Childhood maltreatment, posttraumatic stress disorder symptoms, and sleep

Today, I present an article that deals with one of my favorite research topics – sleep. Harb, González-Van Wart, Brzezinski, deRoon-Cassini & Larson (2024) published “Subtypes of Childhood Maltreatment and Posttraumatic Stress Disorder Symptoms in an Adult Trauma Sample: The mechanistic role of sleep” in Psychological Trauma: Theory, Research, Practice, and Policy.  Here are the edited abstract and impact statements:

Childhood maltreatment is indisputably linked to adverse mental health outcomes, including an increased risk to develop posttraumatic stress disorder (PTSD) in adulthood. The role of childhood maltreatment in the context of recovery from a trauma later in adulthood is not well understood. A variable related to both childhood maltreatment and PTSD symptoms, and a potential link between the two, is sleep. The current study aimed to understand how sleep disturbances may play a mechanistic role in the effect of subtypes of childhood maltreatment on PTSD symptom severity in an adult trauma sample. 160 adults (90 women; Mage = 33.73, SD = 10.86) were recruited from the emergency department at a Level-1 trauma center in southeastern Wisconsin after experiencing a traumatic injury. Experiences of childhood maltreatment and sleep were self-reported at 2-week and 3-month posttrauma, respectively. PTSD symptoms were clinically assessed 6 months later. Sleep disturbances 3-month posttrauma mediated the effect of emotional abuse, physical neglect, and emotional neglect on PTSD symptom 6 months after the traumatic injury. The effect of sexual and physical abuse on PTSD symptoms was not significantly mediated by sleep disturbances. These findings highlight the differential impact of subtypes of childhood maltreatment on PTSD symptoms, the mechanistic role of sleep, and the need to consider early life adversity when assessing adult posttrauma experiences. These results also suggest that interventions aimed at improving sleep quality might improve PTSD symptoms in those who have experienced childhood maltreatment and a subsequent traumatic injury in adulthood. 

The current study highlights how early adversity in childhood, such as experiences of abuse and neglect, can be related to long-term recovery outcomes after a traumatic injury in adulthood. This, in part, can be explained by sleep disturbances that result from childhood experiences of maltreatment and impact later posttraumatic stress disorder symptom severity in adulthood. These findings emphasize the need for clinical interventions to assess for childhood maltreatment and sleep disturbances. This allows for a cumulative understanding of early life adversity and a target for intervention—sleep—to improve outcomes posttrauma in adulthood. 

What I liked about this study is its selection criterion of adults who had sustained a traumatic injury. It’s not a huge sample, but a big enough one. It makes perfect sense to me that sleep disturbances mediate the effects of childhood trauma on PTSD and I would love to see more research of this kind. I think the concluding statements make the impact of this work very clear.