Melbourne School of Psychological Sciences - Theses
Permanent URI for this collection
Search Results
1 - 2 of 2
-
ItemNo Preview AvailableCharacterising Sleep in Young People with Borderline Personality Disorder( 2021)Background. Borderline personality disorder (BPD) features typically have their clinical onset during adolescence and early adulthood, coinciding with normative developmental changes to sleep quality and sleep-wake patterns. Sleep disturbances are commonly reported by individuals with BPD features and are independently associated with a range of adverse outcomes. Yet, few studies have investigated sleep in young people with BPD. Aims. This thesis consists of five studies. Study 1 was a scoping review that mapped the existing literature, highlighted areas for further investigation, and provided methodological recommendations for future research. Study 2 assessed inter-device reliability between two actigraphs (Actiwatch-2 and GENEActiv). This was an essential methodological step in this research program because it allowed actigraphy-derived sleep parameters to be reliably compared across BPD and clinical comparison groups, despite different actigraphs having been used. Studies 3-5 addressed the overarching aim of this thesis: to characterise sleep in young people with BPD features. This involved investigating whether subjective and objective (actigraphy) sleep patterns were non-normative and/or specific to BPD (Study 3), exploring the mechanisms underlying sleep disturbance (Study 4), and assessing the feasibility of using polysomnography in this population and providing pilot data (Study 5). Method. Participants in studies 3 and 4 were 96 young people aged 15-25 years (M = 20.02, SD = 2.62). This included 40 with 3 or more BPD features, 38 healthy individuals, and 18 young people seeking help for non-BPD psychopathology. Sleep was assessed subjectively (self- report questionnaires) and objectively (10 days wrist actigraphy). In study 5, a subset of participants (7 with BPD features, 6 healthy individuals) completed overnight polysomnography monitoring. Results. Young people with BPD features reported poorer sleep quality, more severe insomnia and later chronotype than healthy and clinical comparison groups. Impulse control difficulties, limited access to emotion regulation strategies and anxiety indirectly affected the relationship between BPD features and subjective sleep disturbances. Actigraphy data revealed that young people with BPD features had irregular sleep timing, later rise times, greater time in bed, and longer sleep durations compared with healthy young people. Additionally, individuals with BPD features displayed superior sleep quality (greater sleep efficiency, less wake after sleep onset) and slept longer than the clinical comparison group. Anxiety and lack of emotional awareness indirectly affected the association between BPD features and actigraphy-assessed bedtime variability and longer time in bed, respectively. The feasibility of in-home and sleep laboratory-based polysomnography were both demonstrated. Pilot polysomnography data indicated that individuals with BPD features had fewer arousals from sleep than healthy young people, but displayed an otherwise comparable sleep profile. Conclusion. Young people with BPD features reported sleep disturbances beyond the normative changes found during this developmental period and beyond those reported by young people seeking help for non-BPD psychopathology. Although a subjective-objective sleep discrepancy was revealed, subjective sleep disturbances alone reflect sleep-related distress and thus warrant clinical attention. Sleep-improvement interventions should be investigated as possible beneficial adjuncts to current early interventions for young people with BPD features to improve subjective sleep, quality of life, and potentially promote broader symptomatic and functional recovery.
-
ItemThe development of overt aggression across adolescence: The role of temperamental and environmental risk factors and the contribution of overt aggression to the emergence of antisocial psychopathology( 2020)Purpose of the study: The research reported in this study aimed to model the stability and change in overt aggression in a community sample of Australian adolescents over six years, and to contribute to the development of a comprehensive etiological model of antisocial psychopathology. It examined the impact of sex, effortful control (a temperamental risk factor), callous and unemotional traits (a hypothesized primary factor associated with youth psychopathy) and conditional aversive parenting (an environmental risk factor) and their interactions, on latent trajectories of overt aggression. It was hypothesized that combinations of these risk factors will predict much of the variation in overt aggression across adolescence and that variation in overt aggression would predict features of Conduct Disorder and Antisocial Personality Disorder in early adulthood. Method: A risk-enriched community sample of 245 adolescents and their parents participated. Repeated measurement of overt aggression occurred at four time points using the Child Behaviour Checklist/6-18 and Youth Self Report, from early adolescence (mean age=12.4 years) to early adulthood (mean age= 18.9 years). At Time 1 self-report questionnaires were used to assess the individual difference factors, and an observational measure of parent-adolescent interactions were recorded. At Time 4, both semi structured interviews and questionnaires were used to assess antisocial psychopathology and the other dimensions examined. Latent growth curve modeling was used to examine the patterns of stability and change in overt aggression over time. Growth mixture modeling was then used to examine the relationships between the latent trajectories, the predictor covariates and the distal outcomes. Results: In the sample as whole, self-reported overt aggression remained stable across adolescence, while parent-reported overt aggression decreased slightly. Two trajectories (almost equal in size) of self-reported overt aggression were evident in the sample: a low and slightly increasing trajectory and a moderate to high, stable trajectory. Low effortful control was associated with the moderate-high trajectory, and while there was some evidence of an association between callous and unemotional trait and the moderate-high trajectory, this association was not significant in the final model. Neither sex nor conditional aversive parenting was found to predict trajectories of overt aggression. Moderate-high stable overt aggression across adolescence was found to be prospectively associated with higher levels of antisocial psychopathology in early adulthood. Conclusions: The findings reported in this study contribute to the understanding of the etiological factors involved in the persistence of overt aggression across adolescence. The findings suggest that low effortful control may be the most important individual difference factor contributing to the persistence of overt aggression in adolescence, and suggests that research examining the role of callous and unemotional traits should incorporate measures of normal temperament or personality. The absence of any sex differences in the current study suggests that persistent overt aggression in both male and female Australian children and adolescents is worthy of attention and treatment. The findings also have implications for the prevention, early intervention and treatment of overt aggression and antisocial psychopathology, in particular, the potential for adapting interventions based on temperamental differences, and targeting effortful control and its components in future prevention efforts.