Adverse childhood experiences and sleep difficulties among young adult college students

Childhood maltreatment predicts poor sleep quality in Chinese adults: The influence of coping style tendencies

BACKGROUND

This longitudinal study assessed the prospective link between childhood maltreatment and sleep quality in adulthood, with a specific focus on examining whether different coping style tendencies influence these associations.

METHODS

The baseline sample included 1600 adult participants, with 1140 participants successfully followed up 5 years later. The key variables were measured using the Childhood Trauma Questionnaire (CTQ), Simplified Coping Style Questionnaire (SCSQ), and Pittsburgh Sleep Quality Index (PSQI). Generalized linear mixed models were employed to estimate unstandardized β estimates and 95 % confidence intervals (95%CIs). Structural equation modeling was used to test the mediation model.

RESULTS

Individuals reported childhood maltreatment at baseline were at an increased risk for sleep disturbances at follow-up. Childhood maltreatment negatively predicted the baseline coping style tendency (β = -0.29, P < 0.001), the baseline coping style tendencies negatively predicted the follow-up sleep quality (β = -0.10, P < 0.001), and childhood maltreatment positively predicted the follow-up sleep quality (β = 0.42, P < 0.01). The mediating effect of baseline coping style tendencies between childhood maltreatment and the follow-up sleep quality was significant, with an effect value of 0.03.

LIMITATIONS

First, the sample was from a single province (Shandong), which limits the generalizability of the findings. Second, recall bias was unavoidable in this adult sample study.

CONCLUSIONS

Developing positive coping strategies is an important way to reduce the risk of sleep problems in adults with a history of childhood maltreatment.

Adverse childhood experiences as precursors to cannabis use in adulthood: A systematic review

BACKGROUND

Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use.

OBJECTIVE

The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood.

METHODS

Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase.

RESULTS

Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs-childhood sexual abuse in particular-was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use.

CONCLUSIONS

This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.

Allostasis, health, and development in Latin America

The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nested in environmental and social stressors, such as exposure to pollution, violence, and nutritional deficiencies, which critically influence current and later-life health outcomes. We review several manifestations across cognition, behavior, and the body, observed at the psychological (e.g., cognitive, socioemotional, and behavioral dysfunctions), brain (e.g., alteration of the development, structure, and function of the brain), and physiological levels (e.g., dysregulation of the body systems and damage to organs). To address the complexity of the interactions between environmental and health-related factors, we present an allostatic framework regarding the cumulative burden of environmental stressors on physiological systems (e.g., cardiovascular, metabolic, immune, and neuroendocrine) related to health across the life course. Lastly, we explore the relevance of this allostatic integrative approach in informing regional interventions and public policy recommendations. We also propose a research agenda, potentially providing detailed profiling and personalized care by assessing the social and environmental conditions. This framework could facilitate the delivery of evidence-based interventions and informed childhood-centered policy-making.

Racial/ethnic disparities in the trajectories of insomnia symptoms from childhood to young adulthood

STUDY OBJECTIVES

To examine differences in the longitudinal prevalence of childhood insomnia symptoms across black/African American, Hispanic/Latinx, and non-Hispanic white groups.

METHODS

Participants were 519 children from the Penn State Child Cohort (baseline [V1] from 2000-2005) who were followed up 8 years later as adolescents (V2) and 15 years later as young adults (S3). Mean age at S3 was 24.1 ± 2.7 years. Approximately, 76.5% identified as non-Hispanic white, 12.9% as black/African American, 7.1% as Hispanic/Latinx, and 3.5% as "other" race/ethnicity. Insomnia symptoms were defined as parent-reported (childhood) or self-reported (adolescence and young adulthood) moderate-to-severe difficulties initiating/maintaining sleep. Longitudinal trajectories of insomnia symptoms were identified across three-time points and the odds of each trajectory were compared between racial/ethnic groups, adjusting for sex, age, overweight, sleep apnea, periodic limb movements, psychiatric/behavioral disorders, and psychotropic medication use.

