1114 Predicting Post-Trauma Insomnia and Nightmare Severity Two Weeks After Interpersonal Violence

Abstract Introduction The Hospital Mental Health Risk Screen (HMHRS) predicts risk for negative outcomes following acute trauma, including posttraumatic stress disorder (PTSD). Insomnia and nightmares are common reactions to acute trauma and are considered modifiable risk factors for the development of PTSD. The HMHRS may be useful for detecting risk for post-trauma insomnia and nightmares, however, no studies have tested if the HMHRS predicts sleep disturbances within the acute aftermath of trauma. We tested the hypothesis that the HMHRS would predict (1) more severe insomnia and nightmares immediately after trauma, and (2) worsening of insomnia and nightmares from pre- to post-trauma. Methods We recruited 29 patients discharged from the emergency department (ED) at an urban Level I trauma center following interpersonal violence exposure (Mage = 37. 3 ± SD 14. 2, 65. 5% female, 75. 9% Black or African American, 44. 8% ≤ 20, 000, 65. 5% physical assault). Patients completed the HMHRS within 72 hours of violence exposure, as well as the Insomnia Severity Index (ISI) and Nightmare Disorder Index (NDI) to retrospectively report their pre-trauma insomnia and nightmare severity. Patients completed the ISI and NDI again two weeks later (Mdays = 13) to report their post-trauma insomnia and nightmare severity. We performed linear regression modeling HMHRS sum scores as a predictor of: (1) post-trauma ISI and NDI sum scores, adjusting for pre-trauma ISI and NDI, and (2) change in ISI and NDI scores from pre- to post-trauma. Results The HMHRS prospectively predicted post-trauma ISI (β = 0. 36, p =. 002, R2 = 0. 26) and NDI scores (β = 0. 22, p =. 005, R2 = 0. 31) above and beyond pre-trauma scores. The HMHRS did not predict change in pre- to post-trauma ISI (β = 0. 28, p =. 167) or NDI scores (β = 0. 04, p =. 762). Conclusion These preliminary data suggest the HMHRS predicts post-trauma insomnia and nightmare severity within the acute aftermath of interpersonal violence. Patients presenting to the ED with elevated HMHRS scores following interpersonal violence may potentially be suitable for insomnia- and nightmare-focused treatments during the acute recovery period to prophylactically reduce risk of posttraumatic psychopathology, including PTSD. Support (if any) AASM, Strategic Research Grant (371-SR-25; Study), NIMH (K23MH134032; A. N. R).