RELATIONSHIP BETWEEN EARLY ABUSE, POSTTRAUMATIC-STRESS-DISORDER, AND ACTIVITY LEVELS IN PREPUBERTAL CHILDREN

Objective: To examine the relationship between early physical and sexu al abuse, posttraumatic stress disorder (PTSD), major depression, and activity levels in prepubertal children. Method: Nineteen unmedicated children with documented abuse (9.4 +/- 2.3 years; 6 girls, 13 boys) w ere compared with 15 healthy controls (8.3 +/- 1.9 years; 6 girls, 9 b oys). Diagnoses were derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemio logic Version). Motionlogger actigraphs collected activity data for 72 continuous hours in I-minute epochs. Results: Overall, abused childre n were 10% more active than normal children (p < .05) and displayed a paucity of periods of low-level daytime activity (p < .01). Abused chi ldren with PTSD were largely responsible for the increase in activity. Abused children with PTSD had a robust and normal circadian activity rhythm. Abused children in whom PTSD failed to develop had an attenuat ed circadian amplitude compared with subjects with PTSD (101% versus 9 3%, p < .01) and were phase-delayed by 61 minutes versus controls (p = .01). Early onset of abuse was significantly associated with greater likelihood of the development of PTSD and hyperactivity. Later age of abuse was associated with circadian dysregulation. Conclusions: These preliminary observations indicate that abused children with PTSD have activity profiles similar to those of children with attention-deficit hyperactivity disorder, while abused children without PTSD have activi ty profiles more similar to those of depressed children.