Sleep problems in sexually abused preschoolers and their mediation effects on behavior problems.

This study aims at exploring the association between sexual abuse (SA) and sleep problems over a year in preschoolers, and at testing a mediation model with behavior problems as an outcome. Method. At time 1 (T1), the sample consisted of 224 sexually abused preschoolers, and 83 non-abused preschoolers (mean age: 4.66 years old). At time 2 (T2), 85 abused children and 73 non-abused children were evaluated (mean age: 5.39 years old). Parents completed the Child Behavior Checklist (CBC; Achenbach & Rescorla, 2000) at both measurement times, and T-scores of sleep problems and of internalized and externalized behavior problems were used. Results. Abused preschoolers presented higher total scores of sleep problems than non-abused preschoolers at T1 and T2, but no time or time x group interaction effects were found. Sleep problems at T1 acted as a mediator of the association between SA and internalized (partial) and externalized (complete) behavior problems at T2. Conclusions. Given the deleterious impact of sleep problems on childhood development, our results underline the relevance of pursuing research on sleep and SA in young children. Furthermore, sleep problems seem to play a crucial role in the development of behavior problems. The clinical and research implications of the results will be discussed.