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INTRODUCTION: We test the effects of positive affect and its arousal subscale components of calm, wellbeing, and vigor on asthma control and symptom severity in adolescents with moderate to severe asthma. Additionally, we test whether positive affect (and its arousal components) moderate how stress impacts asthma control and symptom severity. METHODS: Adolescents with asthma (N = 66, ages 12-17) completed brief surveys 4 times a day for 7 days reporting on their positive affect, stress, and asthma symptom severity and conducted a morning peak expiratory flow assessment each day. Asthma control and psychological asthma triggers were assessed at the end of the 7 days. RESULTS: Positive affect moderated the association between stress and asthma control (b = -0.33, p = 0.009) as well as the association between psychological triggers and asthma control (b = -0.74, p = 0.007). When assessing the positive affect arousal components, calm and wellbeing seemed to be driving these effects. Additionally, calm moderated the association between stress and asthma symptom severity (b = -0.33, p = 0.036) as well as the association between psychological triggers and asthma symptom severity (b = -0.75, p = 0.021). CONCLUSIONS: When considering patient stress (e.g., general stress, psychological asthma triggers), positive affect and its arousal components of calm and wellbeing may be helpful for patients with higher levels of stress and/or for patients experiencing greater numbers of psychological triggers.
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Increasing evidence suggests that within-person variation in affect is a dimension distinct from mean levels along which individuals can be characterized. This study investigated affect variability's association with concurrent and longitudinal mental health and how mean affect levels moderate these associations. The mental health outcomes of depression, panic disorder, self-rated mental health, and mental health professional visits from the second and third waves of the Midlife in the United States Study were used for cross-sectional (n = 1,676) and longitudinal outcomes (n = 1,271), respectively. These participants took part in the National Study of Daily Experiences (NSDE II), where they self-reported their affect once a day for 8 days, and this was used to compute affect mean and variability. Greater positive affect variability cross-sectionally predicted a higher likelihood of depression, panic disorder, mental health professional use, and poorer self-rated mental health. Greater negative affect variability predicted higher panic disorder probability. Longitudinally, elevated positive and negative affect variability predicted higher depression likelihood and worse self-rated mental health over time, while greater positive affect variability also predicted increased panic disorder probability. Additionally, mean affect moderated associations between variability and health such that variability-mental health associations primarily took place when mean positive affect was high (for concurrent mental health professional use and longitudinal depression) and when mean negative affect was low (for concurrent depression, panic disorder, self-rated mental health, and longitudinal self-rated mental health). Taken together, affect variability may have implications for both short- and long-term health and mean levels should be considered. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-024-00238-0.
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Causes of asthma exacerbation in children have been studied extensively at the individual level, but contributions of neighborhood-level factors are less explored. We test which distinctive residential characteristics produce variation in uncontrolled asthma among pediatric patients. We extracted electronic medical record data from pediatric patients living in Southern California and used multilevel modeling techniques to isolate which neighborhood characteristics drive inequitable asthma control. Above and beyond the individual-level factors known to predict inadequate disease control, neighborhoods with greater concentration of non-Hispanic black residents (odds ratios [OR] = 1.02; 95% confidence interval [CI]: 0.99-1.03; P < .05), higher proportions of female-headed households (OR = 1.01; 95% CI: 0.99-1.01; P < .05), and higher levels of ambient air pollution (OR = 1.05; 95% CI: 1.01-1.10; P < .001) associate with greater odds of asthma exacerbation. The interplay between community characteristics and asthma management during childhood is complex, and place-based initiatives are needed to narrow the gap in asthma exacerbation.
