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Presence of Sleep Disturbances Among Child Trauma Survivors: Comparison of Caregiver and Child Reports

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Abstract

A significant body of research has been devoted to demonstrating high rates of sleep impairment, and the subsequent adverse implications of sleep difficulties, among adult trauma survivors, particularly those diagnosed with posttraumatic stress disorder (PTSD). Yet considerably less work has been focused on sleep disturbances among trauma-exposed children, especially preschoolers. Pediatric research is paramount in light of the numerous developmental and functional implications that may result from sleep impairment. Prior studies have also documented disagreement between caregiver’s and children’s reports of trauma-related symptoms; however, the level of concordance rates regarding sleep difficulties is unknown in this population. The present study investigated the rates of multiple types of sleep disturbances using caregiver’s and children’s reports as well as caregiver-child concordance rates regarding these difficulties. Three hundred and forty-two treatment-seeking children ages of 3–18 years (M = 9.68, SD = 4.00; 61.1% female, 60.4% Black) and their caregivers were included in the study. Sleep disturbances were common in this sample, and children endorsed higher levels of sleep symptoms (range 46–72%) than their caregivers (range 14–51%). Nearly half (47%) of preschool children evinced significant sleep impairment per their caregiver. Inter-rater agreement between caregiver’s and children’s reports for all sleep symptoms were below acceptable levels (range κ = 0.01-.13), indicating that the concordance rate for caregiver-child trauma-related sleep problems is quite low. Findings illustrate the relevance of sleep disturbances among trauma-exposed children and point to the need to assess both caregiver’s and children’s symptoms regarding sleep impairment.

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References

  • Achenbach, T. M., & Rescorla, L. A. (2000). ASEBA preschool forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth and Families.

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington: University of Vermont, Research Center for Children, Youth, and Families.

  • Alisic, E., Zalta, A. K., van Wesel, F., Larsen, S. E., Hafsrad, G. S., Hassanpour, K., & Smid, G. E. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis. The British Journal of Psychiatry, 204, 335–340.

    Article  Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (DSM-III). Washington, DC: Author.

  • Arnberg, F. K., Rydelius, P. A., & Lundin, T. (2011). A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident. Child and Adolescent Psychiatry and Mental Health, 5, 3–8. https://doi.org/10.1186/1753-2000-5-8.

    Article  Google Scholar 

  • Babson, K. A., & Feldner, M. T. (2010). Temporal relations between sleep problems and both traumatic event exposure and PTSD: A critical review of the empirical literature. Journal of Anxiety Disorders, 24(1), 1–15. https://doi.org/10.1016/j.janxdis.2009.08.002.

    Article  PubMed  PubMed Central  Google Scholar 

  • Briere, J. (1996). Trauma Symptom Checklist for Children (TSCC). Psychological Assessment Resources, Odessa.

    Google Scholar 

  • Briere, J. (2005). Trauma Symptom Checklist for Young Children (TSCYC). Psychological Assessment Resources, Odessa.

    Google Scholar 

  • Briere, J., Johnson, K., Bissada, A., Damon, L., Crouch, J., Gil, E., Hanson, R., & Ernst, V. (2001). The trauma symptom checklist for young children (TSCYC): reliability and association with abuse exposure in a multi-site study. Child Abuse & Neglect, 25, 1001–1014. https://doi.org/10.1016/S0145-2134(01)00253-8.

    Article  Google Scholar 

  • Brown, D. W., Anda, R. F., Tiemeier, H., Felitti, V. J., Edwards, V. J., Croft, J. B., & Giles, W. H. (2009). Adverse childhood experiences and the risk of premature mortality. American journal of Preventive Medicine, 37(5), 389–396. https://doi.org/10.1016/j.amepre.2009.06.021.

    Article  PubMed  Google Scholar 

  • Bryant, R. A., Creamer, M., O’Donnell, M., Silove, D., & McFarlane, A. C. (2010). Sleep disturbance immediately prior to trauma predicts subsequent psychiatric disorder. Sleep, 33(1), 69–74.

    Article  Google Scholar 

  • Carrion, V. G., Weems, C. F., Ray, R., & Reiss, A. L. (2002). Toward an empirical definition of pediatric PTSD: the phenomenology of PTSD symptoms in youth. Journal of the American Academy of Child & Adolescent Psychiatry, 41(2), 166–173.

    Article  Google Scholar 

  • Ceballo, R., Dahl, T. A., Aretakis, M. T., & Ramirez, C. (2001). Inner-city children’s exposure to community violence: how much do parents know? Journal of Marriage and Family, 63(4), 927–940.

    Article  Google Scholar 

  • Charuvastra, A., & Cloitre, M. (2009). Safe enough to sleep: Sleep disruptions associated with trauma, posttraumatic stress, and anxiety in children and adolescents. Child Adolescent Psychiatric Clinics of North America 18, 877 – 91.

    Article  Google Scholar 

  • Chemtob, C. M., Nomura, Y., & Abramovitz, R. A. (2008). Impact of conjoined exposure to the world trade center attacks and to other traumatic events on the behavioral problems of preschool children. Archives of Pediatrics & Adolescent Medicine, 162(2), 126–133. https://doi.org/10.1001/archpediatrics.2007.36.

