Sleep problems as a transdiagnostic hub bridging impaired attention control, generalized anxiety, and depression

doi:10.1016/j.jad.2021.09.092

Journal of Affective Disorders

Volume 296, 1 January 2022, Pages 305-308

https://doi.org/10.1016/j.jad.2021.09.092 Get rights and content

Highlights

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Generalized anxiety disorder (GAD) and Major Depressive Disorder (MDD) often co-occur.
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Yet, uncertainty remains regarding the role of attention control (AC) in this co-occurrence.
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We examined whether AC was primarily associated with symptoms unique or common to MDD and GAD.
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Our findings pointed to sleep problems as a hub bridging AC to hallmark symptoms of MDD and GAD.

Abstract

Background

Major Depression Disorder (MDD) and Generalized Anxiety Disorder (GAD) often co-occur, but uncertainty remains regarding the neurocognitive mechanisms linked to this co-occurrence. In this study, we applied network analytic methods to characterize the associations of the attention control (AC) components, as assessed using laboratory-based measurement tools, with MDD and GAD symptoms. Of critical interest was identifying whether AC components were primarily associated with symptoms unique or common to MDD and GAD.

Methods

We computed a regularized partial correlation network to examine the associations between attention control with symptoms specific to MDD, specific to GAD, and symptoms common to MDD and GAD (n = 371).

Results

Symptoms that are common to MDD and GAD emerged as highly influential nodes in the network. In particular, our findings pointed to sleep problems as a hub bridging attention control components to hallmark symptoms of MDD and GAD.

Limitations

The present results should not be interpreted as definitive but instead as hypothesis-generating and highlighting the utility of rethinking the conceptualization of the associations between attention control, MDD, and GAD through the lens of sleep problems. Future studies would especially want to consider the temporal unfolding of the network structure.

Conclusions

To our knowledge, this is the first study to identify sleep problems as a potential pathway bridging together components of attention control with symptoms of GAD and MDD.

Section snippets

Participants

We relied on an unselected sample of 371 Belgian French-speaking participants (75.7% women) from the general community and the Belgian “Beau Vallon” Psychiatric Hospital. Following guidelines for network analysis in psychopathology (Fried, 2016), we opted for an unselected sampling approach to avoid potential problems of range restriction that are likely among samples comprising only clinical or healthy volunteers. Participants were between the ages of 18 and 63 (M = 26.89, SD=10.84). Their

Results

Fig. 1 shows the GGM network, which was highly stable and robust (see the supplementary material). The thickness of the edge denotes the strength of the association, with a thicker edge indicating a larger association. We used the Fruchterman-Reingold layout algorithm to determine node placement so that nodes closer to the center of the network tend to yield the strongest associations with other nodes.

Although there were strong associations between nodes belonging to the same category, a few

Discussion

Many people with MDD also suffer from GAD, and vice versa. Prominent cognitive models of GAD and MDD have pointed to AC as a potent neurocognitive mechanism of these disorders. To our knowledge, this is the first study to examine the network structure of the cross-associations between AC components with symptoms specific to either MDD or GAD and common to MDD and GAD.

Perhaps the most striking result was the observation that symptoms common to MDD and GAD emerged as highly influential nodes,

Funding sources

This research was funded by a research grant (Grant ”1.C.059.18F”) awarded to AH by the FRS-FNRS Belgian Science Foundation and a research fellowship award (Grant “G0118001”) to CC by the Beau Vallon Psychiatric Hospital.

CRediT authorship contribution statement

Charlotte Coussement: Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Writing – original draft. Alexandre Heeren: Conceptualization, Formal analysis, Supervision, Project administration, Visualization, Writing – original draft, Funding acquisition.

Declaration of Competing Interest

The authors have no known conflict of interest to disclose.

Acknowledgement

The authors are thankful to Yorgo Hoebeke, David Gamero, and Mónica Riesco de Vega for their help in the data collection.

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Short communicationSleep problems as a transdiagnostic hub bridging impaired attention control, generalized anxiety, and depression

Highlights

Abstract

Background

Methods

Results

Limitations

Conclusions

Section snippets

Participants

Results

Discussion

Funding sources

CRediT authorship contribution statement

Declaration of Competing Interest

Acknowledgement

Sleep Med. Rev.

J. Psychiatr. Res.

Person. Individ. Differ.

Lancet Psychiatry

J. Anxiety Disord.

J. Affect. Disord.

Epilepsy Behav.

Beck Depression Inventory Manual

Ongoing and future challenges of the network approach to psychopathology: from theoretical conjectures to clinical translations

Short communication
Sleep problems as a transdiagnostic hub bridging impaired attention control, generalized anxiety, and depression