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Cited by 101Schizophrenia research and treatmentSleep and related disordersMental Health Research Topics

High resolution examination of the role of sleep disturbance in predicting functioning and psychotic symptoms in schizophrenia: A novel experience sampling study

Open access
Mulligan, Lee D., Haddock, Gillian, Emsley, Richard, Neil, Sandra T., Kyle, Simon D.·2016·Journal of Abnormal Psychology
DOI 10.1037/abn0000180
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Abstract

Sleep disturbance is common in schizophrenia, but its role in predicting functioning and psychotic symptoms has yet to be rigorously examined. The purpose of this study was to conduct a prospective, high-resolution examination of the relationship between nightly sleep and next-day functioning and psychotic symptoms in people with a diagnosis of schizophrenia. Experience sampling methodology was integrated with actigraphy and sleep diaries across 7 days in 22 patients with a diagnosis of schizophrenia. Momentary assessments of mood, psychotic symptoms, and functioning were gathered at 5 points each day following pseudorandom schedules. Multilevel modeling was performed to evaluate the links between variables. Objective and subjective sleep disturbance predicted reduced next-day functioning, which remained significant after controlling for psychotic symptom severity. Increased sleep fragmentation and reduced subjective and objective sleep efficiency predicted greater next-day auditory hallucinations, whereas increased objective sleep fragmentation and reduced subjective sleep quality predicted greater paranoia and delusions of control. Negative affect on awakening mediated a proportion of these relationships (range: 17.9-57.3%). For the first time, we show that sleep disturbance is a predictor of next-day impaired functioning and psychotic symptom severity in people with a diagnosis of schizophrenia. Therefore, interventions targeting sleep may have the potential to directly and indirectly enhance functional and symptomatic recovery in those experiencing psychosis. (PsycINFO Database Record

AI snapshot

Written from the paper’s full text.

TL;DR

In 22 patients with schizophrenia-spectrum diagnoses and insomnia, nightly objective and subjective sleep disturbance predicted worse next-day functioning and more severe psychotic symptoms, with morning negative affect mediating part of these relationships. Sleep continuity and quality, rather than duration, were particularly implicated in next-day auditory hallucinations, paranoia, and delusions of control.

Key findings

  • Both objective and subjective sleep disturbance predicted reduced next-day functioning after controlling for baseline PANSS score; greater objective/subjective sleep efficiency, subjective sleep quality, and objective/subjective total sleep time predicted greater next-day functioning, while greater objective sleep fragmentation predicted decreased next-day functioning.
  • Increased objective and subjective sleep efficiency predicted reduced auditory hallucinations; increased objective sleep fragmentation predicted increased auditory hallucinations and paranoia; increased subjective sleep quality predicted reduced auditory hallucinations, paranoia, and delusions of control.
  • Morning negative affect mediated a proportion of the total effects of sleep parameters on next-day functioning and psychotic symptoms (abstract range: 17.9%–57.3%; results: functioning 19.5%–57.3%, psychotic symptoms 17.9%–50.9%). Direct effects of objective sleep fragmentation and subjective sleep quality on paranoia remained significant, whereas direct effects between sleep parameters and both auditory hallucinations and delusions of control failed to reach significance after including negative affect.

Methods

  • Prospective, high-resolution experience sampling study integrated with actigraphy and sleep diaries across seven days in 22 eligible patients with a schizophrenia-spectrum diagnosis and Insomnia Severity Index score ≥10; two participants were excluded for circadian rhythm disturbances. ESM prompts occurred five times per day on pseudo-random schedules; actigraphy was recorded over six days and nights, and sleep diaries were completed each morning.
  • Baseline measures included PANSS, PSYRATS, Calgary Depression Scale, DAST-10, AUDIT-10, and PSP. Daily sleep variables were sleep efficiency, sleep fragmentation, total sleep time, and subjective sleep quality; ESM items assessed negative/positive affect, psychotic symptoms, and functioning.
  • Multilevel modelling used random-effects regression with maximum likelihood estimation, participant as a random effect, and non-parametric bootstrapping with 200 replications for skewed day-level variables. Mediation by morning negative affect was tested using the differences-in-coefficients approach.

