Childhood maltreatment, sleep disturbances, and psychiatric symptoms: A prospective longitudinal investigation

• In Event: Effects of maltreatment across the life course and across generations

Abstract

Introduction: Child maltreatment represents a major public health problem in the United States and abroad and has lasting impacts on mental and physical health, social, and economic functioning. Childhood maltreatment has also been associated with sleep disturbances and sleep disturbances have been associated with psychiatric problems. There is also emerging evidence that sleep disorders may play a role in explaining the association between childhood maltreatment and psychiatric disorders, although few longitudinal studies have examined this issue. The goal of the present study was to determine whether inadequate sleep conditions in childhood and sleep problems in young adulthood explain in part the relationship between childhood abuse and neglect and subsequent psychiatric problems later in life. Four major hypotheses were tested: (1) Individuals with documented histories of childhood abuse and neglect will be more likely to report having inadequate sleep conditions as children and more problems with sleep as adults compared to demographically matched controls without these histories; (2) Inadequate sleep conditions in childhood will predict higher levels of psychiatric symptoms (depression and anxiety) in adulthood (at age 47); (3) Sleep problems in adulthood (at age 29) will predict higher levels of psychiatric symptoms (depression and anxiety; at age 41); and (4) Inadequate sleep conditions and sleep problems will mediate the relationship between child maltreatment and these psychiatric symptoms later in adulthood.
Methods: Data are from a prospective cohort design study involving court documented cases of childhood abuse and neglect and matched controls (N = 1196, 56.5% maltreated, 51.0% male, 61.5% White, non-Hispanic). Mediating and outcome variables were assessed via self-reports when participants were young adults and in middle adulthood. Research hypotheses were tested using structural equation modeling (SEM). Analyses controlled for sex, age, and race.
Results: Individuals with documented histories of childhood abuse and neglect were more likely to experience inadequate sleep conditions in childhood, sleep problems in young adulthood and higher levels of depression and anxiety in middle adulthood. SEM results indicated significant indirect paths from childhood maltreatment to psychiatric symptoms of anxiety and depression through inadequate sleep conditions in childhood (indirect effect: β = .06, 95% BCCI = [.03; .12]) and poor quality sleep in young adulthood (β = .03, 95% BCCI = [.01; .08]). The results for specific types of maltreatment revealed notable differences: childhood physical abuse predicted sleep disturbances in childhood and young adulthood, neglect predicted inadequate sleep conditions in childhood only, and sexual abuse was not associated with these disturbances.
Conclusions: With its prospective cohorts design and lengthy follow up of children with documented cases of abuse and neglect and matched controls, the present study provides evidence of the important role that sleep disturbances play in the lives of maltreated children and adults and the role of sleep disturbances in the development of subsequent psychiatric symptoms of anxiety and depression. This work also adds to an increasing literature showing that there are different long-term consequences associated with different types of childhood maltreatment.

Authors

• Magda Javakhishvili, John Jay College of Criminal Justice, City University of New York
  Presenting Author

• Cathy Spatz Widom, John Jay College
  Non-Presenting Author