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Jessica Ruth Lunsford-Avery

Jessica Ruth Lunsford-Avery

Associate Professor in Psychiatry and Behavioral Sciences
Psychiatry, Child & Family Mental Health & Community Psychiatry
jessica.r.avery@duke.edu
2608 Erwin Road Suite 300, Durham, NC 27705
2400 Pratt Street, 7th Floor, Durham, NC 27705

Selected Publications

Sleep and fatigue complaints during pregnancy versus perinatal depression: Impact on toddler cognition.

Journal Article J Affect Disord · January 1, 2026 BACKGROUND: Sleep and fatigue complaints during pregnancy may increase risk for cognitive impairment among offspring, yet this relationship is difficult to disentangle from related risk factors such as perinatal depression. This longitudinal study examined ... Full text Link to item Cite

Effects of initial nicotine exposure on cognition and nicotine reinforcement among non-smoking young adults with and without attention deficit hyperactivity disorder.

Journal Article J Psychopharmacol · July 2025 BACKGROUND: People with attention deficit hyperactivity disorder (ADHD) use nicotine products at higher rates than those without. Greater initial sensitivity to nicotine's cognitive effects may explain this association. AIMS: This study examined associatio ... Full text Link to item Cite

Circadian rhythm dysfunction and clinical heterogeneity in pediatric ADHD: A critical need for innovation in assessment and treatment.

Journal Article JCPP Adv · March 2025 Despite success of pharmacologic and psychosocial treatments, attention-deficit/hyperactivity disorder (ADHD) frequently results in significant personal impairment and socioeconomic burden. A challenge for the development of effective treatments targeting ... Full text Open Access Link to item Cite

Topical review: sleep regulation as a novel target for treating preschool-aged children with attention-deficit/hyperactivity disorder symptoms.

Journal Article J Pediatr Psychol · March 1, 2025 OBJECTIVE: Elevated attention-deficit/hyperactivity disorder (ADHD) symptoms in preschoolers are a risk factor for poorer psychiatric health, cognitive deficits, and social and academic impairment across the lifespan. The first-line treatment for these pre ... Full text Link to item Cite

Trait mindfulness in adolescents with and without Attention-Deficit/Hyperactivity Disorder.

Journal Article Res Dev Disabil · March 2025 BACKGROUND AND OBJECTIVES: Mindfulness-based interventions (MBIs) are proposed to cultivate trait mindfulness through mindfulness practice, which may in turn to lead improved clinical outcomes. Individuals who report lower levels of this trait may be promi ... Full text Link to item Cite

Sleep Physiology and Neurocognition Among Adolescents With Attention-Deficit/Hyperactivity Disorder.

Journal Article J Am Acad Child Adolesc Psychiatry · February 2025 OBJECTIVE: Few studies have characterized the nature of sleep problems among adolescents with attention-deficit/hyperactivity disorder (ADHD) using polysomnography (PSG). Additionally, although adolescents with ADHD and adolescents with sleep disturbances ... Full text Link to item Cite

The role of sleep disturbances in the onset and maintenance of psychiatric disorders in childhood and adolescence: A review of subjective and polysomnographic findings.

Journal Article Curr Sleep Med Rep · September 2024 PURPOSE OF REVIEW: To summarize subjective and polysomnographically-measured sleep disturbances in children and adolescents with psychiatric conditions, including anxiety, mood, and neurodevelopmental disorders and high-risk syndromes for psychosis. Eviden ... Full text Link to item Cite

Psychiatric comorbidities and prescribing tendencies of sleep medications and related medications in young people with insomnia: a United States commercial claims-based analysis.

Journal Article Sleep · May 10, 2024 STUDY OBJECTIVES: To characterize children and youth newly diagnosed with insomnia and to describe their use of sleep and other related prescription medications. METHODS: Within a commercial claims database (January 1, 2016-December 31, 2021), we identifie ... Full text Link to item Cite

Behavioral Treatment of Insomnia and Sleep Disturbances in School-Aged Children and Adolescents.

