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Adolescents With Greater Mental Toughness Show Higher Sleep Efficiency, More Deep Sleep and Fewer Awakenings After Sleep Onset
Abstract
Mental toughness (MT) is understood as the display of confidence, commitment, challenge, and control. Mental toughness is associated with resilience against stress. However, research has not yet focused on the relation between MT and objective sleep. The aim of the present study was therefore to explore the extent to which greater MT is associated with objectively assessed sleep among adolescents.
A total of 92 adolescents (35% females; mean age, 18.92 years) completed the Mental Toughness Questionnaire. Participants were split into groups of high and low mental toughness. Objective sleep was recorded via sleep electroencephalograms and subjective sleep was assessed via a questionnaire.
Compared with participants with low MT, participants with high MT had higher sleep efficiency, a lower number of awakenings after sleep onset, less light sleep, and more deep sleep. They also reported lower daytime sleepiness.
Adolescents reporting higher MT also had objectively better sleep, as recorded via sleep electroencephalograms. A bidirectional association between MT and sleep seems likely; therefore, among adolescence, improving sleep should increase MT, and improving MT should increase sleep.
... Sleep deprivation can also induce alteration in the immune and inflammatory systems [21]. Sleep deprivation and chronic sleep loss can negatively impact cognitive functioning, mood, learning and memory, reaction time, and alertness [20,22], and mental toughness [22]. ...
... Sleep deprivation can also induce alteration in the immune and inflammatory systems [21]. Sleep deprivation and chronic sleep loss can negatively impact cognitive functioning, mood, learning and memory, reaction time, and alertness [20,22], and mental toughness [22]. ...
... Since sleep deprivation can influence psychological attributes, such as mental health and sports mental toughness, which are recognized as major contributors of sporting success [22]. It is important to understand the prevalence of sleep problems and mental health status among athletes from time to time to provide suitable interventions. ...
... Sleep deprivation can also induce alteration in the immune and inflammatory systems [21]. Sleep deprivation and chronic sleep loss can negatively impact cognitive functioning, mood, learning and memory, reaction time, and alertness [20,22], and mental toughness [22]. ...
... Sleep deprivation can also induce alteration in the immune and inflammatory systems [21]. Sleep deprivation and chronic sleep loss can negatively impact cognitive functioning, mood, learning and memory, reaction time, and alertness [20,22], and mental toughness [22]. ...
... Since sleep deprivation can influence psychological attributes, such as mental health and sports mental toughness, which are recognized as major contributors of sporting success [22]. It is important to understand the prevalence of sleep problems and mental health status among athletes from time to time to provide suitable interventions. ...
Objective
The aim of the present study was to investigate the sleep quality and its association with mental toughness, stress, depression, anxiety, and sports anxiety of Indian male Kho Kho players.
Methods
Participants were 52 male Indian Kho Kho players (aged 23.1 ± 3.70 years) of the pre-competition phase. Self-reported sleep quality of participants was assessed using Pittsburgh Sleep Quality Index (PSQI) questionnaire. Depression, Anxiety and Stress Scale (DASS-21) and Physical Activity and Sport Anxiety Scale (PASAS) and Mental Toughness Questionnaire-Short Form (SMTQ) questionnaires were used as tools to assess the mental health status of the athletes. Descriptive statistics and one-way ANOVA were computed to test the study hypothesis.
Results
Sleep problems (PSQI Score > 5) were prevalent among 38.5% of athletes. Poor sleep quality (PSQI Score 6–10; 21.2%) and very poor sleep quality (PSQI Score > 11; 17.3%) were observed among the athletes. Sleep quality index scores were significantly associated (p < 0.05) with sleep disturbance, daytime dysfunction, and medication. Symptoms related to depression (15.3%), anxiety (36.5%), stress (9.6%), and sports anxiety (7.7%) were also found among athletes. Stress levels were found to be significantly increased (p < 0.05) in athletes with poor sleep quality. However, anxiety, depression and sports anxiety and mental toughness did not show a significant association with sleep quality.
Conclusion
Poor sleep quality can be associated with increased stress levels, but not with depression, anxiety and sports anxiety and mental toughness among Indian male Kho Kho players.
... Wang & Fan, 2023;Zagaria et al., 2023;Zhang et al., 2024), while dimensions of mental toughness (and resilience) appeared to be a protective factor against insomnia. Importantly, the associations between restoring sleep and higher scores for mental toughness have been observed among children, adolescents, adults and among clinical samples of individuals with multiple sclerosis (Arora et al., 2022;Brand et al., 2014aBrand et al., , 2014bEisenhut et al., 2023;Sadeghi Bahmani et al., 2018;Su & He, 2023;Zhu et al., 2024). Thus, the two aims of the present study were to associate symptoms of insomnia severity with scores for stress and mental toughness, though, in a military context. ...
... With the third hypothesis, we expected that higher scores for insomnia were associated with lower mental toughness scores among cadets; data did confirm both the hypothesis and what has been observed so far in a non-military context (Arora et al., 2022;Brand et al., 2014aBrand et al., , 2014bEisenhut et al., 2023;Sadeghi Bahmani et al., 2018;. Again, the novelty is that such an insomnia-mental toughness-link has been observed among military personnel. ...
Background: Compared to the general population, military personnel are at increased risk for insomnia and poor psychological well-being. The present study: (1) compared categories of insomnia severity between cadets of the Swiss Armed Forces (SAF) and previously published norms, and (2) investigated the associations between insomnia and psychological well-being related to perceived stress, mental toughness, dark triad traits, and organizational citizenship behavior (OCB).
Methods: A total of 216 cadets of the SAF (mean age:20.80 years) completed self-rating questionnaires covering sociodemographic information, insomnia, perceived stress, mental toughness, dark triad and organizational citizenship behavior. Data on insomnia sum scores and categories of historical samples (862 young adults and 533 police and emergency response service officers) were used for comparison.
Results: Cadets of the SAF reported higher insomnia sum scores and insomnia severity categories, compared to young adults and police officers. Higher scores for insomnia were associated with higher scores for stress, dark triad traits, and with lower scores for mental toughness and OCB. Categories of low, medium, and high stress moderated the association between insomnia and dark triad traits.
Conclusions: Compared to norms of the general population, cadets of the SAF reported a higher insomnia severity. Given that standardized treatment programs for insomnia, mental toughness and above all for coping with stress are available, such interventions might be promising avenues to improve a cadet’s overall sleep, psychological well-being and behavior.
... Cowden et al. (2016) schlagen außerdem vor, in zukünftigen Studien den Aufmerksamkeitsfokus und die Konzentrationskapazitäten als mögliche Prädiktoren oder Einflussfaktoren auf mentale Stärke zu untersuchen. Mentale Stärke scheint zudem mit günstigeren Schlafparametern in der Adoleszenz zusammen zu hängen (Brand et al. 2014). Dabei nehmen Brand et al. (2014) eine bidirektionale Beziehung an, wodurch sich durch verbesserten Schlaf eine höhere mentale Stärke erzielen lässt, respektive durch eine erhöhte mentale Stärke einen erholsameren Schlaf. ...
... Mentale Stärke scheint zudem mit günstigeren Schlafparametern in der Adoleszenz zusammen zu hängen (Brand et al. 2014). Dabei nehmen Brand et al. (2014) eine bidirektionale Beziehung an, wodurch sich durch verbesserten Schlaf eine höhere mentale Stärke erzielen lässt, respektive durch eine erhöhte mentale Stärke einen erholsameren Schlaf. Eine Längsschnittstudie mit Berufsschülerinnen und -schülern zeigte zudem, dass Personen mit einer hoch ausgeprägten mentalen Stärke besser mit wahrgenommenem Stress umgehen können (Gerber et al. 2013). ...
Mentale Ermüdung und Erholung rücken immer mehr in das Interesse der Sportpraxis und Forschung. Ermüdungs- und Erholungsprozesse können auf physiologischer, verhaltensbezogener und subjektiver Ebene betrachtet und für Interventionen herangezogen werden. Während die Entstehungsmechanismen mentaler Ermüdung bisher weitgehend unklar sind, können einhergehende Indikatoren am deutlichsten subjektiv erfasst werden. Entspannungsverfahren und sportpsychologische Regulationsstrategien sind mögliche Interventionen vor, zwischen oder nach sportlichen Belastungen. Forschungsbedarf besteht jedoch bzgl. der Effekte auf die Verminderung sowie Prävention mentaler Ermüdung. Ein regelmäßiges Monitoring stellt eine wichtige Maßnahme zur Unterstützung der Trainingssteuerung und effektivem Regenerationsmanagement dar. Dieser Beitrag ist Teil der Sektion Sportpsychologie, herausgegeben vom Teilherausgeber Dieter Hackfort, innerhalb des Handbuchs Sport und Sportwissenschaft, herausgegeben von Arne Güllich und Michael Krüger.
... Almost by definition, a personality trait tightly related to sports performance is mental toughness. Indeed, there is sufficient evidence of a favorable association between higher physical activity patterns and higher mental toughness scores [34,[101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118]. Here, mental toughness is understood as the personality trait conferring the ability to control one's life and emotions, to perceive demands and expectations as a challenge (as opposed to a threat), to stay committed to one's own aims and goals, and to have confidence both in one's abilities and in stable relationships. ...
... The answer was not straightforward; while heavy exercisers reported higher mental toughness scores, they also reported more mental health issues. While the former result could be expected from what we know from previous studies [34,[101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118], the latter result appears to confirm the raising research that excessive exercising could also be associated with mental health issues [91][92][93][94][95][96][97][98]. Thus, we claim that the present data expand upon the sparse but increasing literature on the unfavorable association between excessive exercising and mental health issues, in that such a pattern was also observed among heavily exercising Iranian adults. ...
Background:
Physical inactivity has become a global somatic and mental health issue. To counterbalance, promoting regular physical activity appears plausible, above all among adults, where physical inactivity is particularly high. However, some, but sparse, research also indicates that excessive exercising might be associated with unfavorable mental health dimensions. Here, we tested the hypothesis that excessive exercising was associated with more mental health issues. To this end, we assessed mental health issues, stress, mental toughness, and sleep disturbances among heavy and light adult exercisers.
Methods:
A total of 200 adults (mean age: 35 years; 62% females) took part in the study. Of those, 100 were heavy exercisers (18-22 h/week), and 100 were light exercisers (1-6 h/week). Participants completed questionnaires covering sociodemographic information, mental health issues, perceived stress, mental toughness, and sleep disturbances.
Results:
Compared with light exercisers, heavy exercisers reported higher mental health issues, more stress, but also higher mental toughness scores and less sleep disturbances. Higher age, lower mental toughness scores, heavy exerciser-status, and more sleep disturbances predicted higher mental health complaints.
Conclusions:
Compared with light exercising, heavy exercising might be associated with more mental health issues. As such, it appears that the association between exercise frequency, intensity, and duration and psychological well-being might be related to an optimum point, but not to a maximum point. In a similar vein, heavily exercising athletes, their coaches, parents, and representatives of sports associations should get sensitized to possible adverse psychological effects of excessive physical activity patterns.
