Sleep and behavioral control in earlier life predicted resilience in young adulthood: A prospective study of children of alcoholics and controls

Aims: Children of alcoholics (COAs) are at higher risk for developing an alcohol use disorder and substance related problems than non-COAs. This study examined (i) the relationships between sleep rhythmicity in childhood (aged 3-5) and behavioral control in adolescence (aged 9-14) and (ii) whether sleep rhythmicity and behavioral control predicted resilience in COAs in emerging adulthood (aged 21-26). Resilience was defined as successful adaptation in spite of adversity. Resilience among COAs was operationalized in three different ways (i) absence of alcohol disorder diagnoses, (ii) absence of alcohol and drug related problems, (iii) a continuous latent variable measured by depressive symptoms, work satisfaction and relationship satisfaction. Design: A prospective, longitudinal study of children assessed from early childhood (ages 3-5) to emerging adulthood (ages 21-26). Setting: A community study of families at high risk for alcoholism and matched controls conducted in a 4-county area in the Midwest. Participants: 715 children (75% children of alcoholics, 29% female). Measurement Data on sleep were gathered by the Dimensions of Temperament Survey (DOTS) and Child Behavior Checklist. Behavioral Control was measured by Child and Adult Q-sort. Substance use data were collected by Drinking and Drug History - Youth form. Findings: Structural equation modeling analyses indicated that higher rhythmicity of sleep, lower level of tiredness and infrequent sleep difficulties predicted higher behavioral control in adolescence, which in turn predicted two resilience outcomes in young adulthood. Behavioral control significantly mediated the effect of childhood sleep rhythmicity and resilience. No group differences between COAs and controls were found. Conclusions: Good sleep and higher self-regulation act as resource factors for young adults, regardless of parent alcoholism status.