Journal Article Psychiatr Clin North Am · March 2024 Insomnia and related sleep disturbances are prevalent among youth and are associated with adverse consequences, including poorer psychiatric functioning. Behavioral sleep interventions, ranging from brief educational interventions to behavioral therapies ( ... Full text Link to item Cite

56.2 Sleep Physiology in Adolescents With ADHD: Associations With Neurocognition and Cognitive Disengagement

Conference Journal of the American Academy of Child & Adolescent Psychiatry · October 2023 Full text Cite

0335 Persistence of Sleep Duration Phenotypes Across Nights of Laboratory and Home Sleep Recording

Conference SLEEP · May 29, 2023 AbstractIntroductionVgontzas and colleagues have proposed dividing the population of persons with insomnia disorder into short (&l ... Full text Cite

Screen media technology and ADHD in children and adolescents: Potential perils and emerging opportunities

Chapter · January 1, 2023 Screen media technology (SMT) use has become increasingly prevalent among youth, and is associated with a variety of negative outcomes, including poor sleep and impairments in several domains of cognitive functioning, including task-switching, attention, w ... Full text Cite

Sleep onset, duration, or regularity: which matters most for child adiposity outcomes?

Conference Int J Obes (Lond) · August 2022 BACKGROUND/OBJECTIVES: Sleep measures, such as duration and onset timing, are associated with adiposity outcomes among children. Recent research among adults has considered variability in sleep and wake onset times, with the Sleep Regularity Index (SRI) as ... Full text Link to item Cite

Regularity and Timing of Sleep Patterns and Behavioral Health Among Adolescents.

Journal Article Journal of developmental and behavioral pediatrics : JDBP · May 2022 ObjectiveSleep is vital to supporting adolescent behavioral health and functioning; however, sleep disturbances remain under-recognized and undertreated in many health care settings. One barrier is the complexity of sleep, which makes it difficult ... Full text Cite

The relationship between stress responding in family context and stress sensitivity with sleep dysfunction in individuals at clinical high-risk for psychosis.

Journal Article J Psychiatr Res · May 2022 Stress and sleep have been implicated in the etiology of psychosis, and literature suggests they are closely related. Two distinct domains of stress associated with sleep dysfunction in the general population are responsivity to environmental stressors and ... Full text Link to item Cite

Impact of daily caffeine intake and timing on electroencephalogram-measured sleep in adolescents.

Journal Article J Clin Sleep Med · March 1, 2022 STUDY OBJECTIVES: Caffeine use is ubiquitous among adolescents and may be harmful to sleep, with downstream implications for health and development. Research has been limited by self-reported and/or aggregated measures of sleep and caffeine collected at a ... Full text Link to item Cite

Overnight Delta Dynamics Associated with Daytime Psychomotor Performance in Adults with Insomnia and Healthy Controls.

Journal Article Nat Sci Sleep · 2022 PURPOSE: Sleep is vital to cognition, yet underlying mechanisms remain unclear. Although sleep duration and continuity are two well-established contributors, additional factors-including homeostatic sleep drive processes-may also underlie cognition-related ... Full text Link to item Cite

Eveningness Diurnal Preference: Putting the "Sluggish" in Sluggish Cognitive Tempo.

Journal Article J Atten Disord · December 2021 OBJECTIVE: Eveningness diurnal preference is common in psychiatric conditions, including attention-deficit/hyperactivity disorder (ADHD) and internalizing disorders. Little is known about how diurnal preference relates to sluggish cognitive tempo (SCT)-a d ... Full text Link to item Cite

Psychotic-Like Experiences Associated with Sleep Disturbance and Brain Volumes in Youth: Findings from the Adolescent Brain Cognitive Development Study.

Journal Article JCPP Adv · December 2021 BACKGROUND: Sleep disturbance is characteristic of schizophrenia and at-risk populations, suggesting a possible etiological role in psychosis. Biological mechanisms underlying associations between sleep and psychosis vulnerability are unclear, although red ... Full text Link to item Cite

Eveningness chronotype preference among individuals at clinical high risk for psychosis.

