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Triple Vulnerability? Circadian Tendency, Sleep Deprivation and Adolescence

Not Applicable
Completed
Conditions
Eveningness/Sleep
Interventions
Behavioral: Cognitive Behavior Therapy for Insomnia, Interpersonal and Social Rhythms Therapy, Chronotherapy
Behavioral: Psychoeducation
Registration Number
NCT01828320
Lead Sponsor
University of California, Berkeley
Brief Summary

There is an urgent need to identify modifiable mechanisms contributing to risk and vulnerability among youth. The investigators test the hypothesis that eveningness, the tendency to go to sleep late and wake late, is an important contributor to, and even cause of, vicious cycles that escalate vulnerability and risk among youth. This study seeks to determine whether two interventions to reduce eveningness can reduce risk and confer resilience in critical aspects of health, development and functioning in youth.

Detailed Description

Teens who exhibit a circadian tendency toward eveningness ('night-owls') follow a delayed sleep schedule, increasing activity later in the day and both going to sleep and getting up later, compared to morning-types ('larks'). The circadian tendency toward eveningness during adolescence arises from a confluence of psychosocial, behavioral and biological factors and is an important contributor to, and maybe even cause of, vicious cycles that escalate vulnerability and risk for poor health and major forms of psychopathology. Indeed, an evening circadian tendency has been associated with a wide range of adverse effects including poorer health, poorer academic performance, poorer self-regulation, greater use of substances, greater tendency for impulsivity, more depression and anxiety, greater emotional instability and more aggressive and antisocial behavior. While the biological shift toward eveningness during puberty may be difficult to modify, the psychosocial and behavioral contributors are modifiable. Moreover, modifying these contributors will eliminate key factors that exacerbate the biological shift. The proposed research will advance current knowledge on the role of eveningness as a mechanism contributing to poorer outcomes during adolescence. The investigators aim to reduce eveningness among 10-18 year olds via an intervention which integrates evidence-based treatments derived from basic research on the circadian system (Treatment 1) compared to a psychoeducational intervention that highlights the interplay between sleep, diet, exercise and stress (Treatment 2). The investigators will randomly allocate adolescents with an evening circadian tendency, and who are 'at risk' in at least one of five health domains (emotional, cognitive, behavioral, social, physical), to either: (a) Treatment 1 (n = 86) or (b) Treatment 2 (n = 86). Measures will be taken pre-treatment, post-treatment, and at 6 and 12 months post-treatment. This research is a first step within a longer term plan to accelerate knowledge on the potentially powerful positive effects, for the developing neural system, of simple, disseminable psychosocial interventions specifically designed to target modifiable risk factors across adolescence.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
176
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Treatment 1Cognitive Behavior Therapy for Insomnia, Interpersonal and Social Rhythms Therapy, ChronotherapyIntegrates evidence-based treatments derived from basic research on the circadian system
Treatment 2PsychoeducationPsychoeducation on the inter-associations between sleep, diet, exercise and stress.
Primary Outcome Measures
NameTimeMethod
Composite Score for Behavioral DomainChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups

A composite score of the Alcohol and Substance Use (Past 30 days items only) and Sensation Seeking Scale will be used to assess functioning in the Behavioral domain.

Composite Score for Emotional DomainChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups

A composite score of the Child Depression Rating Scale and Multidimensional Anxiety Scale for Children will be used to assess functioning in the Emotional domain.

Morning Eveningness preference measured via Childrens Morningness Eveningness Preference ScaleChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups
Total sleep time (TST) average on weeknights via Daily Sleep DiaryChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups
Composite Score for Cognitive DomainChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups

A composite score of the Attentional Control Scale and Youth Social Adjustment Scale (school/cognitive items only) will be used to assess functioning in the Cognitive domain.

Average bedtime on weeknights measured via Daily Sleep DiaryChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups
Score for Social DomainChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups

The Youth Social Adjustment Scale (social items only) will be used to assess functioning in the Social domain.

Composite Score for Physical DomainChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups

A composite score of the Modifiable Activity Questionnaire and Physical Health Questionnaire will be used to assess functioning in the Physical domain.

Secondary Outcome Measures
NameTimeMethod
Sleepiness scaleChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups

embedded within the School Sleep Habits Survey

Pittsburgh Sleep Quality IndexChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups
Dim Light Melatonin OnsetChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment
Composite Risk Score of Functioning in Five Health-relevant Domains (Emotional, Cognitive, Behavioral, Social and Physical)Change from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment

Measured via Ecological Momentary Assessment

Discrepancy between weeknights and weekends for Total Sleep Time, Bedtime, and Waketime via Daily Sleep DiaryChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups
Child Behavior ChecklistChange from baseline to post treatment, which is an average of 9 weeks after the beginning of treatment, and to 6-month and 12-month followups

Parent Measure

Trial Locations

Locations (1)

University of California, Berkeley

🇺🇸

Berkeley, California, United States

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