    Article  Google Scholar 

  • Chimienti, G., Nasr, J. A., & Khalifeh, I. (1989). Children’s reactions to war-related stress. Affective symptoms and behaviour problems. Social Psychiatry &Psychiatric Epidemiology, 24, 282–287.

    Article  Google Scholar 

  • Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Academy of Child & Adolescent Psychiatry, 34(5), 541–565. https://doi.org/10.1097/00004583-199505000-00008.

    Article  Google Scholar 

  • Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York: Guilford Press.

    Google Scholar 

  • Colvonen, P. J., Masino, T., Drummond, S. P. A., Myers, U. S., Angkaw, A. C., & Norman, S. B. (2015). Obstructive sleep apnea and posttraumatic stress disorder among OIF/OEF/OND veterans. Journal of Clinical Sleep Medicine, 11, 513–518. https://doi.org/10.5664/jcsm.4692.

    Article  PubMed  PubMed Central  Google Scholar 

  • Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64(5), 577–584. https://doi.org/10.1001/archpsyc.64.5.577.

    Article  PubMed  Google Scholar 

  • De Bellis, M. D. (2001). Developmental traumatology: The psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 13(03), 539–564.

    Article  Google Scholar 

  • De Bellis, M. D., Woolley, D. P., & Hooper, S. R. (2013). Neuropsychological findings in pediatric maltreatment: relationship of PTSD, dissociative symptoms, and abuse/neglect indices to neurocognitive outcomes. Child Maltreatment, 18(3), 171–183. https://doi.org/10.1177/1077559513497420.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dollinger, S. J. (1986). The measurement of children’s sleep disturbances and somatic complaints following a disaster. Child Psychiatry & Human Development, 16(3), 148–153.

    Article  Google Scholar 

  • Finkelhor, D., Turner, H., Ormond, R., & Hamby, S. L. (2009). Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics, 124, 1411–1423. https://doi.org/10.1542/peds.2009-0467.

    Article  Google Scholar 

  • Galovski, T. E., Monson, C., Bruce, S. E., & Resick, P. A. (2009). Does cognitive–behavioral therapy for PTSD improve perceived health and sleep impairment? Journal of Traumatic Stress, 22, 197–204. https://doi.org/10.1002/jts.20418.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gehrman, P., Seelig, A. D., Jacobson, I. G., Boyko, E. J., Hooper, T. I., Gackstetter, G. D., … & Smith, T. C. (2012). Predeployment sleep duration and insomnia symptoms as risk factors for new-onset mental health disorders following military deployment. Sleep, 36(7), 1009–1018. https://doi.org/10.5665/sleep.2798.

    Article  Google Scholar 

  • Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National survey of adolescents. Journal of Consulting Clinical Psychology, 71, 692–700.

    Article  Google Scholar 

  • Koffel, E., Polusny, M. A., Arbisi, P. A., & Erbes, C. R. (2013). Pre-deployment daytime and nighttime sleep complaints as predictors of post-deployment PTSD and depression in national guard troops. Journal of Anxiety Disorders, 27(5), 512–519. https://doi.org/10.1016/j.janxdis.2013.07.003.

    Article  PubMed  Google Scholar 

  • Koren, D., Arnon, I., Lavie, P., & Klein, E. (2002). Sleep complaints as early predictors of posttraumatic stress disorder: a 1-year prospective study of injured survivors of motor vehicle accidents. American Journal of Psychiatry, 159(5), 855–857.

    Article  Google Scholar 

  • Kovachy, B., O’Hara, R., Hawkins, N., Gershon, A., Primeau, M. M., Madej, J., & Carrion, V. (2013). Sleep disturbance in pediatric PTSD: current findings and future directions. Journal of Clinical Sleep Medicine, 9, 501–510. https://doi.org/10.5664/jcsm.2678.

    Article  PubMed  PubMed Central  Google Scholar 

  • Krakow, B., Haynes, P. L., Warner, T. D., Melendrez, D., Sisley, B. N., Johnston, L., Hollifield, M., & Lee, S. (2007). Clinical sleep disorder profiles in a large sample of trauma survivors: an interdisciplinary view of posttraumatic sleep disturbance. Sleep and Hypnosis, 9, 6–15.

    Google Scholar 

  • Mellman, T. A., Bustamante, V., Fins, A. I., Pigeon, W. R., & Nolan, B. (2002). REM sleep and the early development of posttraumatic stress disorder. American Journal of Psychiatry, 159(10), 1696. https://doi.org/10.1176/appi.ajp.159.10.1696.

    Article  PubMed  Google Scholar 

  • Mellman, T. A., & Hipolito, M. M. S. (2006). Sleep disturbances in the aftermath of trauma and posttraumatic stress disorder. CNS Spectrums, 11(08), 611–615.

    Article  Google Scholar 

  • Mellman, T. A., Pigeon, W. R., Nowell, P. D., & Nolan, B. (2007). Relationships between REM sleep findings and PTSD symptoms during the early aftermath of trauma. Journal of Traumatic Stress, 20(5), 893–901. https://doi.org/10.1002/jts.20246.

