Childhood Trauma and Mental Health Status in General Population: A Series Mediation Examination of Psychological Distress in COVID-19 Pandemic and Global Sleep Quality

Abstract

Background: Coronavirus-2019 (COVID-19) has been coexisting with humans for almost 2 years, consistently impacting people's daily life, medical environment, and mental health. This study aimed to test the series mediation model triggered by childhood trauma, in which perceived psychological impact of COVID-19 pandemic and sleep quality mediated the path sequentially and led to adverse mental health outcomes.Methods: A cross-sectional design involving 817 participants were enrolled via WeChat online survey. Participants completed questionnaires, including demographic features, the Childhood Trauma Questionnaire, Impact of Event Scale-Revised (IES-R) questionnaire, Pittsburgh Sleep Quality Index (PSQI) questionnaire, and Depression, Anxiety, and Stress Scale (DASS-21). Pearson correlations and hierarchical multiple linear regression were employed to examine the association of childhood trauma and psychological stress of COVID-19, sleep quality, and mental health status. In addition, a series mediate analysis was carried out to examine sequence mediating effects of psychological impact of COVID-19 and sleep quality between childhood trauma and mental health status.Results: The results showed that childhood trauma is positively and significantly related to psychological distress of COVID-19 pandemic, sleep quality, and mental health status (p < 0.05). Hierarchical multiple linear regression analysis shown that demographic features explained 4.4, 2.1, and 4.0% of the total variance in DASS-21, IES-R, and PSQI total scale scores, respectively. Adding childhood trauma significantly increased the model variance of DASS-21 (ΔR2 = 0.129, F = 126.092, p = 0.000), IES-R (ΔR2 = 0.062, F = 54.771, p = 0.000), and PSQI total scale scores (ΔR2 = 0.055, F = 48.733, p = 0.000), respectively. Moreover, the series mediation model showed that the perceived impact of the COVID-19 pandemic and sleep quality were sequential mediators between childhood trauma and mental health status (proportion explained: 49.17%, p < 0.05).Conclusion: Amid the ravages of COVID-19, childhood trauma predicts poor mental health status, in part because of greater psychological impact related to COVID-19 and poorer global sleep quality. In order to improve mental health, future researchers should pay more attention to individuals with childhood trauma, for its association with greater stress related to life events and poorer sleep quality.

Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma

“…Although many studies have confirmed that the COVID-19 epidemic affects SI among college students, the impact on SI among Chinese medical students is elusive. COVID-19 is a socially traumatic public health event, especially for individuals who have experienced a traumatic childhood event and are more vulnerable to the effects of COVID-19 [36]. Several studies have found that individuals who experienced adverse childhood events during the COVID-19 pandemic exhibited higher levels of anxiety, depression and PTSD symptoms [37][38][39].In addition, individuals with a history of childhood abuse experienced increased psychological distress and PTSD symptoms during the pandemic, even over and above demographic characteristics and stressors associated with COVID-19 [40].…”

Association between childhood trauma and mental health disorders in adolescents during the second pandemic wave of COVID-19, Chiclayo-Peru

“…Childhood trauma has been identified as a significant risk factor for developing mental health disorders later in life and has been associated with increased vulnerability to the negative impacts of stress and adversity (27). Previous studies have indicated that childhood trauma plays a role in the development of an unfavorable mental state during the COVID-19 pandemic (28,29). Trauma at an early age can cause an over-activation of the hypothalamus, releasing corticotropin-releasing hormone (CRF), which would lead to an increase in stress hormones such as cortisol and adrenaline (30)(31)(32)(33).…”

COVID-19 Related Emotional Stress and Bedtime Procrastination Among College Students in China: A Moderated Mediation Model

“…2,3 Combined with strict social distancing rules in many countries around the world, these multiple stressors have had tremendous impacts on mental health and sleep. [4][5][6] Surveys conducted in several countries since the beginning of the pandemic, have reported an increased risk of post-traumatic stress disorder, fear, anxiety, and depression in different populations. [7][8][9][10][11][12] Sleep problems in response to the COVID-19 pandemic are high in prevalence, 13,14 as are psychological symptoms.…”