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Life stress, sleep disturbance and depressive symptoms: The moderating role of prefrontal activation during emotion regulation

Authors
Lee, Kyung HwaLee, Ha YoungPark, InkyungJeon, Jeong EunKim, NambeomOh, Seong MinJeon, SehyunKim, SoohyunLee, Yu JinKim, Seog Ju
Issue Date
Jun-2022
Publisher
Blackwell Publishing Inc.
Keywords
Stress; sleep disturbance; depressive symptoms; prefrontal cortical activation; emotion regulation
Citation
Australian and New Zealand Journal of Psychiatry, v.56, no.6, pp.709 - 720
Indexed
SCIE
SSCI
SCOPUS
Journal Title
Australian and New Zealand Journal of Psychiatry
Volume
56
Number
6
Start Page
709
End Page
720
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/53886
DOI
10.1177/00048674211025729
ISSN
0004-8674
Abstract
Objectives: Evidence suggests that emotion regulation difficulty may play an important role in the association between life stress, sleep disturbance and depressive symptoms. We proposed two models depicting the possible moderating roles of prefrontal cortex activation during emotion regulation in the associations among these variables and tested them. We hypothesized that (1) the association between stress and sleep disturbance would differ across prefrontal cortex activation during emotion regulation (moderation model) and (2) the indirect effects of stress on depressive symptoms through sleep disturbance would depend on prefrontal cortex activation during emotion regulation (moderated mediation model). Methods: Forty-eight healthy adults without sleep disorders based on nocturnal polysomnography participated in this study. They received functional magnetic resonance imaging scans while performing an emotion regulation task. They also completed questionnaires assessing life stress, sleep disturbance and depressive symptoms. The proposed models were tested using the PROCESS macro for SPSS. Results: As hypothesized, there was a significant moderating effect of prefrontal cortex activation during emotion regulation on the association between life stress and sleep disturbance. Furthermore, right lateral prefrontal cortex activation had a moderating role in the indirect effect of life stress on depressive symptoms through sleep disturbance. Conclusion: These findings highlight the important role of prefrontal cortex function during emotion regulation in the associations between stress, sleep disturbance and depressive symptoms. Increasing lateral prefrontal cortex recruitment when regulating the emotional response to negative life events may be critical for the prevention and intervention of depression as well as sleep problems.
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