... Li et al. (18) and Cheng et al. (21) found that people with low resilience directly lead to poor sleep quality. Similarly, Brand et al. (22) reported that compared with the high resilience group, the low resilience group has lower sleep efficiency, more awakenings, and lighter sleep. A recent study also found a significant positive correlation between the resilience and the quality of sleep in pregnant woman (17). ...
... Our study also showed that non-insomnia medical staff had better psychological resilience and stronger strength and hardiness. This was in accordance with other studies showing that participants with low resilience directly lead to poor sleep quality (17,20), such as lower sleep efficiency, more awakening times, and lighter sleep than those with higher resilience (22). ...
Background: The outbreak of novel coronavirus disease (COVID-19) has brought serious psychological pressure to people, especially medical health staff. At present, there are few studies on insomnia and related factors of medical health staff in the middle and late stage of the epidemic of COVID-19. Therefore, the purpose of this study was to investigate the prevalence of insomnia and its related risk factors among medical workers in China in the middle and later stage of COVID-19 epidemic, as well as the relationship between insomnia and psychological resilience.
Methods: From February 14 to March 29, 2020, a cross-sectional survey was conducted among 606 medical staff in China through Ranxing Technology's “SurveyStar” network platform. All subjects were assessed with the Insomnia Severity Index (ISI) and simplified Chinese version of Connor-Davidson Resilience scale (CD-RISC-10).
Results: In the middle and later stages of the COVID-19 outbreak, the incidence of insomnia among medical staff was 32.0%. Compared with non-insomnia group, the insomnia group had younger age, lower education level, longer daily working hours and less psychological resilience. In addition, the prevalence of insomnia was higher in medical staff with a history of somatic diseases. The severity of insomnia of Chinese medical staff was associated with age, education level, daily working hours, psychological resilience and somatic diseases.
Conclusions: Our study shows that nearly 1/3 of Chinese medical workers suffer from insomnia nearly a month after the COVID-19 outbreak. Compared with the general population, medical staff who are working with COVID are more prone to insomnia. Risk factors for insomnia include younger age, lower education level, longer working hours per day, and physical illness. The tenacious dimension of psychological resilience is a protective factor for insomnia.
... Furthermore, adolescents with insufficient sleep in our study had lower resilience scores (P< 0.001), consistent with previous studies. 77 Insufficient sleep impairs the functioning of the prefrontal cortex, which is associated with resilience, leading to decreased ability to handle stress. 78 In fact, findings from a study in Australia suggested that sleep duration mediated depression in adolescents through psychological resilience. ...
Purpose
There is a lack of national studies examining the relationship between insufficient sleep and depression among Chinese adolescents, and previous research has not comprehensively considered related factors. This study aimed to investigate the prevalence of depressive symptoms in adolescents with insufficient sleep and explore the role of associated factors using a nationally representative sample in China.
Patients and Methods
A pen-and-paper survey was conducted among 24147 Chinese adolescents from November 2019 to January 2020. Data on depressive symptoms, maltreatment experiences, psychological resilience, demographic information, parent–child relationships, parental marital status, and sleep duration were collected.
Results
A total of 22231 valid questionnaires were analyzed. Among the respondents, 67.7% reported insufficient sleep, while 32.3% had sufficient sleep. The prevalence of depressive symptoms was 25.3% in adolescents with insufficient sleep, compared to 8.2% in those with sufficient sleep. Insufficient sleep was identified as an independent risk factor for depressive symptoms (OR = 3.058, 95% CI: 2.753–3.396, P < 0.001). In adolescents with sufficient sleep, being female, emotional abuse, physical abuse, sexual abuse, and physical neglect were significant risk factors for depressive symptoms (P < 0.05), while higher resilience scores and a good parent–child relationship were protective factors (P < 0.05). Among adolescents with insufficient sleep, additional risk factors included higher body mass index (BMI), older age, parental divorce, and living with a single parent (P < 0.05).
Conclusion
Insufficient sleep is significantly associated with depressive symptoms in Chinese adolescents. The adolescents with insufficient sleep, particularly those who are older, have a higher BMI, or come from divorced or single-parent households, require increased attention.
... 6. Brand et al.,(2014). This paper looks at the hypothetical and experimental variables characterizing ideal rest, particularly in children, and evaluates the significance of each in creating rules. ...
... Some experiments have shown that improving sleep quality significantly improves mental health problems, such as depression, anxiety, and rumination (Scott et al., 2021). There was a significant positive correlation between the percentage of deep sleep and mental toughness (Brand et al., 2014). In addition, related experiments have demonstrated the moderating roles of self-compassion (Kotera et al., 2021) and physical activity (Zhang et al., 2022), as well as the negative mediating effect of mental distress (Shi et al., 2023;Tang et al., 2018), in the relationship between sleep and mental health. ...
Noise is an important environmental risk factor for physical and mental health. Furthermore, long-term noise exposure is burdensome for the mind and body and has become a serious problem. Rail transportation is one of the main methods used to transport goods in China; however, the noise and vibrations generated by freight trains have serious impacts on residents in nearby regions. To further investigate the relationship between railway noise and road noise exposure and changes in sleep duration and mental health scores, a field study in Harbin, China, was conducted and a health risk prediction model was constructed. The results showed that for every 1 dB increase in the Equivalent continuous A-weighted sound pressure level (LAeq), the percentage of deep sleep among residents living near the railway decreased by 0.2 %. Although residents near the railway reported similar sleep evaluations compared to those living farther away, they exhibited poorer mental health. Cox risk modeling indicates that the risk of mental health problems is approximately three times higher for those living near the railway. These findings potentially provide benefits in developing strategies to reduce the risk of mental illness for people residing near railways.
... La importancia de la relación entre la fortaleza mental y el rendimiento deportivo ha sido demostrada, ya que según la revisión de la literatura efectuada por Cowden (2017a), el 88% de los estudios relevantes encontraron que los deportistas con niveles más altos de fortaleza mental tendían a mayores niveles de logro y de rendimiento. Pero además de los beneficios sobre el deportista en competición, se ha comprobado que la fortaleza mental también se asocia a una mayor confianza (Chen & Cheesman, 2013), un mayor control emocional (Danielsen et al., 2017) y bienestar psicológico (Stamp et al., 2015), mejor afrontamiento y gestión del estrés (Nicholls et al., 2008;Levy et al., 2012), y al mismo tiempo, la fortaleza mental se ha relacionado con menores niveles de burnout (Madigan & Nicholls, 2017), de ansiedad (Schaefer et al., 2016) y de síntomas depresivos (Brand et al., 2014). ...
The objective of this study was to analyze the psychometric properties of the Mental Toughness Index (MTI) and Sports Mental Toughness Questionnaire (SMTQ), for their adaptation and use in the field of Mexican sport. The MTI consists of eight items and constitutes a one-dimensional measure of mental toughness. The SMTQ is composed of 14 items, with three factors (confidence, constancy, and control). The sample was composed of 375 athletes from different sports. The results indicated appropriate characteristics of MTI and its one-dimensional structure, with a reliability of α=.81, adequate factor loads, satisfactory goodness and fit indices, and convergent validity. The SMTQ presented inferior results, with α=.69 for total scale, and low reliability of constancy and control. Fit indices were not optimal, and there were low correlations between scales and discriminant validity problems.
... Haghighi and Gerber (2019) found that mental toughness was associated with fewer mental health disturbances, irrespective of the amount of stress experienced. Mental toughness has also been related to better quality sleep, which may result from reduced stress, reduced hyperarousal, or fewer dysfunctional thoughts because of higher mental toughness (e.g., Brand et al., 2014aBrand et al., , 2014b. ...
Mental toughness describes a set of positive psychological resources that predict a range of outcomes, including wellbeing. It has been conceptualized as a state, but research has not yet examined the impact of positive or adverse childhood experiences on its development. Such experiences are known to be important for wellbeing and mental health. The current study aimed to examine the relationships between adverse and positive childhood experiences and later mental toughness, and whether mental toughness mediated the relationship between childhood experiences and wellbeing. Three hundred and eleven participants (53 males and 256 females, with a mean of 35.5 years (SD 13.67) completed measures of childhood experiences, mental toughness, and wellbeing. Positive, but not adverse childhood experiences predicted mental toughness, and there was a significant indirect path from positive experiences to wellbeing via mental toughness. The results are discussed in terms of implications for the theory of mental toughness, and implications for supporting the development of mental toughness, which may in turn enhance wellbeing. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
... First, those who report greater psychological resilience also exhibit more robust sleep (e.g. greater sleep efficiency, fewer and shorter awakenings after sleep onset, less light sleep, and more deep sleep) (Brand et al., 2014a(Brand et al., , 2014b(Brand et al., , 2016. Similarly, those with poor sleep also report less resilience. ...
Background
While the negative consequences of insomnia are well-documented, a strengths-based understanding of how sleep can increase health promotion is still emerging and much-needed. Correlational evidence has connected sleep and insomnia to resilience; however, this relationship has not yet been experimentally tested. This study examined resilience as a mediator of treatment outcomes in a randomized clinical trial with insomnia patients.
Methods
Participants were randomized to either digital cognitive behavioral therapy for insomnia (dCBT-I; n = 358) or sleep education control ( n = 300), and assessed at pre-treatment, post-treatment, and 1-year follow-up. A structural equation modeling framework was utilized to test resilience as a mediator of insomnia and depression. Risk for insomnia and depression was also tested in the model, operationalized as a latent factor with sleep reactivity, stress, and rumination as indicators (aligned with the 3-P model). Sensitivity analyses tested the impact of change in resilience on the insomnia relapse and incident depression at 1-year follow-up.
Results
dCBT-I resulted in greater improvements in resilience compared to the sleep education control. Furthermore, improved resilience following dCBT-I lowered latent risk, which was further associated with reduced insomnia and depression at 1-year follow-up. Sensitivity analyses indicated that each point improvement in resilience following treatment reduced the odds of insomnia relapse and incident depression 1 year later by 76% and 65%, respectively.
Conclusions
Improved resilience is likely a contributing mechanism to treatment gains following insomnia therapy, which may then reduce longer-term risk for insomnia relapse and depression.
... However, it is known that the college context has demands and academic, personal, and social demands for students (BRAND et al., 2014). Besides that, and as previously said, the pandemic made the situation more complex, since they also had to deal with some emergent problems, such as accessibility and connectivity (MOLINA et al., 2021), fear of infection for Covid-19, and economic precariousness (ORELLANA, C.; ORELLANA, L., 2020), factors that increased their stress levels and favored the prevalence of a very common phenomenon at times like these: emotional fatigue. ...