Journal Article Schizophr Res · October 2021 BACKGROUND: Circadian rhythm disturbances are frequently implicated in psychosis. Indeed, research has suggested several avenues by which circadian rhythms may play a mechanistic role as well as contribute to clinical outcomes. Despite its potential role a ... Full text Link to item Cite

600 Differential Impact of Overnight Delta Power Dynamics on Neurocognition among Adolescents with ADHD versus Healthy Controls

Conference Sleep · May 3, 2021 AbstractIntroductionAttention-Deficit/Hyperactivity Disorder (ADHD) is associated with neurocognitive impairment; however, mechanisms ... Full text Cite

Sluggish Cognitive Tempo in Adults Referred for an ADHD Evaluation: A Psychometric Analysis of Self- and Collateral Report.

Journal Article J Atten Disord · February 2021 Objective: Sluggish cognitive tempo (SCT) symptoms uniquely contribute to psychiatric and functional outcomes in child samples; however, the psychometric properties of SCT measures among adult outpatients are unknown. Method: Adults (n = 124) presenting fo ... Full text Link to item Cite

Optimizing computation of overnight decline in delta power: Evidence for slower rate of decline in delta power in insomnia patients.

Journal Article Clin Neurophysiol · February 2021 OBJECTIVE: To determine the best of commonly used methods for computing the rate of decline in non-rapid eye movement (NREM) sleep EEG delta power overnight (Delta Decline) in terms of vulnerability to missing data and to evaluate whether this rate is slow ... Full text Link to item Cite

Behavioral Treatment of Insomnia and Sleep Disturbances in School-Aged Children and Adolescents.

Journal Article Child Adolesc Psychiatr Clin N Am · January 2021 Insomnia and related sleep disturbances are prevalent among youth and are associated with adverse consequences, including poorer psychiatric functioning. Behavioral sleep interventions, ranging from brief educational interventions to behavioral therapies ( ... Full text Link to item Cite

Sluggish cognitive tempo (SCT) in an adult outpatient sample seeking an attention-deficit/hyperactivity disorder assessment: Age of onset and assessment method impact on SCT rates.

Journal Article J Psychiatr Res · December 2020 BACKGROUND: Sluggish cognitive tempo (SCT) is associated with-but distinct from-attention-deficit/hyperactivity disorder (ADHD). This study examined SCT rates in adult outpatients seeking an ADHD assessment, differences in rates based on ADHD status, impac ... Full text Link to item Cite

Feasibility and Acceptability of Wearable Sleep Electroencephalogram Device Use in Adolescents: Observational Study.

Journal Article JMIR Mhealth Uhealth · October 1, 2020 BACKGROUND: Adolescence is an important life stage for the development of healthy behaviors, which have a long-lasting impact on health across the lifespan. Sleep undergoes significant changes during adolescence and is linked to physical and psychiatric he ... Full text Link to item Cite

0983 Sleep Associated With Executive Functioning Among Adolescents Across The Adhd Continuum

Conference Sleep · May 27, 2020 AbstractIntroductionExecutive functioning (EF) deficits are a key feature of ADHD, and sleep disturbances may be an important contribu ... Full text Cite

Feasibility and Acceptability of Wearable Sleep Electroencephalogram Device Use in Adolescents: Observational Study (Preprint)

Journal Article · May 25, 2020 BACKGROUNDAdolescence is an important life stage for the development of healthy behaviors, which have a long-lasting impact on health across the lifespan. Sleep undergoes significant chan ... Full text Cite

Author Correction: Validation of the Sleep Regularity Index in Older Adults and Associations with Cardiometabolic Risk.

Journal Article Sci Rep · February 14, 2020 An amendment to this paper has been published and can be accessed via a link at the top of the paper. ... Full text Link to item Cite

Sleep/Wake Regularity Associated with Default Mode Network Structure among Healthy Adolescents and Young Adults.

