Lind Mackenzie J, Baylor Allison, Overstreet Cassie M, Hawn Sage E, Rybarczyk Bruce D, Kendler Kenneth S, Dick Danielle M, Amstadter Ananda B
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, PO Box 980126, Richmond, VA, 23298-0126, USA.
Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, PO Box 842018, Richmond, VA, 23284-2018, USA.
Sleep Med. 2017 Jun;34:141-147. doi: 10.1016/j.sleep.2017.02.024. Epub 2017 Mar 18.
Traumatic events, particularly those that are interpersonal in nature, are associated with increased risk for co-occurring sequelae, including sleep disturbances, posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD). However, the associations between these phenotypes have not been explored among college students.
We examined relationships between type of potentially traumatic event (PTE) exposure (pre-college) and sleep disturbances, as well as mediating effects of lifetime PTSD and AUD symptoms on these relationships, in a large undergraduate sample (N = 1599, 64.7% female). Hierarchical linear regressions were conducted, beginning with demographics and then adding interpersonal and accidental PTEs in a stepwise regression; mediation analyses were run.
Within the sample, 33.7% endorsed at least one interpersonal PTE, while 64.4% endorsed at least one accidental PTE. Hierarchical regressions demonstrated that interpersonal (β = 0.202, p = 0.000), but not accidental PTE exposure significantly predicted disturbed sleep. Both PTSD and AUD symptoms significantly mediated (p values < 0.001) the relationship between interpersonal PTE exposure and sleep, with indirect effects accounting for 61% and 17% of total effects, respectively. In the correlated mediation model, both disorders remained significant mediators (p < 0.001), with indirect effects accounting for 56% (PTSD symptoms) and 14% (AUD symptoms) of total effects on sleep.
Results suggest that interpersonal PTEs are more potent predictors of sleep problems than accidental PTEs. Further, trauma exposure psychiatric symptom sequelae (PTSD, AUD) account for part of the relationship between interpersonal PTE exposure and disturbed sleep, which both independently and jointly suggests that treating PTSD and AUD symptoms in college students may also improve sleep.
创伤性事件，尤其是那些具有人际性质的事件，与共病后遗症的风险增加相关，包括睡眠障碍、创伤后应激障碍（PTSD）和酒精使用障碍（AUD）。然而，这些表型之间的关联尚未在大学生中进行探讨。
我们在一个大型本科样本（N = 1599，64.7%为女性）中，研究了潜在创伤性事件（PTE）暴露类型（大学前）与睡眠障碍之间的关系，以及终生PTSD和AUD症状对这些关系的中介作用。进行了分层线性回归，首先纳入人口统计学变量，然后在逐步回归中加入人际和意外PTE；进行了中介分析。
在样本中，33.7%的人认可至少一次人际PTE，而64.4%的人认可至少一次意外PTE。分层回归表明，人际PTE（β = 0.202，p = 0.000）而非意外PTE暴露显著预测了睡眠障碍。PTSD和AUD症状均显著中介了（p值<0.001）人际PTE暴露与睡眠之间的关系，间接效应分别占总效应的61%和17%。在相关中介模型中，两种障碍仍然是显著的中介因素（p < 0.001），间接效应分别占对睡眠总效应的56%（PTSD症状）和14%（AUD症状）。
结果表明，人际PTE比意外PTE更能有效预测睡眠问题。此外，创伤暴露后的精神症状后遗症（PTSD、AUD）解释了人际PTE暴露与睡眠障碍之间关系的一部分，这既独立又共同表明，治疗大学生的PTSD和AUD症状也可能改善睡眠。
