INTRODUCTION: Poor sleep quality is a significant risk factor for the development of postpartum depression. This thesis examined the impact of a post-delivery intervention which promoted and protected sleep during the immediate postpartum period on maternal mood, sleep quality, and anxiety. METHODS: 41 women with lifetime or current mood and/or anxiety disorders (12 receiving the intervention) were enrolled in this prospective naturalistic cohort study from the third trimester of pregnancy until 24 weeks postpartum. Depression, the primary outcome, was measured using the Edinburgh Postnatal Depression Scale at 12 weeks postpartum. Remaining outcomes (sleep quality and anxiety) were measured using self-report questionnaires (Insomnia Severity Index and State-Trait Anxiety Inventory, respectfully), and objective measures (i.e., actigraphy for sleep quality). RESULTS: There were no significant differences between the comparison and intervention group in depressive symptomatology at postpartum week 12 (primary outcome). On our secondary outcomes, we found that there were no significant differences in subjective and objective sleep quality at postpartum week two, or anxiety symptomatology at postpartum week eight between the two groups. There were also no significant differences in breastfeeding rates between the two groups at postpartum week 24. CONCLUSION AND FUTURE DIRECTIONS: Floor effects, specialized perinatal psychiatric treatment for a specific population, and low statistical power offer explanations for the observed null results. Strengths of our study include diagnosis of mood/anxiety disorders using the gold-standard (i.e., clinician diagnosis), and use of objective sleep measures. Future studies may benefit from implementing this intervention in resource-poor settings, using adequately powered research designs. / Thesis / Master of Science (MSc) / While the arrival of a child is a celebrated and joyous occasion, it can also be a source of duress and anguish, particularly for the mother. Postpartum depression is a mood disorder experienced by 10-15% of mothers after childbirth. One of the strongest risk factors for the development of postpartum depression is disrupted postpartum sleep quality. This thesis examined the impact of an intervention designed to protect and promote sleep of mothers during the postpartum period in an effort to improve mood, sleep quality, and anxiety symptomatology. By improving maternal mental health, not only do women benefit, but their children, their partners, and the healthcare system.

The purpose of this study was to contribute to the paucity of literature present on educational psychology involvement in supporting primary school-aged children’s sleep. The research was formed using a pragmatic, mixed-methods approach with a two-phase design. Phase one explored the views of 59 participants (teachers, n= 16; parents/carers, n= 21; children, n= 22) about children’s sleep, their academic outcomes and psychosocial functioning. There were some associations between parent, child, and teacher reports of children’s sleep-related difficulties, academic outcomes and aspects of children’s psychosocial functioning. Phase two adopted a time-series pre- and post-intervention design with the aim of evaluating a school-based, six-week Sleep Club intervention for children. Twenty-nine participants (teaching assistants, n= 2; parents/carers, n= 13; and children, n= 14) took part in phase two, with the findings drawing on evaluations, quizzes, field notes, surveys, and parent interviews. Six children were selected to provide greater insight into parent and child views through case study analysis. At the end of the intervention, there was an increase in children’s sleep-related knowledge, and there were improvements in many aspects of children’s sleep-related behaviours. Thematic analysis identified that the Sleep Club facilitated communication about sleep between children and their parents and raised children’s awareness and understanding of their sleep. Children enjoyed being part of a club with other children, from whom they felt they were able to learn. Learning about emotions, sleep and the body was noted by several children, though some children did not enjoy completing the given questionnaires. Overall, participants felt that the individual sessions and the intervention could have lasted longer than the time offered. Twenty-two participants (76%, including parents, children, and school staff) reported that they would recommend the Sleep Club intervention to others. The role of the educational psychologist in supporting children with sleep difficulties is discussed.

Self-regulation and self-control are motivational constructs involved in the process of goal pursuit (Karoly, 1993). Although investigators within and across various fields of psychology have used the terms interchangeably (e.g., Hofmann, Rauch, & Gawronski, 2007; Lord, Diefendorff, Schmidt, & Hall, 2009; Wood, 2005), theoretical work stemming from the clinical field suggests that they are distinct yet related constructs (e.g., F. Kanfer, 1970, 1977; F. Kanfer & Karoly, 1972). However, until now, the relationship between self-regulation and self-control had not been investigated empirically. In the current program of research, I delineated their relationship in two ways. First, I developed and evaluated new self-report measures that better match theoretical models of self-regulation and self-control. Participants (N = 199) completed a battery of self-report questionnaires regarding personality, motivation, self-regulation, and self-control. The new measures had acceptable internal consistency and test-retest reliabilities, and displayed relationships expected for convergent and discriminant validity. Modeling techniques indicated that self-control and self-regulation are not strongly enough associated to fall under one higher-order factor, and that the relationship between the two constructs was best represented by a model in which self-control was associated with the self-regulatory stage of goal striving. Second, I evaluated the efficacy of a training session that included self-control techniques in addition to self-regulation skills, and compared outcomes to those from a self-regulation only training group, and a control group. One sample of undergraduate students (N = 49) and one sample of day-shift employees (N=41) were included. Participants completed questionnaires twice daily for a period of three weeks to report sleep-wake behavior, fatigue, affect, and productivity. Objective sleep measures also were obtained through the use of actigraphs, which monitor sleep-wake activity. The self-regulation training groups showed better goal adherence following the intervention compared to the control group, and the combined training groups had even better goal adherence than the self-regulation group. Positive affective changes were also reported among the training groups following the study period. The development of new measurement and training techniques, which better align with the theoretical formulations of self-regulation and self-control, will help to advance the theoretical work concerning these constructs, and could lead to improvement in workplace outcomes.

Establishing healthy sleep-wake patterns early in infancy is vitally important as sleep problems can persist. Behavioural sleep interventions such as the parental presence procedure are well established and have been found to improve infant sleep as determined by parent report. The exact nature of this improvement is, however, unclear. Sleep consolidation, sleep-state organisation, and self-soothing are thought likely to change after intervention; however, no known research has comprehensively determined which of these variables change as infant sleep changes in response to intervention. Three participants aged between 7 to 11 months who met the criteria for Infant Sleep Disturbance (ISD) were referred by a Health Centre and the parental presence behavioural sleep intervention was implemented. Parental report and videosomonography (VSG) data were used to measure sleep before and after intervention. While parental report is limited in that parents can only report what they can hear and/or see, VSG offers a tool that can be used to measure sleep-state organisation, state changes, and periods when the infant is awake and quiet. The present research found that infants’ sleep became more consolidated resulting in fewer sleep-wake transitions and night wakings. Infants who had difficulties initiating sleep on their own also demonstrated decrease in Sleep Onset Delay (SOD). Furthermore, infants were found to sleep through a greater number of sleep-state transitions and sleep for a greater duration of time before waking. Collectively this research provides some evidence that changing parental behaviours to those that promote self-initiation through self-soothing and consistency, can change sleep-state organisation and improve self-soothing.