Journal Article Sci Rep · January 16, 2020 Sleep deprivation and disorders are linked to reduced DMN connectivity. Less is known about how naturalistic sleep patterns - specifically sleep irregularity - relate to the DMN, particularly among adolescents and young adults. Additionally, no studies hav ... Full text Link to item Cite

A generic algorithm for sleep-wake cycle detection using unlabeled actigraphy data

Conference 2019 IEEE EMBS International Conference on Biomedical and Health Informatics Bhi 2019 Proceedings · May 1, 2019 One key component when analyzing actigraphy data for sleep studies is sleep-wake cycle detection. Most detection algorithms rely on accurate sleep diary labels to generate supervised classifiers, with parameters optimized for a particular dataset. However, ... Full text Cite

Eveningness diurnal preference associated with poorer socioemotional cognition and social functioning among healthy adolescents and young adults.

Journal Article Chronobiol Int · March 2019 Recently there has been growing interest in associations between sleep, emotion, and social functioning. Less is known about relationships between chronotype preference and socioemotional cognition and functioning, particularly among adolescents, who exper ... Full text Link to item Cite

Editorial Perspective: Delayed circadian rhythm phase: a cause of late-onset attention-deficit/hyperactivity disorder among adolescents?

Journal Article J Child Psychol Psychiatry · December 2018 Late-onset attention-deficit/hyperactivity disorder (ADHD) has been a topic of significant debate within our field. One question focuses on whether there may be alternative explanations for the onset of inattentive and/or hyperactive symptoms in adolescenc ... Full text Link to item Cite

Validation of the Sleep Regularity Index in Older Adults and Associations with Cardiometabolic Risk.

Journal Article Sci Rep · September 21, 2018 Sleep disturbances, including insufficient sleep duration and circadian misalignment, confer risk for cardiometabolic disease. Less is known about the association between the regularity of sleep/wake schedules and cardiometabolic risk. This study evaluated ... Full text Open Access Link to item Cite

Self-reported sleep disturbances associated with procedural learning impairment in adolescents at ultra-high risk for psychosis.

Journal Article Schizophr Res · December 2017 Sleep disturbance contributes to impaired procedural learning in schizophrenia, yet little is known about this relationship prior to psychosis onset. Adolescents at ultra high-risk (UHR; N=62) for psychosis completed the Pittsburgh Sleep Quality Index (PSQ ... Full text Link to item Cite

Adolescents at clinical-high risk for psychosis: Circadian rhythm disturbances predict worsened prognosis at 1-year follow-up.

Journal Article Schizophr Res · November 2017 BACKGROUND: Individuals with psychotic disorders experience disruptions to both the sleep and circadian components of the sleep/wake cycle. Recent evidence has supported a role of sleep disturbances in emerging psychosis. However, less is known about how c ... Full text Link to item Cite

Sleep disturbances in adolescents with ADHD: A systematic review and framework for future research.

Journal Article Clin Psychol Rev · December 2016 BACKGROUND: Biological mechanisms underlying symptom and prognostic heterogeneity in Attention-Deficit/Hyperactivity Disorder (ADHD) are unclear. Sleep impacts neurocognition and daytime functioning and is disrupted in ADHD, yet little is known about sleep ... Full text Link to item Cite

Actigraphic-measured sleep disturbance predicts increased positive symptoms in adolescents at ultra high-risk for psychosis: A longitudinal study.

Journal Article Schizophr Res · May 2015 BACKGROUND: Sleep disturbance is prevalent among patients with psychosis, yet little is known about sleep health during the ultra high-risk (UHR) period. This study used actigraphy to evaluate sleep in healthy control (HC) and UHR adolescents to examine th ... Full text Link to item Cite

Cerebellar networks in individuals at ultra high-risk of psychosis: impact on postural sway and symptom severity.

Journal Article Hum Brain Mapp · August 2014 Despite known deficits in postural control in patients with schizophrenia, this domain has not been investigated in youth at ultra high-risk (UHR) for psychosis. This is particularly relevant as postural control implicates dysfunction in the cerebellum-a r ... Full text Link to item Cite

Orbitofrontal cortex volume and intrinsic religiosity in non-clinical psychosis.

