Relationship between Early Abuse, Posttraumatic Stress Disorder, and Activity Levels in Prepubertal Children

Abstract

To examine the relationship between early physical and sexual abuse, posttraumatic stress disorder (PTSD), major depression, and activity levels in prepubertal children. Nineteen unmedicated children with documented abuse (9.4 +/- 2.3 years; 6 girls, 13 boys) were compared with 15 healthy controls (8.3 +/- 1.9 years; 6 girls, 9 boys). Diagnoses were derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version). Motionlogger actigraphs collected activity data for 72 continuous hours in 1-minute epochs. Overall, abused children were 10% more active than normal children (p < .05) and displayed a paucity of periods of low-level daytime activity (p < .01). Abused children with PTSD were largely responsible for the increase in activity. Abused children with PTSD had a robust and normal circadian activity rhythm. Abused children in whom PTSD failed to develop had an attenuated circadian amplitude compared with subjects with PTSD (101% versus 93%, p < .01) and were phase-delayed by 61 minutes versus controls (p = .01). Early onset of abuse was significantly associated with greater likelihood of the development of PTSD and hyperactivity. Later age of abuse was associated with circadian dysregulation. These preliminary observations indicate that abused children with PTSD have activity profiles similar to those of children with attention-deficit hyperactivity disorder, while abused children without PTSD have activity profiles more similar to those of depressed children.