Relationships between potentially traumatic events, sleep disturbances, and symptoms of PTSD and alcohol use disorder in a young adult sample

Mackenzie J Lind; Allison Baylor; Cassie M Overstreet; Sage E Hawn; Bruce D Rybarczyk; Kenneth S Kendler; Danielle M Dick; Ananda B Amstadter

doi:10.1016/j.sleep.2017.02.024

Relationships between potentially traumatic events, sleep disturbances, and symptoms of PTSD and alcohol use disorder in a young adult sample

Sleep Med. 2017 Jun:34:141-147. doi: 10.1016/j.sleep.2017.02.024. Epub 2017 Mar 18.

Authors

Mackenzie J Lind¹, Allison Baylor², Cassie M Overstreet³, Sage E Hawn⁴, Bruce D Rybarczyk⁵, Kenneth S Kendler⁶, Danielle M Dick⁷, Ananda B Amstadter⁸

Affiliations

¹ Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, PO Box 980126, Richmond, VA, 23298-0126, USA. Electronic address: lindmj@vcu.edu.
² Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, PO Box 842018, Richmond, VA, 23284-2018, USA. Electronic address: abaylor@mymail.vcu.edu.
³ 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. Electronic address: overstreetcm@mymail.vcu.edu.
⁴ 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. Electronic address: hawnse@mymail.vcu.edu.
⁵ Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, PO Box 842018, Richmond, VA, 23284-2018, USA. Electronic address: bdrybarczyk@vcu.edu.
⁶ Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, PO Box 980126, Richmond, VA, 23298-0126, USA; Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, PO Box 980003, Richmond, VA, 23298-0003, USA. Electronic address: kenneth.kendler@vcuhealth.org.
⁷ Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, PO Box 842018, Richmond, VA, 23284-2018, USA; College Behavioral and Emotional Health Institute, Virginia Commonwealth University, 816 W. Franklin St, PO Box 843092, Richmond, VA, 23284-3092, USA. Electronic address: ddick@vcu.edu.
⁸ Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, PO Box 980126, Richmond, VA, 23298-0126, USA; Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, PO Box 980003, Richmond, VA, 23298-0003, USA. Electronic address: abamstadter@vcu.edu.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Alcohol use disorder; College students; Posttraumatic stress disorder; Potentially traumatic events; Sleep disturbances.

MeSH terms

Adolescent
Alcohol-Related Disorders / epidemiology*
Female
Humans
Life Change Events*
Linear Models
Male
Models, Theoretical
Retrospective Studies
Sleep Wake Disorders / epidemiology*
Stress Disorders, Post-Traumatic / epidemiology*
Students / psychology
Universities
Young Adult

Abstract

MeSH terms

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