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2.
Dementia (London) ; 21(8): 2418-2441, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35976758

ABSTRACT

INTRODUCTION: Pain of nursing homes residents with Alzheimer's disease remains under detected compared to their cognitively intact counterparts. Communication difficulties may partly explain this poor quality of care but the influence of stigmatization on pain assessment has never been explored. RESEARCH QUESTION: The objective of this research was to analyze whether a diagnosis label of Alzheimer's disease or the stage of the disease may bias pain assessment scores and empathic reactions of health care staff in nursing homes. METHODS: Two studies were conducted based on a similar experimental between-subjects design with a video showing an older adult woman experiencing undefined pain. Different labels and vignettes were manipulated to characterize the subject of the video. In the first study, 84 certified nursing assistants were asked to watch the video and then to assess the pain intensity and their empathic reaction. Participants were randomized in two conditions that varied the disease label (Alzheimer's disease vs no diagnosis). In the second study, 67 certified nursing assistants were enrolled who did not participate in the first study. They watched the same video as in the first study and assessed the pain intensity and their empathic reaction. They were randomized in two conditions that varied the stage of the Alzheimer's disease (mild stage vs severe stage). RESULTS: Alzheimer's disease label had no influence on assessment scores. In contrast, the stage of the disease had a significant effect on the health care staff assessments with severe stage associated with lower pain intensity scores and empathic reactions. CONCLUSION: These results confirm that the Alzheimer's disease stigma is a real phenomenon that tends to be mainly elicited by the symptoms of the acute phase of the disease. These findings are crucial to better understand the stigma related to Alzheimer's disease and to enhance the pain management of this frail population.


Subject(s)
Alzheimer Disease , Dementia , Female , Humans , Aged , Aged, 80 and over , Pain Measurement , Dementia/complications , Nursing Homes , Pain/diagnosis , Pain/complications
3.
Geriatr Psychol Neuropsychiatr Vieil ; 20(1): 131-141, 2022 Mar 01.
Article in French | MEDLINE | ID: mdl-35652837

ABSTRACT

Résumé Une analyse phénoménologique interprétative longitudinale des difficultés et des besoins non satisfaits rencontrés par les aidants de patients atteints de maladies neuro-dégénératives a été effectuée sur un groupe de 14 conjoints avant (T1) et après (T2) avoir participé à un groupe de psychoéducation de 6 mois. Lors du premier temps (T1), les aidants décrivent principalement une perte des échanges avec le patient, la solitude et la détresse qu'elle entraîne. Ils verbalisent également les difficultés de gérer la relation d'aide, en particulier leurs besoins non satisfaits de temps libre. Lors du second temps (T2) et sous les effets de la progression de la pathologie, ce sont nouvelles difficultés qui apparaissent, avec l'augmentation de la difficulté à gérer les pertes fonctionnelles et les troubles psychocomportementaux. Nos résultats suggèrent que la psychoéducation a aidé les soignants à faire face aux difficultés liées au fardeau objectif (besoin de temps personnel). Les interventions psychoéducatives devraient à l'avenir aborder davantage la relation dyadique et le besoin de soutien affectif de l'aidant, car il s'agit d'un besoin fort, non satisfait, des aidants. Des interventions de psychoéducation systématiques et répétées peuvent ainsi permettre de mieux identifier les difficultés et les besoins des aidants et de leur fournir une aide adaptée, tout particulièrement en ce qui concerne la relation de couple et l'état émotionnel des aidants. Abstract Psycho-education provides information, tools and support to caregivers, and a strong consensus favors the importance of tailoring psycho-education interventions to caregiver needs. Most studies assess needs cross-sectionally, neglecting the evolving nature of needs and challenges inherent to dementia and caregiving, failing to report on how psycho-educative interventions address or incorporate caregiver needs. The purpose of this study was to provide a qualitative and longitudinal assessment of the difficulties and unmet needs of spousal caregivers before and after participating in a psycho-education group. To investigate the difficulties and needs related to caregiving, before and after psycho-education participation, we used a longitudinal Interpretative Phenomenological Analysis (LIPA). LIPA is a prospective person-centered method that explores the lived experience of phenomena without formulating a priori hypotheses. The psycho-educational program was available to any informal caregiver of a person living with dementia (PLWD) in the Brussels region. The multimodal program contains: educational and practical information on dementia sessions with a neuropsychologist specialized in dementia, group sharing and support; home visits by a nurse for personalized assistance to caregivers, art therapy group: available for PLWD that could not be left unsupervised in conjunction with psycho-education sessions. Our study yielded three key findings: (1) caregivers described a loss of relational reciprocity with the person living with dementia at T1 and T2, and reported feeling distressed; (2) at T1, caregivers verbalised difficulties related to their role, the majority of them only identified the lack of personal time as an unmet need; (3) at T2, most caregivers had actively addressed their unmet need for personal time and used respite services to obtain personal time. Our findings would suggest that psycho-education helped caregivers to address difficulties related to objective burden (need for personal time). Psycho-education interventions should systematically and repeatedly assess caregiver difficulties and assist them in identifying their needs in order to provide adequate and tailored strategies and support.


