Longitudinal trajectories of sleep quality in correlation with maltreatment in early childhood: A cohort of Chinese early adolescents

Authors：Cao L, Wang S, Li Y, Li Y, Yuan M, Chang J, Wang G, Su P.

Source：J Affect Disord. 2023 Aug 11:S0165-0327(23)01036-4.

DOI: 10.1016/j.jad.2023.08.057.

Abstract：

Background: Child maltreatment may lead to sleep disturbance during the critical period of child development. Our study examined the effect of maltreatment in early childhood on trajectories of sleep quality among early adolescents.

Methods: The study included 1611 participants (mean ± standard deviation age at baseline: 12.5 ± 0.5 years) from a middle school in southeastern China. Of these participants, 60.5 % were males. Information on early childhood maltreatment during pre-seventh grade was obtained through a self-report questionnaire at baseline, and sleep quality was collected at baseline and during follow-up. We used a group-based trajectory model to characterize trajectories of sleep quality.

Results: The study identified four trajectories of sleep quality, namely the low sleep score group (25.0 %), the moderate-low sleep score group (51.0 %), the moderate-increasing sleep score (17.0 %), and the high-decreasing sleep score (7.0 %) group. After adjusting for covariates, the findings revealed that emotional abuse and physical abuse were associated with an increased risk of developing new-onset sleep disturbances in early adolescents. Particularly, emotional abuse (incidence rate ratio = 1.71, 95 % confidence interval: 1.08-2.71) significantly increased the risk of belonging to the high-decreasing sleep score group. Moreover, there existed a dose-response relationship between early childhood maltreatment and sleep quality trajectories, with a higher number of maltreatment types in early childhood correlating with a greater risk of belonging to the high-decreasing sleep score group.

Conclusions: The findings of our study provide compelling evidence indicating that specific types and cumulative maltreatment during early childhood contribute to sleep disturbances among early adolescents. The study findings highlight the significance of preventing and reducing early childhood maltreatment to enhance sleep quality during early adolescence.

Keywords: Child maltreatment; Early adolescence; Longitudinal study; Sleep quality; Trajectory.

中文摘要：

背景：儿童虐待可能导致儿童发育关键期的睡眠障碍。我们的研究考察了儿童早期虐待对青少年早期睡眠质量轨迹的影响。

方法：本研究纳入中国东南部一所中学的1611名参与者(基线年龄平均±标准差:12.5±0.5岁)。在这些参与者中，60.5%是男性。在基线时通过自我报告问卷获得七年级前儿童早期虐待的信息，并在基线和随访期间收集睡眠质量。我们使用基于群体的轨迹模型来描述睡眠质量的轨迹。

结果：研究确定了四种睡眠质量轨迹，即低睡眠评分组(25.0%)、中低睡眠评分组(51.0%)、中高睡眠评分组(17.0%)和高睡眠评分组(7.0%)。在调整协变量后，研究结果显示，情绪虐待和身体虐待与青少年早期出现新发睡眠障碍的风险增加有关。特别是，情绪虐待(发生率比= 1.71,95%可信区间:1.08-2.71)显著增加了属于睡眠评分高下降组的风险。此外，儿童早期虐待与睡眠质量轨迹之间存在剂量-反应关系，儿童早期虐待类型数量越多，属于睡眠评分高下降组的风险越大。

结论：我们的研究结果提供了令人信服的证据，表明儿童早期特定类型和累积的虐待增加早期青少年的睡眠障碍。研究结果强调了预防和减少儿童早期虐待对提高青少年早期睡眠质量的重要性。

关键词：虐待儿童；早期的青春期；纵向研究;睡眠质量；轨迹。