La presente investigación tuvo como objetivo describir el cansancio emocional de los estudiantes universitarios peruanos de la carrera profesional de Educación en el contexto de la pandemia de COVID-19. El enfoque fue cuantitativo, el diseño no experimental y el tipo, descriptivo transversal. La muestra fue conformada por 232 estudiantes, a quienes se les aplicó la Escala de Cansancio Emocional, instrumento con adecuados niveles de confiabilidad y validez. Según los resultados, la mayoría de estudiantes presentaban altos niveles de cansancio emocional y se pudo determinar que la prevalencia de dicha variable se asociaba de manera significativa al sexo y grupo etario de los estudiantes (p<0,05). Se concluyó que es necesario que el área de Psicopedagogía de la universidad realice la detección oportuna de los estudiantes que padezcan de cansancio emocional para que recuperen su bienestar psicológico y apliquen programas preventivos para disminuir la prevalencia de dicho fenómeno.
... Moreover, high levels of Mental Toughness predict stress resilience, ward off depression, and help to maintain life satisfaction (Gerber et al., 2013a). Other studies also link high levels of Mental Toughness to health benefits (i.e., improved sleep quality; Brand et al., 2014). Noting this, theorists have recently framed Mental Toughness as a range of psychological resources that promote positive mental health (Lin et al., 2017;Drinkwater et al., 2019;Papageorgiou et al., 2019a,b). ...
The spread of COVID-19 has had a significant impact on global sport. This is especially true at the elite level, where it has disrupted training and competition. Concomitantly, restrictions have disrupted long-term event planning. Many elite athletes remain unsure when major events will occur and worry about further interruptions. Although some athletes have successfully adapted to the demands of the COVID-19 crisis, many have experienced difficulties adjusting. This has resulted in psychological complications including increased stress, anxiety, and depression. This article critically examines the extent to which non-cognitive skills training, in the form of increased awareness of Mental Toughness, can help elite athletes inoculate against and cope with negative psychological effects arising from the COVID-19 pandemic. Non-cognitive skills encompass intrapersonal (motivations, learning strategies, and self-regulation) and interpersonal (interactions with others) domains not directly affected by intellectual capacity. Previous research indicates that enhancement of these spheres can assist performance and enhance mental well-being. Moreover, it suggests that training in the form of increased awareness of Mental Toughness, can improve the ability to cope with COVID-19 related challenges. In this context, Mental Toughness encompasses a broad set of enabling attributes (i.e., inherent and evolved values, attitudes, emotions, and cognitions). Indeed, academics commonly regard Mental Toughness as a resistance resource that protects against stress. Accordingly, this article advocates the use of the 4/6Cs model of Mental Toughness (i.e., Challenge, Commitment, Control, and Confidence) to counter negative psychological effects arising from COVID-19.
... Specifically, no research conducted in Iran focused so far on sleep patterns among full-time hospital staff members working with patients with COVID-19. This is surprising for the following reasons: First, restoring sleep is highly associated with favorable psychological functioning, such as low anxiety, low stress [21,44,45], optimism [46], mental toughness [47][48][49][50][51][52][53], and lower odds of suffering from psychiatric disorders [19,20]. Second, poor sleep is related to work-related issues and higher absenteeism [54,55]. ...
Hospital staff members reported increased stress-related workload, when caring for inpatients with COVID-19 (“frontline hospital staff members”). Here, we tested, if depression, anxiety, and stress were associated with poor sleep and lower general health, and if social support mediated these associations. Further, we compared current insomnia scores and general health with normative data.
A total of 321 full-time frontline hospital staff members (mean age: 36.86; 58% females) took part in the study during the COVID-19 pandemic. They completed a series of questionnaires covering demographic and work-related information, symptoms of depression, anxiety, stress, social support, self-efficacy, and symptoms of insomnia and general health.
Higher symptoms of depression, anxiety, and stress were associated with higher symptoms of insomnia and lower general health. Higher scores of depression, anxiety and stress directly predicted higher insomnia scores and lower general health scores, while the indirect effect of social support was modest. Compared to normative data, full-time frontline hospital staff members had a 3.14 higher odds to complain about insomnia and a significantly lower general health. Symptoms of insomnia and general health were unrelated to age, job experience, educational level, and gender.
Compared to normative data, full-time frontline hospital staff members were at increased risk to report higher insomnia and lower general health scores. Depression, anxiety and stress predicted insomnia and poor health, irrespective of age, job experience, and gender. Further, social support had a modest mediating influence. Given this background, it appears that the working context had a higher impact on individuals’ well-being, compared to individual characteristics.
... Moreover, high resilience was quoted as a possible reason for the low sleep reactivity among elite athletes in the study by Gupta et al. (2017). Similarly, mental resilience was shown to predict better sleep, based on both objective (non-athletes, mean age 18.9 years, in Brand et al., 2014) and subjective (junior athletes, mean age 18 years, in Hrozanova et al., 2019) parameters. In the latter study of junior athletes, two mental resilience factors, social resources and structured style [i.e., an individual's tendency to approach daily routines and goals in a planned, structured manner (Friborg et al., 2005)], were protective of sleep quality . ...
On their journeys toward senior athletic status, junior endurance athletes are faced with a multitude of stressors. How athletes react to stressors plays a vital part in effective adaptation to the demanding, ever-changing athletic environment. Sleep, the most valued recovery strategy available to athletes, has the potential to influence and balance athletic stress, and enable optimal functioning. However, sleep is sensitive to disturbances by stress, which is described by the concept of sleep reactivity. Among athletes, poor sleep quality is frequently reported, but our understanding of the associations between stress and sleep in junior athletes is currently incomplete. The present study therefore investigated the themes of stress and sleep, and the associations between these variables with the use of in-depth semi-structured interviews in six junior endurance athletes (three men and three women, mean age 17.7 ± 0.5 years). Data was analyzed qualitatively based on the Grounded Theory. The qualitative material was supplemented with quantitative data on subjective sleep quality (Pittsburg Sleep Quality Index), sleep reactivity (Ford Insomnia Response to Stress Test), and mental strain (visual analog scale). The main results showed that stress could be differentiated into relevant stressors (encompassing poor performance, uncertainty in relation to training, school, daily hassles, and sleep) and reactions to stress (with sub-categories facilitative and maladaptive). Sleep could be differentiated into sleep benefits (encompassing energy levels and athletic functioning) and sleep quality (with sub-categories satisfactory and inadequate). All athletes identified relevant stressors, and all athletes were aware of the benefits of sleep for athletic functioning. However, athletes formed two distinctive categories based on the interactions between stress and sleep: three exhibited facilitative reactions to stress and good sleep quality, as well as low sleep reactivity, and low mental strain. The remaining participants exhibited maladaptive reactions to stress and poor sleep quality, as well as high sleep reactivity and high mental strain. Conceptualizing sleep quality based on the evaluation of stressors, reactions to stress, degree of mental strain, and the propensity to stress-related sleep disturbance may offer a plausible explanation for why the occurrence of stressors leads to poor sleep quality in some athletes, but not others.
... For example, MT has been associated positively with motivation [49,50] and self-efficacy [51]. MT has also been interrelated negatively with stress [52] and depression [53], and positively with thriving [54], sleep quality [55], psychological well-being [56], and MH [57]. Of note, preliminary evidence suggests that males present higher levels of MT than women [51]. ...
Recent tragic events and data from official NCAA reports suggest student-athletes' well-being is compromised by symptoms of mental health (MH) disorders. Self-compassion (SC) and mental toughness (MT) are two psychological constructs that have been shown effective against stressors associated with sports. The purpose of this study was to investigate SC, MT, and MH in a NCAA environment for the first time and provide practical suggestions for MH best practice No.4. In total, 542 student-athletes participated across Divisions (Mage = 19.84, SD = 1.7). Data were collected through Mental Toughness Index, Self-Compassion Scale, and Mental Health Continuum–Short Form. MT, SC (including mindfulness), and MH were positively correlated. Males scored higher than females on all three scales. No differences were found between divisions. SC partially mediated the MT-MH relationship, but moderation was not significant. Working towards NCAA MH best practice should include training athletes in both MT and SC skills (via mindfulness).
... This result suggests that increased nocturnal aircraft noise exposure decreases the sleep duration in humans. Possible consequences are that a decreased deep sleep duration can cause decreased blood pressure dipping, causing higher overall nocturnal blood pressure, increased hypertension and lowered mental toughness in people [24] [25] [26]. ...
Annoyance is the most prevalent community response to environmental noise. Observational and experimental lab studies have shown that exposure to environmental noise leads to annoyance, sleep disturbance, daytime sleepiness, increased heart rate and increased blood pressure. However, previous literature is preliminary based on controlled settings or experimental design, raising the question of the generalizability and applicability in daily life scenarios. This study aimed to investigate two main research questions. First, that is the relationship between short-term annoyance and different amounts of nocturnal aircraft noise exposure in daily life? Second, what is the relationship between physiological
parameters, including heart rate, number of awakenings, sleep efficiency, sleep duration and different amounts of nocturnal aircraft noise exposure in daily life? This study also aimed to explore the suitability of non-invasive commercially available activity trackers to measure physiological metrics in a scientific way. During this field study, participants were wearing Fitbit Charge 3 activity trackers recording heart rate and different sleep-derived metrics (e.g. deep sleep duration, sleep efficiency and awakenings). The used activity trackers were readily available, non-intrusive, relatively cheap and easy to use by the participants. Simultaneously, a logbook was used by the participants to track the subjective perception
and situational context of air traffic noise exposure. The noise levels corresponding to the exposure of air traffic of each participant were calculated based on the location of the participant and the corresponding radar track using an aircraft noise monitoring system.
We hypothesize that a higher amount of exposure to aircraft noise in real life will be
associated with increased annoyance, increased rest heartrate, higher number of awakenings, decreased sleep efficiency and decreased deep sleep duration.
Preliminary results on the interactions between aircraft noise exposure, perceived annoyance and physiological metrics suggest increased nocturnal aircraft noise exposure seems to negatively affect sleep efficiency and deep sleep duration.
... P < 0.001) (Brand et al. 2016). Similar associations were also reported in several subsequent studies (Brand et al. 2014a(Brand et al. , 2014b. These data highlight the positive relationship between mental toughness and quality of life. ...
Childhood and adolescence are critical time periods for growth and development. Given the current physical and psychological health concerns affecting United States youth, an emerging area of interest exists supporting the importance of physical and psychological aspects of strength for health, resilience, and well-being through these life stages. This synopsis highlights the key concepts that were presented within the 2018 Strength Summit conference, entitled The Role of Strength in Optimal Health and Well-being. During the conference, strength was broadly defined as the ability to successfully respond to a challenge. Although much of the current research focuses on strength from a muscle function and performance perspective, mental and emotional strength are also important components of overall health and well-being, especially in children and adolescents. This paper provides a brief overview of the clinical and/or research-based strength outcomes, summarizes the relationship between strength and health, and discusses evidence-based dietary factors that promote strength in children and adolescents.
NoveltyBuilding physical, mental, and emotional strength during childhood and adolescence lays the foundation for health and well-being.
Emerging evidence indicate positive associations between diet quality and strength in children and adolescents.
Promising areas include the promotion of family-based meals, with focus on breakfast, for improved strength in United States youth.
... For example, MT has been associated positively with motivation [49,50] and self-efficacy [51]. MT has also been interrelated negatively with stress [52] and depression [53], and positively with thriving [54], sleep quality [55], psychological well-being [56], and MH [57]. Of note, preliminary evidence suggests that males present higher levels of MT than women [51]. ...