Subject(s)
Caregivers , Dementia , Aged , Humans , Prospective Studies
4.
Eur Neurol ; 84(5): 333-339, 2021.
Article in English | MEDLINE | ID: mdl-34182546

ABSTRACT

BACKGROUND: Insomnia is a highly common sleep disorder in patients with Parkinson's disease (PD). Yet, no screening questionnaires following the Diagnostic and Statistical Manual-5 (DSM-5) criteria have been validated in PD patients. OBJECTIVES: We assessed the validity and reliability of the French version of the sleep condition indicator (SCI), in patients with PD. METHODS: In a sample of 65 patients (46% women, mean age 63.8 ± 7.9 years) with PD, but without dementia, insomnia was assessed with a clinical interview and the SCI. Statistical analyses were performed to determine the reliability, construct validity, and divergent validity of the SCI. In addition, an explanatory factor analysis was performed to assess the underlying structure of the SCI. RESULTS: Of the 65 patients (mean duration PD 9.7 ± 6.9 years), 51% met the criteria for insomnia disorder when measured with a clinical interview. The mean SCI score was 18.05 ± 8.3. The internal consistency (α = 0.89) of the SCI was high. Using the previously defined cutoff value of ≤16, the area under the receiver operating characteristic curve was 0.86 with a sensitivity of 86% and a specificity of 87%. Exploratory factor analysis showed a 2-factor structure with a focus on sleep and daytime effects. Additionally, good construct and divergent validity were demonstrated. CONCLUSION: The SCI can be used as a valid and reliable screener for DSM-5 insomnia disorder in PD patients. Due to its short length, it is useful in both clinical practice and scientific research.


Subject(s)
Parkinson Disease , Sleep Initiation and Maintenance Disorders , Sleep Wake Disorders , Aged , Female , Humans , Male , Middle Aged , Parkinson Disease/complications , Parkinson Disease/diagnosis , Psychometrics , Reproducibility of Results , Sleep , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/etiology , Surveys and Questionnaires
5.
Article in English | MEDLINE | ID: mdl-33832875

ABSTRACT

Insomnia is four times more frequent in patients with Parkinson's disease (PD) than in the general population. In PD, insomnia is associated with a very significant decrease in quality of life and has deleterious consequences on both patients' and caregivers' health. When insomnia is comorbid to PD, the main therapeutic response is the prescription of benzodiazepines or related drugs. As in the general population, these sedative-hypnotic molecules have very low efficacy in PD and are associated with adverse effects. They are highly addictive and are also associated with drowsiness, a risk of falling and decreased life expectancy. These side effects may in themselves be symptoms associated with PD in the absence of insomnia. In this clinical context, it is clear that sedative-hypnotic drugs are likely to potentiate these clinical symptoms in PD. We recently documented that insomnia disorder comorbid to PD is associated with the classic psychological factors that perpetuate insomnia in neurologically disease-free individuals with insomnia. These results enabled us to emphasise that target-oriented interventions, such as cognitive-behavioural therapy for chronic insomnia (CBT-i), should be considered as a treatment for insomnia comorbid to PD. As a reminder, for decades CBT-i has been considered to be the most effective first-line treatment for the management of chronic insomnia, whether or not it is associated with a comorbidity. In this context, we demonstrated the acceptability of CBT-i in the treatment of insomnia comorbid to PD and its effectiveness for the management of noctural and diurnal symptoms of insomnia associated with this neurological condition. The objective of this paper is to raise awareness among health professionals of the relevance of psychological therapies (mostly CBT) for insomnia in PD. Unlike drug treatments, these therapies are safe for patients who are already weakened by PD itself.

