Childhood adversity and insomnia in adolescence.
Childhood adversity and insomnia in adolescence.
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DOI：
10.1016/j.sleep.2016.01.011
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发表时间：
2016-05
期刊：
影响因子：
4.8
通讯作者：
Dunn EC
中科院分区：
文献类型：
--
作者：
Wang Y;Raffeld MR;Slopen N;Hale L;Dunn EC
评估暴露于童年逆境和失眠之间的关联，重点是逆境类型，时间和积累（即儿童报告暴露于特定类型逆境的数量）的作用。我们的分析样本包括来自全国科摩罗调查重复青少年补充（NCS-A）的9，582名青少年，这是一个具有全国代表性的基于人口的样本。我们研究了18种不同类型的回顾性报告的逆境（捕获人际暴力，事故和伤害，社交网络或目击事件，其他不良事件）与自我报告的过去一年失眠风险之间的关联。我们还研究了第一次接触逆境的年龄是否与失眠的风险有关，以及接触更多不同类型的逆境（即积累）是否会增加失眠的风险。此外，我们进行了敏感性分析，排除了过去一年诊断为重度抑郁症、心境恶劣、创伤后应激障碍或广泛性焦虑障碍的青少年。近三分之一的青少年报告失眠，女孩和少数种族/族裔群体的患病率较高。暴露于至少一种任何类型的童年逆境的青少年（59.41%）比未暴露的同龄人更有可能经历失眠（在逆境中，患病率从1.31到1.89不等）。失眠的风险根据第一次接触逆境的年龄以及逆境的类型而有所不同。与经历较少逆境的青少年相比，暴露于更多不同类型逆境的青少年患失眠症的风险更高。这些结果大体上与排除了过去四年中至少有一种精神疾病的青少年后获得的结果相似。暴露在逆境中会增加失眠的风险。这种关联因暴露的类型、时间和累积而异，似乎与精神疾病无关。鉴于失眠对身心健康的影响有充分的证据，这些发现进一步支持了从业人员对儿童暴露于童年逆境和失眠症状进行筛查的必要性。
To evaluate the association between exposure to childhood adversity and insomnia, with an emphasis on the role of adversity type, timing, and accumulation (i.e. the number of specific types of adversities the child reported being exposed to). Our analytic sample comprised 9,582 adolescents from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally-representative population-based sample. We examined the association between 18 different types of retrospectively-reported adversities (capturing interpersonal violence, accidents and injuries, social network or witnessing events, other adverse events) and risk of self-reported past-year insomnia. We also examined whether the age at first exposure to adversity was associated with risk for insomnia, and whether exposure to a greater number of different types of adversities (i.e. accumulation) conferred an elevated risk for insomnia. Additionally, we performed a sensitivity analysis excluding adolescents with a past-year diagnosis of major depression, dysthymia, post-traumatic stress disorder, or generalized anxiety disorder. Almost one third of adolescents reported insomnia, with a higher prevalence among girls and those from racial/ethnic minority groups. Adolescents exposed to at least one childhood adversity of any type (59.41%) were more likely than their non-exposed peers to experience insomnia (across adversities, prevalence ratios ranged from 1.31 to 1.89). Risk of insomnia differed based on the age at first exposure to adversity as well as the type of adversity. Adolescents exposed to a greater number of different types of adversities had a higher risk of insomnia compared to those experiencing fewer adversities. These results were similar, by and large, to those obtained after excluding adolescents with at least one of the four past-year psychiatric disorders. Exposure to adversity confers an elevated risk for insomnia. This association varied by type, timing, and accumulation of exposure and did not appear to be driven by psychiatric disorders. Given the well-documented physical and mental health consequences of insomnia, such findings add further support to the need for practitioners to screen children for exposure to childhood adversity and insomnia symptoms.