Limitations

  • Paper-stated limitations: linear associations preclude causal inferences; psychotic symptom items were fairly simplistic and may not capture multidimensional hallucinations and delusions; the chronic, antipsychotic-medicated sample may have confounded relationships; actigraphy and sleep diaries could not assess sleep architecture or oscillations; two individuals were excluded for circadian rhythm disturbances; substance use was low but not examined.
  • Paper-stated: some non-significant findings had p-values less than 0.1, suggesting the analyses might have been underpowered. Evident from the text: the sample was small (n = 22), chronic in presentation (mean duration since diagnosis 12 years, S.D. = 6.2), and selected for insomnia severity, limiting generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1037/abn0000180

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 36 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Negative affect on awakening mediated a proportion of the relationships between sleep and next-day functioning and psychotic symptoms, with mediation proportions ranging from 17.9% to 57.3%.

    “Negative affect on awakening mediated a proportion of these relationships (range: 17.9% -57.3%).”
    Quote in the paperSubstantial claim
  • Findingown data

    Reduced subjective sleep quality predicted greater delusions of control.

    “increased objective sleep fragmentation and reduced subjective sleep quality predicted greater paranoia and delusions of control.”
    Quote in the paperSubstantial claim
  • Findingown data

    Increased objective sleep fragmentation predicted greater delusions of control.

    “increased objective sleep fragmentation and reduced subjective sleep quality predicted greater paranoia and delusions of control.”
    Quote in the paperSubstantial claim
  • Findingown data

    Increased sleep fragmentation predicted greater next-day auditory hallucinations.

    “Increased sleep fragmentation and reduced subjective and objective sleep efficiency predicted greater next-day auditory hallucinations”
    Quote in the paperSubstantial claim
  • Findingown data

    Increased objective sleep fragmentation predicted greater paranoia.

    “increased objective sleep fragmentation and reduced subjective sleep quality predicted greater paranoia and delusions of control.”
    Quote in the paperSubstantial claim
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 26

  • May combine two claims.

    Findingown data

    Both objective and subjective sleep disturbance predicted reduced next-day functioning, and this remained significant after controlling for psychotic symptom severity.

    “Both objective and subjective sleep disturbance predicted reduced next-day functioning, which remained significant after controlling for psychotic symptom severity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Morning NA mediated a proportion of the total effect of all sleep parameters on next-day functioning; direct effects remained significant for all sleep parameters except subjective SQ.

    “For all sleep parameters, morning NA mediated a proportion of the total effect on next-day functioning; however, direct effects remained significant for all but one sleep parameter (subjective SQ).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Preliminary studies find evidence for partial mediation of the link between insomnia severity and paranoia via negative affect.

    “preliminary studies find evidence for partial mediation of the link between insomnia severity and paranoia via negative affect (Freeman, Pugh, Vorontsova & Southgate, 2009;Myers et al., 2011)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Freeman, Pugh, Vorontsova & Southgate, 2009

      Not checked in the free run.

    • cites Myers et al., 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Interventions targeting sleep may have the potential to enhance functional and symptomatic recovery in those experiencing psychosis, both directly and indirectly.

    “Interventions targeting sleep may therefore have the potential to enhance functional and symptomatic recovery in those experiencing psychosis, both directly and indirectly.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The sample of 22 patients with chronic schizophrenia and insomnia is representative of people with a diagnosis of schizophrenia.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Sleep disturbance contributes to impaired performance on tasks of sustained attention, executive functioning, and IQ.

    “Neuropsychological findings also demonstrate that sleep disturbance contributes to impaired performance on tasks of sustained attention (Forest et al., 2007), executive functioning (Keshavan, Cashmere, Miewald, & Yeragani, 2004) and IQ (Manoach et al., 2014).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Forest et al., 2007

      Not checked in the free run.

    • cites Keshavan, Cashmere, Miewald, & Yeragani, 2004

      Not checked in the free run.

    • cites Manoach et al., 2014

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The PANSS total and subscales have high reliability and validity.

    “The PANSS can be subdivided into positive, negative and general psychopathology scores and both the total and its subscales have high reliability and validity (Kay, Opler & Lindenmayer, 1988).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kay, Opler & Lindenmayer, 1988

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The PSYRATS has been widely validated and has high reliability.

    “The PSYRATS has been widely validated and has high reliability (Haddock et al., 1999).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Haddock et al., 1999

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Sleep disturbance is associated with impaired quality of life and coping in people experiencing psychosis.

    “Indeed, research has shown that sleep disturbance is associated with impaired quality of life (QoL) and coping in people experiencing psychosis (Ritsner, Kurs, Ponizovsky, & Hadjez, 2004;Hofstetter, Lysaker, & Mayeda, 2005).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Ritsner, Kurs, Ponizovsky, & Hadjez, 2004

      Not checked in the free run.

    • cites Hofstetter, Lysaker, & Mayeda, 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sleep disturbance is an important transdiagnostic factor implicated in the development and maintenance of a range of psychiatric disorders.

    “Sleep disturbance is considered an important transdiagnostic factor, implicated in the development and maintenance of a range of psychiatric disorders (Harvey, 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harvey, 2008

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The ISI cut-off score of 10 is optimal for identifying insomnia with the highest sensitivity and specificity.

    “A cut-off score of 10 was used to determine eligibility, as this has been judged as optimal for identifying insomnia with the highest sensitivity and specificity (Morin, Belleville, Bélanger, & Ivers, 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Morin, Belleville, Bélanger, & Ivers, 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Premisenone given

    Low-resolution and cross-sectional studies are vulnerable to recall bias, are limited in depth and range of measurement, and are unable to examine relationships on a micro-scale.

    “While this work has been informative, low-resolution and cross-sectional studies are vulnerable to recall bias, are limited in depth and range of measurement, and are unable to examine relationships on a micro-scale.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The DAST-10 reliability and validity has been demonstrated in samples experiencing psychosis.

    “The reliability and validity of the DAST-10 has been demonstrated in samples experiencing psychosis (Cassidy, Schmitz, & Malla, 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cassidy, Schmitz, & Malla, 2008

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sleep disturbance is common in schizophrenia.

    “Sleep disturbance is common in schizophrenia but its role in predicting functioning and psychotic symptoms has yet to be rigorously examined.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cohrs, 2008

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The AUDIT is reliable and valid for use with people experiencing psychosis.

    “The AUDIT is reliable and valid for use with people experiencing psychosis (Dawe, Seinen, & Kavanagh, 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dawe, Seinen, & Kavanagh, 2000

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The CDS has proven reliability and validity in populations with a diagnosis of schizophrenia.

    “The CDS has proven reliability and validity in populations with a diagnosis of schizophrenia (Addington et al., 1993).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Addington et al., 1993

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    The sample included individuals who were chronic in presentation and in receipt of antipsychotic medication.

    “Third, the sample included individuals who were chronic in presentation and in receipt of antipsychotic medication.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Out of a possible 154 days of actigraph monitoring, 150 complete days were recorded (97.4%).

    “Out of a possible 154 days of actigraph monitoring, 150 complete days were recorded (97.4%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Both objective and subjective sleep parameters may be robust determinants of negative outcomes in people with a diagnosis of schizophrenia, as supported by their correspondence in relationships with next-day variables.

    “Furthermore, the correspondence between objective and subjective sleep parameters in the relationship with next-day variables supports the proposition that both may be robust determinants of negative outcomes in people with a diagnosis of schizophrenia.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Out of a possible 720 assessment points, a total of 557 entries were completed by participants within 15 minutes of each prompt, representing a 77.4% overall response rate.

    “Out of a possible 720 assessment points, a total of 557 entries were completed by participants within 15 minutes of each prompt, representing a 77.4% overall response rate.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The psychotic symptom items were fairly simplistic and may not capture the multidimensional experience of hallucinations and delusions.

    “Second, although psychotic symptoms were assessed, these items were fairly simplistic and may not capture the multidimensional experience of hallucinations and delusions (Haddock et al., 1999).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Haddock et al., 1999

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The NA and PA subscales had good internal consistency (α = .808 and α = .797, respectively).

    “The NA (sad, anxious, irritable) and PA (happy, cheerful, relaxed, sleepy and energetic) subscales had good internal consistency (α = .808and α = .797,respectively).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The CSD has been credited as a gold-standard sleep diary.

    “The CSD was developed by sleep experts and has been credited as a gold-standard sleep diary (Carney et al., 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Carney et al., 2012

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    All twenty-two participants completed the full ESM schedule and completed more entries than the traditionally accepted one-third of assessment points.

    “All twenty-two participants completed the full ESM schedule and completed more entries than the traditionally accepted one-third of assessment points (Palmier-Claus et al., 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Palmier-Claus et al., 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Completion of sleep diaries was high, as 147 nights out of a possible 154 nights of sleep were subjectively estimated (95.5%).

    “Completion of sleep diaries was also high, as 147 nights out of a possible 154 nights of sleep were subjectively estimated (95.5%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study relied on the computation of linear associations between variables, so no causal inferences can be made regarding any relationships.

    “First, the study relied on the computation of linear associations between variables and as such, no causal inferences can be made regarding any relationships.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The inclusion of the functioning measure enabled the examination of how sleep impacts functioning as relevant to those with a diagnosis of schizophrenia.

    “This enabled the examination of how sleep impacts functioning as relevant to those with a diagnosis of schizophrenia.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The total functioning scale had high internal consistency (α = .905).

    “The total functioning scale was used in the analyses, which had high internal consistency (α = .905).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Two individuals were excluded from the study for exhibiting circadian rhythm disturbances.

    “Fifth, two individuals were excluded from the study for exhibiting circadian rhythm disturbances.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Medication may have confounded the observed relationships between sleep and next-day variables.

    “Medication may have confounded the observed relationships between sleep and next-day variables.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The PSP is valid and reliable for use in samples with a diagnosis of schizophrenia.

    “The PSP is valid and reliable for use in samples with a diagnosis of schizophrenia (Kawata & Revicki, 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kawata & Revicki, 2008

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The integration of actigraphy with ESM measurement on a single device potentially opens up a novel approach to further investigate sleep and psychosis.

    “3) it is the first study to integrate actigraphy with ESM measurement on a single device, which may account for our high adherence rates and potentially opens up a novel approach to further investigate sleep and psychosis”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Sleep has a pronounced effect on next-day functioning independent of symptom severity, a proportion of which is mediated by morning NA.

    “This indicates that sleep has a pronounced effect on nextday functioning independent of symptom severity, a proportion of which is mediated by morning NA.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Actigraphy has been validated for use within psychosis populations.

    “Actigraphy provides a recording of continuous motor activity and has been validated for use within psychosis populations (Tahmasian, Khazaie, Golshani, & Avis, 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Tahmasian, Khazaie, Golshani, & Avis, 2013

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Nightly sleep impairment is a significant predictor of poorer next-day functioning and greater symptom severity in individuals with a diagnosis of schizophrenia.

    “We show that nightly sleep impairment is a significant predictor of poorer next-day functioning and greater symptom severity in individuals with a diagnosis of schizophrenia.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    Therapeutic interventions targeting sleep may have the potential to enhance both clinical and functional outcomes for people with schizophrenia.

    “These findings suggest that therapeutic interventions targeting sleep may also have the potential to enhance both clinical and functional outcomes for people with schizophrenia (Freeman et al. 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Freeman et al. 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Levels of alcohol and drug use were notably low in the sample.

    “Lastly, although levels of alcohol and drug use were notably low in our sample, the impact of substance use on sleep parameters and next-day variables could be an interesting avenue for further research.”
    Quote in the paperNot a substantial claim
36 of 36

  • The paper relies on this without support.

    Comparatively little research has investigated the effects of sleep disturbance on functioning in people with a diagnosis of schizophrenia.

    “Moreover, comparatively little research has investigated the effects of sleep disturbance on functioning in people with a diagnosis of schizophrenia.”

  • The paper relies on this without support.

    Sleep is multi-dimensional and can fluctuate across nights, with corresponding next-day consequences.

    “This is particularly important as sleep is multi-dimensional in nature and can fluctuate across nights, with corresponding next-day consequences.”

  • The paper relies on this without support.

    Sleep disturbance, functioning and symptoms are all associated with negative affect.

    “since 1) sleep disturbance, functioning and symptoms are all associated with negative affect”

  • The paper relies on this without support.

    The sample of 22 patients with chronic schizophrenia and insomnia is representative of people with a diagnosis of schizophrenia.

    “For the first time, we show that sleep disturbance is a predictor of next-day impaired functioning and psychotic symptom severity in people with a diagnosis of schizophrenia.”

  • The paper relies on this without support.

    The seven-day ESM period is sufficient to capture stable relationships between nightly sleep and next-day functioning and symptoms.

    “Experience sampling methodology was integrated with actigraphy and sleep diaries across seven days in twenty-two patients with a diagnosis of schizophrenia.”

  • The paper relies on this without support.

    The study is the first well-controlled longitudinal evaluation of the relationship between objective and subjective sleep-wake patterns, functioning and psychotic symptoms in individuals with a diagnosis of schizophrenia.

    “This study represents the first, well-controlled, longitudinal evaluation of the relationship between objective and subjective sleep-wake patterns, functioning and psychotic symptoms in individuals with a diagnosis of schizophrenia.”

  • The paper relies on this without support.

    The study is the first to employ rigorous, high resolution measurement of sleep parameters and next-day variables over time within ESM.

    “1) it is the first study to employ rigorous, high resolution measurement of sleep parameters and next-day variables over time, within the context of experience sampling methodology”

  • The paper relies on this without support.

    The study is the first to explicitly test mediators of the night-to-day relationship between sleep, individual psychotic symptoms and functioning.

    “2) it is the first study to explicitly test mediators of the night-to-day relationship between sleep, individual psychotic symptoms and functioning”

  • The paper relies on this without support.

    The study is the first to integrate actigraphy with ESM measurement on a single device.

    “3) it is the first study to integrate actigraphy with ESM measurement on a single device”
9 of 9

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Actigraphy duration differs between methods and results

    Minor

    The methods specify six days and nights of actigraphy, whereas the results report 154 possible monitoring days for 22 participants-seven days per participant.

  • Wood citation year differs from the reference list

    Minor

    The in-text citation gives 2011, but the matching reference with the same four authors is dated 2013.

  • Conflicting results for sleep fragmentation and delusions of control

    Minor

    The discussion says greater objective sleep fragmentation predicted increased delusions of control. The results summary lists fragmentation as a predictor of auditory hallucinations and paranoia, but lists only subjective sleep quality as a predictor of delusions of control.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Cohrs, S. (2008). Sleep disturbances in patients with schizophrenia. CNS drugs, 22(11), 939- 962.

Cited by

Sorted by citations

Related

Authors
Mulligan, L. D., Haddock, G., Emsley, R., Neil, S. T., & Kyle, S. D.
Affiliations
  • University of Manchester (GB)
  • National Health Service (GB)
  • John Radcliffe Hospital (GB)
Corresponding author
Mulligan, Lee D.
ORCID
Venue
Journal of Abnormal Psychology
Publisher
American Psychological Association (APA)
Published
2016-08
Volume
125
Issue
6
Pages
788-797
ISSN
  • 0021-843X (ISSN-L)
  • 1939-1846
DOI
10.1037/abn0000180
OpenAlex
W2469538675
Cited by
101
References
51
Citations by year
2026: 6 · 2025: 3 · 2024: 9 · 2023: 15 · 2022: 9 · 2021: 13 · 2020: 12 · 2019: 9 · 2018: 12 · 2017: 11 · 2016: 2
FWCI
10.09
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Journal of Abnormal Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, other-oa)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
sleep disorders, schizophrenia, sleep fragmentation, sleep efficiency, sleep quality, auditory hallucinations, paranoia, delusions of control, functioning, psychotic symptoms, actigraphy, ecological momentary assessment
MeSH terms
Ecological Momentary Assessment, Adult, Female, Humans, Male, Middle Aged, Schizophrenia, Schizophrenic Psychology, Sleep Deprivation, Sleep Wake Disorders, Young Adult, Actigraphy

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