6.
Pain Manag Nurs ; 22(3): 377-385, 2021 06.
Article in English | MEDLINE | ID: mdl-33446451

ABSTRACT

PURPOSE: People with dementia are at great risk of their pain being undetected. In long-term care facilities, certified nursing assistants are on the front-line to detect whether a resident with dementia is experiencing pain, but research on certified nursing assistants' abilities to accurately assess pain are scarce. This study aims to examine certified nursing assistants' pain assessment skills using a simulated standardized video context. DESIGN: A cross-sectional study was conducted. METHODS: Fifty certified nursing assistants and 40 individuals with no professional experience in the field of care (controls) watched the same video of an older adult woman with dementia experiencing pain. Afterwards, they completed visual analog scales (pain intensity, affective distress), an observational pain assessment scale (Algoplus), and a set of questionnaires. RESULTS: In both groups, pain intensity assessment and empathic reaction scores showed important interrater variability. Moreover, certified nursing assistants and controls did not differ in detecting the presence of pain or assessing its intensity. But certified nursing assistants displayed lower empathic reactions and dispositions. Certified nursing assistants pain assessment scores decreased with experience and expertise. CONCLUSIONS: The practice of pain assessment is challenging for certified nursing assistants in long-term care facilities. Their professional status does not prevent inter-personal inconsistency and tends to lower their empathic dispositions. Personal determinants may interfere with their assessment behaviors and must be considered to enhance pain management for residents with dementia.


Subject(s)
Dementia , Nursing Assistants , Aged , Cross-Sectional Studies , Dementia/complications , Female , Humans , Long-Term Care , Pain Measurement
7.
Geriatr Psychol Neuropsychiatr Vieil ; 18(3): 331-342, 2020 09 01.
Article in French | MEDLINE | ID: mdl-32897195

ABSTRACT

Insomnia disorder is four times more frequent in Parkinson's disease (PD) than in the general population. In PD, insomnia is associated with a very significant decrease in quality of life and deleterious consequences on both patients and caregivers' health. The main therapeutic option in response to insomnia comorbid to PD is the prescription of benzodiazepines or related drugs. As in the general population, these sedative-hypnotic molecules have very low efficacy in PD and are associated with adverse effects. They are highly addictive and are also associated with drowsiness, risk of falling and decreased life expectancy. These side effects may in themselves be symptoms associated with PD in the absence of insomnia. In this clinical context, we can easily conceive that sedative-hypnotics are likely to potentiate these clinical symptoms in PD. We have recently documented that insomnia disorder comorbid to PD is associated with the classical psychological factors perpetuating insomnia in neurological disease-free individuals with insomnia. These results have allowed us to emphasize that target-oriented interventions for instance cognitive-behavioral therapy for chronic insomnia (CBT-i) should be considered as a treatment approach for insomnia disorder comorbid to PD. As a reminder, for decades, CBT-i is considered the most effective first-line treatment for the management of chronic insomnia associated or not with comorbidity. In this context, we demonstrated the acceptability of CBT-i in the treatment of insomnia comorbid to PD and its effectiveness for the management of night and daytime symptoms of insomnia associated with this neurological condition. The objective of this synthesis is to raise awareness among health professionals of the relevance of psychological therapies (mostly CBT) for insomnia in PD. Unlike drug treatments, these therapies are safety for patients who are already weakened by the PD itself.