    Article  PubMed  Google Scholar 

  • Noll, J. G., Trickett, P. K., Susman, E. J., & Putnam, F. W. (2006). Sleep disturbances and childhood sexual abuse. Journal of Pediatric Psychology, 31, 469–480. https://doi.org/10.1093/jpepsy/jsj040.

    Article  PubMed  Google Scholar 

  • Norman, S. B., Stein, M. B., & Davidson, J. R. (2007). Profiling posttraumatic functional impairment. Journal of Nervous and Mental Disease, 195(1), 48–53. https://doi.org/10.1097/01.nmd.0000252135.25114.02.

    Article  PubMed  Google Scholar 

  • Ohayon, M. M., & Shapiro, C. M. (2000). Sleep disturbances and psychiatric disorders associated with posttraumatic stress disorder in the general population. Comprehensive Psychiatry, 41, 469–478. https://doi.org/10.1053/comp.2000.16568.

    Article  PubMed  Google Scholar 

  • Oransky, M., Hahn, H., & Stover, C. S. (2013). Caregiver and youth agreement regarding youths’ trauma histories: implications for youths’ functioning after exposure to trauma. Journal of Youth and Adolescence, 42(10), 1528–1542. https://doi.org/10.1007/s10964-013-9947-z.

    Article  PubMed  Google Scholar 

  • Pynoos, R., Rodriguez, N., Steinberg, A., Stuber, M., & Frederick, C. (1998). UCLA PTSD Index for DSM-IV. UCLA Trauma Psychiatry Program, Los Angeles

    Google Scholar 

  • Roberts, R. E., Roberts, C. R., & Duong, H. T. (2009). Sleepless in adolescence: prospective data on sleep deprivation, health and functioning. Journal of Adolescence, 32, 1045–1057. https://doi.org/10.1016/j.adolescence.2009.03.007.

    Article  PubMed  PubMed Central  Google Scholar 

  • Scheeringa, M. S. (2011). PTSD in children younger than the age of 13: Toward developmentally sensitive assessment and management. Journal of Child & Adolescent Trauma, 4(3), 181–197. https://doi.org/10.1080/19361521.2011.597079.

    Article  Google Scholar 

  • Scheeringa, M. S., Zeanah, C. H., & Cohen, J. A. (2011). PTSD in children and adolescents: toward an empirically based algorithm. Depression and Anxiety, 28(9), 770–782. https://doi.org/10.1002/da.20736.

    Article  PubMed  Google Scholar 

  • Scheeringa, M. S., Zeanah, C. H., Myers, L., & Putnam, F. W. (2003). New findings on alternative criteria for PTSD in preschool children. Journal of the American Academy of Child & Adolescent Psychiatry, 42(5), 561–570. https://doi.org/10.1097/01.CHI.0000046822.95464.14.

    Article  Google Scholar 

  • Schreier, H., Ladakakos, C., Morabito, D., Chapman, L., & Knudson, M. M. (2005). Posttraumatic stress symptoms in children after mild to moderate pediatric trauma: a longitudinal examination of symptom prevalence, correlates, and parent-child symptom reporting. Journal of Trauma and Acute Care Surgery, 58(2), 353–363.

    Article  Google Scholar 

  • Sharafkhaneh, A., Giray, N., Richardson, P., Young, T., & Hirshkowitz, M. (2005). Association of psychiatric disorders and sleep apnea in a large cohort. Sleep, 28, 1405–1411.

    Article  Google Scholar 

  • Spoormaker, V. I., & Montgomery, P. (2008). Disturbed sleep in post-traumatic stress disorder: Secondary symptom or core feature? Sleep Medicine Review, 12, 169–184. https://doi.org/10.1016/j.smrv.2007.08.008.

    Article  Google Scholar 

  • Stover, C. S., Hahn, H., Im, J. J., & Berkowitz, S. (2010). Agreement of parent and child reports of trauma exposure and symptoms in the early aftermath of a traumatic event. Psychological Trauma: Theory, Research, Practice, and Policy, 2(3), 159–168. https://doi.org/10.1037/a0019156.

    Article  Google Scholar 

  • Wittmann, L., Zehnder, D., Schredl, M., Jenni, O. G., & Landolt, M. A. (2010). Posttraumatic nightmares and psychopathology in children after road traffic accidents. Journal of Traumatic Stress, 23(2), 232–239. https://doi.org/10.1002/jts.20514.

    Article  PubMed  Google Scholar 

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  1. Psychological Sciences, University of Missouri- St. Louis, St. Louis, MO, 63121, USA

    Rachel Wamser-Nanney & Rebecca E. Chesher

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  1. Rachel Wamser-Nanney
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Correspondence to Rebecca E. Chesher.

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Wamser-Nanney, R., Chesher, R.E. Presence of Sleep Disturbances Among Child Trauma Survivors: Comparison of Caregiver and Child Reports. Journ Child Adol Trauma 11, 391–399 (2018). https://doi.org/10.1007/s40653-017-0198-0

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