Distress Tolerance Links Sleep Problems with Stress and Health in Homeless

Reitzel, Lorraine R.; Short, Nicole A.; Schmidt, Norman B.; Garey, Lorra; Zvolensky, Michael J.; Moisiuc, Alexis; Reddick, Carrie; Kendzor, Darla E.; Businelle, Michael S.

doi:10.5993/ajhb.41.6.10

Cited by 37 publications

(27 citation statements)

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“…Homelessness-both sheltered and unsheltered-is associated with poor sleep quality and insufficient duration (1)(2)(3). Insomnia, which refers to dissatisfaction with sleep quantity or quality (4), can both contribute to and be a consequence of disproportionately high rates of disease found among adults experiencing homelessness, including obesity, hypertension, cancer, and depression; it can also contribute to early mortality that is well documented in this population (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

et al. 2019

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Objectives.-To examine the longitudinal change in insomnia as adults transition from homelessness to permanent support housing (PSH), and whether additional factors may moderate this relationship. Methods.-Standardized interviews were conducted with 331 homeless participants in Los Angeles prior to moving into PSH. Outcomes were measured 3, 6, and 12 months after move-in. Insomnia was assessed using the sleep condition indicator, which is a two-item validated shortform inventory that is intended to be used in clinical settings as a brief screening instrument for insomnia. Mixed-effects models were used to examine insomnia across all four measurement points and to test for interactions between time and covariates. Results.-Participants were on average approximately 55 years old and had spent an average of 5.6 years homeless in their lifetime, with approximately 70% identifying as male. Sixty-two percent of the sample screened positive for insomnia disorder at baseline. There was a significantly reduced likelihood of insomnia at each measurement period compared to baseline but no differences were found between 3, 6, or 12 months. Mental health symptoms, physical health comorbidities, tobacco consumption, and female gender were associated with an increased likelihood of insomnia. Conclusion.-Findings indicate a significant decrease in insomnia after moving into PSH, regardless of time spent homeless.

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Section: Introductionmentioning

confidence: 99%

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

et al. 2019

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“…Adults experiencing homelessness were recruited within two independent studies on health and health risk factors. Participants for Study 1 were recruited in the summer of 2013 in Dallas, TX [37], and participants for Study 2 were recruited between July and August of 2016 from 6 homeless-serving agencies in Oklahoma City, OK [38]. Participants from both studies were recruited using flyers placed around the shelter areas and targeted settings.…”

Section: Participants and Proceduresmentioning

confidence: 99%

“…Inclusion criteria were: aged 18 or over, English-speaking, at least a 7th grade English literacy level as indicated by a score of >4 on the Rapid Estimate of Adult Literacy in Medicine-Short Form [39], and receiving services and/or shelter at the targeted agencies. Overall, 470 participants were screened in Study 1 and 648 were screened in Study 2, from which 76 (Study 1) and 38 (Study 2) individuals were ineligible for participation (for more information, see [37,40] and [38,41]). Overall, 394 (Study 1) and 610 (Study 2) participants enrolled.…”

Section: Participants and Proceduresmentioning

confidence: 99%

Mental Illness and Youth-Onset Homelessness: A Retrospective Study among Adults Experiencing Homelessness

Iwundu

Chen

Edereka-Great

et al. 2020

IJERPH

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Financial challenges, social and material instability, familial problems, living conditions, structural issues, and mental health problems have been shown to contribute to youth homelessness. Based on the paucity of literature on mental illness as a reason for youth homelessness, the current study retrospectively evaluated the association between the timing of homelessness onset (youth versus adult) and mental illness as a reason for homelessness among homeless adults living in homeless shelters and/or receiving services from homeless-serving agencies. Homeless participants (N = 919; 67.3% men) were recruited within two independent studies from Dallas and Oklahoma. Covariate-adjusted logistic regressions were used to measure associations between homelessness onset and mental illness as a reason for current homelessness, history of specific mental illnesses, the historical presence of severe mental illness, and severe mental illness comorbidity. Overall, 29.5% of the sample reported youth-onset homelessness and 24.4% reported mental illness as the reason for current homelessness. Results indicated that mental illness as a reason for current homelessness (AOR = 1.62, 95% CI = 1.12–2.34), history of specific mental illnesses (Bipolar disorder–AOR = 1.75, 95% CI = 1.24–2.45, and Schizophrenia/schizoaffective disorder–AOR = 1.83, 95% CI = 1.22–2.74), history of severe mental illness (AOR = 1.48, 95% CI = 1.04–2.10), and severe mental illness comorbidities (AOR = 1.30, 95% CI: 1.11–1.52) were each associated with increased odds of youth-onset homelessness. A better understanding of these relationships could inform needs for early interventions and/or better prepare agencies that serve at-risk youth to address precursors to youth homelessness.

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“…Lower perceived distress tolerance has been associated with various psychological symptoms, including depression and PTSD [ 15 , 16 , 17 , 18 ]. In the limited available research, lower perceived distress tolerance has been identified as a link between sleep problems and stress [ 19 ]. Further, distress tolerance has shown significant indirect effects on the association between food insecurity and physical and mental health among adults who experience homelessness [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Urban Stress Indirectly Influences Psychological Symptoms through Its Association with Distress Tolerance and Perceived Social Support among Adults Experiencing Homelessness

Hernandez

Daundasekara

Zvolensky

et al. 2020

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Traditionally, intrapersonal characteristics (distress tolerance) and interpersonal characteristics (social support) have been studied separately rather than simultaneously. In the current study, we address this gap by simultaneously examining these characteristics as potential indirect associations linking established urban stress–depression and urban stress–Post-Traumatic Stress Disorder (PTSD) relationships. Adults experiencing homelessness were recruited from six homeless shelters in Oklahoma City (n = 567). Participants self-reported urban life stress (Urban Life Stress Scale), distress tolerance (Distress Tolerance Scale), social support (Interpersonal Support Evaluation List 12), major depressive disorder (Patient Health Questionnaire-8), and PTSD symptoms (Primary Care Post-Traumatic Stress Disorder screener). Covariate-adjusted structural equation models indicated a significant indirect effect of distress tolerance on the urban stress–depression (b = 0.101, 95% CI = 0.061, 0.147) and urban stress–PTSD (b = 0.065, 95% CI = 0.023, 0.112) relationships. Additionally, a significant indirect effect of social support on the urban stress–depression (b = 0.091, 95% CI = 0.053, 0.133) and urban stress-PTSD relationships (b = 0.043, 95% CI = 0.006, 0.082) was evident. Further, both the urban stress–depression (b = 0.022, 95% CI = 0.011, 0.037) and urban stress–PTSD relationships (b = 0.014, 95% CI = 0.005, 0.026) were associated indirectly through social support to distress tolerance. Interventions that aim to increase social support may also increase distress tolerance skills and indirectly reduce depressive and PTSD symptoms in the context of urban stress among adults experiencing homelessness.

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Distress Tolerance Links Sleep Problems with Stress and Health in Homeless

Cited by 37 publications

References 0 publications

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

Longitudinal effects of permanent supportive housing on insomnia for homeless adults

Mental Illness and Youth-Onset Homelessness: A Retrospective Study among Adults Experiencing Homelessness

Urban Stress Indirectly Influences Psychological Symptoms through Its Association with Distress Tolerance and Perceived Social Support among Adults Experiencing Homelessness

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