Childhood paternal abuse and low paternal affection predict adult panic symptoms 18 years later via actigraphy-indexed sleep disruptions.

BACKGROUND

Child abuse and low parental affection are established risk factors for higher adulthood panic disorder (PD) severity, but their plausible sleep mediators are under-investigated. We thus examined how actigraphy indices mediated the links between child parental abuse and affection deficits to adulthood PD severity.

METHODS

Community-dwelling adult participants (N = 1,054) completed a series of self-reports on child parental abuse and affection at Wave 1. An eight-day actigraphy protocol was conducted at Wave 2, 9 years later. Telephone-administered clinical interviews assessing PD symptoms were conducted in W1 and Wave 3, separated by 18 years. A series of bias-corrected, bootstrapped causal mediation analyses was performed.

RESULTS

Paternal, but not maternal abuse, predicted higher rest- and sleep-stage actigraphy markers after 9 years (βs = 0.263-469.79, p < .001), comprising more activity counts, longer wake time, higher wake time percentage, and wake bouts. These markers, thereby, mediated the trajectory from paternal abuse to higher PD severity (average causal mediation effects (ACMEs): βs = 0.003-0.020, 95% CIs excluding zero, p < .001). Likewise, paternal affection deficits predicted greater disturbances in rest- and sleep-stage actigraphy (all p < .05), thereby mediating the link to greater PD severity (ACMEs: βs = 0.001-0.002, p ≤ .04). Neither maternal abuse nor affection was a significant mediator.

DISCUSSION: These outcomes aligned with, but do not verify, a causal mediation argument wherein actigraphy-derived nocturnal sleep-wake disturbances partially accounted for the trajectory from adverse paternal caregiving encounters to adulthood PD severity. Strategically targeting sleep disturbances may reflect a viable intervention approach for persons with past child paternal abuse learning histories.