Sleep disturbance as transdiagnostic mediator between adverse childhood experiences and psychopathology in children and adolescents: A structural equation modeling meta‐analysis

Abstract Background Increasing research efforts have focused on understanding why some individuals develop severe psychopathology after exposure to adverse childhood experiences (ACEs). Sleep disturbances (insomnia, nightmares, and sleep disorders) are prevalent sequelae of ACEs and associated with psychopathology; however, there is no meta‐analytic evidence on whether sleep disturbance functions as a transdiagnostic mediator in the relationship between ACEs and psychopathology (internalizing/externalizing disorders and psychosis) in children and adolescents. Methods Systematic searches in three databases (PubMed; PsycINFO; Web of Science) identified 98 articles (N = 402,718; age range 1–17 years) and the present study used a novel two‐stage meta‐analytic structural equation model to investigate whether ACEs predict psychopathology through sleep disturbance. Subgroup analyses determined potential biases due to study design (cross‐sectional vs. longitudinal) and geographical differences (Western vs. non‐Western countries). Sensitivity analyses evaluated the influence of early childhood (