Subject(s)
Parkinson Disease/complications , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/therapy , Aged , Cognitive Behavioral Therapy , Humans
8.
Geriatr Psychol Neuropsychiatr Vieil ; 18(3): 321-330, 2020 09 01.
Article in French | MEDLINE | ID: mdl-32715999

ABSTRACT

Insomnia is a common complaint in Parkinson's disease (PD) affecting more than three-quarters of patients. Longitudinal studies show that insomnia complaint is a persistent condition in PD, especially in patients with more severe insomnia at baseline. When international and standardized criteria are used, it is estimated that more than half of the patients meet the criteria for insomnia disorder. These data define insomnia as the most prevalent sleep disorder in PD. Given that background, it is surprising that none of the scales recommended by the International Parkinson and movement disorder society to assess sleep disturbances in PD is specifically dedicated to the assessment of insomnia disorder. In this insufficient methodological context, we have recently established the discriminant validity of the Sleep condition indicator for insomnia disorder in PD, as diagnosed with a clinical interview according to the DSM-5 criteria. As in the general population, female sex, symptoms of depression, anxiety, fatigue and daytime sleepiness have been associated with insomnia complaint severity in PD. Insomnia also reduces the quality of life of patients affected by PD and that of their caregivers. In contrast, clinical features of the disease were very slightly related to insomnia with small effect sizes. These features include motor fluctuations, autonomic problems, cardiovascular and thermoregulatory dysfunctions and doses of dopaminergic medications. This observation implies not systematically considering insomnia as a symptomatic manifestation secondary to PD but as a clinical entity requiring specific treatment. The objective of this synthesis is to raise awareness among health professionals of the importance of early detection of insomnia in PD in order to limit the consequences associated with its chronicity. Identifying and assessing insomnia in PD is therefore a major health issue.


Subject(s)
Parkinson Disease/complications , Sleep Initiation and Maintenance Disorders/complications , Aged , Diagnostic Self Evaluation , Humans , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/epidemiology
9.
Memory ; 28(5): 632-641, 2020 05.
Article in English | MEDLINE | ID: mdl-32336202

ABSTRACT

The concept of "Self-Defining Future Projections" (SDFPs) has been recently introduced to better explore the link between future thinking and identity. To date, SDFPs have only been examined in young adults and it remains unknown how self-defining future thoughts evolve in aging. In this cross-sectional study, 43 young adults (age range = 19-28; mean age = 23.06) and 43 older adults (age range 60-80; mean age = 69.46) were asked to generate three SDFPs. Our results indicated that SDFPs were less specific in older adults compared to young adults, but there was no difference between the two groups concerning autobiographical reasoning. However, regarding subjective experience, older adults rated imagined future events as containing more sensory details and contextual information and reported a higher feeling of pre-experiencing the personal future. Additionally, older participants described future events that were more positive and less distant in the future, with fewer narratives about future achievements but more narratives describing leisure time, with a similar probability between the two groups that the event will occur in the future. Our study extends previous aging research and adds to the literature by better understanding how future event representations are formed in older adults.


Subject(s)
Aging , Forecasting , Memory, Episodic , Mental Recall , Narration , Self Concept , Adult , Age Factors , Aged , Cross-Sectional Studies , Female , Humans , Imagination , Male , Young Adult
10.
Psychiatry Res ; 287: 112901, 2020 05.
Article in English | MEDLINE | ID: mdl-32155443

ABSTRACT

Sleepiness and mind-wandering are frequently experienced by patients with attention-deficit/hyperactivity disorder (ADHD), without ever having been jointly explored. We aimed to investigate the co-occurrence of these two phenomena in ADHD adults. Drug-free ADHD adults (n = 25) and healthy controls (n = 28) underwent an online experience sampling of mind-wandering episodes and subjective sleepiness. Participants completed self-reported measures of mind-wandering and sleepiness in daily life. Higher trait of mind-wandering was observed in ADHD patients compared to controls. On the whole sample, self-reported mind-wandering propensity was strongly associated with the severity of inattentive, impulsive and hyperactive symptoms. During the probes, patients reported more frequent episodes of mind-wandering and mind-blanking, and higher sleepiness. Their mind-wandering episodes were less intentional and belonged less frequently to a structured succession of thoughts. In both groups, mind-wandering and mind-blanking were associated with higher sleepiness. On the SART, patients were less accurate than controls. We provide first initial evidence for higher propensity of mind-wandering and mind-blanking using experience sampling in patients with formal ADHD diagnosis. This propensity was associated with sleepiness without negatively impacting attention performances. Mind-wandering and sleepiness have common determinants potentially involved in ADHD pathophysiology. Correlates of mind-blanking in ADHD adults remain to be characterized.


Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Attention/physiology , Psychomotor Performance/physiology , Sleepiness , Adult , Ecological Momentary Assessment , Female , Humans , Male , Photic Stimulation/methods , Self Report
11.
Behav Sleep Med ; 18(1): 107-119, 2020.
Article in English | MEDLINE | ID: mdl-30462561

ABSTRACT

Objective/Background: Safety behaviors play a prominent role in the development and maintenance of insomnia. The Sleep-Related Behaviors Questionnaire (SRBQ) is a self-report questionnaire designed to assess safety behaviors employed to cope with fatigue or to improve sleep. Despite its frequent use in insomnia, no systematic psychometric validation of the SRBQ has been conducted; its factor structure has never been explored. Furthermore, there is no French version of this scale. The goal of this study was to empirically validate a French version of the SRBQ. Participants/Methods: A total of 539 French-speaking community-dwelling participants from the general population completed a face-to-face clinical interview to determine insomnia disorder against DSM-5 criteria and several questionnaires including the French SRBQ. Results: SRBQ items with poor psychometric properties were removed, thus leading to a 20-item version (SRBQ-20). Exploratory factor analysis and parallel analysis revealed three distinct factors with good internal consistency. The results supported the internal temporal stability of the SRBQ-20. The construct validity of that instrument was underpinned by correlations obtained with various measures of insomnia and related constructs. Adequate discriminative validity was established by comparing individuals with insomnia and individuals without insomnia. Conclusions: This study demonstrated that the French version of the SRBQ-20 has good psychometric properties.


Subject(s)
Psychometrics/methods , Sleep/physiology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Reproducibility of Results , Surveys and Questionnaires , Young Adult
12.
J Clin Psychol ; 76(3): 356-376, 2020 03.
Article in English | MEDLINE | ID: mdl-31746468

ABSTRACT

OBJECTIVE: To test the efficacy of cognitive behavioral therapy for insomnia (CBT-i) in Parkinson's Disease (PD) and to evaluate its impact on indices of daytime and psychological functioning. METHOD: Fifteen patients with insomnia disorder (ID) comorbid to PD were enrolled in a single-case design with multiple baselines. Total wake time, sleep efficiency, and daytime sleepiness were recorded on a sleep diary. Self-reported measures of insomnia, anxiety and depressive symptoms, health-related quality of life, and psychological variables perpetuating ID were completed. All patients also underwent a clinical interview for ID diagnosis. RESULTS: CBT-i was associated with significant changes in sleep variables and ID criteria. Significant positive treatment-related effects were also noted for all indices of daytime and psychological functioning, and for variables perpetuating ID. All of these improvements were well maintained at 3-month follow-up. CONCLUSION: CBT-i is a promising therapeutic avenue for patients with PD.


Subject(s)
Cognitive Behavioral Therapy , Parkinson Disease/epidemiology , Parkinson Disease/psychology , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Sleep Initiation and Maintenance Disorders/therapy , Adult , Aged , Anxiety/psychology , Comorbidity , Depression , Female , Humans , Male , Middle Aged , Quality of Life , Self Report , Single-Case Studies as Topic , Treatment Outcome
13.
J Sleep Res ; 29(2): e12973, 2020 04.
Article in English | MEDLINE | ID: mdl-31868977

