Subjective – Objective Sleep Comparisons and Discrepancies Among Clinically-Anxious and Healthy Children

Abstract

We compared subjective and objective sleep patterns and problems, and examined cross-method correspondence across parent reports, child reports, and actigraphy-derived sleep variables in clinically-anxious children and healthy controls. In a multi-site, cross-sectional study, 75 pre-adolescent children (6 to 11 years; M = 8.7 years; SD = 1.4; n = 39/52 % female) were examined including 39 with a diagnosis of primary generalized anxiety disorder (GAD) and 36 controls recruited from university-based clinics in Houston, TX and Washington, DC. Structured interviews, validated sleep questionnaires, and 1 week of actigraphy data were utilized. Despite subjective reports of significantly greater sleep problems among anxious children, actigraphy data revealed no significant differences between the groups. All parents estimated earlier bedtimes and greater total sleep duration relative to actigraphy, and all children endorsed more sleep problems than parents. With few exceptions, subjective reports exhibited low and non-significant correspondence with actigraphy-based sleep patterns and problems. Our findings suggest that high rates of sleep complaints found among children with GAD (and their parents) are not corroborated by objective sleep abnormalities, with the exception of marginally prolonged sleep onset latency compared to controls. Objective-subjective sleep discrepancies were observed in both groups but more apparent overall in the GAD group. Frequent complaints of sleep problems and daytime tiredness among anxious youth might more accurately reflect difficulties prior to the actual sleep period, cognitive-affective biases associated with sleep, and/or poor sleep quality. Findings highlight the importance of considering sleep from multiple perspectives.

Are the Clinical Characteristics of Anxious Youths Participating in Non-treatment-Related Research Comparable to those of Youths Receiving Treatment?

“…In line with procedures outlined in the ADIS-C/P Clinician Manual, children and parents were interviewed separately and final diagnoses were assigned based on integrated information from children and parents. As noted in prior work (Alfano et al 2015), reliability for a GAD diagnosis in previous studies by this research team (i.e., in NTRY sample) was excellent (kappa = 1.00).…”

Discrepancies Between Adolescent and Parent Reports About Family Relationships

“…When examining discrepant reports about family relationships, it is important to consider that informants' reports of psychological phenomena commonly yield discrepant estimates of such phenomena (Achenbach, 2017;De Los Reyes, 2013;De Los Reyes & Kazdin, 2005. Beyond family relationships, discrepant reports manifest in psychological assessments across the lifespan (i.e., reports of children, adolescents, adults); domains (e.g., crime victimization, mental health, personality, pubertal status, sleep, social functioning); informants (e.g., reports by the adolescents themselves, family members, teachers, clinical staff); methods of measurement (e.g., continuous scores from surveys, discrete scores from interviews); research settings (e.g., clinic, field, laboratory); and cultures (see Achenbach, Krukowski, Dumenci, & Ivanova, 2005;Alfano, Patriquin, & De Los Reyes, 2015;De Los Reyes et al, 2015;Goodman, De Los Reyes, & Bradshaw, 2010;Hawley & Weisz, 2003;Laird & De Los Reyes, 2013;Oltmanns & Turkheimer, 2009;Renk & Phares, 2004;Rescorla et al, 2013Rescorla et al, , 2014Rescorla et al, , 2017. Across these works, these informant discrepancies have posed significant interpretive problems, which likely have their roots in converging operations (Garner, Hake, & Eriksen, 1956).…”

Introduction to the Special Issue: Discrepancies in Adolescent–Parent Perceptions of the Family and Adolescent Adjustment

“…Other approaches possess similar capabilities and have been successfully implemented in the study of informant discrepancies. These include metaanalysis of cross-informant correspondence (e.g., Achenbach et al 1987;De Los Reyes et al 2015b), direct assessment of discrepant views (i.e., via structured interview: De Los Reyes et al 2012, 2013d, nested repeated measures analytic models (e.g., generalized estimating equations; Alfano et al 2015;Augenstein et al 2016;De Los Reyes et al 2013b); and person-centered models (e.g., latent class analysis; De Los Reyes et al 2009, 2011, 2016a, 2013aLippold et al 2011Lippold et al , 2013Lippold et al , 2014. In line with this recent work, a key aim of this Special Issue is to report recent work on discrepancies between adolescents' and parents' reports of family functioning, using these emerging measurement and analytic models.…”