MECHANISMS OF SLEEP DISTURBANCE IN CHILDREN WITH GENERALIZED ANXIETY DISORDER (G

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 广泛性焦虑症(GAD)是儿童最常见的焦虑症之一，与学习、职业、社交、家庭和心理等多个领域的功能障碍有关。除了慢性焦虑和躯体症状外，广泛性焦虑症患者还经常出现失眠(定义为启动和/或维持睡眠困难)。尽管在高达70%的成年人中很好地认识到了这种疾病，但直到最近才开始研究儿童睡眠障碍的程度。该协会和咨询师根据主观和客观评估进行的初步研究表明，90%患有广泛性痴呆症的儿童存在睡眠问题(Alfano，Ginsburg&Kingery，2007年；福布斯等人，2008年)。然而，在缺乏对照的前瞻性研究的情况下，这些问题的持久性和严重性是未知的。在其他健康的儿童中，持续的睡眠障碍与功能损害有关，包括学业失败(Kahn等人，1989)、工作记忆和注意力缺陷(Bruni等人，2005；Steenari等人，2003)、情绪调节能力下降(Leotta等人，1997；Wolfson&Carskadon，1998)以及受伤风险(Owens等人，2005)。因此，广泛性痴呆症儿童中持续睡眠障碍的存在可能会加剧现有的白天功能障碍，加剧焦虑症状，并导致较低的恢复率。目前的研究将使用自然主义和基于实验室的评估方法来评估广泛性痴呆症儿童睡眠障碍的持续性、严重性和特征，包括与焦虑症状和功能障碍的关系。与睡眠障碍相关的共同和独特的因素也将被调查，包括睡眠前唤醒的神经生理和认知维度，以及父母教养和环境因素。这项研究的结果可能有助于确定儿童失眠和广泛性AD的风险，以及临床研究和实践的具体目标。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Generalized Anxiety Disorder (GAD) is among the most common anxiety disorders in children and is associated with impairments in multiple areas of functioning including academic, occupational, social, familial, and psychological domains. In addition to chronic worry and somatic complaints, patients with GAD frequently experience insomnia (defined as difficulty initiating and/or maintaining sleep). Although well-recognized in up to 70% of adults with the disorder, only recently has research begun to examine the extent of sleep disturbance in children. Preliminary research conducted by the PI and consultants based on both subjective and objective assessment indicates that 90% children with GAD experience sleep problems (Alfano, Ginsburg & Kingery, 2007; Forbes et al., 2008). However, in the absence of controlled, prospective studies, the persistence and severity of these problems are unknown. In otherwise healthy children, persistent sleep disturbance is associated with functional impairment including academic failure (Kahn et al., 1989), deficits in working memory and attention (Bruni et al., 2005; Steenari et al., 2003), decreased emotion regulation (Leotta et al.,1997; Wolfson & Carskadon, 1998), and injury risk (Owens et al., 2005). The presence of persistent sleep disturbance among children with GAD may therefore compound existing impairments in daytime functioning, exacerbate anxiety symptoms, and result in lower recovery rates. The current study will use both naturalistic and laboratory-based methods of assessment to evaluate the persistence, severity and features of sleep disturbance in children with GAD, including relationships with anxiety symptoms and impairments in functioning. Shared and unique factors associated with sleep disturbance also will be investigated including neurophysiological and cognitive dimensions of pre-sleep arousal, and parenting and environmental factors. Findings from this study may serve to identify children at risk for the later development of insomnia and GAD, as well as specific targets for clinical research and practice.