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Relationships Among Anxiety, Depression, Induced Stress, Sleep Disturbance, Health Related Quality of Life, and Impulsivity in Emerging Adults
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Anxiety disorders are the most commonly diagnosed psychological disorders in the United States. They are often comorbid with other psychological disorders, most commonly depressive disorders. Anxiety and depression are associated with difficulties in academic achievement, social and peer relations, and lost productivity and absenteeism at work. Sleep disorders are frequently associated with anxiety and depressive disorders. In turn, sleep deprivation may increase an individual’s tendency to make impulsive decisions. Further, anxiety symptoms, depressive symptoms, sleep disturbances, and impulsive behaviors have been associated with lower levels of health-related quality of life (HRQOL). The combination of an anxiety disorder and poor sleep or a disorder of impulsivity and poor sleep have been correlated with poorer HRQOL and daily functioning. Sleep disturbance can impair cognition and decision making, including impulsivity, in otherwise healthy individuals. The present study recruited emerging adults from the Texas A&M University Department of Psychological and Brain Sciences research participant pool. Participants completed measures related to their anxiety symptoms and stress, depressive symptoms, sleep patterns, impulsivity, perceived health influence, and health-related quality of life. The Trier Social Stress Test (TSST) was used as an induced stressor during completion of some of the measures. Participants completed a sleep diary using Qualtrics during the week following the initial in-person session. Results indicated the State Trait Anxiety Inventory State Anxiety Scale (STAI-S) showed increased participant reported state anxiety from pretest to posttest after the TSST administration, the induced stressor. Additionally, anxious arousal and anhedonic depression symptoms explained a significant portion of the variance on sleep disturbance, HRQOL, and perceived health influence. Sleep disturbance was also found to be a partial or full mediator on the HRQOL outcomes. Sleep disturbance was associated with more self-reported impulsivity. Implications include early assessment of anxiety and depressive symptoms and sleep patterns may provide quality improvement of health-related outcomes. The high prevalence of sleep disturbances and their association with increased levels of anxiety, depression, and impulsivity symptoms in emerging adults should inform interventions to address this health issue. The induced stress method used in this study is a common scenario for university students that may have long-term health implications. In addition, this study accentuates the importance of assessing individuals’ perceived influence of life events on their psychological and health functioning.
state trait anxiety inventory
health related quality of life
Triers Social Stress Test
Calles, Ivette Marie (2018). Relationships Among Anxiety, Depression, Induced Stress, Sleep Disturbance, Health Related Quality of Life, and Impulsivity in Emerging Adults. Doctoral dissertation, Texas A & M University. Available electronically from