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Positive and negative affect have been shown to have implications for hormones like cortisol but how moment to moment changes in affect (i.e., affect variability) influence cortisol secretion is less well understood. Additionally, context characteristics such as mean affect and stress may influence the association between affect variability and cortisol output. In the current study, we examined affect, stress, and cortisol data from 113 participants (age range = 25-63, M = 35.63, SD = 11.34; 29% male; 42% White/Caucasian, 37% Asian or Pacific Islander, 13% Hispanic/Latino, 4% Black/African American, 1% Native American, Eskimo, or Aleut, 4% selected "other" for their race/ethnicity). Participants completed ecological momentary assessments assessing positive and negative affect and stress four times per day for five days and provided saliva samples at each time point. Saliva was assayed for cortisol, and area under the curve with respect to ground was computed. In a three-way interaction, both positive affect mean level and stress moderated the association between positive affect variability and cortisol (b = -1.55, t(100) = -3.29, SE = 0.47, p <.01, ß = -4.05). When breaking down this three-way interaction, in the context of low stress and high mean positive affect, variability was positively related to total cortisol output. In contrast, in the context of high stress and high mean positive affect, variability was negatively related to total cortisol output. While greater positive affect variability is generally worse for health-relevant outcomes (as prior research has shown and as we show here at low levels of stress), at high levels of stress, fluctuation in affect may be adaptive. For someone experiencing a high stress week, having fluctuations in positive affect may mean that they are adaptively changing to meet their environmental needs especially when they typically report high mean positive affect levels. There were no associations between negative affect variability and cortisol secretion nor did mean negative affect or stress play a moderating role for negative affect variability. This study provides evidence that positive affect variability's association with cortisol secretion throughout the day may vary based on stress and mean positive affect levels.
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Afeto , Hidrocortisona , Saliva , Estresse Psicológico , Humanos , Hidrocortisona/metabolismo , Hidrocortisona/análise , Masculino , Saliva/química , Saliva/metabolismo , Feminino , Estresse Psicológico/metabolismo , Adulto , Afeto/fisiologia , Pessoa de Meia-Idade , Avaliação Momentânea EcológicaRESUMO
Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children's body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for comorbid conditions and found that a child's place of residence independently associates with higher body mass index z-scores. Interactions further reveal that Latinx children living in Middle-Class neighborhoods have higher BMI z-scores than Asian and Other Race children residing in the most disadvantaged communities. Our findings underscore the complex relationship between community racial/ethnic composition and neighborhood socioeconomic context on body weight status during childhood.
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Etnicidade , Obesidade , Criança , Humanos , Índice de Massa Corporal , Peso Corporal , Hispânico ou Latino , Características de Residência , Asiático , Grupos RaciaisRESUMO
Research has only begun to explore how affect variability relates to physical health and has typically not assessed long-term associations nor considered the moderating role of mean affect. Therefore, we used data from the Midlife in the United States Study waves 2 (N = 1512) and 3 (N = 1499) to test how affect variability predicted concurrent and long-term physical health while also testing the moderating role of mean affect. Results indicated that greater negative affect variability was associated concurrently with a greater number of chronic conditions (p = .03) and longitudinally with worse self-rated physical health (p < .01). Greater positive affect variability was associated concurrently with more chronic conditions (p < .01) and medications (p < .01) and longitudinally with worse self-rated physical health (p = .04). Further, mean negative affect played a moderating role such that at lower levels of mean negative affect, as affect variability increased, so did the number of concurrent chronic conditions (p < .01) and medications (p = .03) and the likelihood of reporting worse long-term self-rated physical health (p < .01). Thus, the role of mean affect should be considered when testing short- and long-term associations between affect variability and physical health.
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Afeto , Humanos , Estados Unidos , Doença CrônicaRESUMO
BACKGROUND: To explore the role of children's residential environment on opioid prescribing patterns in a predominantly Latinx sample. METHODS: We connected geocoded data from electronic medical records in a diverse sample of pediatric patients to neighborhood environments constructed using latent profile modeling techniques. We then estimated a series of multilevel models to determine whether opioid prescribing patterns vary by residential context. RESULTS: A stepwise pattern exists between neighborhood disadvantage and pediatric opioid prescription patterns, such that higher levels of disadvantage associate with a greater likelihood of opioid prescription, independent of the patient's individual profile. CONCLUSION: In a largely Latinx sample of children, the neighborhood in which a child lives influences whether or not they will receive opioids. Considering the differences in patient residential environment may reduce variation in opioid dispensing rates among pediatric patients.
