Abstract
Sleep disturbance is related to a variety of health issues and represents a prominent occupational concern among firefighters. Two potential predictors relevant to disturbed sleep are alcohol use and distress tolerance, which refers to the perceived ability to withstand negative emotional states. Main and interactive effects of alcohol use and distress tolerance on sleep disturbance were examined, after controlling for the covariates of service years and occupational stress. Participants included 652 firefighters (93.7% male; 77.9% white; Mage = 38.4 years), of whom 23.5% screened positive for hazardous alcohol use and 48.6% for disturbed sleep. Results indicated that higher alcohol misuse and lower distress tolerance were each significantly associated with greater sleep disturbance. Distress tolerance moderated the association between alcohol misuse and sleep disturbance, and the total model accounted for 28% of variance. Results indicate that firefighters with higher levels of hazardous alcohol use and lower levels of distress tolerance may exhibit higher levels of sleep disturbance.
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Abrantes, A. M., Strong, D. R., Lejuez, C. W., Kahler, C. W., Carpenter, L. L., Price, L. H., … Brown, R. A. (2008). The role of negative affect in risk for early lapse among low distress tolerance smokers. Addictive Behaviors, 33(11), 1394–1401. https://doi.org/10.1016/j.addbeh.2008.06.018.
Akerstedt, T., Knutsson, A., Westerholm, P., Theorell, T., Alfredsson, L., & Kecklund, G. (2002). Sleep disturbances, work stress and work hours: A cross-sectional study. Journal of Psychosomatic Research, 53(3), 741–748. https://doi.org/10.1016/S0022-3999(02)00333-1.
Ali, B., Green, K. M., Daughters, S. B., & Lejuez, C. W. (2017). Distress tolerance interacts with circumstances, motivation, and readiness to predict substance abuse treatment retention. Addictive Behaviors, 73, 99–104. https://doi.org/10.1016/j.addbeh.2017.04.016.
Arbona, C., & Schwartz, J. P. (2016). Posttraumatic stress disorder symptom clusters, depression, alcohol abuse, and general stress among hispanic male firefighters. Hispanic Journal of Behavioral Sciences. https://doi.org/10.1177/0739986316661328.
Barry, K. L., & Fleming, M. F. (1993). The Alcohol Use Disorders Identification Test (AUDIT) and the SMAST-13: Predictive validity in a rural primary care sample. Alcohol and Alcoholism, 28(1), 33–42. https://doi.org/10.1093/oxfordjournals.alcalc.a045346.
Bartlett, B. A., Jardin, C., Martin, C., Tran, J. K., Buser, S., Anestis, M. D., & Vujanovic, A. A. (2018). Posttraumatic stress and suicidality among firefighters: The moderating role of distress tolerance. Cognitive Therapy and Research, 42(5), 483–496. https://doi.org/10.1007/s10608-018-9892-y.
Beaton, R. D., & Murphy, S. A. (1993). Sources of occupational stress among firefighter/EMTs and firefighter/paramedics and correlations with job-related outcomes. Prehospital and Disaster Medicine, 8(2), 140–150.
Boffa, J. W., Stanley, I. H., Smith, L. J., Mathes, B. M., Schmidt, N. B., & Vujanovic, A. A. (2018). Posttraumatic stress disorder symptoms and suicide risk in male firefighters: The mediating role of anxiety sensitivity. Journal of Nervous and Mental Disease, 206(3), 179–186. https://doi.org/10.1097/NMD.0000000000000779.
Bohn, M. J., Babor, T. F., & Kranzler, H. R. (1995). The Alcohol Use Disorders Identification Test (AUDIT): Validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol, 56(4), 423–432. https://doi.org/10.15288/jsa.1995.56.423.
Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Hunt, E. D., & Lejuez, C. W. (2012). Initial RCT of a distress tolerance treatment for individuals with substance use disorders. Drug and Alcohol Dependence, 122(1–2), 70–76. https://doi.org/10.1016/j.drugalcdep.2011.09.012.
Boxer, P. A., & Wild, D. (1993). Psychological distress and alcohol use among fire fighters. Scandanavian Journal of Work, Environment and Health, 19(2), 121–125. https://doi.org/10.5271/sjweh.1497.
Breslau, N., Roth, T., Rosenthal, L., & Andreski, P. (1996). Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young adults. Biological Psychiatry, 39(6), 411–418.
