Application of life history theory to explain the association between childhood maltreatment and adulthood sleep problems in Chinese men with drug abuse: multiple mediating roles of emotion regulation, future-oriented coping, and anxiety.

Background: Despite the practical importance of addressing the drug user's sleep problems to enhance the efficacy of treatment and rehabilitation, little is known about whether and how history of childhood maltreatment relates to this issue. This study takes an evolutionary perspective to investigate the associations between history of childhood maltreatment and sleep problems in adults with drug abuse via their emotion regulation difficulties, future-oriented coping, and anxiety.Methods: Participants were 604 male adults with drug abuse between the ages of 18-58 years (M = 36.20, SD = 8.17) in a drug rehabilitation centre in China. In addition to bivariate correlation analysis, path analysis was conducted to examine goodness-of-fit of the conceptual model, controlling for the effect of demographic characteristics.Results: Thirty-two percent of participants (n = 194) reported poor sleep quality (PSQI > 5), whereas sleep disturbance (81.3%), daytime dysfunction (77.3%), and sleep latency (66.5%) were the three most common problems among them. Correlation analysis supported the hypothesised positive correlations between poor sleep quality and childhood maltreatment, emotion regulation difficulties, and anxiety, and a negative correlation with future-oriented coping. Results of path analysis showed a significant indirect effect of childhood maltreatment on sleep problems via both emotion regulation difficulties and anxiety, whereas such effects via both future-oriented coping and anxiety were statistically nonsignificant.Conclusions: The findings suggest life history theory is applicable to understanding drug users' sleep problems, and interventions regarding both emotion regulation difficulties and anxiety can lessen the risk posed by childhood maltreatment on sleep problems.