Poster #21 - Early Childhood Sleep Difficulties and Middle Childhood Psychopathology Among Children with Histories of Early Adversity

• In Event: Poster Session 02

Abstract

Empirical studies support prospective associations between childhood sleep quality and later psychopathology. (Quach et al., 2018; Zheng et al., 2021; Jensen et al., 2011). More specifically, sleep disturbance during the earliest years appears to be a robust predictor of emerging childhood psychopathology, including internalizing and externalizing problems. Early childhood (i.e., birth to 5) is a sensitive period for the development of sleep-wake regulation (Covington et al., 2020), and therefore, examination of sleep problems during this period may aid in preventive intervention efforts for children with increased vulnerability to psychopathology. Children with histories of CPS involvement are one such group for whom sleep disturbance has been proposed as a potential mechanism underlying poor mental health trajectories (Fuligni et al., 2021; Koss & Gunnar, 2018). Here, we examined the associations between caregiver-reported sleep problems during early childhood and internalizing and externalizing psychopathology during middle childhood (i.e., ages 8-10) among children with histories of early caregiving adversity. Data were obtained from a randomized controlled trial of a parenting intervention for Child Protective Service (CPS)-involved infants and their caregivers followed longitudinally through middle childhood. We hypothesized that early childhood sleep problems would be positively associated with both internalizing and externalizing symptom severity in middle childhood.

Participants included 153 children (44% female) and their primary caregivers (92% biological parents). At baseline assessment for the current study, children ranged in ages from 24 to 36 months, Mage = 27.52, SDage = 3.32. Sixty-six percent of children were Black/African American, 18% were multiracial, 8% were Hispanic, and 8% were white. At ages 2, 3, and 4, caregivers reported on children’s sleep problems using the 7-item Sleep Problems scale on the Child behavior Checklist for ages 1.5-5 (Achenbach & Rescorla, 2001). At ages 8, 9, and 10, caregivers again completed measures of children’s internalizing and externalizing problems using the Child Behavior Checklist for ages 6-18. We used a structural equation modeling framework to examine the effects of early sleep problems on mean levels of middle childhood internalizing and externalizing psychopathology, accounting for the effects of relevant covariates including child sex, early childhood caregiver depression, early childhood internalizing and externalizing scores, and intervention condition (active vs. control).

The full model (see Figure 1) fit the data adequately, RMSEA = .068, 90% CI [.045, .090], CFI = .926, TLI = .904, SRMR = .095. We found that that early childhood sleep problems were significantly and positively associated with middle childhood internalizing, β = .449, p = .010, 95% CI [.106, .792], but not externalizing, β = .228, p = .137, 95% CI [-.024, .529], problems. Findings suggest that younger children’s sleep problems following early caregiving adversity may confer risk for internalizing, but not externalizing, problems in middle childhood. Among young children with early CPS involvement, efforts to improve sleep quality may decrease risk for later mental health problems and promote resilient psychological functioning.

Authors

• Amy Hyoeun Lee, Hofstra University
  Presenting Author

• Kristin L Bernard, Stony Brook University

• Mary Dozier, University of Delaware