Abstract Introduction Eveningness, a circadian preference for later sleep-wake timing, may increase exposure to traumatic events that disproportionately occur at nighttime, namely assaults. Further, eveningness is associated with a host of negative outcomes that may hinder post-trauma recovery. The current study investigated the correlates of eveningness in acutely traumatized patients, a population at risk for myriad posttraumatic outcomes. We recruited patients hospitalized following traumatic injury and hypothesized that, relative to morningness, eveningness would be associated with (1) greater likelihood of being hospitalized following interpersonal violence exposure, and (2) future depression, suicidal ideation (SI), and posttraumatic stress disorder (PTSD). Methods We recruited 88 patients hospitalized in a Level I trauma center in Detroit, MI within one week following traumatic injury (Mage = 39.53 ± 14.31, 67.0% male, 67.0% Black). Electronic medical records were reviewed to code the mechanism of injury by interpersonal violence (assault with a weapon, physical assault, sexual assault) and non-interpersonal trauma (motor vehicle collisions, falls). Participants responded to a single item during hospitalization to identify as evening types (“Definitely an 'evening' type / Rather more an 'evening' type”) or morning types (“Definitely a 'morning' type” / Rather more a 'morning' type”). Patients then reported their depression symptoms, SI, and PTSD symptoms approximately one-month post-trauma. Results The rates of interpersonal violence exposure significantly differed by morningness-eveningness (χ² = 6.07, p = 0.014). Specifically, 58.8% of patients with an evening preference were hospitalized following interpersonal violence compared to 31.1% of patients with a morning preference (Relative Risk = 1.89). Eveningness was prospectively associated with increased odds of posttraumatic sequelae one-month post-trauma: depression (OR = 4.13, p = .026), SI (OR = 8.57, p = .008), and PTSD (OR = 5.40, p = .019), above and beyond baseline symptoms and time. Conclusion Patients with an evening preference had nearly twice the risk of being hospitalized for interpersonal violence exposure, perhaps because they are more likely to be out at night when violent crime peaks. The prospective links between eveningness and posttraumatic sequelae may be due in part to neurophysiological consequences of nocturnal wakefulness, such as elevations in negative affect, emotion dysregulation, and behavioral disinhibition. Support (if any) K23MH134032 (A.N.R.).
Reffi et al. (Fri,) studied this question.