Abstract
BackgroundAlthough academic stress is a well-known risk factor for students' depression, little is known about the possible psychological mechanisms underlying this association. In this study, we investigated the prevalence of depression and sleep disturbance among Chinese students, examined the relationship between perceived academic stress and depression, considered if mobile phone addiction and sleep quality is a mediator of this relationship, and tested if mobile phone addiction and sleep quality together play a serial mediating role in the influence of perceived academic stress on depression.MethodA cross-sectional survey was conducted among students from September to December 2018 in Heilongjiang Province, China. The final analysis included 5,109 students. Mobile phone addiction, sleep quality, and depressive symptoms were assessed using the Mobile Phone Addiction Index, Pittsburgh Sleep Quality Index, and Center for Epidemiologic Studies-Depression scales, respectively. The serial mediation model was used to analyse the relationship between perceived academic stress, mobile phone addiction, sleep quality, and depression.ResultsAmong all participants, the prevalence of depressive symptoms and sleep disturbance was 28.69 and 27.95%, respectively. High school students showed the highest scores of perceived academic stress (2.68 ± 1.06), and the highest prevalence of depressive symptoms (33.14%) and sleep disturbance (36.47%). The serial mediation model indicated that perceived academic stress was a significant predictor of depression (B = 0.10, SE = 0.02, 95% CI = 0.06 – 0.13). Additionally, mobile phone addiction (B = 0.08, 95% boot CI = 0.06–0.11) and sleep quality (B = 0.27, 95% boot CI = 0.22–0.33) played a mediating role between perceived academic stress and depression. Mobile phone addiction and sleep quality together played a serial mediating role in the influence of perceived academic stress on depression (B = 0.11, 95% boot CI = 0.08–0.14). Furthermore, the indirect effect (i.e., the mediating effect of mobile phone addiction and sleep quality) was significant and accounted for 64.01% of the total effect.ConclusionsOur research results underscore the need for stakeholders—including family members, educators, and policy makers—to take preventative intervention measures to address depression among Chinese students, especially high school students.
Highlights
Depression is a widespread chronic medical illness that can influence mood, thoughts, and physical health [1], and is a severe problem faced by students worldwide
Our study explored the correlations between perceived academic stress (PAS), mobile phone addiction (MPA), sleep quality, and depression among Chinese students in middle school through college levels
We tested if sleep quality was a mediator of the relationship between PAS and MPA (H3: PAS is positively associated with poor sleep quality (PSQ), H7: PSQ is positively associated with depression, and H8: Sleep quality mediates the relationship between PAS and depression)
Summary
Depression (major depressive disorder) is a widespread chronic medical illness that can influence mood, thoughts, and physical health [1], and is a severe problem faced by students worldwide. Stress has been shown to be one of the most important risk factors of depression, and numerous studies have demonstrated that stress plays an important role in the emergence of depression [13,14,15]. Academic stress is a well-known risk factor for students’ depression, little is known about the possible psychological mechanisms underlying this association. We investigated the prevalence of depression and sleep disturbance among Chinese students, examined the relationship between perceived academic stress and depression, considered if mobile phone addiction and sleep quality is a mediator of this relationship, and tested if mobile phone addiction and sleep quality together play a serial mediating role in the influence of perceived academic stress on depression
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