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Analgésicos Opioides , Pacientes Internados , Humanos , Criança , Analgésicos Opioides/uso terapêutico , Padrões de Prática Médica , Prescrições , Características da VizinhançaRESUMO
BACKGROUND AND OBJECTIVES: Previous studies have demonstrated associations between patient experience scores and physician's demographic characteristics such as gender and race. There is a paucity of data, however, on the effect of broader pediatrician characteristics on caregivers' experience of their children's care. This study assessed pediatric caregiver experience of care ratings within a children's hospital and examined the effects of pediatricians' interpersonal and personality traits on caregiver experience ratings. METHODS: This cross-sectional study included caregivers of children under 18 years old (n = 26,703) and physicians within children's hospital system (n = 65). Caregivers of children who received care from 2017 to 2019 provided their rating (0-10) of care experience via the standardized National Research Corporation Health Survey. Top box provider ratings were used for analyses. Physician's interpersonal and personality data were collected. Multilevel logistic regression analyses were used to examine the effects of physician interpersonal characteristics (empathy, compassion) and personality (perfectionism, Big Five personality traits [openness, conscientiousness, extraversion, agreeableness, neuroticism]) on experience of care rating. RESULTS: The odds of caregivers of Spanish-speaking children to provide a high physician rating were 75% higher than the odds for non-Spanish-speaking patients. At the physician level, lower agreeableness (odds ratio [OR] = 0.63, P = .002), and lower narcissistic perfectionism (OR = 0.98, P = .016) were associated with an increased likelihood of a high care experience rating. The odds of nonemergency medicine pediatricians receiving high ratings were approximately 4.17 times higher than that of EM pediatricians. CONCLUSIONS: Current results may inform future interventions that address pediatrician personality characteristics associated with caregivers of children experience outcomes.
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Pediatras , Personalidade , Humanos , Criança , Adolescente , Estudos Transversais , Neuroticismo , Avaliação de Resultados da Assistência ao PacienteRESUMO
This study investigates associations between resilience factors (optimism and positive affect) and self-rated health during the COVID-19 pandemic. Longitudinal data were collected (N = 292) across five assessments. Multilevel modeling tested main effects of the resilience factors and how they interacted with stress to predict health. Greater optimism and positive affect were prospectively associated with fewer depressive symptoms (ps < 0.01) and a lower burden of physical health symptoms (ps <0.01). Positive affect interacted with stress to predict depressive symptoms (p < 0.05), suggesting a stress buffering effect. These findings suggest that resilience factors may improve health during COVID-19.
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COVID-19 , Pandemias , Humanos , Depressão/epidemiologia , OtimismoRESUMO
OBJECTIVE: There is a need for a brief affect scale that also encompasses different components of affect relevant for researchers interested in physiological and health outcomes. The Subcomponents of Affect Scale (SAS) meets this need. This 18-item scale has nine positive and nine negative affect items encompassing six subscales (calm, well-being, vigour, depression, anxiety, anger). Previous research using the SAS has demonstrated its predictive validity, but no work has tested its subscale structure or longitudinal validity. DESIGN: Data from the Common Cold Project in which individuals (N = 610) completed the SAS over the course of seven days were used. RESULTS: Confirmatory factor analysis demonstrated the reliability of the subscale structure of the SAS across seven days (positive affect subscale structure: CFIs ≥ 0.98; negative affect subscale structure: CFIs ≥ 0.94 with day 6 CFI = 0.91) and tests of factorial invariance showed the scale is valid to use over time. CONCLUSIONS: These results confirm the psychometric validity of the subscale structure of the SAS and imply that the subscales can be used longitudinally, allowing for its use in health research as well as non-health research that can benefit from its subscale structure and longitudinal capabilities.