... Unlike laboratory settings, assessing objective sleep under naturalistic conditions should reflect sleep patterns in a more authentic and reliable manner. Previous studies with clinical samples (borderline personality disorders [36]; patients with ruptured aneurysms posttreatment [37]; children and adolescents with autism spectrum disorder [38]) and non-clinical samples (children [39]; adolescents [40,41]; adolescent children and their parents [42]) showed that the sleep measurements with portable EEG-devices were reliable; furthermore, such devices did not negatively impact on individuals' subjective sleep quality. ...
Abstract: Background: Persons with multiple sclerosis (PwMS) often complain about sleep problems. There is less known about objective sleep-EEG dimensions within naturalistic conditions (i.e., home and/or familiar setting). The present cross-sectional study examined the associations between objective and subjective sleep, depression, physical activity scores, and MS-related information among PwMS in their familiar setting. Methods: The sample consisted of 16 PwMS (mean age: 50.3 years; median Expanded Disability Status Scale (EDSS): 5.3) who completed questionnaires covering subjective sleep (symptoms of insomnia, restless legs syndrome (RLS), and sleep-disordered breathing; daytime sleepiness), subjective physical activity, depression and MS-related information (fatigue, EDSS; disease-modifying treatments). Objective sleep was assessed with a mobile sleep-EEG device under naturalist conditions within the home. Results: Descriptively, better objective sleep patterns were associated with lower sleep complaints (rs = -.51) and daytime sleepiness (rs = -.43), and with lower symptoms of RLS (rs = -.35), but not with sleep-disordered breathing (rs = -.17). More deep sleep was associated with higher moderate physical activity levels (rs = .56). Objective sleep parameters were not associated with vigorous physical activity levels (rs <.25). Descriptively, moderate, and vigorous physical activity scores were associated with lower symptoms of RLS (rs = -.43 to -.47). Conclusions: Results from this small study carried out under naturalistic conditions suggest that among PwMS better objective sleep correlated with better subjective sleep and higher moderate physical activity levels.
... Adolescents who were exposed to sleep restrictions, even for one night, had worsened mood and decreased ability to control negative emotion and thus greater vulnerability to EBPs [46][47][48]. The study of Brand et al. [49] found that adolescents with higher mental toughness had objectively and subjectively better sleep quality and this association was likely bidirectional. It has been discussed in several studies that adverse changes in emotional regulation might be one pathway by which sleep loss and sleep onset difficulties increase the risk of EBPs [6,12,44,50]. ...
Sleep problems are common in adolescence with a negative impact on the mental health and functioning of adolescents. However, the roles of different sleep problems in relation to emotional and behavioural problems (EBPs), classified according to the 10th version of the International Classification of Diseases as emotional, conduct, hyperactivity and social functioning disorders, are not clear. The first aim of the study was to investigate the association between difficulties in getting to sleep and EBPs in adolescents. The second aim was to explore the role of sleep duration in this association. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2018 in Slovakia. Presented are results for specific age groups of 13-year-old (N = 1909) and 15-year-old (N = 1293) adolescents. Subjective measures of sleep variables were used. Binary logistic regression models adjusted for age and gender were used to assess associations between difficulties in getting to sleep, sleep duration and EBPs measured using the Strengths and Difficulties Questionnaire. Modification of the association between difficulties in getting to sleep and EBPs by sleep duration was also explored. We found that difficulties in getting to sleep at least once a week as well as insufficient sleep (less than 8 h) increased the probability of EBPs. Interactions of sleep duration with difficulties in getting to sleep on EBPs were found to be non-significant. The results suggest that caregivers and clinicians should screen and intervene for both sleep quality and quantity problems in adolescents as they might indicate and promote EBPs.
... Gucciardi's (2017) characterisation recognises both the traditional roots of MT and its contemporary application to a range of settings. These I n r e v i e w PSYCHOMETRIC ASSESSMENT 3 include sport (Meggs, Chen, & Hoehn, 2018), education (Gerber et al., 2013a;St Clair-Thompson et al., 2015;Haghighi, & Gerber, 2018), occupational (Marchant et al., 2009), and health (Brand et al., 2014;Sadeghi Bahmani et al., 2016b;Kruger, 2018) (see Clough & Strycharczyk, 2012;Coulter, Mallett, & Gucciardi, 2010). ...
The 18-item Mental Toughness Questionnaire (MTQ-18) is a brief, widely used measure of mental toughness. The MTQ-18 derives from the longer MTQ-48, which comprises four independent but correlated factors (challenge, commitment, control, and confidence). Despite sampling items from across MTQ-48 dimensions, the MTQ-18 (as intended) provides a global, unidimensional score. Researchers have recently developed a further abridged version of the MTQ-18, the MTQ-10, which has demonstrated promising psychometric performance. The current paper assessed the factorial structure, reliability, predictive validity and invariance of the MTQ-18 and MTQ-10 in a sample of 944 students from English independent schools (year 11, aged 16 years). Respondents completed the MTQ-18 items online alongside the Satisfaction with Life Scale. Confirmatory factor analysis revealed that the MTQ-10 was a superior general measure, because the MTQ-18 possessed additional variance to that accounted for by an unidimensional solution. Additionally, the MTQ-10 evidenced higher factor loadings and demonstrated better data-model fit. Tests of concurrent validity revealed the MTQ-10 was a stronger predictor of well-being (life satisfaction). Both the MTQ-18 and MTQ-10 demonstrated gender invariance at the configural, metric, and scalar level. Overall, although the MTQ-18 was a psychometrically acceptable measure, the MTQ-10 was a superior unidimensional measure of MT.
... Second, in regards to sleep, there is a host of studies showing that regular physical activity has the potential to improve subjective and objective sleep [22,[52][53][54][57][58][59][60][61][62][63][64]. However, such results are missing so far for both cancer survivors in general, and for cancer survivors with HGG. ...
Background
There is existing evidence on whether and to what degree regular exercise training improves the quality of life (QoL) among cancer survivors. However, in regards to patients with high-grade glioma (HGG; WHO grade III and IV), no conclusive study has been performed so far. The present trial aims to fill this gap and examines whether psychological well-being, sleep, QoL and physical fitness might be improved with two different types of exercise, always compared to an active control condition.
Methods
A total of 45 patients with HGG after undergoing neurosurgery and postoperative adjuvant radiotherapy, chemotherapy, or chemoradiotherapy will be consecutively and randomly assigned to (a) an endurance training, (b) a resistance training or (c) to an active control condition. The intervention will last for six consecutive weeks, consisting of two weekly sessions (30-45min per session). At baseline, three weeks later, and six weeks later at the end of the study, aerobic exercise performance will be assessed objectively with a 6-min walking test, and a handgrip test will be used to assess the upper body strength. Further, participants will complete a battery of questionnaires covering sociodemographic information, QoL, sleep quality and sleep patterns, coping with stress, state- and trait-anxiety, depression, and fatigue. In parallel, experts will use the Hamilton Depression Rating Scale to determine and rate participants’ symptoms of depression.
Conclusion
The present study will be the first to investigate and to compare the impact of two different exercise modalities, namely endurance and resistance training, on physical fitness and dimensions of well-being, and sleep among patients with HGG who underwent neurosurgery followed by adjuvant radiotherapy, chemotherapy, or chemoradiotherapy. Importantly, unlike the majority of previous studies, the control condition consists of an active set-up to detect possible factual beneficial effects of exercise training, irrespective of social interactions.
... The factors tracked included sleep [17,18], caffeine intake [19], nutrition [20], stress [21], training fatigue [22], connection with significant other [23] and current injury or illness status [8]. Specifically, participants were asked to report on sleep quantity (in hours), sleep quality from 1 (poor) to 10 (excellent), nutrition from 1 (poor) to 3 (excellent), stress from 1 (low) to 5 (high), training fatigue from 1 (low) to 3 (high), connection with significant other from 1 (poor) to 5 (excellent), caffeine intake (in mg), and current injury/illness status from 1 (none) to 3 (affecting training). ...
The purpose of this study was to explore whether mental toughness varies across a 30-day training block and whether such variability is associated with specific antecedents. This exploratory case study research investigated mental toughness variability using the Mental Toughness Index (MTI) with thirteen elite master runners across a series of self-selected training sessions, followed by interviews and follow-up questionnaires, to identify primary influencers of variability. There were significant differences in the MTI scores between baseline (before the training period), and the minimum and the maximum reported score over five self-selected training sessions (p’s < 0.004). The proceeding follow-up interviews and questionnaires then provided insights into factors influencing this intra-individual variability. These higher-level themes included foundational wellbeing, specific preparation, and actions utilized in the moment. This study is the first to demonstrate within-person MTI variability across specific training sessions and provides initial insights for both athletes and practitioners into potential influencers of mental toughness.
The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate this association. The aim of this study was to explore the association of emotional exhaustion and anxiety in post-traumatic stress symptomatology, and the mediating role of resilience and psychological well-being in university students. A total of 526 university students of both sexes participated in this study, and they were aged between 17 and 62 years old. Symptoms of anxiety and emotional exhaustion were significantly higher in females, in contrast, males showed on average more resilience and psychological well-being. Additionally, participants with COVID-19 infection had higher levels of emotional exhaustion, anxiety, and PTSD. The results indicated that the variables were correlated with each other (p < 0.001). A conceptual model was confirmed that describes anxiety and emotional exhaustion as predictors, post-traumatic stress symptomatology as an outcome variable, and resilience and psychological well-being as mediators. Resilience and psychological well-being can be important protective factors for adaptive responses in stressful situations. The findings obtained in this study will provide a theoretical basis for designing targeted interventions to improve psychological health, whether for crisis intervention, the process of adapting to higher education, or for recovery plans from psychological trauma.
Keywords: pandemic; symptomatology mental health; anxiety; emotional exhaustion; post-traumatic stress symptomatology; psychological well-being; resilience; university students
Evidence suggests that sleep is a vital component of physical and health well-being. However, while sleep problems are present in individuals with mental health problems such as depression, it has not been clear whether these conditions are independent or whether they might be causally related. Indeed, if sleep or sleep disorders predispose or modify onset and outcomes of mental health issues, treatment of these factors could be explored as new mental health prevention or treatment options. The aim of this review was to examine in detail the bidirectional relationship between sleep, sleep disorders, and mental and physical health and well-being. It has considered the evidence that sleep architecture disruption, occurring through both quantity, quality, and timing of sleep as well as through the presence of sleep disorders may both influence mental health and well-being as well as be disrupted by both physical and mental health conditions. Also, the review has explored the effects of sleep disruption on mental health and performance through fatigue, mood, and vigilance. The review has considered the bidirectionality between sleep, sleep disorders, and mental health to examine how these may lead to or exacerbate mental health disorders such as affective, anxiety, autism, depressive and schizophrenia disorders but also considers how these conditions can affect sleep. The review highlights that poor sleep or the presence of a sleep disorder can increase the risks from mental health conditions such as suicidality. Furthermore, mental health conditions such as anxiety and worry can cause racing or repetitive thoughts that can keep an individual awake, leading to shortened sleep. It is important that sleep and sleep disorders are considered potential modifiable factors that could improve mental health outcomes. The important interconnect between both physical and mental health and sleep, in patient evaluations, also needs to be considered as these may affect treatment pathways and patient outcomes. Further, more robust and perspective research is required to establish the triad relationship of physical, mental health, and sleep.
