Does sleep link child maltreatment to depressive symptoms among incoming first-year college students?

Abstract

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. 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. 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). 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.