CIRCADIAN DYSREGULATION IN ABUSED CHILDREN (SLEEP DISTURBANCES, POSTTRAUMATIC STRESS DISORDER).
Contributors: Boston College.
Published: 1994
Number of pages: 91
Subjects: Health Sciences, Nursing.; Psychology, Psychobiology.; Psychology, Clinical.
Description: Childhood abuse has been associated with a variety of psychiatric sequelae, including Post-Traumatic Stress Disorder (PTSD). Several studies suggest that sleep disturbance may be a "hallmark of PTSD" in adults. The purpose of this study is to assess whether intense averse stimulation during early development (in the form of physical and sexual abuse) leads to disruption of sleep/wake and rest/activity cycles.

Methods. Sixteen hospitalized abused children (mean age 9.7 $\pm$ 2.1; 4 females, 12 males) were compared with those of 15 healthy pediatric controls (mean age 8.3 $\pm$ 1.9 yrs; 6 females, 9 males). All children were essentially medication-free and diagnoses were assessed via structured diagnostic interview (K-SADS-E). Abused children were one outpatient and 15 inpatients recruited from a child psychiatric unit, and had suffered substantiated episodes of either physical and/or sexual abuse. Children were studied using belt-worn ambulatory activity monitors (Motionlogger AM-16) for 72 consecutive hours, during weekdays, between day 3 and day 30 of admission.

Results. The abused group reported a variety of psychological symptoms and had significantly higher scores on the Child Behavior Checklist. Abused children took over twice as long to fall asleep than controls, 27.9 $\pm$ 22.9 vs. 11 $\pm$ 8.8 minutes and had significantly poorer sleep efficiencies (92.9 $\pm$ 3.8%) compared with controls (96.1 $\pm$ 1.6%). Abused children had higher mean diurnal activity levels compared with controls, however, this just failed to reach statistical significance. Significant differences emerged in the circadian frequency, although both groups were well-entrained to a 24-hour day. The circadian acrophase occurred 62 minutes later in the abused group compared with controls.

Discussion. These results are consistent with clinical observations suggesting behavioral and sleep disruption secondary to trauma. Quantifiable disturbances in sleep/wake and rest/activity cycles supports the hypothesis of circadian dysregulation in abused children.
Notes: Source: Dissertation Abstracts International, Volume: 56-10, Section: B, page: 5416.

Thesis (PH.D.)--BOSTON COLLEGE, 1994.

School code: 0016.