Background: In sport context learning a skill, and performing it flawlessly is of great importance. There is a unanimous consensus among sport scientists, coaches, and athletes, that along with physical, technical and tactical skills, psychological skills are also necessary for an optimal sport performance. Objectives: The aim of the present study was to investigate the role of mental toughness in motor learning and sport performance in wrestling. Methods: This study was semi-experimental and its population were physical education students of the University of Tehran in 2018. Using intensive sampling method, 28 student-athletes, who never had any past wrestling skill practices, were selected. Subsequently, using Mental Toughness-48 questionnaires, they were divided into two equal groups of high and low in mental toughness. After that, all participants were randomly assigned into two groups of equal size and 30 wrestling skills were taught to them twice a week for 3 months by two professional wrestling coaches. Their motor learning was assessed by three other professional coaches in the last week of training and one week after the last session. Motor learning score was obtained by calculating the mean scores of acquisition and retention stages. Then, two groups with high and low levels of mental toughness were compared regarding their motor learning scores. Tools used in this study included demographic consent form, wrestling skills test and The Mental Toughness Questionnaire-48 (MTQ 48). Results: The results suggested that mentally tough student-athletes demonstrated significantly higher motor learning scores compared with their counterparts who had lower levels of mental toughness (P ≤ 0/05). This advantage was persistent both in the acquisition and retention stages (P ≤ 0/05). Conclusions: It was concluded that mental toughness could be considered as a key factor in motor learning. Therefore, it is recommended to coaches and athletes to develop mental toughness in order to enhance motor learning and achieve successful performance.
The neuroendocrine stress response is a natural process of our body which, however, might become toxic if not properly turned on and off. Resilience is the ability to adapt to adverse situations and, particularly, to cope with uncontrolled stress. Resilience and stress are two opposite faces of the same coin, and both are deeply linked to sleep: low resilience means higher stress and, through that, more sleep disorders. The aim of the present paper is to review the complex relationship between these actors and to highlight the possible positive role of good sleep in contrasting chronic stress situations.
Promotion of cognitive-behavioral therapy for insomnia patients improves sleep quality and, through that, produces lower general stress, lower depressive symptom severity, and better global health.
Sleep is a modifiable behavior and, according to recent studies, its improvement might enhance resilience and, in turn, reduce stress.
Background: In sport context learning a skill, and performing it flawlessly is of great importance. There is a unanimous consensus among sport scientists, coaches, and athletes, that along with physical, technical and tactical skills, psychological skills are also necessary for an optimal sport performance. Objectives: The aim of the present study was to investigate the role of mental toughness in motor learning and sport performance in wrestling. Methods: This study was semi-experimental and its population were physical education students of the University of Tehran in 2018. Using intensive sampling method, 28 student-athletes, who never had any past wrestling skill practices, were selected. Subsequently, using Mental Toughness-48 questionnaires, they were divided into two equal groups of high and low in mental toughness. After that, all participants were randomly assigned into two groups of equal size and 30 wrestling skills were taught to them twice a week for 3 months by two professional wrestling coaches. Their motor learning was assessed by three other professional coaches in the last week of training and one week after the last session. Motor learning score was obtained by calculating the mean scores of acquisition and retention stages. Then, two groups with high and low levels of mental toughness were compared regarding their motor learning scores. Tools used in this study included demographic consent form, wrestling skills test and The Mental Toughness Questionnaire-48 (MTQ 48). Results: The results suggested that mentally tough student-athletes demonstrated significantly higher motor learning scores compared with their counterparts who had lower levels of mental toughness (P ≤ 0/05). This advantage was persistent both in the acquisition and retention stages (P ≤ 0/05). Conclusions: It was concluded that mental toughness could be considered as a key factor in motor learning. Therefore, it is recommended to coaches and athletes to develop mental toughness in order to enhance motor learning and achieve successful performance.
Little cross-sectional and even less longitudinal research has been conducted on sleep quality and well-being in junior elite athletes. This study analyzed the relationship between subjective sleep quality and both psychological and physiological well-being in junior elite athletes using both a cross-sectional ( N = 625 athletes; 49.9 % = female; M = 16.4 years, SD = 3.5 years) and a longitudinal approach ( n = 79; 44.3 % = female; M = 16.4 years, SD = 3.5 years) over a period of M = 1.66 years ( SD = 0.87 years). The results demonstrated that both samples showed that subjective sleep quality is correlated with well-being in junior elite athletes. In addition, the results showed that athletes of prepuberty age reported significantly better sleep quality than athletes during and after puberty, and that the relationship between sleep quality and psychological well-being is stronger in female junior athletes than in male athletes. This study emphasizes the need to ensure quality sleep in junior elite athletes.
Sleep insufficiency is a risk factor for mental and physical ill-health. In recent years, research has attributed sleep insufficiency to problematic smartphone use (PSU). In addition, research has indicated a relationship between sleep and the construct of mental toughness (MT). However, previous research exploring the relationship between sleep, PSU and MT has relied on self-report measures. Therefore, this study aimed to explore the tentative links between sleep, PSU and MT by gathering objective data. 2053 participants completed measures of sleep quality, PSU and MT. Objective smartphone usage data were collected using pre-installed smartphone applications. A sub-sample of 614 participants provided sleep duration data from validated sleep tracking devices. In line with previous research, sleep quality was found to correlate weakly with both MT and PSU. While several significant correlations emerged when objective data were explored, in all cases, the effect sizes were negligible. This study does not support the claim that PSU has a clinically meaningful impact upon sleep duration. Sleep hygiene recommendations with more well-established empirical support should be prioritised during sleep promotion efforts.
Mental toughness is the ability to handle pressure, adversity, and stress by overcoming failures. It is also the state of persisting without refusing to quit, with the possession of superiority in mental skills. This review aimed to describe the effect of mental toughness on the performance of athletes and also to have an insight into the various interventions to improve mental toughness. For this, PubMed was searched using the appropriate keywords till December 2021 and a narrative synthesis was performed. Mental tightness was evident to be correlated with many important aspects such as better performance, goal progress, withholding stress, coping, optimism and self-reflection. It also helps in a better level of confidence, constancy, control, positive cognition, visualization and challenges than the opponent team. Many interventional strategies have been adopted in previous years which mainly focused on personalized programs including psychological skills training, coping and optimism training, mindfulness, yoga, general relaxation, imagery, and a combination of both, and many more other aspects were observed to be effective in improving mental toughness. However, physical training alone did not observe to be beneficial. The current evidence indicates the important role of mental toughness on the sports performance of athletics and the role of various interventional strategies focusing on mindfulness and psychological interventions in improving mental toughness. All these interventional strategies need to be implemented in the actual practice.
The majority of sleep research has focused on deleterious health outcomes, with little attention to positive sequels. A systematic review of the literature regarding sleep duration and/or sleep quality in relation to mental toughness and resilience amongst non-clinical, healthy populations was completed. Eight databases and selected sources for grey literature were searched from their inception to April 2021. A total of 1,925 unique records (1,898 from the database search and 27 from grey sources) were identified and screened against the pre-set inclusion and exclusion criteria. Of these, 68 studies were eligible and 63 were included in the meta-analysis. Pooled results indicated a weak, positive correlation between sleep duration and resilience (r=0.11, p<0.001), and sleep quality (r=0.27, p<0.001). The pooled correlation was slightly attenuated for prospective studies pertaining to sleep quality and resilience (r=0.18, p<0.001). We found evidence of high publication bias for studies that explored the relationship between sleep quality and resilience. Sleep and resilience are positively correlated but additional research is needed to verify the direct relationship through carefully designed, prospective studies that capture both subjective and objective sleep estimates. For a more comprehensive understanding, complementary reviews that explore the sleep-resilience association are needed for clinical populations, and those who have suffered extreme hardship.
In this paper, we present several original methods for classifying sleep stages, including threshold based and k-means clustering based methods. The proposed algorithms use only acceleration data from non-dominant wrist, resulting in a classification into 4-sleep stages (“awake”, “light sleep”, “deep sleep” and “REM (Rapid eye movement)”) for overnight sleep. We validate our methods by referring to the results of “Fitbit” and subjective feedbacks from volunteers on quality of sleep. Our algorithms compute the duration of each sleep stage to evaluate changes in sleep quality between different nights. A method of calculating a sleep score based on the duration of sleep and the duration of each sleep stage is proposed, which facilitates the evaluation of sleep quality by a single score. 5 volunteers were recruited for the tests. Among all the test nights, the proposed algorithm based on k-means clustering shows a superior or equivalent performance compared to the “Fitbit” results. These promising results allow us to consider a new non-intrusive method for users and medical staff to monitor the evolution of sleep quality through long-term follow-up. In addition, to evaluate the performance of our proposed system in terms of sleep stage classification, we use the PSG (Polysomnography) sleep monitoring gold standard to monitor the sleep of one of the volunteers throughout the night in a hospital’s professional sleep laboratory. This experiment shows that the proposed 5km2 (5 iterations of k-means clustering with k=2) method and the threshold method are in good agreement with the PSG results. The accuracy of awake, REM, light sleep and deep sleep detection reaches respectively 0.78, 0.96, 0.75 and 0.97 by the Threshold method. More specifically, both methods we propose show good performance in the detection of awake and deep sleep. This longitudinal monitoring can help to detect abnormal changes in sleep that are usually a sign of a change in health status.
Recently there has been an increasing interest in subjective mental illness recovery, and it has been recognised that there is an important role for characteristics such as self-efficacy and locus of control. Mental toughness describes a set of characteristics important for dealing with stress and pressure, and is comprised of challenge, commitment, control of emotion, control of life, confidence in abilities, and interpersonal confidence. The current study explored relationships between mental toughness and subjective mental illness recovery. Seventy-seven participants (nineteen males and fifty-eight females, the majority of which were young adults aged 18–21 years) who had previously recovered from, or were currently recovering from a mental illness (self-reported) completed questionnaire measures of mental toughness and subjective mental illness recovery. Mental toughness had a positive significant relationship to recovery, with particular roles for commitment and confidence in abilities. The findings are discussed in terms of implications for recovery-oriented practice, intervention, and measurement. Further research should examine the role of mental toughness in different aspects of subjective recovery, and also explore relationships with objective measures of recovery.