Brown, R. A., Lejuez, C. W., Kahler, C. W., Strong, D. R., & Zvolensky, M. J. (2005). Distress tolerance and early smoking lapse. Clinical Psychology Review, 25(6), 713–733. https://doi.org/10.1016/j.cpr.2005.05.003.
Buckner, J. D., Keough, M. E., & Schmidt, N. B. (2007). Problematic alcohol and cannabis use among young adults: The roles of depression and discomfort and distress tolerance. Addictive Behaviors, 32(9), 1957–1963. https://doi.org/10.1016/j.addbeh.2006.12.019.
Buysse, D. J., Reynolds, C. F. III, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4.
Carey, M. G., Al-Zaiti, S. S., Dean, G. E., Sessanna, L., & Finnell, D. S. (2011). Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters. Journal of Occupational and Environmental Medicine, 53(8), 928–933. https://doi.org/10.1097/JOM.0b013e318225898f.
Casement, M. D., Harrington, K. M., Miller, M. W., & Resick, P. A. (2012). Associations between Pittsburgh Sleep Quality Index factors and health outcomes in women with posttraumatic stress disorder. Sleep Medicine, 13(6), 752–758. https://doi.org/10.1016/j.sleep.2012.02.014.
Cole, J. C., Motivala, S. J., Buysse, D. J., Oxman, M. N., Levin, M. J., & Irwin, M. R. (2006). Validation of a 3-factor scoring model for the Pittsburgh sleep quality index in older adults. Sleep, 29(1), 112–116. https://doi.org/10.1093/sleep/29.1.112.
Colrain, I. M., Nicholas, C. L., & Baker, F. C. (2014). Alcohol and the sleeping brain. Handbook of Clinical Neurology, 125, 415–431. https://doi.org/10.1016/b978-0-444-62619-6.00024-0.
Decker, P. J., & Borgen, F. H. (1993). Dimensions of work appraisal: Stress, strain, coping, job satisfaction, and negative affectivity. Journal of Counseling Psychology, 40(4), 470–478. https://doi.org/10.1037/0022-0167.40.4.470.
Dragioti, E., Bernfort, L., Larsson, B., Gerdle, B., & Levin, L. A. (2018). Association of insomnia severity with well-being, quality of life and health care costs: A cross-sectional study in older adults with chronic pain (PainS65+). European Journal of Pain, 22(2), 414–425. https://doi.org/10.1002/ejp.1130.
Falco, A., Girardi, D., Marcuzzo, G., De Carlo, A., & Bartolucci, G. B. (2013). Work stress and negative affectivity: A multi-method study. Occupational Medicine, 63(5), 341–347. https://doi.org/10.1093/occmed/kqt054.
Fogarty, G. J., Machin, M. A., Albion, M. J., Sutherland, L. F., Lalor, G. I., & Revitt, S. (1999). Predicting occupational strain and job satisfaction: The role of stress, coping, personality, and affectivity variables. Journal of Vocational Behavior, 54(3), 429–452. https://doi.org/10.1006/jvbe.1998.1670.
Foster, J. H., Marshall, E. J., & Peters, T. J. (1998). Predictors of relapse to heavy drinking in alcohol dependent subjects following alcohol detoxification-the role of quality of life measures, ethnicity, social class, cigarette and drug use. Addiction Biology, 3(3), 333–343. https://doi.org/10.1080/13556219872146.
Garcia Carretero, M. A., Novalbos Ruiz, J. P., Martinez Delgado, J. M., & O’Ferrall Gonzalez, C. (2016). Validation of the Alcohol Use Disorders Identification Test in university students: AUDIT and AUDIT-C. Adicciones, 28(4), 194–204. https://doi.org/10.20882/adicciones.775.
George, D., & Mallery, M. (2003). SPSS for windows step by step: A simple study guide and reference, 17.0 update, 10/e. Pearson Education India.
Girschik, J., Fritschi, L., Heyworth, J., & Waters, F. (2012). Validation of self-reported sleep against actigraphy. Journal of Epidemiology, 22(5), 462–468. https://doi.org/10.2188/jea.JE20120012.
Goel, N., Basner, M., Rao, H., & Dinges, D. F. (2013). Circadian rhythms, sleep deprivation, and human performance. Progress in Molecular Biology and Translational Science, 119, 155–190. https://doi.org/10.1016/b978-0-12-396971-2.00007-5.
