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Does sleep link child maltreatment to depressive symptoms among incoming first-year college students?
Darlynn M Rojo-Wissar1,2,3, Stephanie H Parade1,2, David H Barker1,3
1Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Insights
Child maltreatment (CM) is linked to increased depressive symptoms in college students, with poor sleep quality partially explaining this association. Interventions targeting sleep may improve mental health outcomes for students with a history of CM.
Area of Science:
- Psychology
- Public Health
- Sleep Science
Background:
- Child maltreatment (CM) is a significant risk factor for mental health issues.
- Emerging adults experience major life transitions, such as starting college, which can exacerbate mental health challenges.
- Sleep disturbances are common among college students and are linked to various adverse outcomes.
Purpose of the Study:
- To investigate the mediating role of sleep (quality, regularity, duration) in the association between child maltreatment and depressive symptoms among college students.
- To examine how sleep patterns influence the relationship between past trauma and current mental health during a critical developmental period.
Main Methods:
- A cohort of 1400 college students completed daily sleep diaries for 9 weeks.
- Participants also completed validated questionnaires assessing childhood trauma, sleep quality, and depressive symptoms.
- Nonparametric structural equation modeling with bootstrapping was used to analyze the data, controlling for demographic factors and baseline depression.
Main Results:
- The prevalence of moderate-to-severe child maltreatment was 22%.
- Worse sleep quality and lower sleep regularity partially mediated the association between child maltreatment and increased depressive symptoms.
- After adjusting for baseline depression, only the indirect effect of sleep quality remained significant.
Conclusions:
- Poorer sleep quality may partially explain why students with a history of child maltreatment experience more depressive symptoms during their first semester of college.
- Integrating sleep-focused interventions into college health programs could mitigate negative mental health, academic, and socioeconomic outcomes for at-risk students.
Study Objectives:
We examined whether sleep (i.e. quality, regularity, and duration) mediated associations between child maltreatment (CM) and depressive symptoms among emerging adults undergoing the major life transition of starting college.
Methods:
Students (N = 1400; 44% male; 48% non-Hispanic white, 20% non-Hispanic Asian, 15% Hispanic all races, 7% non-Hispanic black, and 10% non-Hispanic other races) completed daily sleep diaries for 9 weeks, followed by the Childhood Trauma Questionnaire-Short Form, Pittsburgh Sleep Quality Index, and the Center for Epidemiologic Studies Depression Scale (CES-D). DSD data were used to compute participants' Sleep Regularity Index and average 24-hour total sleep time. We used a nonparametric structural equation modeling bootstrap approach and full information maximum likelihood to account for missing data. In model 1, we controlled for sex and race and ethnicity. In model 2, we further adjusted for baseline CES-D scores.
Results:
The prevalence of self-reported moderate-to-severe CM was 22%. Small but significant indirect effects of CM on greater depressive symptoms through worse sleep quality (β = 0.06, 95% CI = 0.04, 0.09) and lower sleep regularity (β = 0.02, 95% CI = 0.005, 0.03) were observed in model 1. In model 2, only the indirect effect of sleep quality remained significant (β = 0.03, 95% CI = 0.01, 0.06).
Conclusions:
Poorer sleep quality may partially account for associations between CM and depressive symptoms during the first semester of college. Including sleep as a target in student health interventions on college campuses may not only help buffer against poor mental health outcomes for students with CM, but also poor academic and socioeconomic outcomes long-term.
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