RESULTS

Black/African Americans compared to non-Hispanic whites were at significantly higher odds of having a childhood-onset persistent trajectory through young adulthood (OR = 2.58, 95% CI [1.29, 5.14]), while Hispanics/Latinx were at nonsignificantly higher odds to have the same trajectory (OR = 1.81, 95% CI [0.77, 4.25]). No significant racial/ethnic differences were observed for remitted and waxing-and-waning trajectories since childhood or incident/new-onset trajectories in young adulthood.

CONCLUSIONS

The results indicate that disparities in insomnia symptoms among black/African American and, to a lesser extent, Hispanic/Latinx groups start early in childhood and persist into young adulthood. Identifying and intervening upon upstream determinants of racial/ethnic insomnia disparities are warranted to directly address these disparities and to prevent their adverse health sequelae.

CLINICAL TRIAL INFORMATION

N/A; Not a clinical trial.

Adverse childhood experiences among doctor of pharmacy students

OBJECTIVE

Adverse Childhood Experiences (ACEs) have demonstrated negative impact on physical, emotional, and cognitive health outcomes. This study aimed to assess prevalence of ACEs among Doctor of Pharmacy (PharmD) students, and their associations with mental health, substance use, academic performance, and sleep patterns.

METHODS

A cross-sectional survey was conducted on PharmD students at a private University. ACE scores, mental health history, substance use, academic performance, and sleep habits were self-reported. Descriptive statistics and chi-square tests were used for analysis.

RESULTS

From 54 participants across all cohorts of students in the curriculum (response rate: 19%), 48% reported ≥4 ACEs. A majority of students reported having been diagnosed with or sought treatment for depression (56%) or anxiety (67%), while 42.9% reported a history of contemplating suicide. Participants with ACE scores of ≥4 were more likely to have sought treatment for depression, any mental health condition, contemplated suicide, or used alcohol for mental health purposes. No differences in academic performance based on ACE scores were found.

CONCLUSION

High numbers of ACEs were common and linked to mental illness, suicidality, and use of alcohol for mental health purposes. While no direct academic impact was found in this small sample size, adopting a trauma-informed approach is crucial to supporting student well-being. Further research in this area is needed to optimize interventions to support academic and professional success among students with ≥4 ACEs.

Recent Stressful Life Events and Perceived Stress as Serial Mediators of the Association between Adverse Childhood Events and Insomnia

Insomnia is common in college students and linked to poorer mental and physical health. There is growing evidence that adverse childhood experiences (ACEs) may contribute to insomnia in adulthood. However, beyond the need for additional replication of these findings, there is a need to identify underlying mechanisms that plausibly connect the two experiences. Based on a serial mediation model, the current study examined the role of two theoretically informed mediators: recent stressful life events and perceived stress. A cross-sectional survey of 2,218 college students at a large university in the southwestern United States was conducted between August 2020 and December 2021. The sample was predominantly Hispanic (96%) and female (73%), with a mean age of 20.7 years. Standardized measures of adverse childhood experiences, recent stressful life events, perceived stress, and insomnia were administered to participants online. Almost 20% of participants reported having experienced four or more adverse childhood experiences and 63% met the threshold for insomnia. Reporting four or more ACEs was associated with significantly greater insomnia severity, and this relationship was serially mediated by both recent stressful life events and perceived stress. However, recent stressful life events appeared to be the most powerful mediator. The results of the current study indicate that recent exposure to stressful life events serves as a plausible mechanism linking early adversity during childhood to adult insomnia and could therefore serve as a potential target for intervention. The findings suggest that students would benefit from university-wide efforts to reduce the number and/or intensity of common stressors.

Sleep and mental health among youth experiencing homelessness: A retrospective pilot diary study

OBJECTIVES

The goal of this study was to describe the nightly sleep conditions of youth experiencing homelessness, and examine the association between sleep and mental health, both cross-sectionally and using diary data.

