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Abstract

Background: Sleep difficulties have been identified as a potential causal factor in psychotic experiences (Freeman et al., 2017), but the underlying mechanisms are less understood (Waite et al., 2020). Childhood trauma, depression and anxiety have been considered as mediators in clinical samples (Laskemoen et al., 2021; Reeve et al., 2018). In order to develop successful interventions, it is essential to incorporate client perspectives of the presenting problem and their experiences of sleep-based treatment.

Objectives: A mixed method approach was employed to investigate the contribution of childhood trauma, depression and anxiety in the association of sleep difficulties and psychotic experiences. The study sought to understand the experience of individual’s with sleep difficulties using a focus group.

Methods: Measures of depression, anxiety, paranoia, hallucinations, sleep difficulties, nightmare impact and childhood trauma were collected from 483 individuals. Path analysis models examined the role of depression and anxiety as mediators and the contribution of childhood trauma. A focus group was conducted with six individuals who had engaged in treatment for sleep difficulties.

Results: Two separate paths were demonstrated from childhood trauma to paranoia via sleep difficulties and depression, and from childhood trauma to paranoia, and hallucinations via nightmare impact and anxiety. Five themes were generated from the analysis of the focus group data: ‘barriers to treatment seeking’, ‘sleep and mental health’; ‘the end of a ‘one size fits all’ approach’, ‘use of digital technology’ and ‘lack of recognition of the importance of sleep’.

Conclusions: These findings suggest that the role of childhood trauma needs to be considered across a range of psychological outcomes. Secondly, that there is a dynamic interplay between the associations of sleep difficulties, nightmare impact, depression, anxiety and psychotic experiences. Finally, the focus group data highlighted the importance of considering sleep difficulties as an important part of an individual’s presenting problem.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments:	School of Health & Medical Sciences > Psychology School of Health & Medical Sciences > School of Health & Medical Sciences Doctoral Theses Doctoral Theses

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