Childhood adversity may increase veterans’ risk for disturbed sleep, suicide

Childhood adversity appeared associated with increased risk for disturbed sleep and suicide among United States veterans, according to study results published in Journal of Psychiatric Research.

“Limited data from veterans are available on how stressors during childhood impair individuals’ long-term sleep quality and impact depression risk and severity,” Sharon Alter, of the James J. Peters VA Medical Center in New York, and colleagues wrote. “This motivated the present investigation to examine the relationship between childhood trauma, depression and associated behavioral traits including hostility and impulsivity, and their effect on sleep quality and suicide in veterans.”

The investigators recruited veterans across three groups, which included major depressive disorder with/without a history of a suicide attempt (n = 35 and n = 37, respectively), as well as 33 non-psychiatric controls with no history of mental illness or suicidal behavior. Participants provided data via validated self-report assessments with in-depth phenotyping for relevant risk factors linked to suicidal behavior, such as childhood adversity, depression severity, impulsivity, hostility and sleep quality. The researchers used path analysis to include these factors in mediation models.

Results showed higher levels of childhood trauma were linked to an indirect effect on poor sleep quality (P = .001) among all participants. Alter and colleagues noted the orthogonal nature of this effect, such that it was independently mediated by MDD psychopathology (P = .003), as well as higher traits of impulsivity (P = .001) and hostility (P = .015). Childhood trauma appeared directly associated with increased risk for suicide among veterans, irrespective of depression severity or degree of hostility and impulsivity.

“Supported by data presented in this study, this unified model underscores the complexity of the confluence of risk factors of sleep disturbances and suicidal behavior, providing evidence for the association between childhood adversity, psychopathology, impulsivity and hostility on one hand, and sleep disturbances and suicidal behavior on the other,” Alter and colleagues wrote.