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The Role of Executive Function in Predicting Children’s Outcomes in a Cognitive Behavioral Treatment for Trauma-Related Nightmares and Secondary Sleep Disturbances

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Abstract

Predictors of children’s outcomes in trauma-focused interventions are well documented. However, little is known about the role of higher-order cognitive processes, specifically executive function (EF) abilities, in determining children’s responses to treatments specifically for trauma-related sleep disturbances. EF is independently related to PTSD reactions, sleep deficits, and nightmares. Furthermore, well-developed EF can be protective; thus, we sought to examine whether higher EF predicted better treatment outcomes for trauma-related sleep disturbances. Twenty-three children aged 5 to 17 presenting with post-traumatic nightmares (PTNs) participated in a cognitive behavioral therapy to address their trauma-related nightmares (CBT-NC). Pre- and post-treatment data were used in analyses. Findings from discriminant function analyses revealed that EF was not a statistically significant predictor of treatment outcomes across indices of nightmare frequency and distress, sleep quality, and PTSD symptomology. However, effect sizes suggested that EF was a moderate predictor of sleep quality outcomes, which has clinical implications. Treatment duration for sleep problems could be related to EF with briefer interventions being more suitable for children with high EF, whereas children with low EF may benefit from longer treatment protocols.

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Acknowledgements

Special thanks to The University of Tulsa Institute of Trauma Adversity and iNjustice (TITAN) and previous investigators (Dr. Shantel Fernandez-Lopez, Dr. Cameo Stanick, Dr. Joanne Davis, Dr. Lisa Cromer) for sharing data so this study could be possible.

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  1. Department of Psychology, The University of Tulsa, University of Tulsa Institute of Trauma, Adversity, & iNjustice (TITAN), 800 South Tucker Drive, Tulsa, OK, 74104, USA

    Mollie E. Rischard & Lisa D. Cromer

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  1. Mollie E. Rischard
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Correspondence to Mollie E. Rischard.

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Rischard, M.E., Cromer, L.D. The Role of Executive Function in Predicting Children’s Outcomes in a Cognitive Behavioral Treatment for Trauma-Related Nightmares and Secondary Sleep Disturbances. Journ Child Adol Trauma 12, 501–513 (2019). https://doi.org/10.1007/s40653-019-00252-6

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