Sleep, Executive Control, and Psychopathology in Children: A Longitudinal Study and an Examination of Brief Sleep Treatment

Researchers have acknowledged that poor sleep is not merely a symptom of psychopathology but also a contributing factor to the development of psychopathology in children (Walker & Harvey, 2010). However, more research is needed to explicate the associations among sleep, executive control (EC), and psychopathology. Specifically, there are few studies using longitudinal designs and limited research on how treating sleep can improve mental health symptoms. This dissertation provides a conceptual framework for the associations among sleep, EC, and psychopathology. The conceptual framework is bolstered by two studies. Study 1 is an examination of early sleep problems and preschool EC as predictors of risk for attention-deficit/hyperactivity disorder (ADHD) using an extended longitudinal design within a community sample. Study 2 is a pilot of a brief sleep treatment for children presenting to an outpatient clinic for emotional and behavioral disorders. Study 1 consisted of a cohort sequential, longitudinal design (N = 271). At study entry, parents answered questions about sleep when children were three years old. Then, children completed nine behavioral EC tasks in the laboratory at 4.5 years. In the spring of 4 th grade, teachers completed measures of ADHD symptoms. The results of a latent moderated structural equation (LMS) model demonstrated that early sleep problems and EC deficits predicted later ADHD symptoms. EC moderated the relationship between sleep problems and ADHD symptoms, such that children with both sleep problems and poor EC were particularly vulnerable to experiencing ADHD symptoms. Study 2 was an evaluation of a treatment protocol involving one to three sessions of sleep treatment followed by behavioral treatment of mental health symptoms. Parents of children ages six to 11 years (N = 13) completed measures of psychopathology symptoms and EC at baseline and following sleep treatment. Additionally, children wore actigraphs to objectively measure sleep, and parents completed weekly assessments of children's symptoms. The results indicated that there was a rapid effect of sleep treatment such that psychopathology and EC improved from baseline. A full understanding of the associations among sleep, EC, and psychopathology is critical for improving existing theories and developing more effective interventions. iii ACKNOWLEDGEMENTS