The Perfect Storm: Poor Sleep Amplifies Connection Between low Emotion Regulation and Later Anxiety in Adolescence

• In Event: Poster Session 13
  In Poster Session: PS 13 Topic - Developmental Psychopathology

Abstract

Anxiety disorders are one of the most common mental health disorders, with estimates reporting a 7.3% global prevalence rate (Baxter et al., 2012). One proposed risk factor for the development of anxiety is emotion regulation, or the processes that allow one to modulate emotional states (Amstadter et al., 2008). Evidence from previous literature supports the association between emotion regulation and maladaptive outcomes in adolescence and early adulthood, such as the development of anxiety disorders (Cistler et al., 2010); one proposed explanation poses that adolescents with poor emotion regulation are particularly at risk, as adolescence is a time when emotion regulation ability becomes necessary to successfully navigate shifting social landscapes and increased responsibilities that are characteristic of this developmental time period (Zimmermann & Iwanski, 2014). Youth with low emotion regulation ability may therefore be ill-equipped to handle the demands of adolescence, resulting in the emergence of anxious symptoms over time.

Sleep is also an important factor during adolescence, as significant cortical maturation occurs during adolescents' sleep (Telzer, 2013). Theories within sleep literature suggest that poor sleep quality in adolescence may disrupt the development of brain pathways that underlie higher-order cognitive functioning (Telzer, 2013). In support of these claims, studies examining sleep in adolescence have linked poor sleep quality to disorders characterized by poor attentional control and emotion regulation, such as anxiety disorders (Gregory et al., 2005). Moreover, children with both poor sleep quality and emotion regulation ability may be at greater risk for this association (Amstadter et al., 2008), as compromised sleep patterns may further dull the regulatory ability of a child who is unable to emotionally regulate amidst the stressors of adolescence, resulting in increasing anxiety over time.

The current study examines whether the interaction between emotion regulation ability and sleep quality is associated with later anxious symptoms in adolescence. It was hypothesized that youth with low emotion regulation and poor sleep quality will experience greater anxious symptoms in adolescence relative to youth with low emotion regulation and high sleep quality.

Participants were 147 families who are part of an ongoing longitudinal study of youth social and emotional development. Participants completed the Child Emotion Management Scale and Pittsburgh Sleep Quality Index at age 15, as well as completing the Multidimensional Anxiety Scale for Children at age 17. Covariates included were anxious symptoms at age 15.

Using a multiple regression analysis, poor sleep quality moderated the association between emotion regulation ability and anxious symptoms (B=2.12, p=.018). Upon probing the interaction, lower levels of emotion regulation significantly predicted greater anxious symptoms at high, mean and low levels of sleep quality, with the strongest association observed at low levels of sleep quality (B=.899, p=.018).

Results suggest that youth with poor emotion regulation, who also experience poor sleep quality in adolescence, are at greater risk for later anxious symptoms, indicating the importance of sleep for teens with emotion regulation difficulties. However, as emotion regulation predicted anxious symptoms at all levels of sleep quality, intervention methods teaching emotion regulation skills may benefit children more broadly.

Authors

• Sabine Reasbeck Huber, University of North Carolina at Greensboro
  Presenting Author

• Susan Phillips Keane, University of North Carolina at Greensboro
  Non-Presenting Author

• Jessica Dollar, University of North Carolina at Greensboro
  Non-Presenting Author

• Lilly Shanahan, University of Zurich
  Non-Presenting Author

• Susan D Calkins, University of North Carolina at Greensboro
  Non-Presenting Author

• Lenka Shriver, University of North Carolina at Greensboro
  Non-Presenting Author

• Laurie Wideman, UNC Greensboro
  Non-Presenting Author