The Role of Sleep and Affect in the Relationship Between Preadoptive Risk and Problem Behavior

• In Event: Sleep and Behavioral Adjustment in Early and Middle Childhood

Abstract

Introduction
Internationally adopted children are at a high risk for early adversity, which has a great impact on later health and functioning. Despite a high likelihood of developmental resilience after being placed in families, internationally adopted children continue to display high rates of problem behavior and disordered sleep (Gunnar & Van Dulmen, 2007; Tan, 2010). Although data are limited for this population, Rettig and McCarthy-Rettig (2006) suggest that sleep problems are a common complaint among parents of internationally adopted children, and these problems tend to persist. However, little is known about how pre-adoptive risk and ensuing sleep difficulties impact other behavior domains in internationally adopted children.

Method
This study examined sleep disturbance and behavioral sequelae in a diverse sample of 106 internationally adopted children ages 6-10 (60.4% female). A single parent-reported survey item was used to assess overall care received prior to adoption (extremely neglectful to good). The Health and Behavior Questionnaire, Parent Version (HBQ-P 1.0; Boyce et al., 2002) was used to assess internalizing and externalizing behavior, and the Child Sleep Habits Questionnaire (CSHQ; Owens, Spirito, & McGuinn, 2000) assessed sleep disturbance.

Results
Serial multiple mediation analysis using PROCESS (Hayes, 2018) revealed that pre-adoptive risk influences internalizing and externalizing behavior independently through sleep problems and dysregulated negative affect. As can be seen in Figure 1, participants with higher pre-adoptive risk exhibited increased sleep difficulties (a1 = 1.783) and, in turn, higher rates of problem behavior (b1 = 0.010). Additionally, participants with higher pre-adoptive risk also exhibited higher levels of dysregulated negative affect (a2 = 0.101), which predicted higher rates of problem behavior (b2 = 0.418). While each simple mediation was significant, the full serial model with both mediators was not significant.

Conclusions
Pre-adoptive conditions may put internationally adopted children at risk for sleep difficulties and higher levels of dysregulated negative affect. Sleep and emotional difficulties, in turn, are associated with higher rates of internalizing and externalizing behavior. Interventions targeting sleep and emotion regulation may improve problem behavior in internationally adopted children and should be explored.

Authors

• Kristin Aho, Eastern Michigan University
  Presenting Author

• Morgan Daugherty, University of Michigan - Ann Arbor
  Non-Presenting Author

• Angela D Staples, Eastern Michigan University
  Non-Presenting Author

• Jamie Lawler, Eastern Michigan University
  Non-Presenting Author