Gorka, S. M., Ali, B., & Daughters, S. B. (2012). The role of distress tolerance in the relationship between depressive symptoms and problematic alcohol use. Psychology of Addictive Behaviors, 26(3), 621–626. https://doi.org/10.1037/a0026386.
Grant, B. F., Goldstein, R. B., Saha, T. D., Chou, S. P., Jung, J., Zhang, H., … Hasin, D. S. (2015). Epidemiology of DSM-5 alcohol use disorder: Results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry, 72(8), 757–766. https://doi.org/10.1001/jamapsychiatry.2015.0584.
Haddock, C. K., Day, R. S., Poston, W. S., Jahnke, S. A., & Jitnarin, N. (2015). Alcohol use and caloric intake from alcohol in a national cohort of U.S. career firefighters. Journal of Studies on Alcohol and Drugs, 76(3), 360–366. https://doi.org/10.15288/jsad.2015.76.360.
Haddock, C. K., Jahnke, S. A., Poston, W. S., Jitnarin, N., Kaipust, C. M., Tuley, B., & Hyder, M. L. (2012). Alcohol use among firefighters in the Central United States. Occupational Medicine, 62(8), 661–664. https://doi.org/10.1093/occmed/kqs162.
Hartwell, E. E., Bujarski, S., Glasner-Edwards, S., & Ray, L. A. (2015). The association of alcohol severity and sleep quality in problem drinkers. Alcohol and Alcoholism, 50(5), 536–541. https://doi.org/10.1093/alcalc/agv046.
Harvey, S. B., Milligan-Saville, J. S., Paterson, H. M., Harkness, E. L., Marsh, A. M., Dobson, M., … Bryant, R. A. (2016). The mental health of fire-fighters: An examination of the impact of repeated trauma exposure. Austrailian and New Zealand Journal of Psychiatry, 50(7), 649–658. https://doi.org/10.1177/0004867415615217.
Holzhauer, C. G., Wemm, S., & Wulfert, E. (2017). Distress tolerance and physiological reactivity to stress predict women’s problematic alcohol use. Experimental and Clinical Psychopharmacology, 25(3), 156–165. https://doi.org/10.1037/pha0000116.
Hom, M. A., Stanley, I. H., Ringer, F. B., & Joiner, T. E. (2016). Mental health service use among firefighters with suicidal thoughts and behaviors. Psychiatric Services, 67(6), 688–691. https://doi.org/10.1176/appi.ps.201500177.
Howell, A. N., Leyro, T. M., Hogan, J., Buckner, J. D., & Zvolensky, M. J. (2010). Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addictive Behaviors, 35(12), 1144–1147. https://doi.org/10.1016/j.addbeh.2010.07.003.
Johnson, E. O., Roehrs, T., Roth, T., & Breslau, N. (1998). Epidemiology of alcohol and medication as aids to sleep in early adulthood. Sleep, 21(2), 178–186. https://doi.org/10.1093/sleep/21.2.178.
Jones, S. (2017). Describing the mental health profile of first responders: A systematic review. Journal of the American Psychiatric Nurses Association, 23(3), 200–214. https://doi.org/10.1177/1078390317695266.
Katz, D. A., & McHorney, C. A. (1998). Clinical correlates of insomnia in patients with chronic illness. Archives of Internal Medicine, 158(10), 1099–1107. https://doi.org/10.1001/archinte.158.10.1099.
Kimbrel, N. A., Steffen, L. E., Meyer, E. C., Kruse, M. I., Knight, J. A., Zimering, R. T., & Gulliver, S. B. (2011). A revised measure of occupational stress for fire fighters: Psychometric properties and relationship to PTSD, depression, and substance abuse. Psychological Services, 8(4), 294–306. https://doi.org/10.1037/a0025845.
Klingaman, E. A., Brownlow, J. A., Boland, E. M., Mosti, C., & Gehrman, P. R. (2017). Prevalence, predictors and correlates of insomnia in US army soldiers. Journal of Sleep Research, 27(3), 1–13. https://doi.org/10.1111/jsr.12612.
Kuppermann, M., Lubeck, D. P., Mazonson, P. D., Patrick, D. L., Stewart, A. L., Buesching, D. P., & Fifer, S. K. (1995). Sleep problems and their correlates in a working population. Journal of General Internal Medicine, 10(1), 25–32. https://doi.org/10.1007/BF02599573.
