{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:20:23Z","timestamp":1777483223063,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Singapore Ministry of Health\u2019s National Medical Research Council Individual Research Grant","award":["NMRC 1170\/200"],"award-info":[{"award-number":["NMRC 1170\/200"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Child Psychol Psychiatry"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>In a growing body of literature, poor sleep quality has been associated with externalizing problems. In adults, anxiety was found to mediate the relationship, and callous-unemotional (CU) traits were found to moderate it. We sought to examine these relationships in a child population. We examined these relationships in 239 clinic-referred youth (age 6\u201317) in Singapore with externalizing behavior problems. Parent- but not child-rated sleep problems were associated with increased parent-rated externalizing problems. This association was partially mediated by anxiety. Unlike in adults, CU traits did not moderate the relationship. Sleep problems were associated with externalizing problems regardless of the level of CU traits. It is possible externalizing behaviors may lead children to internalize experiences, leading to anxiety about their behaviors. Another possibility is externalizing behaviors may lead to more stressful life experiences due to negative reactions children with externalizing behaviors receive from parents, teachers, or peers. Regardless, the partial mediation found indicates anxiety may be an important factor to consider in future interventions focused on improving sleep as a means to reduce externalizing problems.<\/jats:p>","DOI":"10.1177\/13591045221076643","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T16:41:18Z","timestamp":1654620078000},"page":"654-667","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The role of anxiety and callous-unemotional traits in the relationship between externalizing behaviors and sleep problems in clinic-referred youth"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0883-4117","authenticated-orcid":false,"given":"Virginia A","family":"Lamoureux","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Alabama, Tuscaloosa, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea L","family":"Glenn","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Alabama, Tuscaloosa, AL, USA"},{"name":"Center for the Prevention of Youth Behavior Problems, University of Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shichun","family":"Ling","sequence":"additional","affiliation":[{"name":"School of Criminal Justice and Criminalistics, California State University, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Raine","sequence":"additional","affiliation":[{"name":"Department of Criminology, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca P","family":"Ang","sequence":"additional","affiliation":[{"name":"Psychological Studies, National Institute of Education, Nanyang Technological University, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,6,7]]},"reference":[{"key":"bibr1-13591045221076643","volume-title":"Manual for the child behavior checklist\/4-18 and 1991 profile","author":"Achenbach T. 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