Sleep as a mediator between childhood trauma and psychopathology in early adolescence: Evidence from the ABCD study

Although the association between childhood trauma and psychopathology is well established, the mechanisms underlying this link remain complex. Sleep is a multidimensional construct that has been implicated in the pathway; less is known about the period of early adolescence or which sleep facets matter.

Participants (N = 4108) were from the Adolescent Brain Cognitive Development (ABCD) cohort. Baseline childhood trauma load was assessed via caregiver report. Objective Fitbit sleep metrics were assessed two years later, including average duration, timing, social jetlag, wake after sleep onset (WASO), and duration and timing variability. Internalizing and externalizing symptoms were assessed via youth report at 3-year follow-up. Models adjusted for sociodemographic covariates and prior psychopathology at 2-year follow-up. Separate mediation models tested each sleep facet as a mediator.

Higher baseline trauma load predicted worse sleep health at 2-year follow-up across all sleep metrics. Shorter average sleep duration, greater social jetlag, and later average bedtimes at the 2-year follow-up predicted higher internalizing and externalizing symptoms at the 3-year follow-up, even after adjusting for prior psychopathology and covariates. Sleep duration and social jetlag mediated associations between trauma load and internalizing and externalizing symptoms. Average bedtime mediated the relationship with internalizing but not externalizing symptoms. All effects were small in magnitude. Average wake time, sleep variability, and WASO were not significant mediators.

Sleep partially but weakly mediates the longitudinal relationship between trauma and youth psychopathology. Findings highlight that multiple facets of sleep may contribute modestly to this relationship and be a potential target for intervention.