Lee, J. S., Ahn, Y. S., Jeong, K. S., Chae, J. H., & Choi, K. S. (2014). Resilience buffers the impact of traumatic events on the development of PTSD symptoms in firefighters. Journal of Affective Disorders, 162, 128–133. https://doi.org/10.1016/j.jad.2014.02.031.
Leyro, Z., & Bernstein (2010). Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults. Psychological Bulletin, 136(4), 576–600. https://doi.org/10.1037/a0019712.
Lusa, S., Häkkänen, M., Luukkonen, R., & Viikari-Juntura, E. (2002). Perceived physical work capacity, stress, sleep disturbance and occupational accidents among firefighters working during a strike. Work & Stress, 16(3), 264–275. https://doi.org/10.1080/02678370210163301.
Mahfoud, Y., Talih, F., Streem, D., & Budur, K. (2009). Sleep disorders in substance abusers: how common are they? Psychiatry, 6(9), 38–42.
Mariman, A., Vogelaers, D., Hanoulle, I., Delesie, L., Tobback, E., & Pevernagie, D. (2012). Validation of the three-factor model of the PSQI in a large sample of chronic fatigue syndrome (CFS) patients. Journal of Psychosomatic Research, 72(2), 111–113. https://doi.org/10.1016/j.jpsychores.2011.11.004.
Mauss, I. B., Troy, A. S., & LeBourgeois, M. K. (2013). Poorer sleep quality is associated with lower emotion-regulation ability in a laboratory paradigm. Cognition and Emotion, 27(3), 567–576. https://doi.org/10.1080/02699931.2012.727783.
McGillis, Z., Dorman, S. C., Robertson, A., Lariviere, M., Leduc, C., Eger, T., … Lariviere, C. (2017). Sleep quantity and quality of Ontario wildland firefighters across a low-hazard fire season. Journal of Occupational and Environmental Medicine, 59(12), 1188–1196. https://doi.org/10.1097/jom.0000000000001175.
Meyer, E. C., Zimering, R., Daly, E., Knight, J., Kamholz, B. W., & Gulliver, S. B. (2012). Predictors of posttraumatic stress disorder and other psychological symptoms in trauma-exposed firefighters. Psychological Services, 9(1), 1–15. https://doi.org/10.1037/a0026414.
Minkel, J. D., Banks, S., Htaik, O., Moreta, M. C., Jones, C. W., McGlinchey, E. L., … Dinges, D. F. (2012). Sleep deprivation and stressors: Evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion, 12(5), 1015–1020. https://doi.org/10.1037/a0026871.
Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C. M., & Colantonio, A. (2016). The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Medicine Reviews, 25, 52–73. https://doi.org/10.1016/j.smrv.2015.01.009.
Murphy, S. A., Beaton, R. D., Pike, K. C., & Johnson, L. C. (1999). Occupational stressors, stress responses, and alcohol consumption among professional firefighters: A prospective, longitudinal analysis. International Journal of Stress Management, 6(3), 179–196. https://doi.org/10.1023/A:1021934725246.
Newcombe, D. A., Humeniuk, R. E., & Ali, R. (2005). Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Report of results from the Australian site. Drug and Alcohol Review, 24(3), 217–226. https://doi.org/10.1080/09595230500170266.
North, C. S., Tivis, L., McMillen, J. C., Pfefferbaum, B., Spitznagel, E. L., Cox, J., … Smith, E. M. (2002). Psychiatric disorders in rescue workers after the Oklahoma City bombing. American Journal of Psychiatry, 159(5), 857–859. https://doi.org/10.1176/appi.ajp.159.5.857.
Ohayon, M. M. (2002). Epidemiology of insomnia: What we know and what we still need to learn. Sleep Medicine Reviews, 6(2), 97–111. https://doi.org/10.1053/smrv.2002.0186.
Paulus, D. J., Gallagher, M. W., Bartlett, B. A., Tran, J. K., & Vujanovic, A. A. (2018). The unique and interactive effects of anxiety sensitivity and emotion dysregulation in relation to posttraumatic stress, depressive, and anxiety symptoms among trauma-exposed firefighters. Comprehensive Psychiatry, 84, 54–61. https://doi.org/10.1016/j.comppsych.2018.03.012.
