Effects Of Childhood Trauma And Subjective And Objective Sleep On Daytime Mood Regulation In Young Adults

Background: Childhood Trauma(CT)refers to the stressful events experienced by individuals in early life,which not only causes harm to individuals when experiencing trauma,but also affects brain structure,epigenetic inheritance,cognitive processing,behavioral pattern,emotional regulation and other aspects,and is an important risk factor for depression or depressive disorder in adulthood.CT increases an individual’s susceptibility to mood disorders both psychologically and physically,and affective instability is closely related to the severity of depressive symptoms,and affective instability is also thought to be a possible precursor to bipolar disorder.However,most previous studies on affective stability rely on self-rating scales,and few studies observe whether CT increases individual affective instability under natural living environment,especially for those with no obvious depressive symptoms at present.In addition,current studies have shown that adults with CT are more prone to sleep disorders such as difficulty falling asleep,low sleep efficiency,and daytime sleepiness,and that sleep significantly contributes to the transformation of depressive symptoms.It is not clear whether sleep patterns such as reduced slow-wave sleep and increased REM sleep are already present in patients with CT without significant depressive symptoms.Finding sleep abnormalities in those with childhood trauma may be helpful for timely intervention to mitigate the further negative effects of traumatic experiences.This paper will carry out research from the following two parts:Part I The effects of childhood trauma on affective stability in general young adultsObjective: To explore whether CT increases the affective instability of individuals,making individuals experience negative and intense emotional experiences more frequently and decreasing positive emotional experiences.Methods: Ecological Momentary Assessment(EMA)is adopted,and timed questionnaire is pushed daily on wechat.A total of 141 participants aged 18-24 were recruited at 8:00 am,12:00 noon,16:00 PM and 20:00 PM four times a day for 14 days.The Positive Affect(PA)and Negative Affect(Negative Affect,NA)Visual Analog Scale(VAS)self-rated.The Childhood Trauma Questionnaire-Short Form was used for the baseline Questionnaire.CTQ-SF,Center for Epidemological Survey-Depression Scale,CES-D),7-item Generalized Anxiety Disorder Scale,GAD-7),10-item Connor-Davidson Resilience Scale(CD-RISC-10).The CT and non-CT groups were divided according to whether any of the CTQ-SF subscale scores reached the cut-off values.A total of 5036 pieces of data were included in the analysis of 120 subjects(72 in the CT group and 48 in the non-CT group).Mean Square Successive Difference(MSSD)and the Probability of Acute Change(PAC)of indicators of emotional stability were calculated and the differences between the two groups were compared using non-parametric tests.Mediating effect analysis explores whether affective stability mediates the effect of CT on depressive emotional experience.Results: The scores of CTQ-SF in CT group was significantly higher than that in non-CT group(46.19±9.05 vs.31.63±4.13).CES-D score in CT group was significantly higher than that in non-CT group(11.37±3.38 versus 8.35±4.74,p<0.001).No significant difference was found in CD-RISC-10 between the two groups(17.92±5.58 versus 18.46±4.39,p=0.554)..PA-ST-PAC2 in CT group was significantly higher than that in non-CT group(0.037±0.046 vs.0.021±0.038,p=0.034).CTQ-SF was correlated with PA-ST-PAC2(r=0.202,p<0.050),but not with other indexes of emotional stability.There was a dose effect between the number of patients undergoing CT and PA-ST-PAC2,and the number of patients undergoing both types of trauma was significantly higher than those without CT(0.047±0.050 vs.0.021±0.038,p=0.019).There was no significant difference with one type of CT(0.047±0.050 vs.0.025±0.039,p=0.255).There was no significant difference between one type of CT and those without CT(0.021±0.038 versus0.025±0.039,p=1.000).The mediating effect analysis showed that CTQ-SF had a major effect on CES-D,and CTQ-SF had a significant effect on PA-ST-PAC2,PA-LT-PAC1 and PA-LT-PAC2,but no significant mediating effect was found.Conclusions: The influence of CT on emotional stability is mainly manifested in the decrease of positive emotional stability.Individuals with CT experience were more likely to experience a sharp decline in positive emotions within a day,and the probability of decline was dose-dependent on the number of trauma types experienced.At present,positive emotional stability does not mediate the effect of childhood trauma on depressive emotional experience,but this study lacks clinical objective evaluation and medical history screening and other limitations.The clinical significance and long-term effects of positive emotional fluctuations still need to be observed and studied.Part II The effects of subjective and objective sleep quality on daytime mood in general young adults with or without childhood traumaObjective: To observe the changes of sleep structure and the effects of sleep components on emotional regulation in patients with CT.This study hypothesized that patients with CT had reduced slow-wave sleep and increased REM sleep,and that subjective and objective sleep had a delayed correlation with the mood of the next day.Methods: Based on the first part of EMA,subjects wore a sleep monitoring bracelet Polar Unite on their non-dominant hand before going to bed at night to collect light sleep,deep sleep,REM sleep and total wake time.Subjective Sleep was evaluated by Pittsburgh Sleep Quality Index(PSQI)and EMA’s two VAS scales.The Chinese Version-Biological Rhythm Interview of Assessment in Neuropsychiatry(CV-BRIAN)was used to compare the disorders of biological rhythm.The sum of Square Successive Difference(SSD)Successive Difference between PA and NA fluctuations within a day is calculated and the mean PA and NA scores for EMA each day are calculated as the overall intensity of emotional experience for the day.A total of 1072 pieces of data were included in the analysis,including 40 in the CT group and 67 in the non-CT group.The generalized estimation equation examines the delayed correlation between sleep and mood of the day.Results: No differences were observed in PSQI(5.58±2.82 vs.5.76±2.46,p=0.721)or objective monitoring of sleep.No significant difference was found between CV-BRIAN(32.15±9.57 vs.32.25±8.68,p=0.954).However,sleep quality significantly affected the emotional stability of CT group.Subjective sleep quality was negatively correlated with NA fluctuations(β=-14.584,p=0.047),and deep sleep was positively correlated with PA fluctuations(β=0.207,p=0.030).Subjective sleep quality significantly affected PA(β=0.285,p<0.001)or NA(β=-0.099,p=0.005)intensity on the same day with or without CT.Conclusions: Subjective sleep quality is closely related to the intensity of individual emotional experience.Good subjective sleep quality is associated with more positive emotional experience and less negative emotional experience.In addition,subjective sleep also affects the emotional stability of childhood trauma victims.Good subjective sleep quality predicts fewer negative emotional fluctuations on the day,and may increase the arousal of positive emotions on the day.However,due to the limitations of sleep monitoring equipment and the improvement effect of participants’ exercise habits on sleep,the influence of objective sleep on mood has not been discovered,and the factors affecting subjective sleep quality still need to be further clarified.