The current mental toughness is multidimensional construct that help the individual to show persistent strength and preservation during the high competitive situations. The university life is the most vulnerable and pressured time for the university students. The aim of the current study was to determine the psychometric properties of the Mental Toughness Scale (MTS) in university students. A total of 306 participants (151 men and 155 women) with the age range of 18-25 (M = 20.66; SD = 1.36) were administered the Mental Toughness Scale, the Resilience Scale and the Student Problem Checklist. The results of the Exploratory and Confirmatory factor analysis yielded a three factor solution Sense of Personal Competence, Problem Solving Skills and Social Competence. Further, the MTS was found high internal consistency, reliability, construct and discriminant validity. The results pave the way for application of the Mental Toughness of University students of Pakistan and are discussed in light of cultural implications.
Mental toughness is a factor related to performance, better coping, and increased confidence. There has been a growing trend toward assessing mental toughness behaviorally. The purpose of this paper was to develop a behavioral assessment of mental toughness in volleyball. Following a five-stage process to develop a systematic observation instrument, the current study identified 10 mental toughness behaviors in volleyball, specifically, six behaviors occurring during a play and four behaviors after a play (i.e., when a point is scored from the opposing team). Furthermore, eight behaviors represent mentally tough actions, while two behaviors represent mentally weak actions. The results indicate that the behavioral checklist is a reliable systematic observation instrument. Coaches and certified mental performance consultants can benefit from using this checklist by discussing mental toughness and behaviors corresponding to mental toughness during game play, and then have a quantifiable way to track behaviors with individuals and volleyball teams.
Along with its economic prosperity, China faces a fast increasing rate of drug use. This study aimed to explore the relationship between perceived stress and sleep quality among Chinese drug users while considering rumination as a mediator and resilience as a moderator. Measuring scales, including the Connor–Davidson Resilience Scale, the Ruminative Response Scale, the Perceived Stress Scale, and the Pittsburg Sleep Quality Index, were used to collect information from 104 Chinese drug users. The mediating analysis documented that the effect of perceived stress on sleep quality was mediated via rumination significantly. Resilience acts as a significant moderator on the relationship between perceived stress and poor sleep quality. Simple slope analysis further suggests that participants with a low level of resilience experienced more sleep disturbances given the same level of perceived stress compared to those with a high level of resilience. These findings indicated that psychological intervention that improves drug users’ resilience and reduces their rumination is helpful to release their stress and improve their sleep quality.
Objective
The study examined whether overall sleep quality and the sleep components comprising the Pittsburgh Sleep Quality Index have a bi-directional relationship with resilience among adolescents, after adjusting for sex, age, depression, and socioeconomic status, and investigated which sleep components have a stronger effect on resilience.
Methods
A total of 1299 students (58% females; mean age, 15.79 years) participated at baseline, with 840 finishing all four study waves over the course of 24 months. Data were collected through questionnaires, including socio-demographics, the Pittsburgh Sleep Quality Index, Patient Health Questionnaire 9-item, and the Connor-Davidson Resilience Scale. Cross-lagged models were used to analyze the relationships between sleep and resilience.
Results
Both daytime dysfunction and sleep disturbance had an independent bi-directional relationship with resilience. Higher resilience scores predicted overall better sleep quality and shorter sleep latency, but not vice versa. Sleep disturbance and daytime dysfunction had stronger effects on resilience.
Conclusions
These findings highlight the importance of future school interventions for sleep to improve students’ resilience.
The aim of this two-wave prospective study was to examine the relationship between emotional exhaustion, mental toughness, and sleep problems. A sample of 227 Chinese university students completed measures of these variables at baseline and then again three months later. When the prospective data were examined, sleep problems at baseline predicted increases in emotional exhaustion over the study period, but not vice versa. In addition, mental toughness at baseline predicted increases in emotional exhaustion via sleep problems at baseline. Finally, mental toughness did not moderate the relationship between emotional exhaustion and sleep problems. These findings provide evidence that sleep problems are involved in the development of emotional exhaustion over time. The findings also provide initial evidence that mental toughness plays a significant role in preventing emotional exhaustion by decreasing sleep problems.
This article outlines issues that potentially limit the usefulness of research examining relationships between dark triad traits (narcissism, Machiavellianism, and psychopathy) and sleep-related measures. Addressing these factors will ensure that future research produces more robust, convincing findings.
This study aimed to investigate the relationships between cognitive emotion regulation (CER) strategies, resilience, and insomnia and the underlying mechanism that explains the relationships. Six hundred and fifty-three middle-aged and old people recruited from community service centers in Henan province completed questionnaires related to CER strategies, resilience, and insomnia. Results showed refocus on planning and positive reappraisal negatively predicted insomnia, and catastrophising, rumination and self-blame positively predicted insomnia. Moreover, maladaptive emotion regulation strategies (especially catastrophising) mediated the relationship between resilience and insomnia. The findings suggest the middle-aged and elderly with insomnia tended to employ maladaptive emotion regulation strategies and had lower resilience. Maladaptive emotion regulation strategies buffered the positive effect of resilience on sleep.
Background: Internal migrant workers in the service industry are an important population in China, but the sleep quality of this population has not been well studied. The aims of the present study were to examine the prevalence of poor sleep quality among internal migrant workers in the service industry, explore the risk factors associated with poor sleep quality, and assess the correlation between insomnia and psychiatric factors. Methods: We conducted a cross-sectional study in Shenzhen, a migrant city in China. The respondent-driven sampling (RDS) method was used to recruit participants. Sociodemographic data and physical and psychiatric health status were investigated using questionnaires. In total, 1756 internal migrant workers completed the questionnaires. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, the General Anxiety Disorder-7 (GAD-7) and Center for Epidemiologic Studies Depression (CES-D) scales were used to assess anxiety and depression, respectively. Mental resilience was assessed by the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC). Regression analysis was used to identify the risk factors of poor sleep quality. A structural equation model (SEM) was used to analyze the relationships among sleep, anxiety, depression and resilience. Results: The prevalence of poor sleep quality among internal migrant workers in the service industry was 25.4%. Multivariate regression analysis revealed that participants who were older (OR = 1.452), worked >8 h per day (OR = 1.553), had experienced physical illness in the past 2 weeks (OR = 3.631) and had psychiatric problems such as anxiety (OR = 1.695–3.331) and depression (OR = 1.437) had an increased risk of poor sleep quality (P
Mental toughness (MT) is understood as the display of confidence, commitment, challenge, and control. The aim of this study was to explore the extent to which greater MT is associated with subjectively assessed sleep among adolescents. A total of 284 adolescents (M = 18.26 years) completed a series of questionnaires assessing MT, psychological functioning, and sleep. Greater MT was significantly associated with better sleep quality, shorter sleep onset latency, fewer awakenings after sleep onset, and longer sleep duration. Greater MT was also associated with less perceived stress and less depressive symptoms. MT was directly and indirectly associated with sleep quality. Mentally tough adolescents report good sleep quality and sleep schedules, along with psychological wellbeing.
In this study, we assessed the relationship between mental toughness and athletes' use of psychological performance strategies. Sixty-seven male (mean age 22.6 years, s=5.0) and 40 female (mean age 21.1 years, s=2.8) athletes, who competed at club/university to national standard in a variety of sports, participated in the study. Participants completed the MTQ48 (Clough et al., 2002) to measure mental toughness, and the Test of Performance Strategies (TOPS; Thomas et al., 1999) to measure the use of psychological strategies in practice and competition. Results of Pearson correlations and linear regression analyses revealed that self-talk, emotional control, and relaxation strategies were significantly and positively (r=0.26 to 0.37, P
The recent emphasis on positive psychology is welcome, and has spurred much relevant research. But, there are still many unresolved conceptual and research issues, as more variables are being proposed as relevant. As part of this process, the present paper proposes hardiness as an addition to positive psychology. Hardiness is a combination of attitudes that provides the courage and motivation to do the hard, strategic work of turning stressful circumstances from potential disasters into growth opportunities. In this regard, the inherently stressful nature of living is discussed. Also clarified are the particular aspects of excellence in performance and health to which hardiness is relevant. The paper concludes with a call for issue-resolving research through which orientations and actions proposed as part of positive psychology can be compared in their contributions to performance and health. Two studies along these lines have found hardiness more powerful than optimism and religiousness in coping with stresses.
BACKGROUND: There is evidence that positive personality characteristics, such as optimism and self-esteem, are important for health. Less is known about possible determinants of positive personality characteristics. PURPOSE: To test the relationship of optimism and self-esteem with insomnia symptoms and sleep duration.
METHOD: Sleep parameters, optimism, and self-esteem were assessed by self-report in a community-based sample of 1,805 adults aged between 30 and 84 years in the USA. Moderation of the relation between sleep and positive characteristics by gender and age as well as potential confounding of the association by depressive disorder was tested.
RESULTS: Individuals with insomnia symptoms scored lower on optimism and self-esteem largely independent of age and sex, controlling for symptoms of depression and sleep duration. Short sleep duration (<6 h) was related to lower optimism and self-esteem when compared to individuals sleeping 7-8 h, controlling depressive symptoms. Long sleep duration (>9 h) was also related to low optimism and self-esteem independent of age and sex.
CONCLUSION: Good and sufficient sleep is associated with positive personality characteristics. This relationship is independent of the association between poor sleep and depression.
Restoring sleep is strongly associated with a better physical, cognitive, and psychological well-being. By contrast, poor or disordered sleep is related to impairment of cognitive and psychological functioning and worsened physical health. These associations are well documented not only in adults but also in children and adolescents. Importantly, adolescence is hallmarked by dramatic maturational changes in sleep and its neurobiological regulation, hormonal status, and many psychosocial and physical processes. Thus, the role of sleep in mental and physical health during adolescence and in adolescent patients is complex. However, it has so far received little attention. This review first presents contemporary views about the complex neurobiology of sleep and its functions with important implications for adolescence. Second, existing complex relationships between common adolescent somatic/organic, sleep-related, and psychiatric disorders and certain sleep alterations are discussed. It is concluded that poor or altered sleep in adolescent patients may trigger and maintain many psychiatric and physical disorders or combinations of these conditions, which presumably hinder recovery and may cross into later stages of life. Therefore, timely diagnosis and management of sleep problems appear critical for growth and development in adolescent patients.
Adolescence is marked by dramatic changes in sleep. Older adolescents go to bed later, have an increased preference for evening activities, and sleep less than younger adolescents. This behavior change is driven by external factors, notably increased pressures from academic, social, and extracurricular activities and by biological circadian factors. There are also substantial changes in sleep architecture across adolescence, with dramatic declines in slow wave sleep, and slow wave activity (delta, ~ 0.5-4.5 Hz). These changes are associated with underlying changes in brain structure and organization, with a decrease in synaptic density likely underlying the reduction in high amplitude slow waveforms. While changes in sleep across adolescence are a normal part of development, many adolescents are getting insufficient sleep and are consequently, less likely to perform well at school, more likely to develop mood-related disturbances, be obese, and are at greater risk for traffic accidents, alcohol and drug abuse.
The peak age of onset for many psychiatric disorders is adolescence, a time of remarkable physical and behavioural changes. The processes in the brain that underlie these behavioural changes have been the subject of recent investigations. What do we know about the maturation of the human brain during adolescence? Do structural changes in the cerebral cortex reflect synaptic pruning? Are increases in white-matter volume driven by myelination? Is the adolescent brain more or less sensitive to reward? Finding answers to these questions might enable us to further our understanding of mental health during adolescence.
