An Examination of Sleep as a Mediator of the Relationship between Childhood Adversity and Depression in Hispanic and Non-Hispanic Young Adults

Abstract

The current study integrates previous research on adverse childhood experiences (ACEs) and long-term health outcomes to examine associations between ACEs, sleep duration, and depression in a diverse, mostly healthy, sample of young adults. We examine whether sleep duration mediates the association between ACEs and depression among young adults, and whether ethnicity may moderate observed relationships between ACEs, sleep duration and depression. Data were collected from 518 young adults (66.8% female, M_age=19.79 years, SD_age=3.43 years) enrolled in undergraduate Psychology courses at a large Southwestern university. Participants primarily reported their racial/ethnic background as Non-Hispanic White (60.6%) and Hispanic/Latino (25.1%). Participants self-reported their ACEs exposure, sleep characteristics, and depressive symptoms. In addition to calculating overall exposure to ACEs, scores for the specific dimensions of adversity were also calculated (Abuse, Neglect, Exposure to Violence). Results supported a mediation model whereby higher reports of ACEs were associated with depressive symptoms both directly and through sleep duration. Results were not moderated by ethnicity. Findings provide support for sleep duration as one potential pathway through which ACEs may be associated with depressive symptoms in young adulthood, and suggest that this pathway is similar in Hispanic and non-Hispanic young adults.

Keywords:

• Adverse childhood experiences
• depression
• ethnic identity
• sleep duration

Conflicts of interest

Authors have no relevant financial or non-financial interests to disclose.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval

Study was approved by the Texas Tech University Institutional Review Boards.

Funding

The authors did not receive support from any organization for the submitted work.

Notes

1 To acknowledge the possibility that age may not present a relevant confounder within this relatively young study sample (M_age = 19.79 years, SD_age=3.43 years), we examined the original analytic models without age included as a covariate (refer to Supplemental Tables 2-5). Although observed direct and indirect effects did not differ depending on whether age was included as a covariate, we elected to preserve our a priori decision to control for age due to its association with sleep duration in this sample and empirically supported influence on changes in sleep duration throughout the lifespan, including young adulthood.⁴⁶,⁴⁷

2 All continuous mediation analyses were also run separately controlling for cigarette usage, alcohol consumption, caffeine consumption, and sleep medicine usage. All direct effects were significant for the models using total ACEs, abuse, and exposure to violence as the predictors. Mediation analyses revealed an indirect effect of total ACEs on depressive symptoms through continuous sleep duration (B= .03, SE = .02, 95% CI .004, .086), as well as an indirect effect of abuse on depressive symptoms through continuous sleep duration (B= .13, SE= .06, 95% CI .033, .310). Reports of neglect remained not associated with sleep duration.

3 All categorical mediation analyses were also run separately controlling for cigarette usage, alcohol consumption, caffeine consumption, and sleep medicine usage. All models revealed direct effects of ACEs scores (B’s > .65 , p’s < .001), short sleep occurrence (B’s > .80, p’s < .01), and long sleep occurrence (B’s > -.80, p’s < .05) on depressive symptoms. There was a significant direct effect of total ACEs on occurrence of short sleep (B = 0.10, SE = .05, Odds Ratio (OR) = 1.107, p = .029), as well as a significant direct effect of abuse on occurrence of short sleep (B = 0.40, SE = .13, OR = 1.482, p = .002). Mediation analyses revealed an indirect effect of abuse on depressive symptoms through short sleep (B = 1.17, SE = .55, 95% CI .198, 2.748). No other main effects or indirect effects were observed.