title: Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents.
abstract: BACKGROUND
  Existing research indicates sleep problems to be prevalent in youth with internalizing disorders. However, childhood sleep problems are common in the general population and few data are available examining unique relationships between sleep, specific types of anxiety and depressive symptoms among non-clinical samples of children and adolescents.
  
  
  METHODS
  The presence of sleep problems was examined among a community sample of children and adolescents (N=175) in association with anxiety and depressive symptoms, age, and gender. Based on emerging findings from the adult literature we also examined associations between cognitive biases and sleep problems.
  
  
  RESULTS
  Overall findings revealed significant associations between sleep problems and both anxiety and depressive symptoms, though results varied by age. Depressive symptoms showed a greater association with sleep problems among adolescents, while anxiety symptoms were generally associated with sleep problems in all youth. Cognitive factors (cognitive errors and control beliefs) linked with anxiety and depression also were associated with sleep problems among adolescents, though these correlations were no longer significant after controlling for internalizing symptoms.
  
  
  CONCLUSIONS
  Results are discussed in terms of their implications for research and treatment of sleep and internalizing disorders in youth.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, The George Washington University School of Medicine, 111 Michigan Avenue NW, Washington, DC 20010, USA. calfano@cnmc.org
authors.forename: Candice A
authors.initials: CA
authors.lastname: Alfano
authors.forename: Alan H
authors.initials: AH
authors.lastname: Zakem
authors.forename: Natalie M
authors.initials: NM
authors.lastname: Costa
authors.forename: Leslie K
authors.initials: LK
authors.lastname: Taylor
authors.forename: Carl F
authors.initials: CF
authors.lastname: Weems
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003469:Culture; D003674:Defense Mechanisms; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D007389:Internal-External Control; D007600:Judgment; D008297:Male; D010552:Personality Assessment / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D015203:Reproducibility of Results; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D014481:United States