The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.
Pediatric neuroimaging studies1, 2, 3, 4, 5, up to now exclusively cross sectional, identify linear decreases in cortical gray matter and increases in white matter across ages 4 to 20. In this large-scale longitudinal pediatric neuroimaging study, we confirmed linear increases in white matter, but demonstrated nonlinear changes in cortical gray matter, with a preadolescent increase followed by a postadolescent decrease. These changes in cortical gray matter were regionally specific, with developmental curves for the frontal and parietal lobe peaking at about age 12 and for the temporal lobe at about age 16, whereas cortical gray matter continued to increase in the occipital lobe through age 20.
Relatively little is known about sleep habits, sleep disturbances, and the consequences of disordered sleep in school-aged children. This descriptive study examined a variety of common sleep behaviors in a group of 494 elementary school children, grades kindergarten through fourth, using a battery of sleep questionnaires that included parent, teacher, and self-report surveys. The prevalence of parent-defined sleep problems ranged from 3.7% (Sleep-Disordered Breathing) to 15.1% (Bedtime Resistance), with 37% of the overall sample described as having significant sleep problems in at least one sleep domain. Younger children were more likely than older children to have sleep problems noted by parents (particularly bedtime struggles and night wakings), as well as by teacher and self-report. Children tended to identify more sleep problems by self-report, particularly sleep-onset delay and night wakings, than did their parents. Overall, approximately 10% of the sample was identified by all three measures as having significant problems with daytime sleepiness. The results of this study emphasize the importance of screening for sleep disorders in this age group in the clinical setting. The need for consensus regarding the use of sleep screening instruments and the definition of "problem" sleep in school-aged children is also discussed.
This study examines the prevalence and developmental changes of parasomnias and assesses gender differences, relationships between parasomnias, and associations with anxiety and family adversity using data collected during the course of a longitudinal study of a representative sample of children from Québec.
The present analyses are based on results available for 664 boys and 689 girls for whom mothers have completed questions concerning demographics, parasomnias, and anxiety level. For the prevalence and developmental aspects of parasomnias, prospective data were collected at annual intervals from 11 to 13 years old and retrospective data for the period between ages 3 and 10 years were collected when the children were 10 years old.
Somniloquy, leg restlessness, and sleep bruxism are the most frequent parasomnias. More girls were afflicted with leg restlessness, while enuresis and somniloquy were more common in boys. High anxiety scores were found in children suffering from night terrors, somniloquy, leg restlessness, sleep bruxism, and body rocking. Parasomnias were unrelated to the index of family adversity.
Although sleepwalking, night terrors, enuresis, and body rocking dramatically decreased during childhood, somniloquy, leg restlessness, and sleep bruxism were still highly prevalent at age 13 years, paralleling results found in adults. Sleepwalking, night terrors, and somniloquy are conditions often found together. The only robust gender difference was for enuresis. High anxiety scores in parasomnias are reported for the first time in a large, controlled study. Sociodemographic variables do not seem to play a major role in the occurrence of parasomnias.
Background: Insomnia is a prevalent health complaint that is often difficult to evaluate reliably. There is an important need for brief and valid assessment tools to assist practitioners in the clinical evaluation of insomnia complaints.Objective: This paper reports on the clinical validation of the Insomnia Severity Index (ISI) as a brief screening measure of insomnia and as an outcome measure in treatment research. The psychometric properties (internal consistency, concurrent validity, factor structure) of the ISI were evaluated in two samples of insomnia patients.Methods: The first study examined the internal consistency and concurrent validity of the ISI in 145 patients evaluated for insomnia at a sleep disorders clinic. Data from the ISI were compared to those of a sleep diary measure. In the second study, the concurrent validity of the ISI was evaluated in a sample of 78 older patients who participated in a randomized-controlled trial of behavioral and pharmacological therapies for insomnia. Change scores on the ISI over time were compared with those obtained from sleep diaries and polysomnography. Comparisons were also made between ISI scores obtained from patients, significant others, and clinicians.Results: The results of Study 1 showed that the ISI has adequate internal consistency and is a reliable self-report measure to evaluate perceived sleep difficulties. The results from Study 2 also indicated that the ISI is a valid and sensitive measure to detect changes in perceived sleep difficulties with treatment. In addition, there is a close convergence between scores obtained from the ISI patient's version and those from the clinician's and significant other's versions.Conclusions: The present findings indicate that the ISI is a reliable and valid instrument to quantify perceived insomnia severity. The ISI is likely to be a clinically useful tool as a screening device or as an outcome measure in insomnia treatment research.
Principles for reporting analyses using structural equation modeling are reviewed, with the goal of supplying readers with complete and accurate information. It is recommended that every report give a detailed justification of the model used, along with plausible alternatives and an account of identifiability. Nonnormality and missing data problems should also be addressed. A complete set of parameters and their standard errors is desirable, and it will often be convenient to supply the correlation matrix and discrepancies, as well as goodness-of-fit indices, so that readers can exercise independent critical judgment. A survey of fairly representative studies compares recent practice with the principles of reporting recommended here.
To examine the validity of self-reported survey estimates of sleep patterns in adolescents through a comparison of retrospective survey descriptions of usual school- and weekend-night sleep habits with diary-reported sleep patterns and actigraphically estimated sleep behaviors over a subsequent week.
High school students completed a Sleep Habits Survey about the previous 2 weeks and then wore an actigraph (AMI, Ardsley, NY) for 8 days while keeping a daily sleep diary. Matched-pair t tests assessed average differences between survey and diary reports and between survey and actigraph estimates. Pearson correlations assessed the extent to which survey reports were in agreement with diary reports and actigraphy estimates.
302 high school students (196 girls, 106 boys) in grades 9-12 from five high schools.
School-night survey total sleep times and wake times did not differ from sleep amounts reported in the diary or estimated by actigraphy; survey bedtimes were slightly earlier. On weekends, survey total sleep times and wake times were longer and later, respectively, than estimated with actigraphy and reported on diaries. Moreover, school- and weekend-night survey variables were significantly correlated both with diary and actigraphy variables. Strengths of the associations were consistently greater for school-night variables than the corresponding weekend-night variables.
The findings support the validity of the Sleep Habits Survey estimates in comparison with diary and actigraphy. Strengths and limitations for survey measures of high school students' usual sleep/wake patterns are discussed.
This article reviews existing research on the association between stressors and symptoms of psychopathology in children and adolescents with a focus on measurement issues and prospective effects. The first half of the article focuses on the measurement of stressors, emphasizing checklists and interviews. Available measures of stressful experiences are reviewed and critiqued. Results of this review reveal both substantial progress (i.e., development of valid stressor assessment tools) and remaining problems (i.e., inconsistent measurement across studies). The second half of this article reviews studies that have tested for prospective associations between stressors and symptoms of psychopathology in children and adolescents. Studies that have examined the prospective effects of recent or prior stressors on current psychological symptoms, while controlling for prior psychological symptoms, are reviewed. Results overall suggest that stressors predict changes in rates of symptoms of psychopathology in children and adolescents over time. Results also suggest that symptoms of psychopathology predict changes in rates of stressors over time. Implications of these findings are that conclusive evidence now exists for the importance of stressors in the development of child and adolescent psychopathology.
Maladaptive beliefs about sleep are associated with insomnia and are assessed with the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS). Three studies explored which DBAS items (1) maximally differentiated people with insomnia from good sleepers, (2) declined with cognitive behavior therapy (CBT), and (3) were related to other clinical improvement indexes.
Data from previous studies were analyzed to evaluate the above 3 hypotheses.
The total sample (N = 332) was comprised of experimental and treatment-seeking people with insomnia and good sleepers ranging from 20 to 79 years of age (mean +/- SD 51.3 +/- 14.7).
The analyses of variance of the 30 items of the DBAS in Study 1 suggested that 16 items differentiated insomnia sufferers from good sleepers. In Study 2, 8 items showed significantly greater changes in response to CBT than alternate therapies. However, only 2 of these items were among the 16 items that discriminated insomnia sufferers from good sleepers in Study 1. In Study 3, declining scores on 15 of 30 DBAS items in response to CBT were related to 1 or more indexes of clinical improvement.
The 16 beliefs of the DBAS-30 that best discriminated insomnia sufferers from good sleepers related to helplessness and hopelessness in the insomnia group. CBT addressed some of these beliefs, although some beliefs relating to helplessness remained relatively elevated. These residual beliefs should be investigated further, as they may confer cognitive risk for future insomnia and imply ways to improve current CBT strategies.
Subject Objective: Maladaptive beliefs about sleep are associated with insomnia and are assessed with the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS). Three studies explored which DBAS items (1) maximally differentiated people with insomnia from good sleepers, (2) declined with cognitive behavior therapy (CBT), and (3) were related to other clinical improvement indexes. Design: Data from previous studies were analyzed to evaluate the above 3 hypotheses. Participants: The total sample (N = 332) was comprised of experimental and treatment-seeking people with insomnia and good sleepers ranging from 20 to 79 years of age (mean +/- SD 51.3 +/- 14.7). Results: The analyses of variance of the 30 items of the DBAS in Study 1 suggested that 16 items differentiated insomnia sufferers from good sleepers. In Study 2, 8 items showed significantly greater changes in response to CBT than alternate therapies. However, only 2 of these items were among the 16 items that discriminated insomnia sufferers from good sleepers in Study 1. In Study 3, declining scores on 15 of 30 DBAS items in response to CBT were related to 1 or more indexes of clinical improvement. Conclusion: The 16 beliefs of the DBAS-30 that best discriminated insomnia sufferers from good sleepers related to helplessness and hopelessness in the insomnia group. CBT addressed some of these beliefs, although some beliefs relating to helplessness remained relatively elevated. These residual beliefs should be investigated further, as they may confer cognitive risk for future insomnia and imply ways to improve current CBT strategies.
Youth experiences are a core requirement for components of positive youth development and may be associated with an athlete’s mental toughness. The purposes of this study were to examine the relationship between mental toughness and youth experiences. Two hundred and ninety nine athletes (Mage 19.48 years, SD 1.30) completed the Sport Mental Toughness Questionnaire and Youth Experiences Survey. We then conducted a standard multiple regression on the data. R for regression was significantly different from zero, F(6, 292) = 8.106, p = .0001, with R2 at .14. Altogether, 14% (13% adjusted) of the variance in mental toughness was accounted for by youth experiences. These results reveal that initiative experiences have the strongest relationship with mental toughness; however, youth experiences may not be as important as previous studies suggest.
