Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 4;17(1):88.
doi: 10.1186/s13034-023-00635-6.

The bridge symptoms of childhood trauma, sleep disorder and depressive symptoms: a network analysis

Weilong Guo #  1 , Yixin Zhao #  1 , Hui Chen  1 , Jiali Liu  1 , Xianliang Chen  1 , Huajia Tang  1 , Jiansong Zhou  2 , Xiaoping Wang  3
Affiliations

The bridge symptoms of childhood trauma, sleep disorder and depressive symptoms: a network analysis

Weilong Guo et al. Child Adolesc Psychiatry Ment Health. .

Abstract

Background: This study aimed to elucidate the characteristics of symptom network of childhood trauma (CT) and sleep disorder (SD) in Chinese adolescents, with the influence of depressive symptoms taken into account.

Method: A total of 1301 adolescent students were included, and their CT, SD and depressive symptoms were measured using the Pittsburgh sleep quality index (PSQI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and The Patient Health Questionnaire-9 (PHQ-9), respectively. Central symptoms and bridge symptoms were identified based on centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure.

Results: In CT and SD symptom network, emotional abuse and sleep quality symptoms had the highest centrality values, and two bridge symptoms, i.e., emotional abuse and sleep disturbance symptoms, were also identified. In symptom network for CT, SD, and depressive symptoms, sleeping difficulty symptoms, daily dysfunction symptoms, and emotional abuse appeared to be potential bridge symptoms. In symptom network of CT, SD, and depressive symptoms (excluding the symptom of sleeping difficulty), daily dysfunction symptoms, emotional abuse, and sleep disturbance symptoms appeared to be bridge symptoms.

Conclusions: In this study, emotional abuse and poor sleep quality were found to be central symptoms in the CT-SD network structure among Chinese adolescent students, with daytime dysfunction as the bridge symptom in the CT-SD-depression network structure. Systemic multi-level interventions targeting the central symptoms and bridge symptoms may be effective in alleviating the co-occurrence of CT, SD and depression in this population.

Keywords: Adolescent; Bridge symptoms; Childhood trauma; Sleep disorder; Symptom network.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The sleep and abuse network, the sleep, abuse and depression Network (1), the sleep, abuse and depression network (2). Note. Labels for sleep symptoms: SQ = sleep quality, SL = sleep latency, SDU = sleep duration, SE = sleep efficiency, SDI = sleep disturbance; SM = sleep medication; DD = daytime dysfunction. Labels for abuse: EA = emotional abuse, PA = physical abuse, SA = sexual abuse, EN = emotional neglect, PN = physical neglect. Strength is indicated by the thickness of lines between nodes, with thicker lines representing stronger ties. Labels for depressive symptoms: D Anhedonia = low interest or pleasure; D Sad Mood = feeling down and hopeless; D Sleep = sleeping difficulty; D Energy = lack of energy; D Appetite = poor appetite/overeating; D Guilt = guilt; D Concentration = difficulty in concentrating; D Motor = moving slowly/restlessness; D Suicide = suicidal thoughts. Strength is indicated by the thickness of lines between nodes, with thicker lines representing stronger ties
Fig. 2
Fig. 2
Centrality indices of the sleep and abuse network, sleep, abuse and depression network (1), sleep, abuse and depression network (2). Note: Values shown on the x-axis are standardized z-scores
Fig. 3
Fig. 3
Bridge centrality indices of the sleep and abuse network, sleep, abuse and depression network (1), sleep, abuse and depression network (2). Note: Labels for sleep symptoms: SQ = sleep quality, SL = sleep latency, SDU = sleep duration, SE = sleep efficiency, SDI = sleep disturbance, SM = sleep medication, DD = daytime dysfunction. Labels for abuse: EA = emotional abuse, PA = physical abuse, SA = sexual abuse, EN = emotional neglect, PN = physical neglect. Labels for depressive symptoms: D Anhedonia = low interest or pleasure, D Sad Mood = feeling down and hopeless; D Sleep = sleeping difficulty, D Energy = lack of energy; D Appetite = poor appetite/overeating; D Guilt = guilt; D Concentration = difficulty in concentrating; D Motor = moving slowly/restlessness; D Suicide = suicidal thoughts. Strength is indicated by the thickness of lines between nodes, with thicker lines representing stronger ties
Fig. 4
Fig. 4
Accuracy of edge weight in the sleep and abuse network, the sleep, abuse and depression network (1) and the sleep, abuse and depression network (2)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bomysoad RN, Francis LA. Adverse childhood experiences and Mental Health Conditions among adolescents. J Adolesc Health. 2020;67(6):868–70. doi: 10.1016/j.jadohealth.2020.04.013. - DOI - PubMed
    1. Lin L, Wang HH, Lu C, Chen W, Guo VY. Adverse childhood experiences and subsequent chronic Diseases among Middle-aged or older adults in China and Associations with demographic and socioeconomic characteristics. JAMA Netw Open. 2021;4(10):e2130143. doi: 10.1001/jamanetworkopen.2021.30143. - DOI - PMC - PubMed
    1. Garon-Bissonnette J, Bolduc MG, Lemieux R, Berthelot N. Cumulative childhood trauma and complex psychiatric symptoms in pregnant women and expecting men. BMC Pregnancy Childbirth. 2022;22(1):10. doi: 10.1186/s12884-021-04327-x. - DOI - PMC - PubMed
    1. Yang M, Sheng X, Ge M, Zhang L, Huang C, Cui S, et al. Childhood trauma and psychological sub-health among chinese adolescents: the mediating effect of internet addiction. BMC Psychiatry. 2022;22(1):762. doi: 10.1186/s12888-022-04384-2. - DOI - PMC - PubMed
    1. Bauer A, Fairchild G, Hammerton G, Murray J, Santos IS, Tovo Rodrigues L, et al. Associations between childhood trauma and childhood psychiatric disorders in Brazil: a population-based, prospective birth cohort study. The lancet Psychiatry. 2022;9(12):969–77. doi: 10.1016/S2215-0366(22)00337-6. - DOI - PubMed

LinkOut - more resources