Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

Impact of Positive Childhood Experiences (PCEs): A Systematic Review of Longitudinal Studies

Positive Childhood Experiences (PCEs) may mitigate the negative outcomes resulting from Adverse Childhood Experiences (ACEs). To date, most PCE research has used cross-sectional or retrospective designs. PubMed, EMBASE, Cochrane, PsychINFO, CINAHL, and Scopus were searched in May 2024 for longitudinal studies that examined the impact of cumulative PCEs. Eight publications from five longitudinal studies with a total of 16,451 participants were included. Three studies focused only on adolescent outcomes. PCEs were associated with reduced rates of depression, substance use, delinquent behavior, risky sexual behavior, persistent insomnia, and lower inflammatory markers. Cumulative PCEs in childhood may moderate the impact of ACEs, potentially playing an important role in reducing the risk for mental disorders and other adverse outcomes later in life.PROSPERO (ID: CRD42022384775).

Recent Stressful Life Events and Perceived Stress as Serial Mediators of the Association between Adverse Childhood Events and Insomnia

Insomnia is common in college students and linked to poorer mental and physical health. There is growing evidence that adverse childhood experiences (ACEs) may contribute to insomnia in adulthood. However, beyond the need for additional replication of these findings, there is a need to identify underlying mechanisms that plausibly connect the two experiences. Based on a serial mediation model, the current study examined the role of two theoretically informed mediators: recent stressful life events and perceived stress. A cross-sectional survey of 2,218 college students at a large university in the southwestern United States was conducted between August 2020 and December 2021. The sample was predominantly Hispanic (96%) and female (73%), with a mean age of 20.7 years. Standardized measures of adverse childhood experiences, recent stressful life events, perceived stress, and insomnia were administered to participants online. Almost 20% of participants reported having experienced four or more adverse childhood experiences and 63% met the threshold for insomnia. Reporting four or more ACEs was associated with significantly greater insomnia severity, and this relationship was serially mediated by both recent stressful life events and perceived stress. However, recent stressful life events appeared to be the most powerful mediator. The results of the current study indicate that recent exposure to stressful life events serves as a plausible mechanism linking early adversity during childhood to adult insomnia and could therefore serve as a potential target for intervention. The findings suggest that students would benefit from university-wide efforts to reduce the number and/or intensity of common stressors.