Religiosity and the relationship between sexual trauma, alcohol use, and sleep quality: a moderated mediation model

Sexual trauma is a known risk factor for both sleep problems and alcohol use. Understanding the complex comorbidity of these three concerns, including potential factors that may mitigate or exacerbate their relationship, is important to improve clinical care. Religiosity may serve as a protective factor for trauma-related outcomes, alcohol use, and sleep quality but also may exacerbate the relationship between sexual trauma and alcohol use. The current study examined whether alcohol use mediates the relationship between sexual trauma and sleep problems and whether religiosity moderates this indirect effect.

Data from 158 participants (Mage = 43.8, SD = 12.0; 32.3% cisgender women, 67.7% cisgender men) were drawn from eligibility screening assessments from three studies on alcohol use and/or post-traumatic stress disorder. Data were analyzed using mediation and moderated mediation analyses.

Alcohol use did not mediate the relationship between sexual trauma and sleep quality (95% Boot CI [-0.07, 0.95]). However, when considering the role of religiosity, formal religious practices (but not God consciousness) moderated the indirect effect of sexual trauma on sleep quality through alcohol use (β = 0.89, 95% Boot CI [0.21, 1.92]). Specifically, the conditional indirect effect was significant for individuals with high levels of formal religious practices relative to individuals with low or average levels.

Sexual trauma was associated with poorer sleep quality due to heavier alcohol use when individuals had higher levels of formal religious practices. Findings have implications for assessment and treatment of comorbid trauma histories, alcohol use, and sleep problems.NCT02884908; NCT04210713.