Paulus, D. J., Vujanovic, A. A., Schuhmann, B. B., Smith, L. J., & Tran, J. (2017). Main and interactive effects of depression and posttraumatic stress in relation to alcohol dependence among urban male firefighters. Psychiatry Research, 251, 69–75. https://doi.org/10.1016/j.psychres.2017.02.011.
Piazza-Gardner, A. K., Barry, A. E., Chaney, E., Dodd, V., Weiler, R., & Delisle, A. (2014). Covariates of alcohol consumption among career firefighters. Occupational Medicine, 64(8), 580–582. https://doi.org/10.1093/occmed/kqu124.
Regehr, C., Dimitropoulos, G., Bright, E., George, S., & Henderson, J. (2005). Behind the brotherhood: Rewards and challenges for wives of firefighters. Family Relations, 54(3), 423–435. https://doi.org/10.1111/j.1741-3729.2005.00328.x.
Reitzel, L. R., Short, N. A., Schmidt, N. B., Garey, L., Zvolensky, M. J., Moisiuc, A., … Businelle, M. S. (2017). Distress tolerance links sleep problems with stress and health in homeless. American Journal of Health Behaviors, 41(6), 760–774. https://doi.org/10.5993/ajhb.41.6.10.
Reynolds, A. C., Appleton, S. L., Gill, T. K., Taylor, A. W., McEvoy, R. D., Ferguson, S. A., & Adams, R. J. (2017). Sickness absenteeism is associated with sleep problems independent of sleep disorders: Results of the 2016 Sleep Health Foundation national survey. Sleep Health, 3(5), 357–361. https://doi.org/10.1016/j.sleh.2017.06.003.
Roehrs, T., & Roth, T. (2001). Sleep, sleepiness, sleep disorders and alcohol use and abuse. Sleep Medicine Reviews, 5(4), 287–297. https://doi.org/10.1053/smrv.2001.0162.
Rosekind, M. R., Gregory, K. B., Mallis, M. M., Brandt, S. L., Seal, B., & Lerner, D. (2010). The cost of poor sleep: Workplace productivity loss and associated costs. Journal of Occupational and Environmental Medicine, 52(1), 91–98. https://doi.org/10.1097/JOM.0b013e3181c78c30.
Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction, 88(6), 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x.
Schmidt, A., Barry, K. L., & Fleming, M. F. (1995). Detection of problem drinkers: The Alcohol Use Disorders Identification Test (AUDIT). Southern Medical Journal, 88(1), 52–59. https://doi.org/10.1097/00007611-199501000-00007.
Selin, K. H. (2003). Test-retest reliability of the alcohol use disorder identification test in a general population sample. Alcoholism, Clinical and Experimental Research, 27(9), 1428–1435. https://doi.org/10.1097/01.alc.0000085633.23230.4a.
Short, N. A., Babson, K. A., Schmidt, N. B., Knight, C. B., Johnson, J., & Bonn-Miller, M. O. (2016). Sleep and affective functioning: Examining the association between sleep quality and distress tolerance among veterans. Personality and Individual Differences, 90, 247–253. https://doi.org/10.1016/j.paid.2015.10.054.
Simons, J. S., & Gaher, R. M. (2005). The distress tolerance scale: Development and validation of a self-report measure. Motivation and Emotion, 29(2), 83–102. https://doi.org/10.1007/s11031-005-7955-3.
Stanley, I. H., Boffa, J. W., Hom, M. A., Kimbrel, N. A., & Joiner, T. E. (2017). Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. Psychiatry Research, 247, 236–242. https://doi.org/10.1016/j.psychres.2016.11.037.
Stanley, I. H., Boffa, J. W., Smith, L. J., Tran, J. K., Schmidt, N. B., Joiner, T. E., & Vujanovic, A. A. (2018). Occupational stress and suicidality among firefighters: Examining the buffering role of distress tolerance. Psychiatry Research, 266, 90–96. https://doi.org/10.1016/j.psychres.2018.05.058.
Sullivan, J. P., O’Brien, C. S., Barger, L. K., Rajaratnam, S. M., Czeisler, C. A., & Lockley, S. W. (2017). Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability. Sleep. https://doi.org/10.1093/sleep/zsw001.
Taylor, D. J., Lichstein, K. L., & Durrence, H. H. (2003). Insomnia as a health risk factor. Behavioral Sleep Medicine, 1(4), 227–247. https://doi.org/10.1207/s15402010bsm0104_5.
