(PS5-78) Roles of Sleep Disturbances and Childhood Maltreatment Severity and Timing on Depressive Symptoms in Response to Behavioral Activation Intervention

Abstract Text:

Background: Childhood maltreatment (CM) is a significant predictor of depressive symptoms (Li et al., 2023; Russotti et al., 2021) and lower depression treatment response (Harkness et al., 2012; Nanni et al., 2012; Toth et al., 2020). It is not well understood why youth with CM exposure exhibit poor depression treatment response; however, sleep disturbances have been identified as a significant factor related to both youth depression treatment response (Manglick et al., 2013) and CM exposure (Brown et al., 2022; Schonning et al., 2022). Although sleep disruptions may be an important factor related to treatment response in CM exposed youth, further work is needed to understand how characteristics of CM, such as severity and timing, may influence both sleep disturbances and depression treatment response in youth. Using an ecological momentary assessments (EMA) design within a pilot clinical trial, this study aimed to (1) investigate the effects of CM severity and timing on sleep disturbance and depressive symptoms trajectory as they relate to a behavioral activation (BA) intervention response and (2) explore if the effects of CM severity and timing on depressive symptoms would be stronger in the context of more sleep disturbance.


Method: The sample included 32 adolescents diagnosed with major depression (Mage = 15.92 years, SD = 1.30; 47.6% female) who completed 12-14 weeks of BA intervention. Participants self-reported their CM history, including timing, type, and severity at baseline and completed morning, afternoon, and evening EMA surveys on sleep disturbances and depressive symptoms twice a week over the course of treatment (n= 84 timepoints).

Analysis Plan: We will conduct a mixed-effects analysis to test associations between CM severity and timing on depressive symptoms and sleep disturbance over time. We will run a mixed-effects analysis with sleep patterns as a fixed moderator in predicting the effects of CM severity and timing on depressive symptoms trajectory. Age, sex, and socioeconomic status will be included as covariates.

Implications: Understanding the role of sleep disturbances and CM severity and timing on depressive symptom trajectories in response to BA intervention may inform ways to optimize treatments for adolescents with CM exposure.