ABSTRACT

This study investigated the relationship between bedtime counterfactual thoughts, depressive symptoms, nocturnal counterproductive thought-control strategies and insomnia disorder. Six hundred and fifty adults from the general population were recruited and provided data on their counterfactual thoughts' frequency at bedtime, depressive symptoms and use of nocturnal maladaptive strategies of thought control. In addition, all participants followed a face-to-face clinical interview for the diagnosis of insomnia disorder. A model positing moderated mediation was tested using conditional process modelling. Overall, 19% of participants met diagnostic criteria for a chronic insomnia diagnosis. Bootstrapped mediation analyses indicated that the association of bedtime counterfactual processing and insomnia diagnosis is mediated by depressive symptoms (B = 0.035, SE = 0.007, bootstrapped 95% CI = 0.023, 0.051). Furthermore, the effects of such a mediation model were significantly larger among individuals with high levels of aggressive suppression than those with low levels of aggressive suppression (B = 0.002, SE = 0.001, bootstrapped 95% CI = 0.001, 0.004). A second model in which a worry strategy moderates the relationship between bedtime counterfactual processing and depressive symptoms was not statistically significant (B = 0.0036, SE = 0.013, p = .78). The present study adds to the literature on the importance of self-attacking thoughts and negative affects at bedtime. We recommend the evaluation of the impact of adding self-attacks management strategies to cognitive behavior therapy for individuals with an insomnia disorder.


Subject(s)
Cognitive Behavioral Therapy/methods , Depression/psychology , Sleep Initiation and Maintenance Disorders/diagnosis , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult
14.
Geriatr Psychol Neuropsychiatr Vieil ; 17(4): 423-428, 2019 12 01.
Article in French | MEDLINE | ID: mdl-31570331

ABSTRACT

In French care facilities for dependent aged people (NHDAP), prevalence of pain among residents with dementia is high, and source of behavior disturbances and quality of life impairment. However, in spite of many international expert statements, pain remains under-assessed and under-managed in these patients. Certified nursing assistants (CNA) are on the front-line in NHDAP to detect the presence of pain in residents with communication difficulties, while they received little training for pain management and directives for specific care. Moreover, no studies were presently devoted to the impact of demographic and socio-professional determinants of CNA on pain assessment. In our study, we assessed the presence and intensity of pain in cognitively impaired residents in NHDAP, by CNA performing as a pair for the morning care. 42 pairs were recruited and independently completed a standardized behavioral assessment for pain (Doloplus scale) as well as a numeric rating scale. CNA personal characteristics were investigated to analyse the determinants of potential assessment discrepancies between each of the pairs. Presence of pain was detected in 51.1 to 91.1% of the patients depending on the tool and analysis criteria. In 28.9% important discrepancies were observed in the pain assessment between the CNA pairs, which could be related to professional status and prior use of the observational assessment. These inter-rater discrepancies should be reduced providing clear pain assessment guidelines for CNA in NHDAP, and further studies should be completed to figure out the role of CNA personal determinants in the patients' pain assessment.


Subject(s)
Nursing Assistants , Pain Measurement , Pain/diagnosis , Adolescent , Adult , Aged , Cognition Disorders/complications , Female , France , Homes for the Aged , Humans , Male , Middle Aged , Nursing Homes , Pain/complications , Young Adult
15.
J Clin Sleep Med ; 15(9): 1217-1224, 2019 09 15.
Article in English | MEDLINE | ID: mdl-31538592

ABSTRACT

STUDY OBJECTIVES: Insomnia disorder (ID) is highly associated with Parkinson disease (PD) with great negative effect on health-related quality of life. Nonetheless, the relevance of psychological processes involved in the maintenance of insomnia is yet to be established in the context of this neurological condition. Our aim was to examine a serial meditation model of sleep-related safety behaviors and dysfunctional beliefs about sleep in association with presleep cognitive arousal and ID in patients with PD. METHODS: A total of 68 patients with PD completed self-report measures including the Sleep-Related Behaviors Questionnaire (SRBQ-20), Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16), and the cognitive subscale of the Presleep Arousal Scale (PSAS-C). ID was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Bootstrapped serial mediation analyses were conducted to test indirect effects. RESULTS: Overall, 55.6% of patients with PD met diagnostic criteria for ID. The association between presleep cognitive arousal (PSAS-C) and ID was serially mediated by sleep-related safety behaviors (SRBQ-20) and strong endorsement of dysfunctional beliefs about sleep (DBAS-16) (bias-corrected 95% confidence interval for the indirect effect = 0.013, 0.093). An alternate serial mediation model in which dysfunctional beliefs about sleep precede sleep-related safety behaviors was not statistically significant (bias-corrected 95% confidence interval for the indirect effect = -0.001, 0.046). CONCLUSIONS: ID comorbid to PD is associated with the classic psychological factors perpetuating ID in neurological disease-free individuals with insomnia. Target-oriented interventions for instance cognitive behavioral therapy for chronic insomnia should be considered as a treatment approach for ID comorbid to PD. CITATION: Lebrun C, Gély-Nargeot M-C, Maudarbocus KH, Rossignol A, Geny C, Bayard S. Presleep cognitive arousal and insomnia comorbid to parkinson disease: evidence for a serial mediation model of sleep-related safety behaviors and dysfunctional beliefs about sleep. J Clin Sleep Med. 2019;15(9):1217-1224.


