Details of Publication 482 for Project A156:

Astbury J, Bruck D & Loxton D. Sexual violence as a predictor of sleep difficulties in a community sample of young women (published abstract). Journal of sleep Research, 2010; 19(S2): 0277

Objectives: Previous studies have focussed on identifying factors that explain the gender difference in sleep disorders but the potential role of sexual violence has not been considered, even though survivors of sexual violence appear to be at high risk for developing sleep problems. Overlooking sexual violence as a potential predictor may hinder the understanding and treatment of sleep problems of some younger women. This study investigated the relative contribution made by forced sex ever’ to sleep difficulty over the last year, adjusting for and compared with the contribution of depression, anxiety, high risk behaviours and low socioeconomic position.Methods: Data analysis related to the cohort of women born 1973–78 who participated in Survey 3 of the Australian Longitudinal Study of Women’s Health (2003). The mean age of participants (n = 9061) was 27.14 years (SD = 1.45). The key dependent variable was reported sleeping difficulty ‘‘often’’ in the last 12 months. Independent variables (IVs) included: (1) Forced into unwanted sexual activity either in the last 12 months’ and/or more than 12 months ago’ (2) Diagnosis or treatment for depression and/or anxiety last 3 years; and ever deliberately harmed/hurt self (3) Demographic variables of marital status, education, occupation and personal income (4) High risk health behaviours relating to drug, tobacco and alcohol use.Results: Valid responses yielded an estimate of forced sex 'ever’ of 9.3% (841/9043), which, when adjusted for the deliberate over sampling or women living in rural and remote areas, gave an estimated prevalence of forced sex of 8.7% (724/9043). Hierarchical logistic regression included those Ivs statistically significant in bivariateanalyses. The high odds (OR = 1.95) of reported recurrent sleep difficulties amongst women who report forced sex in Model 1 (where forced sex was the only IV) become partially attenuated (OR = 1.63) after adjusting for depression, anxiety and self harm (Model 2) and certain demographic variables (OR = 1.52) (Model 3). The additionof substance use in the fully adjusted model (Model 4) further reduced the odds of sleep difficulty associated with forced sex (OR = 1.48). Forced sex remained a significant predictor of sleep difficulties in the past 12 months in all models. The regression models further suggest that the sleep difficulties of survivors of sexual violence may be embedded in complex relationships with depression, anxiety and self harm, underpinned by socioeconomic disadvantage and potentially exacerbated by illicit drug use.Conclusion: Some 9% of this community sample of young women reported forced sex and this group were nearly 50% more likely to report recurrent sleep difficulties relative to those who did not report forced sex. Results suggest that health care providers need to make a careful assessment of any history of sexual violence when youngwomen seek help for recurrent sleep problems.