0321 PREVALENCE, ASSOCIATIONS AND RACIAL DIFFERENCES OF POSTTRAUMATIC STRESS DISORDER, INSOMNIA, AND DEPRESSION AMONG ADULTS EXPOSED TO INTERPERSONAL VIOLENCE

Abstract

Introduction: In addition to posttraumatic stress disorder (PTSD) and depression, exposure to traumatic events is often associated with sleep disturbance. Compared to other forms of trauma, little work has examined sleep and mental health morbidity associated with interpersonal violence (IPV) exposure. We sought to do so in a large, ethnically diverse sample of persons at risk for IPV exposure and to determine whether race was associated with any differences in comorbidity. Methods: Some 2,500 adults were approached for screening at community- based locations, primarily a County Domestic Integrated Family Court and a battered women's shelter outpatient service. Nearly 800 participants completed surveys on demographics, past year exposure to IPV and current living arrangement. Measures included the PTSD Checklist (PCL), Insomnia Severity Index (ISI), and 8-item Patient Health Questionnaire depression scale (PHQ-8). Descriptive statistics on morbidity prevalence, Spearman's rank correlations between measures, and mean symptom severity differences by race were calculated. Results: Among 797 participants, with mean age 34.5 (SD=10.6) years, 764 (95.9%) were female, 44.0% African American (AA), 41.4% white, 14.6% other or multiple races and 18.5% reported Hispanic background. Approximately 95% of participants experienced IPV in the past year (the remainder in prior years). Mean(SD) total scores were ISI = 18.6(6.0), PCL = 59.6(14.2) and PHQ-8 = 15.7(5.6). Based on the ISI, 17.4% of participants had subthreshold, 42.6% moderate, and 34.7% severe insomnia. For the PCL, 84.2% scored above the cut-point for PTSD. PHQ-8 scores indicated 22.6% had moderate and 62.6% severe depression. The ISI was strongly positively correlated with both PCL (rs = .620, p < .001) and PHQ-8 scores (rs = .592, p < .001), after removing sleep items. There were no significant differences between white and AA participants in mean symptom severity on the ISI, PCL or PHQ-8. Conclusion: The prevalence of insomnia and other trauma-related morbidities is exceptionally high among people exposed to IPV. In this sample, insomnia severity did not differ by race, though data to control for socioeconomic status was unavailable. While sampling bias may have occurred, nearly 8 in 10 participants endorsed symptoms consistent with moderate to severe insomnia.