Subject(s)
Arousal/physiology , Cognition/physiology , Health Knowledge, Attitudes, Practice , Parkinson Disease/complications , Parkinson Disease/psychology , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/psychology , Aged , Female , Humans , Male , Middle Aged , Parkinson Disease/physiopathology , Sleep Initiation and Maintenance Disorders/physiopathology , Surveys and Questionnaires
16.
Sleep ; 41(3)2018 03 01.
Article in English | MEDLINE | ID: mdl-29309702

ABSTRACT

Study Objectives: Despite the high comorbidity of insomnia disorder (ID) with multiple sclerosis (MS), the relevance of psychological processes involved in the maintenance of insomnia is yet to be established in this neurological disorder. This study aimed to ascertain to what extent the suggested emotional, cognitive, and behavioral processes maintaining insomnia are relevant in people with insomnia and MS. Methods: A between-subjects design was used to compare 26 patients with insomnia and MS, with 31 patients with MS only, and with 26 matched neurological disease-free individuals with insomnia. All patients participated in a standardized clinical interview and completed a battery of self-reported measures of cognitive and somatic presleep arousal experienced at bedtime, sleep- or insomnia-related unhelpful beliefs, and sleep-related safety behaviors. All patients with MS underwent a neurological examination. Results: ID comorbid to MS was strongly associated with increased levels of cognitive and somatic arousal, higher endorsement of dysfunctional beliefs about the consequences of insomnia on daytime functioning, and worry about insomnia and more frequent engagement in sleep-related safety behaviors. Patients with MS with ID did not differ from neurological disease-free individuals with insomnia on these measures. No link was found between MS clinical peculiarities and ID diagnosis. Conclusions: ID comorbid to MS is associated with the classical psychological factors perpetuating ID in neurological disease-free individuals with insomnia. Primary care providers and neurologists should consider target-oriented therapies like cognitive behavioral therapy for chronic insomnia as a treatment approach for ID comorbid to MS.


Subject(s)
Multiple Sclerosis/physiopathology , Multiple Sclerosis/psychology , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/psychology , Sleep/physiology , Adult , Anxiety/psychology , Arousal/physiology , Comorbidity , Cross-Sectional Studies , Emotions/physiology , Female , Humans , Male , Middle Aged , Multiple Sclerosis/epidemiology , Self Report , Sleep Initiation and Maintenance Disorders/epidemiology
17.
J Sleep Res ; 26(6): 702-708, 2017 12.
Article in English | MEDLINE | ID: mdl-28548308

ABSTRACT

Insomnia disorder is frequent in the population, yet there is no French screening instrument available that is based on the updated DSM-5 criteria. We evaluated the validity and reliability of the French version of an insomnia screening instrument based on DSM-5 criteria, the Sleep Condition Indicator, in a population-based sample of adults. A total of 366 community-dwelling participants completed a face-to-face clinical interview to determine insomnia disorder against DSM-5 criteria and several questionnaires including the French Sleep Condition Indicator version. Three-hundred and twenty-nine participants completed the Sleep Condition Indicator again after 1 month. Statistical analyses were performed to determine the reliability, construct validity, divergent validity and temporal stability of the French translation of the Sleep Condition Indicator. In addition, an explanatory factor analysis was performed to assess the underlying structure. The internal consistency (α = 0.87) and temporal stability (r = 0.86, P < 0.001) of the French Sleep Condition Indicator were high. When using the previously defined cut-off value of ≤ 16, the area under the receiver operating characteristic curve was 0.93 with a sensitivity of 95% and a specificity of 75%. Additionally, good construct and divergent validity were demonstrated. The factor analyses showed a two-factor structure with a focus on sleep and daytime effects. The French version of the Sleep Condition Indicator demonstrates satisfactory psychometric properties while being a useful instrument in detecting cases of insomnia disorder, consistent with features of DSM-5, in the general population.


