Insomnia symptom trajectories among adult survivors of childhood sexual abuse: A longitudinal study |
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| Institution: | 1. UC Berkeley, Department of Psychology, 2121 Berkeley Way, Berkeley, CA, 94704, USA;2. Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015, Bergen, Norway;3. Department of Health Promotion, Division for Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway;4. Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway;5. Clinical Neuroscience Division, VA National Center for PTSD, 950 Campbell Avenue, West Haven, CT, 06516, USA;6. Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, 06511, USA;7. Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015, Bergen, Norway;8. NORCE AS - Regional Centre for Child and Youth Mental Health and Child Welfare, Postbox 7810, 5020, Bergen, Norway;9. Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009, Bergen, Norway;10. Institute of Basic Medical Sciences, University of Oslo, PO Box 1110, Blindern, 0317, Oslo, Norway;11. Department of Global Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway;12. Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021, Bergen, Norway |
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| Abstract: | BackgroundChildhood sexual abuse (CSA) is associated with sleep disturbances in adulthood. However, longitudinal studies have yet to identify among CSA-survivors subgroups distinguished by the trajectory of their insomnia severity, or predictors of subgroup membership.ObjectiveThe objective of this study was to examine longitudinal insomnia symptom trajectories, as well as predictors and correlates of the identified trajectories, over a 4 year study period in a sample of adult, mainly female CSA-survivors.Participants and settingThe sample comprised 533 adult survivors of CSA (94.9% women, mean age 39.2 years, mean age of abuse onset 6.5 years), recruited from support centers for sexual abuse survivors in Norway.MethodsLatent class growth analyses were used to identify insomnia symptom trajectories.ResultsThree distinct trajectories of insomnia symptoms were identified; one characterized by high insomnia symptom scores minimally decreasing over the study period (‘high and decreasing’, 30.6%), one characterized by stable intermediate insomnia symptom scores (‘intermediate and stable’, 41.5%), and one characterized by stable low insomnia symptom scores (‘low and stable’, 27.9%). Predictors of belonging to the high and decreasing trajectory (using the low and stable trajectory as a reference), was lower age of abuse onset (expotentiated coefficient (EC): 0.93, p = 0.026), abuse involving penetration (EC: 2.36, p = 0.005), threats (EC: 3.06, p < 0.001) or physical violence (EC: 3.29 p < 0.001), a higher score on a composite variable comprising multiple other abuse and perpetrator aspects (EC: 2.55, p < 0.001), as well as scoring above a clinical cut-off on a measure of posttraumatic stress symptoms (EC: 12.17, p < 0.001). Those belonging to the high and decreasing trajectory also reported lower levels of perceived social support and higher levels of subjectively experienced relational difficulties compared to those belonging to the two other trajectories.ConclusionsWe conclude that different longitudinal insomnia trajectories exist among adult CSA survivors. The overall results, as well as the significant predictors, are discussed alongside their potential clinical implications. |
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| Keywords: | Childhood sexual abuse Adult survivors of childhood sexual abuse Insomnia symptom trajectories Sleep disturbances Longitudinal symptom outcomes |
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