METHODS

n = 147 youth (ages 16-24) experiencing homelessness completed a baseline survey assessing self-reported sleep and depressive and anxious symptoms. A subsample of n = 49 completed a follow-up 7-day diary study measuring nightly sleep conditions and daily depressive and somatic symptoms.

RESULTS

According to baseline data, the majority of the sample (71%) reported sleeping less than 7 hours per night on average, and feeling like they did not get adequate sleep, especially among youth identifying as LGBTQ. In a qualitative follow-up question, the plurality attributed poor sleep to mental health woes. Cross-sectionally, youth with lower levels of self-reported sleep quality (more daytime fatigue and insomnia) reported higher levels of depressive and anxious symptoms. The diary data indicated that the most common nightly complaints among shelter utilizers are lack of privacy, noise, and uncomfortable temperatures. Multilevel models suggest that poor sleep conditions predicted higher levels of somatic symptoms the following day, after controlling for baseline levels of depressive and anxious symptoms.

CONCLUSIONS

This study highlights the role environmental context plays in sleep health and its subsequent impacts. Individuals experiencing homelessness lack autonomy over their sleeping environments, and thus cannot make adjustments such as reducing disruptions such as noise, temperature, and light. Importantly, these less-than-ideal sleeping conditions contribute to pre-existing health disparities and may have long-term implications.

Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

BACKGROUND

Adverse childhood experiences (ACE) have been documented to have long-term impacts on sleep disturbances. However, less is known about how ACE co-occurs with positive childhood experiences (PCE) and modulate their effects on adult sleep disturbances, particularly in the context of persistent insomnia. Building on resilience theory, this study aims to examine the interplay between ACE and PCE and their effects on persistent insomnia during emerging adulthood.

METHODS

A total of 2,841 emerging adults were recruited from the Taiwan Youth Project. Persistent insomnia during emerging adulthood was assessed using two adult surveys (mean age = 19.8 and 21.9). The ACE (10 items) and PCE (7 items) were obtained from the baseline survey (mean age = 13.8). A series of logistic regression analyses were conducted.

RESULTS

Among the emerging adults, 29.22% had persistent insomnia. Consistent with the compensatory model, ACE and PCE exerted opposing effects on persistent insomnia during emerging adulthood. In line with the protective model, the negative effect of ACE is mitigated when individuals have high PCE. However, consistent with the challenge model, the protective effect of PCE on persistent insomnia was inhibited in individuals with four or more ACE.

CONCLUSIONS

PCE serves as a protective factor, shielding emerging adults from the adverse effects of ACE on persistent insomnia. It is essential to prioritize positive experiences during early life to promote lifelong sleep health.

Adverse childhood experiences and sleep links in a predominantly Black sample of overweight adults

Adverse childhood experiences (ACEs) have been associated with worse sleep, but existing literature is limited by use of predominantly White samples, lack of objective sleep measurement, and use of non-standardized questionnaires. We investigated associations between retrospectively reported ACEs and sleep in adulthood in a sample of 43 adults 20-53 years of age, free from chronic conditions, with a Body mass index (BMI) ≥ 25 (Mean age = 33.14 [SD = 10.05], 74% female, 54% Black). Sleep efficiency (SE), total sleep time (TST), wake after sleep onset (WASO), and sleep onset latency (SOL), were measured by actigraphy and daily diary. Global sleep quality and insomnia severity were measured by questionnaires. Sleepiness, fatigue, and sleep quality were also measured by daily diary. Adjusting for demographic characteristics and BMI, ACEs were significantly associated with poorer global sleep quality and diary measures of greater daytime sleepiness, fatigue, and poorer sleep quality. There were no significant associations between ACEs and SE, TST, WASO, or SOL measured by diary or actigraphy. Findings suggest that ACEs are associated with worse sleep perception and daytime functioning in adulthood. Larger prospective studies are needed to replicate these findings, examine racial/ethnic differences, and determine temporal associations between ACEs, sleep, and health (e.g., BMI).