Subject(s)
Diagnostic and Statistical Manual of Mental Disorders , Sleep Initiation and Maintenance Disorders/diagnosis , Surveys and Questionnaires/standards , Adult , Aged , Aged, 80 and over , Female , France , Humans , Language , Male , Middle Aged , Psychometrics/standards , ROC Curve , Reproducibility of Results , Sensitivity and Specificity , Sleep , Young Adult
18.
Arch Clin Neuropsychol ; 32(5): 585-591, 2017 Aug 01.
Article in English | MEDLINE | ID: mdl-28168283

ABSTRACT

OBJECTIVE: The Hayling Sentence Completion Test (HSCT) measures prepotent response inhibition, useful to assess inhibition deficit in a variety of clinical conditions. Despite its extensive use by numerous clinical and research groups in France, normative data for the HSCT are not yet available for French speakers. METHOD: A French version of the HCST was administered to a sample of 426 healthy community-dwelling French speaking adults (20-87 years of age). Normative data were calculated using a regression-based approach. RESULTS: Regression analyses indicated that both age and education were associated with response latency and number of errors in the inhibition condition. Equations to calculate Z scores are provided for clinical use. In addition, we provided a clear guideline for the error scoring of the inhibition condition by establishing a corpus of errors adjusted for the linguistic and cultural realities of the French population. Using this guideline, a good inter-rater reliability was observed. Because of the restricted ranges of response latency and number of errors in the automatic condition, the relationship between these scores and demographic factors was not explored. By consequence, no norms were proposed for this condition. CONCLUSIONS: We provide normative data of a French version of the HSCT for adults and elderly patients. These normative data obtained will be extremely useful for clinical practice and research purposes.


Subject(s)
Executive Function/physiology , Inhibition, Psychological , Neuropsychological Tests/statistics & numerical data , Psychometrics/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , France , Humans , Male , Middle Aged , Neuropsychological Tests/standards , Psychometrics/standards , Reference Values , Reproducibility of Results , Young Adult
19.
Arch Clin Neuropsychol ; 32(5): 592-597, 2017 Aug 01.
Article in English | MEDLINE | ID: mdl-28174827

ABSTRACT

OBJECTIVE: We previously developed normative data for a French version of the Hayling Sentence Completion Test (f-HSCT) for adults and elderly people. The present study aimed to evaluate the clinical utility of the f-HSCT norms in two clinical populations in which inhibition dysfunction has been largely documented, i.e., Parkinson's disease (PD) and schizophrenia. METHOD: Eighty-five non-demented patients with idiopathic PD and 64 out-patients with schizophrenia completed the automatic and inhibition conditions of the f-HSCT. Time latencies and errors raw data of each patient were compared to the norms previously developed by the authors. RESULTS: In the automatic condition, errors were rare in both clinical groups and time latencies on this condition felt within the normative data range. Compared with the standardized norms, 46% of patients with PD and 61% of patients with schizophrenia had a deviant performance (i.e., borderline or deficit) for the inhibition error score. The proportion of patients with a deviant performance on the inhibition response time score was similar in both clinical samples (respectively, 25% and 23%). Finally, slightly more than half of patients with PD and more than two-thirds of patients with schizophrenia had a deviant performance on at least one of the f-HSCT inhibition measures. CONCLUSIONS: Our results suggest that the f-HSCT has a strong potential for characterizing inhibition of prepotent responses in PD and schizophrenia. Furthermore, it requires only a short administration time so it may be ideal to detect response inhibition in clinical populations with cognitive fatigue.


Subject(s)
Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/etiology , Executive Function/physiology , Inhibition, Psychological , Neuropsychological Tests/standards , Parkinson Disease/complications , Schizophrenia/complications , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Young Adult
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