{"title":"Mediating Effects of Sleep Problems and Emotional Symptoms in the Relationship Between Chronotype and Self-Harm Among Adolescents Aged 11-19 Years.","authors":"Yan Zou, Guoli Yan, Minghui Li, Xiaohui Dai, Xiaofei Hou, Mengmei Wang, Ling Sun, Huifang Yin, Guangming Xu","doi":"10.2147/PRBM.S511075","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Self-harm is linked to numerous adverse health and social outcomes, including repetitive self-harm and an increased risk of suicide. This study aims to explore the influence of chronotype on self-harm among adolescents and further investigate the mediating role of sleep problems and emotional symptoms.</p><p><strong>Participants and methods: </strong>The study was conducted between April and June 2022, involving 13 junior and senior high schools in Tianjin. The participants were asked to complete online questionnaires assessing chronotype, sleep problems, depression, anxiety, and self-harm. The data were analyzed and processed using Spearman correlation and mediation effect analysis. Two mediation pathways were tested: Model 1 with sleep problems and depression as the mediators, and Model 2 with sleep problems and anxiety as the mediators.</p><p><strong>Results: </strong>Participants comprised 13,374 Chinese middle school adolescents (6745 boys) aged 11-19 years. In Model 1, the independent mediation effects of sleep problems and depression were -0.216 (95% CI = [-0.263, -0.172]) and -0.101 (95% CI = [-0.121, -0.083]), accounting for 33.33% and 15.59% of the total effect, respectively. The chain mediation effect was -0.170 (95% CI = [-0.196, -0.146]), accounting for 26.23% of the total effect. In Model 2, the independent mediation effects of sleep problems and anxiety were -0.232 (95% CI = [-0.279, -0.189]) and -0.075 (95% CI = [-0.091, -0.059]), respectively accounting for 35.63% and 11.52% of the total effect. The chain mediation effect was -0.151 (95% CI = [-0.176, -0.128]), accounting for 23.20% of the total effect.</p><p><strong>Conclusion: </strong>Chronotype is a significant predictor of self-harm, with a later chronotype associated with a higher risk. Both sleep problems and emotional symptoms independently and serially mediate the relationship between chronotype and self-harm. These findings highlight the complex pathways through which chronotype influences self-harm behavior and suggest potential targets for intervention.</p>","PeriodicalId":20954,"journal":{"name":"Psychology Research and Behavior Management","volume":"18 ","pages":"629-640"},"PeriodicalIF":3.2000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927583/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychology Research and Behavior Management","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.2147/PRBM.S511075","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Self-harm is linked to numerous adverse health and social outcomes, including repetitive self-harm and an increased risk of suicide. This study aims to explore the influence of chronotype on self-harm among adolescents and further investigate the mediating role of sleep problems and emotional symptoms.
Participants and methods: The study was conducted between April and June 2022, involving 13 junior and senior high schools in Tianjin. The participants were asked to complete online questionnaires assessing chronotype, sleep problems, depression, anxiety, and self-harm. The data were analyzed and processed using Spearman correlation and mediation effect analysis. Two mediation pathways were tested: Model 1 with sleep problems and depression as the mediators, and Model 2 with sleep problems and anxiety as the mediators.
Results: Participants comprised 13,374 Chinese middle school adolescents (6745 boys) aged 11-19 years. In Model 1, the independent mediation effects of sleep problems and depression were -0.216 (95% CI = [-0.263, -0.172]) and -0.101 (95% CI = [-0.121, -0.083]), accounting for 33.33% and 15.59% of the total effect, respectively. The chain mediation effect was -0.170 (95% CI = [-0.196, -0.146]), accounting for 26.23% of the total effect. In Model 2, the independent mediation effects of sleep problems and anxiety were -0.232 (95% CI = [-0.279, -0.189]) and -0.075 (95% CI = [-0.091, -0.059]), respectively accounting for 35.63% and 11.52% of the total effect. The chain mediation effect was -0.151 (95% CI = [-0.176, -0.128]), accounting for 23.20% of the total effect.
Conclusion: Chronotype is a significant predictor of self-harm, with a later chronotype associated with a higher risk. Both sleep problems and emotional symptoms independently and serially mediate the relationship between chronotype and self-harm. These findings highlight the complex pathways through which chronotype influences self-harm behavior and suggest potential targets for intervention.
目的：自残与许多不利的健康和社会后果有关，包括重复自残和自杀风险增加。本研究旨在探讨时间类型对青少年自我伤害的影响，并进一步探讨睡眠问题和情绪症状的中介作用。研究对象和方法：研究于2022年4月至6月进行，涉及天津市13所初中和高中。参与者被要求完成在线问卷，评估睡眠类型、睡眠问题、抑郁、焦虑和自残。采用Spearman相关分析和中介效应分析对数据进行分析和处理。模型1以睡眠问题和抑郁为中介，模型2以睡眠问题和焦虑为中介。结果：参与者包括13374名11-19岁的中国中学生（6745名男生）。在模型1中，睡眠问题和抑郁的独立中介效应分别为-0.216 （95% CI =[-0.263, -0.172]）和-0.101 (95% CI =[-0.121, -0.083])，分别占总效应的33.33%和15.59%。链式中介效应为-0.170 (95% CI =[-0.196, -0.146])，占总效应的26.23%。在模型2中，睡眠问题和焦虑的独立中介效应分别为-0.232 （95% CI =[-0.279, -0.189]）和-0.075 (95% CI =[-0.091, -0.059])，分别占总效应的35.63%和11.52%。链式中介效应为-0.151 (95% CI =[-0.176, -0.128])，占总效应的23.20%。结论：时间类型是自我伤害的重要预测因子，时间类型越晚，风险越高。睡眠问题和情绪症状都独立地、连续地介导时型与自我伤害的关系。这些发现强调了时间类型影响自残行为的复杂途径，并提出了潜在的干预目标。
期刊介绍：
Psychology Research and Behavior Management is an international, peer-reviewed, open access journal focusing on the science of psychology and its application in behavior management to develop improved outcomes in the clinical, educational, sports and business arenas. Specific topics covered in the journal include: -Neuroscience, memory and decision making -Behavior modification and management -Clinical applications -Business and sports performance management -Social and developmental studies -Animal studies The journal welcomes submitted papers covering original research, clinical studies, surveys, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.
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