Sleep disturbance and internalizing symptoms in adolescents: a moderated mediation model of self-control and mindfulness

BMC Psychiatry. 2024 Apr 24;24(1):310. doi: 10.1186/s12888-024-05750-y.

Abstract

Objectives: Despite accumulating evidence regarding the impact of sleep disturbance on internalizing symptoms among adolescents, the underlying psychological mechanisms remain inadequately explored. This study aimed to investigate a conceptual framework elucidating how sleep disturbance influences internalizing symptoms in adolescents through the mediating role of self-control, with mindfulness as a moderator.

Methods: In this cross-sectional study, 1876 Chinese adolescents (Mage = 14.88 years, SD = 1.47 years, range = 12-19 years, 44.7% boys) completed the Youth Self-Rating Insomnia Scale (YSIS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Brief Self-control Scale (BSCS), and Mindful Attention Awareness Scale-Children (MAAS-C) to provide data on sleep-related variables, internalizing symptoms (anxiety and depression), self-control, and mindfulness, respectively. The PROCESS macro for SPSS was applied to perform moderated mediation analysis.

Results: Sleep disturbance demonstrated a significant positive correlation with internalizing symptoms in adolescents, including anxiety (β = 0.481, p < 0.001) and depression (β = 0.543, p < 0.001). Self-control served as a mediator between sleep disturbance and two forms of internalizing symptoms. Moreover, mindfulness moderated the pathways from self-control to internalizing symptoms (for anxiety symptoms: β = 0.007, p < 0.001; for depression symptoms: β = 0.006, p < 0.001), and the mediating relationships were weaker for adolescents exhibiting higher levels of mindfulness.

Conclusions: Our findings enhance understanding of the impact, pathways, and influencing factors of sleep disturbance on adolescent internalizing symptoms, suggesting the importance of enhancing mindfulness levels in addressing self-control deficits and subsequently reducing internalizing symptoms among adolescents.

Keywords: Adolescents.; Internalizing symptoms; Mindfulness; Self-control; Sleep disturbance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety* / psychology
  • Child
  • China
  • Cross-Sectional Studies
  • Depression* / psychology
  • Female
  • Humans
  • Male
  • Mediation Analysis
  • Mindfulness*
  • Self-Control* / psychology
  • Sleep Wake Disorders* / psychology
  • Young Adult