Journal Article Psychiatry Res · June 30, 2014 Research indicates that religiosity plays a complex role in mental illness. Despite this link, little work has been done to clarify the role of religiosity in persons exhibiting non-clinical psychosis (NCP, individuals experiencing fleeting psychotic-like ... Full text Link to item Cite

Striatal abnormalities and spontaneous dyskinesias in non-clinical psychosis.

Journal Article Schizophr Res · December 2013 BACKGROUND: Accumulating evidence suggests that individuals experiencing non-clinical psychosis (NCP) represent a critical group for improving understanding of etiological factors underlying the broader psychosis continuum. Although a wealth of evidence su ... Full text Link to item Cite

Sleep dysfunction and thalamic abnormalities in adolescents at ultra high-risk for psychosis.

Journal Article Schizophr Res · December 2013 BACKGROUND: Sleep dysfunction is a pervasive, distressing characteristic of psychosis, yet little is known regarding sleep quality prior to illness onset. At present, it is unclear whether sleep dysfunction precedes the emergence of psychotic symptoms, sig ... Full text Link to item Cite

Physical activity level and medial temporal health in youth at ultra high-risk for psychosis.

Journal Article J Abnorm Psychol · November 2013 A growing body of evidence suggests that moderate to vigorous activity levels can affect quality of life, cognition, and brain structure in patients diagnosed with schizophrenia. However, physical activity has not been systematically studied during the per ... Full text Link to item Cite

Sleep dysfunction prior to the onset of schizophrenia: A review and neurodevelopmental diathesis-stress conceptualization

Journal Article Clinical Psychology Science and Practice · September 1, 2013 Sleep dysfunction is a pervasive symptom in schizophrenia, yet little is known regarding the extent to which problematic sleep is present prior to illness onset. Results from an online database search targeting genetic high-risk, clinical high-risk, and re ... Full text Cite

Hypothalamic-pituitary-adrenal axis dysfunction in non-clinical psychosis.

Journal Article Psychiatry Res · April 30, 2013 While studies have examined psychosocial stress in non-clinical psychosis (NCP), it is unclear if the elevated cortisol seen in schizophrenia also occurs in this group. Cortisol was sampled in High- and Low-NCP groups, and findings of elevated resting cort ... Full text Link to item Cite

Emotion recognition and social/role dysfunction in non-clinical psychosis.

Journal Article Schizophr Res · January 2013 As researchers continue to understand non-clinical psychosis (NCP-brief psychotic-like experiences occurring in 5-7% of the general population; van Os et al., 2009), it is becoming evident that functioning deficits and facial emotion recognition (FER) impa ... Full text Link to item Cite

Sleep impairment, mood symptoms, and psychosocial functioning in adolescent bipolar disorder.

Journal Article Psychiatry Res · December 30, 2012 Few empirical studies have investigated the role of sleep impairment in the course of adolescent bipolar spectrum disorders (BSD). The present study examined the longitudinal associations between sleep disruption, mood symptom severity, and psychosocial fu ... Full text Link to item Cite

BDNF Val66Met and spontaneous dyskinesias in non-clinical psychosis.

Journal Article Schizophr Res · September 2012 BACKGROUND: Evidence indicating that symptoms of non-clinical psychosis (NCP) occur in 6-8% of the general population suggests that psychosis may occur across a continuum. Although a number of studies have examined environmental contributors, to date there ... Full text Link to item Cite

Amygdala activation during emotion processing of neutral faces in children with severe mood dysregulation versus ADHD or bipolar disorder.

Journal Article Am J Psychiatry · January 2010 OBJECTIVE: To understand disorder-unique and common pathophysiology, studies in multiple patient groups with overlapping symptoms are needed. Deficits in emotion processing and hyperarousal symptoms are prominent features of bipolar disorder, attention def ... Full text Link to item Cite

Practitioner review: the assessment of bipolar disorder in children and adolescents.

Journal Article J Child Psychol Psychiatry · March 2009 BACKGROUND: An increasing number of youth are being diagnosed with, and treated for, bipolar disorder (BD). Controversy exists about whether youth with non-episodic irritability and symptoms of attention deficit hyperactivity disorder (ADHD) should be cons ... Full text Link to item Cite