The day-to-day influence of trauma exposure and sleep dysfunction on everyday stress in youth at familial high-risk for psychotic disorders

Cumulative research finds that exposure to childhood trauma, sleep dysfunction, and high stress levels are prevalent in youth diagnosed with and at-risk for psychotic disorders. However, few studies have investigated the association between nightly sleep and moment-to-moment stress in youth who are at familial high-risk (FHR) for psychotic disorders with varying levels of exposure to childhood trauma. The current study examined the day-to-day associations between trauma severity, nightly sleep duration, and next-day momentary stress in 19 FHR and 19 non-psychiatric youth (ages 13-19 years, 66 % girls). Ecological Momentary Assessment was used to assess these variables across three longitudinal timepoints (baseline, 6-months, and 12-months). The FHR group reported greater trauma severity and shorter sleep duration than the non-psychiatric group. In the whole sample, trauma severity and reduced sleep duration were associated with next-day momentary stress. While group status did not moderate the association between sleep duration and next-day momentary stress, group status did moderate the positive association between trauma severity and next-day momentary stress, showing that the association was specific to the non-psychiatric group. Lastly, the effect of nightly sleep duration on next-day momentary stress was significant and negative, but only at low levels of trauma severity for the whole sample. Findings offer preliminary insights into the associations between trauma severity, sleep duration, and momentary stress. Furthermore, this design can provide a foundation for future research examining environmental and psychosocial risk factors that contribute to symptom progression and prognosis of youth who are genetically vulnerable to psychosis.