A mindset of mental toughness enables an individual to cope successfully with the pressures and demands of life. This 10-month study prospectively examined the association between mental toughness and stress resilience in 865 students (M = 17.86 years, 42.7% girls) from two vocational schools. Within each school, separate cluster analyses identified groups with different profiles of risk (assessed with perceived stress) and adaptation (operationalized with depressive symptoms and life satisfaction). Four clusters emerged characterizing students with well-adjusted (low risk, good adaptation), maladjusted (elevated risk, bad adaptation), deteriorated (low initial risk, worsening adaptation) and resilient profiles (elevated initial risk, improving adaptation). The latter two clusters reported similar levels of mental toughness at baseline, but resilient adolescents scored significantly higher on mental toughness at follow-up. After controlling for possible confounds, baseline toughness levels predicted depressive symptoms and life satisfaction over time. This study shows that mental toughness operates as a stress resilience resource. Mental toughness is, therefore a topic of interest for health specialists working with adolescent populations.
It has been suggested that there are associations among insomnia symptoms and unhealthy behaviours. However, previous studies are sparse and mainly cross-sectional, and have not been focused on several key unhealthy behaviours. The aim of this study was to examine whether the associations are bidirectional, i.e. whether insomnia symptoms are associated with subsequent unhealthy behaviours, and whether unhealthy behaviours are associated with subsequent insomnia symptoms. The data were derived from the Helsinki Health Study prospective cohort study. The baseline data were collected in 2000-02 (n = 8960, response rate 67%) among 40-60-year-old employees of the City Helsinki, Finland. The follow-up data were collected in 2007 (n = 7332, response rate 83%). Logistic regression analysis was used to examine the associations among insomnia symptoms and unhealthy behaviours, including smoking, heavy and binge drinking, physical inactivity and unhealthy food habits. Frequent insomnia symptoms at baseline were associated with subsequent heavy drinking [odds ratio (OR): 1.34; 95% confidence interval (CI): 1.07-1.68] and physical inactivity (OR: 1.27; 95% CI: 1.08-1.48) after full adjustment for gender, age, corresponding unhealthy behaviour at baseline, marital status, occupational class, sleep duration and common mental disorders. Additionally, heavy drinking (OR: 1.48; 95% CI: 1.22-1.80) and binge drinking (OR: 1.26; 95% CI: 1.08-1.46) at baseline were associated with subsequent insomnia symptoms at follow-up after full adjustment. In conclusion, insomnia symptoms were associated with subsequent heavy drinking and physical inactivity, and heavy and binge drinking were also associated with subsequent insomnia symptoms.
Mental toughness has been explored predominantly within sport contexts. Nevertheless, it is difficult to conceive mental toughness as only applicable to athletes. This study examines whether mentally tough participants exhibit resilience against stress. This is a cross-sectional study based on two different samples: Sample 1 consisted of 284 high school students (99 males, 185 females, M = 18.3 years). Sample 2 consisted of 140 first through fifth semester undergraduate students (53 males, 87 females, M = 20.0 years). Participants provided information about their level of perceived stress (10-item Perceived Stress Scale), mental toughness (48-item Mental Toughness Questionnaire) and depressive symptoms (Beck Depression Inventory). Consistent across the two samples, mental toughness mitigated the relationship between high stress and depressive symptoms. The interaction between stress and mental toughness explained 2% of variance in the adolescent sample and 10% of variance among young adults. The promotion of protective factors that foster resilient adaptation is a relevant issue. Mental toughness may appeal to individuals that are typically difficult to be reached with health interventions. Because mental toughness is part of young people's daily speech, it may serve as a less academic resource than other health psychology concepts. Copyright © 2012 John Wiley & Sons, Ltd.
BACKGROUND: One possible risk marker of later internalising symptoms is poor sleep, which is a problem for up to 40% of children. The present study investigated whether prior sleep problems could predict internalising symptoms over a period of 18 years of follow-up. METHODS: The study sample included 1503 French young adults from the TEMPO cohort (mean age=28.8±3.6 years) whose parents participate in the GAZEL cohort study. All TEMPO participants previously took part in a study of children's mental health and behaviour in 1991 (mean age=10.3±3.6 years) and 1999 (mean age=18.8±3.6 years). Sleep problems and internalising symptoms (depression, anxiety, somatic complaints) were assessed three times (1991, 1999, 2009) using the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire. The association between sleep problems in 1991 and trajectories of internalising problems from 1991 to 2009 was tested in a multinomial logistic regression framework, controlling for sex, age, baseline temperament, behavioural problems and stressful life events, as well as family income, and parental history of depression. RESULTS: We identified four trajectories of internalising symptoms: high-persistent (2.5%), high-decreasing (11.4%), low-increasing (11.6%), and low-persistent (74.5%). After controlling for covariates, compared to participants who did not have sleep problems in 1991, those who did were 4.51 times (95% CI=1.54-13.19, P=.006) more likely to have high-persistent internalising symptoms and 3.69 times (95% CI=2.00-6.82, P<.001) more likely to have high-decreasing internalising symptoms over the 18-year follow-up. LIMITATIONS: Sleep problems and internalising symptoms were based on self-report questions, results should be interpreted with due caution. CONCLUSIONS: Sleep problems early in life are associated with an increased likelihood of internalising symptoms that persist from childhood to adulthood.
Previous findings suggest that personality traits and dysfunctional sleep-related cognitions may perpetuate insomnia, but findings concerning this have been scarce. Thus, we hypothesized that personality and sleep-related cognitions influence the severity of insomnia, and investigated the association personality and sleep-related cognitions had with various sleep-related parameters, including severity of insomnia. Forty-four patients with psychophysiological insomnia were assessed using The Temperament and Character Inventory, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Dysfunctional Belief and Attitudes toward Sleep Scale, the Pre-Sleep Arousal Scale and the Hospital Anxiety and Depression Scale. Insomnia severity was significantly and positively correlated with harm avoidance, self-transcendence and sleep-related cognitions, and negatively correlated with novelty seeking, reward dependence, and cooperativeness. Dysfunctional sleep-related cognitions were positively correlated with insomnia severity and sleep quality. Stepwise multiple regression analysis showed that sleep-related cognitions, depression and reward dependence scores were significant determinants of insomnia severity, and that sleep-related cognitions and self-transcendence were significant positive determinants of sleep quality. Reward dependence, depression and sleep-related cognitions were associated with insomnia severity, and comparison with previous findings implied that 'internalizing behavior' and depression may be more plausible candidates for the link between personality and insomnia than anxiety. Considering the major role of cognitive-behavioral treatment (CBT) in the treatment of insomnia, assessment of these factors and management of sleep-related cognitions may help alleviate symptoms in patients with insomnia.
Links between sleep and psychopathology are complex and likely bidirectional. Sleep problems and alteration of normal sleep patterns have been identified in major forms of child psychopathology including anxiety, depression and attention disorders as well as symptoms of difficulties in the full range. This review summarizes some key findings with regard to the links between sleep and associated difficulties in childhood and adolescence. It then proposes a selection of possible mechanisms underlying some of these associations. Suggestions for future research include the need to 1) use multi-methods to assess sleep; 2) measure sleep in large-scale studies; 3) conduct controlled experiments to further establish the effects of sleep variations on emotional and behavioral difficulties; 4) take an interdisciplinary approach to further understand the links between sleep and associated difficulties.
We tested the relationship of objectively measured sleep quantity and quality with positive characteristics of the child. Sleep duration, sleep latency and sleep efficiency were measured by an actigraph for an average of seven (range = 3-14) consecutive nights in 291 8-year-old children (standard deviation = 0.3 years). Children's optimism, self-esteem and social competence were rated by parents and/or teachers. Sleep duration showed a non-linear, reverse J-shaped relationship with optimism (P = 0.02), such that children with sleep duration in the middle of the distribution scored higher in optimism compared with children who slept relatively little. Shorter sleep latency was related to higher optimism (P = 0.01). The associations remained when adjusting for child's age, sex, body mass index, and parental level of education and optimism. In conclusion, sufficient sleep quantity and good sleep quality are related to children's positive characteristics. Our findings may inform why sleep quantity and quality and positive characteristics are associated with wellbeing in children.
Short-term sleep loss is known to cause temporary difficulties in cognition, behaviour and health but the effects of persistent sleep deprivation on brain development have received little or no attention. Yet, severe sleep disorders that last for years are common in children especially when they have neurodevelopmental disabilities. There is increasing evidence that chronic sleep loss can lead to neuronal and cognitive loss in children although this is generally unrecognized by the medical profession and the public. Without the restorative functions of sleep due to total sleep deprivation, death is inevitable within a few weeks. Chronic sleep disturbances at any age deprive children of healthy environmental exposure which is a prerequisite for cognitive growth more so during critical developmental periods. Sleep loss adversely effects pineal melatonin production which causes disturbance of circadian physiology of cells, organs, neurochemicals, neuroprotective and other metabolic functions. Through various mechanisms sleep loss causes widespread deterioration of neuronal functions, memory and learning, gene expression, neurogenesis and numerous other changes which cause decline in cognition, behaviour and health. When these changes are long-standing, excessive cellular stress develops which may result in widespread neuronal loss. In this review, for the first time, recent research advances obtained from various fields of sleep medicine are integrated in order to show that untreated chronic sleep disorders may lead to impaired brain development, neuronal damage and permanent loss of developmental potentials. Further research is urgently needed because these findings have major implications for the treatment of sleep disorders.
To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents.
One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness-Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use.
Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality.
These results demonstrate that insufficient sleep and irregular sleep-wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered.
Lay and scientific opinion alike hold that physical activity is efficient as both remedy and preventative measure for poor sleep. There is evidence that strenuous exercising of adolescent elite athletes leads to favourable sleep patterns. However, research on this in non-elite athletes is limited. The aim of the present study was to compare sleep-EEG patterns of higher leisure time exercisers and controls.
A total 38 adolescents (M = 18.59) took part in the study; 17 were high, and 21 were low exercisers. Mean weekly exercise duration was 8.5 h for high and 2 h for low exercisers. Sleep-EEG recordings were performed following a day without exercise. Participants also completed questionnaires regarding their psychological functioning.
Compared to low exercisers, high exercisers had more slow wave sleep, and less light and REM sleep, higher scores for positive coping and curiosity, and lower scores for depressive symptoms and somatosensory amplification. Multiple regression analyses showed that weekly exercise duration predicted shortened SOL, low number of awakenings, and increased slow wave sleep.
Regular, though not necessarily vigorous, exercise is related to improvement in objective sleep patterns and better psychological functioning. Regular physical activity should be promoted and access to sports facilities should be facilitated.
Primary insomnia is defined as difficulties in falling asleep, maintaining sleep or non-restorative sleep accompanied by significantly impaired daytime functioning in the absence of a specific physical, mental or substance-related cause. The current review provides substantial support for the concept that hyperarousal processes from the molecular to the higher system level play a key role in the pathophysiology of primary insomnia. Autonomous, neuroendocrine, neuroimmunological, electrophysiological and neuroimaging studies demonstrate increased levels of arousal in primary insomnia during both night and daytime. In the light of neurobiological theories of sleep-wake regulation, primary insomnia may be conceptualized as a final common pathway resulting from the interplay between a genetic vulnerability for an imbalance between arousing and sleep-inducing brain activity, psychosocial/medical stressors and perpetuating mechanisms including dysfunctional sleep-related behavior, learned sleep preventing associations and other cognitive factors like tendency to worry/ruminate.
Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.