Objective: A significant minority of adolescents will have persistent postconcussion symptoms after an injury, potentially having a negative impact on family functioning. However, the reasons for a family's negative impact are not clearly understood. The objective of this study was to determine whether preinjury/demographic factors, injury characteristics, and/or worse postinjury symptoms are associated with higher levels of family stress in youth with refractory postconcussion symptoms. Setting: Pediatric refractory concussion clinic in a tertiary care center. Participants: A total of 121 adolescents (13-18 years old) who were 1 to 12 months postconcussion. Measures: Primary outcome was the mean stress rating on the Family Burden of Injury Interview (FBII), a 27-item questionnaire rating the impact on a family as a result of an injury. Preinjury/demographic and injury details were collected. Youth and their parents also completed measures of postconcussion symptoms, depression, anxiety, and behavioral problems. Results: Participants had a mean age of 16.0 years (SD = 1.3), of which, 65% identified as female, and were on an average 5.2 months (SD = 2.4) postconcussion. FBII ratings were not significantly correlated with demographics, preinjury functioning, injury severity, duration of persistent postconcussion problems (ie, time since injury), or self-reported postconcussion symptoms. Greater family burden (higher FBII ratings) significantly correlated with worse parent-reported postconcussion symptoms, worse psychological functioning (self-reported depression, parent-reported anxiety, and depression), and worse behavioral functioning (parent-reported conduct problems and peer problems). A multiple linear regression model revealed that parent-perceived postconcussion cognitive symptoms (β = .292, t = 2.56, P = .012) and parent-perceived peer problems (β = .263, t = 2.59, P = .011) were significantly associated with family burden (F8,105 = 6.53; P < .001; R2 = 0.35). Conclusion: Families of youth with refractory postconcussion symptoms can experience a negative impact. The severity of reported family burden in those with slow recovery from concussion was significantly associated with parents' perception of their child's cognitive symptoms and peer problems. These results could provide support for family-based interventions in this population.

Poor sleep quality during pregnancy is prevalent, commonly persists into the postpartum period, and has been associated with poor maternal and child outcomes including risk of preterm birth and postpartum depression. Pregnant individuals are hesitant to take medication leaving many without evidence-based treatments for sleep problems. Mindfulness-based interventions have been shown to improve sleep in adults, but their impact on sleep in pregnancy has rarely been investigated. The current investigation comprises secondary analysis of a randomized controlled trial (RCT) of an 8-week modified Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD) group intervention for pregnant individuals experiencing psychological distress. A community sample of pregnant individuals who self-identified as experiencing high levels of psychological distress were randomized to MBCT-PD (n=28) or treatment as usual (n=32) conditions. Assessments comprised a sleep quality questionnaire, a sleep diary and actigraphy, at enrolment, post- intervention, and follow-up at 3 months postpartum. Multilevel modeling revealed a significant effect of MBCT-PD on overall sleep quality across time moderated by baseline levels, such that participants with initial worse sleep quality who received treatment had greater improvement from post intervention to follow-up. Sleep efficiency assessed by diary improved significantly among those who received MBCT-PD, but no other differential changes were observed in diary or actigraphy parameters. Among pregnant individuals with high levels of psychological distress, training in mindfulness was associated with secondary benefits for sleep. Further research is warranted to examine what MBCT-PD components are necessary and could be tailored to address sleep problems during pregnancy.

The current study investigated the associations between trait mindfulness and sleep health and examined the interactions between theoretically related mindfulness subscales. Participants ( n = 162, Mage = 19.93) reported trait levels of mindfulness and sleep was assessed using questionnaires and actigraphy. Higher mindfulness scores in awareness, nonreactivity, and nonjudgment were associated with better sleep health. The associations between observing and sleep health were moderated by nonreactivity. Results indicate that observing is associated with better sleep health at higher levels of nonreactivity and worse sleep health at lower levels, helping to explain the often-contradictory findings between observing and health outcomes.