Tomaka, J., Magoc, D., Morales-Monks, S. M., & Reyes, A. C. (2017). Posttraumatic stress symptoms and alcohol-related outcomes among municipal firefighters. Journal of Traumatic Stress, 30(4), 416–424. https://doi.org/10.1002/jts.22203.
Tomfohr, L. M., Schweizer, C. A., Dimsdale, J. E., & Loredo, J. S. (2013). Psychometric characteristics of the Pittsburgh Sleep Quality Index in English speaking non-Hispanic whites and English and Spanish speaking Hispanics of Mexican descent. Journal of Clinical Sleep Medicine, 9(1), 61–66. https://doi.org/10.5664/jcsm.2342.
Vargas de Barros, V., Martins, L. F., Saitz, R., Bastos, R. R., & Ronzani, T. M. (2013). Mental health conditions, individual and job characteristics and sleep disturbances among firefighters. Journal of Health Psychology, 18(3), 350–358. https://doi.org/10.1177/1359105312443402.
Voinescu, B. I., & Orăşan, R. (2014). Sleep disturbance in relation to alcohol misuse. Journal of Evidence-Based Psychotherapies, 14(1), 95–104.
Vujanovic, A. A., Hart, A. S., Potter, C. M., Berenz, E. C., Niles, B., & Bernstein, A. (2013). Main and interactive effects of distress tolerance and negative affect intensity in relation to PTSD symptoms among trauma-exposed adults. Journal of Psychopathology and Behavioral Assessment, 35(2), 235–243. https://doi.org/10.1007/s10862-012-9325-2.
Vujanovic, A. A., Litz, B. T., & Farris, S. G. (2015). Distress tolerance as risk and maintenance factor for PTSD: Empirical and clinical implications. In C. R. Martin, V. R. Preedy & V. B. Patel (Eds.), Comprehensive guide to posttraumatic stress disorder (pp. 1–13). Switzerland: Spinger.
Vujanovic, A. A., Marshall-Berenz, E. C., & Zvolensky, M. J. (2011). Posttraumatic stress and alcohol use motives: A test of the incremental and mediating role of distress tolerance. Journal of Cognitive Psychotherapy, 25(2), 130–141. https://doi.org/10.1891/0889-8391.25.2.130.
Wong, M. M., Brower, K. J., Fitzgerald, H. E., & Zucker, R. A. (2004). Sleep problems in early childhood and early onset of alcohol and other drug use in adolescence. Alcoholism, Clinical and Experimental Research, 28(4), 578–587. https://doi.org/10.1097/01.ALC.0000121651.75952.39.
Yoo, S. S., Gujar, N., Hu, P., Jolesz, F. A., & Walker, M. P. (2007). The human emotional brain without sleep—A prefrontal amygdala disconnect. Current Biology, 17(20), R877–R878. https://doi.org/10.1016/j.cub.2007.08.007.
Yun, J. A., Ahn, Y. S., Jeong, K. S., Joo, E. J., & Choi, K. S. (2015). The relationship between chronotype and sleep quality in Korean firefighters. Clinical Psychopharmacology and Neuroscience, 13(2), 201–208. https://doi.org/10.9758/cpn.2015.13.2.201.
Zohar, D., Tzischinsky, O., Epstein, R., & Lavie, P. (2005). The effects of sleep loss on medical residents’ emotional reactions to work events: A cognitive-energy model. Sleep, 28(1), 47–54. https://doi.org/10.1093/sleep/28.1.47.
Zvolensky, M. J., Marshall, E. C., Johnson, K., Hogan, J., Bernstein, A., & Bonn-Miller, M. O. (2009). Relations between anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations to coping and conformity marijuana use motives among young adult marijuana users. Experimental and Clinical Psychopharmacology, 17(1), 31–42. https://doi.org/10.1037/a0014961.
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Lia J. Smith, Brooke A. Bartlett, Jana K. Tran, Matthew W. Gallagher, Candice Alfano, and Anka A. Vujanovic declare that they have no conflict of interest.
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Smith, L.J., Bartlett, B.A., Tran, J.K. et al. Sleep Disturbance Among Firefighters: Understanding Associations with Alcohol Use and Distress Tolerance. Cogn Ther Res 43, 66–77 (2019). https://doi.org/10.1007/s10608-018-9955-0
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DOI: https://doi.org/10.1007/s10608-018-9955-0