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Ira , Ansiedade , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Ansiedade/diagnóstico , Transtornos de Ansiedade , Análise Fatorial , PsicometriaRESUMO
The purpose of the current prospective cohort study was to determine if acculturation, measured by primary language spoken, impacts the pain response of children being treated for cancer during an experimental pain task. Sixty-seven Spanish-speaking and English-speaking children ages 6 to 18 years being treated for cancer provided ratings of pain and upset severity during the completion of the cold pressor task (CPT). One week following the CPT, participants provided their recollection of average pain and upset during the CPT. Repeated measures analysis of variance revealed Spanish-speaking children reported significantly higher pain (F1,64=5.58, P=0.02) and upset (F1,64=7.69, P=0.007) ratings during the CPT compared with English-speaking children. Also, Spanish-speaking children were over 4 times as likely to remove their hands from the water before the CPT 4-minute uninformed ceiling compared with English-speaking children (P=0.002). These findings suggest that cultural and contextual factors, including the level of acculturation, are important considerations in the assessment and management of pain in children with cancer. Future research should continue to examine the mechanisms underlying the association between acculturation and the symptom experience for children receiving treatment for cancer.
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Idioma , Neoplasias , Dor , Adolescente , Criança , Humanos , Hispânico ou Latino , Neoplasias/complicações , Neoplasias/terapia , Dor/etiologia , Dor/psicologia , Estudos Prospectivos , Medição da Dor , Aculturação , Angústia PsicológicaRESUMO
OBJECTIVE: Exposure to stressors in daily life and dysregulated stress responses are associated with increased risk for a variety of chronic mental and physical health problems, including anxiety disorders, depression, asthma, heart disease, certain cancers, and autoimmune and neurodegenerative disorders. Despite this fact, stress exposure and responses are rarely assessed in the primary care setting and infrequently targeted for disease prevention or treatment. METHOD: In this narrative review, we describe the primary reasons for this striking disjoint between the centrality of stress for promoting disease and how rarely it is assessed by summarizing the main conceptual, measurement, practical, and reimbursement issues that have made stress difficult to routinely measure in primary care. The following issues will be reviewed: a) assessment of stress in primary care, b) biobehavioral pathways linking stress and illness, c) the value of stress measurements for improving outcomes in primary care, d) barriers to measuring and managing stress, and e) key research questions relevant to stress assessment and intervention in primary care. RESULTS: On the basis of our synthesis, we suggest several approaches that can be pursued to advance this work, including feasibility and acceptability studies, cost-benefit studies, and clinical improvement studies. CONCLUSIONS: Although stress is recognized as a key contributor to chronic disease risk and mortality, additional research is needed to determine how and when instruments for assessing life stress might be useful in the primary care setting, and how stress-related data could be integrated into disease prevention and treatment strategies to reduce chronic disease burden and improve human health and well-being.
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Transtornos de Ansiedade , Estresse Psicológico , Transtornos de Ansiedade/terapia , Humanos , Atenção Primária à SaúdeRESUMO
INTRODUCTION: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12-17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children's care in a pediatric ED. METHODS: We examined data from a tertiary pediatric care facility. A health survey questionnaire was administered after ED discharge to capture the outcome of parental likelihood of providing a positive facility rating. We abstracted patient demographic, clinical, and top diagnostic information using electronic health records. Data were merged and multivariable models were constructed. RESULTS: We collected data from 15,895 pediatric patients between the ages of 0-17 years (mean = 6.69; standard deviation = 5.19) and their parents. Approximately 786 (4.94%) patients were administered an opioid; 8212 (51.70%) were administered a non-opioid analgesic; and 3966 (24.95%) expressed clinically significant pain (pain score >/= 4). Results of a multivariable regression analysis from these pediatric patients revealed a three-way interaction of age, pain severity, and opioid administration (odds ratio 1.022, 95% confidence interval, 1.006, 1.038, P = 0.007). Our findings suggest that opioid administration negatively impacted parent satisfaction of older adolescent patients in milder pain who were administered an opioid analgesic, but positively influenced the satisfaction scores of parents of younger children who were administered opioids. When pain levels were severe, the relationship between age and patient experience was not statistically significant. CONCLUSION: This investigation highlights the complexity of the relationship between opioid administration, pain severity, and satisfaction, and suggests that the impact of opioid administration on parent satisfaction is a function of the age of the child.
