University of Missouri - Saint Louis

The Graduate School

Announcement

An oral examination in defense of the dissertation for the degree

Doctor of Philosophy in Psychology

Kimberly Borkowski Werner
M.A. in Psychology – Behavioral Neuroscience, May, 2009, University of Missouri-St. Louis
B.A. in Psychology, May, 2006, Saint Louis University


Physiological and Psychological Measurement of Sleep Disturbance in Female Trauma Survivors with PTSD and Major Depression

 

Abstract

Sleep disturbance is often reported after a traumatic event and is included in the American Psychiatric Association Diagnostic and Statistical Manual criteria for posttraumatic stress disorder (PTSD). Subjective reports from trauma survivors have indicated difficulties in sleep onset, sleep maintenance, overall quality and quantity of sleep. However, objective physiological research has yielded inconsistent findings in PTSD-related sleep impairment. Studies investigating subjective and objective assessments concordantly support a theory of sleep state misperception – subjective over-estimation of sleep disturbance – in PTSD. The majority of these previous investigations have been limited to male, veteran cohorts and have not accounted for the effects of psychiatric comorbidity, such as major depression. The current study examines PTSD-related sleep disturbance in a female interpersonal violence cohort (N=51) assessing subjective and objective physiological (actigraphy) sleep measures concurrently. Specific aims of the study addressed the presence of sleep state misperception in a female PTSD cohort and the effect of comorbid depression symptoms and diagnosis on PTSD-related sleep impairment.
Analyses revealed an overall subjective over-reporting of sleep disturbance when compared to objective physiological measurement. Subjective reports of sleep onset latency were significantly higher than objective measures (t (50) = 4.59, p < .001), and subjective sleep quality (t (50) = 6.03, p < .001) and sleep quantity (t (50) = 4.52, p < .001) were significantly lower than objective assessment. No significant differences were displayed between PTSD-only and PTSD/MDD groups across subjective, objective and sleep state misperception scores for any of the target sleep parameters. However, 24% of the variability in sleep state misperception was predicted by the regression model including re-experiencing symptoms and depressive symptoms as significant contributors (p<.01). Reexperiencing symptoms accounted for 13% of the variance in sleep state misperception, and depressive symptoms contributed a unique 9% of variance (p<.05). Avoidance and surprisingly, hyperarousal symptoms, were not significant predictors.
Overall, findings support the existence of sleep state misperception in a PTSD-positive female cohort. Results also point to the importance of accounting for depressive and reexperiencing symptoms as predictors of subjective sleep impairment in a PTSD cohort. Findings are discussed in terms of implications for understanding sleep impairment in PTSD.


 

Date: Tuesday, July 2, 2013

Time: 5pm (17:00)

Place: 339 Stadler Hall

 

Defense of Dissertation Committee

 

Dr. Michael G. Griffin, Ph.D. – Chairperson

Dr. Tara E. Galovski, Ph.D.

 

Dr. Joseph M. Ojile MD, D.ABSM, FCCP

Dr. George Taylor, Ph.D.