Subjective and objective sleep quality in young women with posttraumatic stress disorder following sexual assault: a prospective study

Abstract

Background : Most posttraumatic stress disorder (PTSD) sleep disturbances reports have been conducted in male combat veteran populations, usually decades after the disorder’s onset. Given the increase in the prevalence of violence against women and the fact that women are at greater risk for developing PTSD, it is critical to examine sleep abnormalities in this population. Objectives : To examine subjective and objective sleep quality in young women with PTSD following sexual assault compared with a control group at baseline and after one year of treatment. Methods : Seventy-four women with PTSD following sexual assault and 64 healthy controls with no history of sexual assault were assessed using the Clinician-Administered PTSD Scale (CAPS-5), the Beck Depression Inventory, the Beck Anxiety Inventory, the Pittsburgh Sleep Quality Index (PSQI), the Modified Fatigue Impact Scale, and the Insomnia Severity Index. Subjects also underwent full in-lab polysomnography. PTSD participants received pharmacological and/or psychological therapy between baseline and one-year follow-up. Results : The PTSD group had significantly higher scores in the clinical and sleep measurements than the control group. Although the PTSD group reported poorer subjective sleep quality than healthy controls, there were few between-group differences in objective sleep. Analysis of the PTSD group at baseline and one-year follow-up showed that the PSQI global score was a significant predictor of PTSD improvement. Conclusions : Sleep quality is impaired in young women with PTSD and may impact long-term treatment responses. Better sleep quality is significantly associated with PTSD improvement, independent of depression and anxiety.

Sexual assault as a public health problem and other developments in psychotraumatology

“…A recent systematic review on the global prevalence of sexual assault confirmed this reality: 27–44% of women, 11–25% of men, and 27–47% of transgender individuals experience sexual assault in their lifetime (Breiding et al, 2014 ; Dworkin, Krahé, & Zinzow, 2021 ; James et al, 2016 ; Langenderfer-Magruder, Eugene Walls, Kattari, Whitfield, & Ramos, 2016 Smith et al, 2018 ; Testa et al, 2012 ) with often significant mental health impact (e.g. Bach et al, 2021 ; Louison Vang, Ali, Christiansen, Dokkedahl, & Elklit, 2020 ; Villalta et al, 2020 ; Yeh et al, 2021 ). As the #MeToo movement clearly demonstrated, sexual assault is rarely perpetrated by strangers, by violent men pulling victims into the bushes, but instead most often by close friends, colleagues and family members.…”

Sleep, circadian system and traumatic stress

“…First, in a large-scale, longitudinal cohort study of over 2,400 deployed Marines, Acheson et al ( 2019 ) examined the long-term relationship between pre-deployment sleep disturbance and post-deployment PTSD symptomatology through several multifactorial pathway models, suggesting that sleep disturbances at pre-deployment remained the most important independent risk factor for the development of PTSD symptoms after deployment. In another prospective study, Yeh et al ( 2021 ) investigated subjective and objective (polysomnographic) sleep quality at baseline and after one year of treatment in young women with and without sexual-assault-related PTSD, suggesting large subjective but only moderate objective differences in sleep quality between the two groups. Thereby, higher PTSD symptomology was associated with larger sleep impairment.…”

Trauma assessment in outpatient psychotherapy and associations with psychotherapist’s gender, own traumatic events, length of work experience, and theoretical orientation

“…More than 70% of people worldwide experience a traumatic event in their lifetime (Benjet et al, 2016 ). Traumatic events are risk factors for most mental illnesses including depression, psychosis, anxiety disorders, sleep disorders, eating disorders, sexual dysfunction, personality disorders, dissociative disorder, posttraumatic stress disorder (PTSD), somatoform disorders, and substance misuse (Bachmann, Czwikla, Jacobs, Fegert, & Hoffmann, 2021 ; Kessler et al, 2010 ; Longden & Read, 2016 ; Read, Sampson, & Critchley, 2016 ; Yeh et al, 2021 ). Moreover, studies showed a strong link between multiple exposure to childhood abuse and chronic illness, mental health problems, and health-risk behaviours in adulthood (Kuhar & Zager Kocjan, 2021 ).…”