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Analgésicos Opioides/uso terapêutico , Dor/tratamento farmacológico , Pais/psicologia , Satisfação Pessoal , Adolescente , Adulto , Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Medicare , Pessoa de Meia-Idade , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Receipt of opioid prescriptions in pediatric and young adult patients may be a risk factor for future opioid misuse. Data from prescription drug monitoring programs provide insight on outpatient opioid use. In our study, we analyzed the opioid dispensing rates for pediatrics and young adults in California. METHODS: A secondary analysis was performed from 2015-2019 using Controlled Utilization Review and Evaluation System data. This database provides dispensing data of controlled substances in California. Patients younger than 25 years who were prescribed opiates were analyzed by county. We further divided them into two groups (children: ≤14 years; adolescents and young adult: 15-24 years). Descriptive statistics and heat maps were used to illustrate the trends in opioid usage among different age groups. RESULTS: The overall percentages for the number of opioids being dispensed to patients aged <25 years have decreased over the past four years. In 2015, 6 out of 58 counties in California were considered "high-rate" with >2.9% of opioids dispensed to patients younger than 25 years old; in 2019, this number reduced to zero. Patients 25 and older received a higher proportion of opioids compared to younger populations; in 2019, 35.91% of opioids were dispensed to patients 45-64, and 8.92% to patients younger than 25. CONCLUSION: Pediatric opioid prescriptions have declined over the recent years. However, a high degree of variability of prescription rates between demographic counties was noted. More studies are warranted in order to understand this discrepancy in opioid prescribing among pediatric and young adult patients.
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Positive emotion, encompassing feelings such as joy and happiness, has been shown to predict a multitude of health outcomes. However, the role of positive emotion in pediatric asthma is not understood. No work to date has examined how positive emotion may offer benefits to children and adolescents with asthma. Based on theory and models of positive emotion and health, we hypothesize that positive emotion may improve asthma outcomes through mediators such as health behaviors and health-relevant physiological functioning. Moreover, boosting positive emotion during times of stress may be particularly relevant in mitigating asthma symptoms. In the present commentary, we elaborate on the hypothesized mechanisms behind such associations grounded within positive emotion theoretical frameworks. Additionally, we summarize the methodologically rigorous work of positive emotion interventions in other clinical settings to propose that positive emotion could be a useful tool in the management of pediatric asthma.
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Asma , Psicologia Positiva , Adolescente , Asma/terapia , Criança , Emoções , Felicidade , Humanos , Modelos TeóricosRESUMO
OBJECTIVE: This study examined whether perceived neighborhood cohesion (the extent to which neighbors trust and count on one another) buffers against the mental health effects of the 2020 COVID-19 pandemic. METHODS: The XXX University National COVID-19 and Mental Health Study surveyed US adults (N = 3965; M age = 39 years), measuring depressive symptoms, staying home more during than before the 2020 pandemic, and perceived neighborhood cohesion. RESULTS: A series of linear regressions indicated that perceiving one's neighborhood as more cohesive was not only associated with fewer depressive symptoms, but also attenuated the relationship between spending more time at home during the pandemic and depressive symptoms. These relationships persisted even after taking into account several individual-level sociodemographic characteristics as well as multiple contextual features, i.e., median household income, population density, and racial/ethnic diversity of the zip codes in which participants resided. CONCLUSIONS: Neighborhood cohesion may be leveraged to mitigate pandemic impacts on depressive symptoms.
