Exploring the negative triad of childhood maltreatment, fear of relapse, and low sleep quality in multiple sclerosis
- 1University of Innsbruck
Abstract
BackgroundMultiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system marked by demyelination and neurodegeneration. Beyond physical symptoms, MS is often linked to clinically relevant sleep disturbances. The variability and unpredictability of symptoms and disease progression can also fuel fear of relapse (FoR), undermining well-being and potentially increasing morbidity through inflammatory processes. Understanding biopsychosocial risk factors, including childhood maltreatment (CM) and sleep, in relation to FoR remains an important gap in MS management and research.
MethodsData from N = 48 participants were collected via an online survey. We used the Pittsburgh Sleep Quality Index (PSQI), the Fear-of-Relapse Scale (FoR), and the Childhood Trauma Questionnaire (CTQ) to assess the variables of interest. In addition, time points of exposure to different CM subtypes were assessed. Linear regression analyses were conducted to examine associations within the proposed negative triad.
ResultsA significant negative association between overall sleep quality and FoR was observed. In the total cohort, the interaction between CM and sleep was not a significant predictor of FoR. However, exploratory analysis revealed a significant interaction between CM and sleep among male participants, whereas the same interaction was not significant among female participants.
ConclusionA history of CM and impaired sleep quality introduce new stressors in managing ones own illness that have received little attention to date. However, the present study found that these factors were at least partly influential on the FoR. The results underscore the translational need for additional support services to enhance prevention and personalized care.
Related
- Exploring links between type- and timing-specific characteristics of childhood maltreatment and epigenetic aging in formerly out-of-home placed young adults
- Exploring Factors and Nonpharmacological Interventions Associated With Respiratory Function in People With Multiple Sclerosis: A Scoping Review
- Relative Importance of Positive and Potentially Traumatic Childhood Experiences in Explaining Multiple Sclerosis Symptoms
- The Relationship Between Childhood Maltreatment and Adolescent Psychological Distress: A Latent Transition Analysis
- The Relationship Between Childhood Maltreatment and Emotion Recognition in Adults: A Systematic Review and Meta-Analysis
BibTeX
@misc{karabatsiakis2026exploring,
title = {{Exploring the negative triad of childhood maltreatment, fear of relapse, and low sleep quality in multiple sclerosis}},
author = {A. Karabatsiakis and N. Trepel and M. Gander and A. Buchheim},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.31.26361813},
url = {https://www.medrxiv.org/content/10.64898/2026.08.31.26361813v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Exploring the negative triad of childhood maltreatment, fear of relapse, and low sleep quality in multiple sclerosis
AU - A. Karabatsiakis
AU - N. Trepel
AU - M. Gander
AU - A. Buchheim
PY - 2026
DA - 2026/08/31
PB - medRxiv
DO - 10.64898/2026.08.31.26361813
UR - https://www.medrxiv.org/content/10.64898/2026.08.31.26361813v1
AB - BackgroundMultiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system marked by demyelination and neurodegeneration. Beyond physical symptoms, MS is often linked to clinically relevant sleep disturbances. The variability and unpredictability of symptoms and disease progression can also fuel fear of relapse (FoR), undermining well-being and potentially increasing morbidity through inflammatory processes. Understanding biopsychosocial risk factors, including childhood maltreatment (CM) and sleep, in relation to FoR remains an important gap in MS management and research. MethodsData from N = 48 participants were collected via an online survey. We used the Pittsburgh Sleep Quality Index (PSQI), the Fear-of-Relapse Scale (FoR), and the Childhood Trauma Questionnaire (CTQ) to assess the variables of interest. In addition, time points of exposure to different CM subtypes were assessed. Linear regression analyses were conducted to examine associations within the proposed negative triad. ResultsA significant negative association between overall sleep quality and FoR was observed. In the total cohort, the interaction between CM and sleep was not a significant predictor of FoR. However, exploratory analysis revealed a significant interaction between CM and sleep among male participants, whereas the same interaction was not significant among female participants. ConclusionA history of CM and impaired sleep quality introduce new stressors in managing ones own illness that have received little attention to date. However, the present study found that these factors were at least partly influential on the FoR. The results underscore the translational need for additional support services to enhance prevention and personalized care.
ER -