TY - JOUR
T1 - Life stress, insomnia, and anxiety/depressive symptoms in adolescents
T2 - A three-wave longitudinal study
AU - Yang, Yanyun
AU - Liu, Xianchen
AU - Liu, Zhen Zhen
AU - Tein, Jenn Yun
AU - Jia, Cun Xian
N1 - Funding Information:
This work was funded in part for data collection by National Natural Science Foundation of China (Grant number 81573233 ).
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Purpose: Life stress has negative impacts on sleep and mental health. Little empirical work has investigated the associations between life stress, insomnia, and anxiety/depressive symptoms (ADS) in multi-wave longitudinal studies. This longitudinal study examined these associations in a large sample of adolescents. Methods: A total of 6995 adolescents (mean age = 14.86 years, 51.4 % male) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess life stress, insomnia, and ADS in 2015 (T1), 1 year later (T2), and 2 years later (T3). Three-wave longitudinal panel models were conducted to examine the prospective relationships between life stress, insomnia, and ADS. Results: The prevalence and persistence rates of insomnia and ADS across T1-T3 significantly increased with elevated life stress score (p <.001). Cross-lagged panel analysis showed that life stress, insomnia, and ADS at a later time point were significantly predicted by the same variable at earlier time points (all p <.01). Life stress, insomnia, and ADS significantly predicted each other bidirectionally over time (all p <.01). The relationship between life stress and ADS was partially mediated by insomnia. The relationship between life stress and insomnia was partially mediated by ADS. Study limitation: Life stress, insomnia, and ADS were all self-reports. Conclusions: Life stress, insomnia, and ADS are prospectively bidirectionally related to one another. Insomnia was a mediator of life stress and subsequent ADS and vice versa. These findings underscore the importance of sleep and mental health assessment and intervention in adolescents following life stress.
AB - Purpose: Life stress has negative impacts on sleep and mental health. Little empirical work has investigated the associations between life stress, insomnia, and anxiety/depressive symptoms (ADS) in multi-wave longitudinal studies. This longitudinal study examined these associations in a large sample of adolescents. Methods: A total of 6995 adolescents (mean age = 14.86 years, 51.4 % male) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess life stress, insomnia, and ADS in 2015 (T1), 1 year later (T2), and 2 years later (T3). Three-wave longitudinal panel models were conducted to examine the prospective relationships between life stress, insomnia, and ADS. Results: The prevalence and persistence rates of insomnia and ADS across T1-T3 significantly increased with elevated life stress score (p <.001). Cross-lagged panel analysis showed that life stress, insomnia, and ADS at a later time point were significantly predicted by the same variable at earlier time points (all p <.01). Life stress, insomnia, and ADS significantly predicted each other bidirectionally over time (all p <.01). The relationship between life stress and ADS was partially mediated by insomnia. The relationship between life stress and insomnia was partially mediated by ADS. Study limitation: Life stress, insomnia, and ADS were all self-reports. Conclusions: Life stress, insomnia, and ADS are prospectively bidirectionally related to one another. Insomnia was a mediator of life stress and subsequent ADS and vice versa. These findings underscore the importance of sleep and mental health assessment and intervention in adolescents following life stress.
KW - Adolescence
KW - Anxiety
KW - Depression
KW - Insomnia
KW - Life stress
KW - Longitudinal study
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U2 - 10.1016/j.jad.2022.11.002
DO - 10.1016/j.jad.2022.11.002
M3 - Article
C2 - 36372126
AN - SCOPUS:85141984785
SN - 0165-0327
VL - 322
SP - 91
EP - 98
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -