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Practice Corner: Stability and Predictive Validity of the Parent-Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers

Practice Corner Author: Amanda Shrewsbury, California Polytechnic State University, San Luis Obispo

Summary: The relation between children’s sleep problems, behavioral problems, cognitive impairments, and psychopathology is well known. This article describes the findings from use of the Parent-Child Sleep Interactions Scale (PSIS) in a longitudinal study with preschoolers. The PSIS is a 12-item, validated, parent-report scale that can be used in clinical practice. It aids in elucidating the interactions between parents and children at bedtime that contribute to a propensity for sleep problems and psychopathology. The PSIS scale items load into three subscales: Sleep-Reinforcement, Sleep-Conflict, and Sleep-Dependence.

Article Title:  Stability and Predictive Validity of the Parent-Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers

Article Authors: Chelsey S. Barrios, Samantha Y. Jay, Victoria C. Smith, Candice A. Alfano, & Lea R. Dougherty

Why is this article relevant to your practice?

Although the relation between early sleep problems and other developmental issues is posited, the underlying mechanisms are less understood. Due to the importance of parent-child interactions for a child’s overall development, the PSIS can help clinicians gain a deeper understanding of the environmental factors that may contribute to children’s sleep problems and development of psychiatric problems. This deeper understanding can aid clinicians when deciding if and how to focus some part of treatment around parent-child bedtime interactions or sleep intervention.

What are the key takeaways from the article?

  • This study aimed to: (1) Examine if there is stability between parent-child sleep interactions and sleep problems over time, and (2) Whether sleep interactions predict sleep problems and psychopathology throughout development.
  • 108 preschool-aged children and their parents participated in the study. Measures were administered at two different time points and included: The PSIS to assess sleep interactions, and the Preschool Age Psychiatric Assessment (PAPA) to assess sleep and psychiatric problems.
  • PSIS scores predicted sleep and psychological problems across a 3-year time span, even after controlling for psychological problems at Time 1 (T1). For example:
  • Higher PSIS scores at Time 1 (T1) were associated with increased sleep difficulties at Time 2 (T2)
  • Higher “Sleep Conflict” sub-scale scores at T1 were associated with increased rates of Oppositional Defiant Disorder at T1
  • Children with higher “Sleep Reinforcement” sub-scales scores and with increased sleep difficulties at T1, showed higher rates of ADHD, depressive, and anxiety symptoms at T2
  • These findings show the predictive utility that gauging parent-child interactions at bedtime have for predicting future sleep problems and psychopathology

What do the authors say are the limitations of the article?

  • By nature, parent-report scales may be influenced by informant biases.
  • Higher rates of parent depression in the current sample warrant further replication of results. The author’s note that they did control for maternal depression in all analyses.

 Helpful links and articles:

  • See the attached word document for a printout with items and scoring instructions
  • Alfano, C. A., Smith, V. C., Reynolds, K. C., Reddy, R., & Dougherty, L. R. (2013). The Parent- Child Sleep Interactions Scale (PSIS) for Preschoolers: Factor Structure and Initial        Psychometric Properties. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine, 9(11),    1153–1160.

Full Article Reference:

Chelsey S. Barrios, Samantha Y. Jay, Victoria C. Smith, Candice A. Alfano & Lea R. Dougherty  (2018) Stability and Predictive Validity of the Parent–Child Sleep Interactions Scale: A  Longitudinal Study Among Preschoolers, Journal of Clinical Child & Adolescent Psychology, 47:3, 382-396, DOI: 10.1080/15374416.2017.1357125

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