The Relationship Between Depression, Sleep Disturbance, and Cognitive Inefficiency in a Child Psychiatric Sample

Kristina J Wong, Pace University


The present study examined the relationship between depression, sleep problems, and cognitive inefficiency in a sample of 1445 child psychiatric inpatients. The study utilized an archival data set of assessment measures completed by patients during their psychiatric hospitalizations. This study explored three general areas of inquiry: therapist ratings of sleep disturbance within the child psychiatric population and its relationship with other psychiatric diagnoses, the relationship between therapist and parent ratings of sleep disruption and the presence of depressive symptoms, and finally the relationship between sleep disruption, depression, and cognitive inefficiency. An exploratory factor analysis of therapist rated sleep variables was first gathered from the sample to examine focal measures of sleep disruption. The factor analysis revealed two factors, however, one of the factors included hypersomnia and sleepwalking, which both have extremely low rates of occurrence in the psychiatric population. Thus, future analyses were conducted using the different components of sleep instead of using factor scores. Comparisons of the frequencies of various types of sleep disturbance across groups with depressive disorders, psychotic disorders, anxiety disorders, and behavioral disorders revealed three significant associations: children with psychotic disorders were more likely than children without psychotic disorders to report hypersomnia, and children with anxiety disorders were more likely than children without anxiety disorders to report both early awakening as well as initial insomnia. Correlational analyses revealed no significant relationships on therapist and parent ratings across symptoms of both depression and sleep. Using therapist ratings, correlational analyses showed that sleep problems and cognitive inefficiency showed that children with symptoms of restless sleep and initial insomnia showed significantly lower scores on attention scales. Correlational analyses between ratings of depression and cognitive inefficiency also revealed significant relationships: children with more depressed moods were found to have higher general cognitive abilities (GAI) and a larger discrepancy between their GM and their cognitive processing abilities (CPI), children with increased psychomotor activity were found to have lower general cognitive abilities, and children with higher likelihood of suicidality were found to have higher GM, and increased planning and attention abilities. Regression analyses were performed to predict cognitive inefficiency from sleep and depression variables. These results revealed that several variables of sleep and depression were found to be predictive of different measurements of cognitive inefficiency. Children reported to have either a prevailing depressed mood state or interrupted sleep predicted to have a larger GAI and CPI discrepancy. Children reported to have more restless sleep were predicted to have lower scores on the Attention scale of the CAS. Lastly, children reported to have more symptoms of initial insomnia showed more omissions on the CPT.

Subject Area

Clinical psychology

Recommended Citation

Wong, Kristina J, "The Relationship Between Depression, Sleep Disturbance, and Cognitive Inefficiency in a Child Psychiatric Sample" (2015). ETD Collection for Pace University. AAI3664415.



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