghai, but advanced in Hong Kong in 10 years' time. Methods: Participants were from two waves of cross-sectional scho...
Article
Study objectives: To compare the secular trends of sleep/wake patterns in school-aged children in Hong Kong and Shanghai, two major metropolitan cities in China with two different policies that school start time was delayed in Shanghai, but advanced in Hong Kong in 10 years' time. Methods: Participants were from two waves of cross-sectional scho...
Article
Introduction Sleep problems are common in children with attention deficit hyperactivity disorder (ADHD), with a prevalence rate as high as 73%. Sleep difficulties are strongly associated with increased behavioural problems and impaired daytime functioning in ADHD children, and often pose significant challenges and stress to the families. The aims o...
Article
Objectives: To investigate whether baseline electromyography (EMG) activity during rapid eye movement (REM) sleep predicts the development of neurodegenerative diseases over time in patients with idiopathic REM sleep behavior disorder (iRBD). Methods: A total of 216 patients with polysomnography-confirmed iRBD were recruited from September 1997...
Article
Weekday-to-weekend sleep discrepancy is a common phenomenon in school-age children and youths. However, the effects of weekday-to-weekend sleep differences remain unclear. A systematic review that included 72 observational studies was conducted to examine the association of weekday-to-weekend differences in bedtime, rise time, mid-point of sleep an...
Article
Background To determine the familial aggregation of idiopathic rapid eye movement sleep behavior disorder (iRBD), neurodegenerative diseases, and related biomarkers. Methods A total of 404 and 387 first‐degree relatives of 102 patients with iRBD and 89 controls were recruited, respectively. Among them, 204 and 208 relatives of patients and control...
Chapter
REM sleep behaviour disorder (RBD) is a distinct parasomnia characterised by a loss of normal skeletal muscle atonia during REM sleep and a clinical presentation of dream enacting behaviours. As a consequence of the vigorous nocturnal motor activities, sleep-related injuries to self and bed partner are common sequelae in RBD patients. Meanwhile, RB...
Chapter
Idiopathic RBD (iRBD), co-morbid psychiatric illnesses, and the use of psychotropics have been increasingly reported in the literature. Among the iRBD patients, depression was found to be a common co-morbid condition. Cohorts of iRBD patients reported that those taking antidepressants were associated with significant abnormalities of early neurodeg...
Article
Objectives: To examine the prevalence and correlates of excessive daytime sleepiness (EDS) among Hong Kong children and adolescents. We investigated the potential roles of sex and puberty in modulating the occurrence of EDS. Methods: A total of 10,086 students (male, 48.1%) aged 6-18 (mean ± SD: 12.3 ± 3.2) years old participated in this cross-s...
Article
Study objectives: To examine the prevalence and correlates of nighttime awakenings and to explore the association between sleep and cognitive development in a community sample of infants and toddlers. Methods: A total of 590 healthy infants (aged 2-11 months) and 512 toddlers (aged 12-30 months) from 8 provinces of China were assessed for their...
Article
Objective Eveningness tendency and insomnia are common in adolescents, but whether they have an independent or synergistic effect on the risk of psychopathology have remained undefined. The present study aimed to examine eveningness chronotype and insomnia symptoms in relation to mental health and emotional and behavioural problems in a community-b...
Conference Paper
Background: Accumulating evidence indicates that circadian rhythm, such as rest-activity rhythm and circadian plasma melatonin, is associated with cognitive and neurological functions at different stages of Parkinson's disease (PD). However, whether these associations exist in idiopathic REM sleep behavior disorder (iRBD) remains unknown. Objective...
Conference Paper
Background and purpose: Circadian rhythm disturbances are commonly observed at different stages of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease. However, whether circadian rhythm is altered in idiopathic REM sleep behavior disorder (iRBD), a widely accepted prodromal stage of neurodegenerative diseases, remains un...
Article
Full-text available
Sleep and circadian rhythmicity both play an important role in human's cognitive functioning, yet the way in which early development of sleep and circadian rhythm affects cognitive processes and social learning in infants remains less understood. We examined the association of sleep and circadian activity rhythm (CAR) with face and emotional inform...
Article
Introduction: There are contradictory findings regarding the associations of parental depression on the hypothalamic-pituitary-adrenal axis activity of their offspring. We aimed to explore the associations of parental depression on the diurnal salivary cortisol profile in their child and adolescent offspring. Methods: A total of 189 unaffected c...