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COVID-19 , Saúde Mental , Adulto , Humanos , Pandemias , Características de Residência , SARS-CoV-2 , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED. METHODS: This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11-21 years old were analyzed. Races/ethnicities were stratified as non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. In addition to race, statistical analysis included the following covariates: pain score, pain diagnosis, age, region, sex, and payment method. RESULTS: There was a weighted total of 189,256,419 ED visits. Those visits involved 109,826,315 (58%) non-Hispanic Whites, 46,314,977 (24%) non-Hispanic Blacks, and 33,115,127 (18%) Hispanics, with 21.6% (95% CI, 21.1%-22.1), 15.2% (95% CI, 14.6-15.9%), and 17.4% (95% CI, 16.5-18.2%) of those visits reporting use of opioids, respectively. Regardless of age, sex, and region, non-Hispanic Whites received opioids at a higher rate than non-Hispanic Blacks and Hispanics. Based on diagnosis, non-Hispanic Whites received opioids at a higher rate in multiple pain diagnoses. Additionally, non-Hispanic Blacks and Hispanics were less likely to receive an opioid when reporting moderate pain (aOR = 0.738, 95% CI 0.601-0.906, aOR = 0.739, 95% CI 0.578-0.945, respectively) and severe pain (aOR = 0.580, 95% CI 0.500-0.672, aOR = 0.807, 95% CI 0.685-0.951, respectively) compared to non-Hispanic Whites. CONCLUSIONS: Differences in the receipt of opioid agonists in EDs among the races/ethnicities exist, with more non-Hispanic Whites receiving opioids than their minority counterparts. Non-Hispanic Black women may be an especially marginalized population. Further investigation into sex-based and regional differences are needed.
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Analgésicos Opioides , Etnicidade , Adolescente , Adulto , Analgésicos Opioides/uso terapêutico , Criança , Estudos Transversais , Serviço Hospitalar de Emergência , Feminino , Humanos , Dor/tratamento farmacológico , Adulto JovemRESUMO
This research examined whether pediatric inpatients without an anxiety/mood disorder are more likely to receive opioids in response to pain compared to patients diagnosed with a mental health condition. Research questions were tested using cross-sectional inpatient electronic medical record data. Propensity score matching was used to match patients with a disorder with patients without the disorder (anxiety analyses: N = 2892; mood analyses: N = 1042). Although patients with anxiety and mood disorders experienced greater pain, physicians were less likely to order opioids for these patients. Analyses also disclosed an interaction of anxiety with pain-the pain-opioid relation was stronger for patients without an anxiety disorder than for patients with an anxiety diagnosis. Instead, physicians were more likely to place non-opioid analgesic orders to manage the pain of patients with anxiety disorders. Findings imply that pain management decisions might be influenced by patient's mental health.
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Analgésicos Opioides , Médicos , Analgésicos Opioides/uso terapêutico , Ansiedade , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/tratamento farmacológico , Criança , Estudos Transversais , Hospitais Pediátricos , Humanos , Transtornos do Humor/tratamento farmacológico , Padrões de Prática MédicaRESUMO
OBJECTIVE/BACKGROUND: Disrupted sleep can be a cause and a consequence of affective experiences. However, daily longitudinal studies show sleep assessed via sleep diaries is more consistently associated with positive and negative affect than sleep assessed via actigraphy. The objective of the study was to test whether sleep parameters derived from ambulatory electroencephalography (EEG) in a naturalistic setting were associated with day-to-day changes in affect. PARTICIPANTS/METHOD: Eighty adults (mean age = 32.65 years, 63% female) completed 7 days of affect and sleep assessments. We examined bidirectional associations between morning positive affect and negative affect with sleep assessed via diary, actigraphy, and ambulatory EEG. RESULTS: Mornings with lower positive affect than average were associated with higher diary- and actigraphy-determined sleep efficiency that night. Mornings with higher negative affect than average were associated with longer actigraphy-determined total sleep time that night. Nights with longer diary-determined total sleep time, greater sleep efficiency, and shorter sleep onset latency than average were associated with higher next-morning positive affect, and nights with lower diary-determined wake-after-sleep-onset were associated with lower next-morning negative affect. EEG-determined sleep and affect results were generally null in both directions: only higher morning negative affect was associated with longer rapid eye movement (REM) sleep that night. CONCLUSIONS: Self-reported sleep and affect may occur in a bidirectional fashion for some sleep parameters. EEG-determined sleep and affect associations were inconsistent but may still be important to assess in future studies to holistically capture sleep. Single-channel EEG represents a novel, ecologically valid tool that may provide information beyond diaries and actigraphy.