Category: Child / Adolescent - Depression
The link between sleep problems and depression has been well established in literature. Sleep difficulties including insufficient sleep and decreased sleep quality have been associated with onset and severity of depression in both children and adults (Alfano et al., 2009; Baglioni et al., 2011; Gregory et al., 2005). Relatedly, an ample body of evidence now suggests that sleep is crucial for adaptive emotional functioning, and that sleep problems are associated with dysfunctional emotion regulation. In particular, poor sleep quality has been associated with increased negative affect and emotional reactivity (Baglioni et al., 2010; Dahl, 1999). Thus, poorer sleep may strengthen the relationship between difficulty regulating emotions and negative mood. However, no studies to date have examined sleep quality as a potential moderator of the relationship between emotion dysregulation and daily fluctuations in depressed mood. Adolescence represents a key period for examining these variables, as during adolescence both depression and sleep problems emerge (Dahl & Harvey, 2007).
The current study examines sleep quality as a moderator in the relationship between emotion dysregulation and both a) between-subjects depression severity and b) within-subjects fluctuations in daily depressed mood, in a community adolescent sample (N=241, M age=15.91, SD=1.09, 53.4% female). Participants completed a baseline visit and both morning and end-of-day diaries for 7 days. Emotion dysregulation was assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz & Romer, 2004). Self-reported sleep quality was assessed using a single face-valid item in the mornings. Depression was assessed using the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS; Orvaschel, 1995) and rated on a dimensional scale based on severity. Daily depressed mood was assessed at bedtime using items drawn from the Profile of Mood States (POMS; Cranford et al., 2006). Moderation analyses were conducted using multilevel modeling (days nested within persons), controlling for the effects of time. Preliminary results suggest that daily sleep quality significantly interacted with baseline emotion dysregulation to predict daily depressed mood (b=-.004, SE= .002, p=.026). Decomposition revealed that baseline emotion dysregulation was more strongly associated with daily depressed mood when sleep quality was lower (b=.026, SE=.004, p<.001) than when sleep quality was higher (b=.017, SE=.004, p < .001). Likewise, mean sleep quality also moderated the association between emotion dysregulation and current major depression (b=-.004, SE=.001, 95%CI [-.005, -.002]). Findings suggest that sleep quality plays a crucial role in the relationship between emotion regulation and both severity of major depression and daily fluctuations in depressed mood.