@article{ref1,
title="Longitudinal course and risk factors for fatigue in adolescents: The mediating role of sleep disturbances",
journal="Journal of pediatric psychology",
year="2013",
author="Tham, See Wan and Holley, Amy Lewandowski and Zhou, Chuan and Clarke, Gregory N. and Palermo, Tonya M.",
volume="38",
number="10",
pages="1070-1080",
abstract="OBJECTIVES: This study (1) examines fatigue over 1 year in adolescents with chronic pain (n = 61) and depressive disorders (n = 51) compared with healthy adolescents (n = 60), (2) identifies longitudinal risk factors, and (3) tests sleep disturbances as a mediator between depression and fatigue. METHODS: Adolescents completed questionnaires at baseline, 6, and 12 months. Mixed effects models examined associations between risk factors and fatigue; structural equation modeling assessed contemporaneous and longitudinal mediation. RESULTS: Results revealed fatigue persisted at 1 year follow-up, with adolescents in the clinical samples experiencing greater fatigue than healthy youth at all time points (ps < .001). Age, baseline depression, and baseline sleep disturbances predicted longitudinal fatigue for the total sample (ps < .05), with variation in predictors by subgroup. Sleep quality mediated the contemporaneous effects of depression on fatigue in the clinical samples (ps < .05). CONCLUSIONS: Findings underscore the longitudinal course of fatigue and suggest that improving sleep disturbances may reduce fatigue in clinical samples.<p /> <p>Language: en</p>",
language="en",
issn="0146-8693",
doi="10.1093/jpepsy/jst051",
url="http://dx.doi.org/10.1093/jpepsy/jst051"
}