Sleep disturbance mediates the association between intrafamily conflict and mental health problems in Chinese adolescents

Abstract

Background: Mental health problems and sleep disturbance are prevalent in adolescents. Intrafamily conflict has been found to be associated with mental health problems and sleep disturbance in adolescents. This study examined the hypothesis that sleep disturbance mediates the effect of intrafamily conflict on mental health problems.

Method: Participants were 11,831 adolescent students who participated in the baseline survey of the Shandong Adolescent Behavior and Health Cohort. Participants completed a self-administered questionnaire and reported demographics, behavioral and emotional problems, and sleep disturbance. Structural equation modeling was used to examine the mediating effects of sleep disturbance on the association between intrafamily conflict and mental health problems, including internalizing, externalizing, and attention problems.

Results: The mean age of the participants was 15 years (SD = 1.46) and 50.9% were males. After controlling for family demographic factors, adolescent age and sex, intrafamily conflict had significant effects on mental health problems (standardized regression coefficient = 0.28, SE = 0.009, p < 0.001) and sleep disturbance (standardized regression coefficient = 0.15, SE = 0.010, p < 0.001). Sleep disturbance significantly mediated the association between intrafamily conflict and mental health problems (standardized indirect effect = 0.05, SE = 0.004, p < 0.001).

Conclusions: Sleep disturbance had significant mediating effects on the relationship between intrafamily conflict and mental health problems in Chinese adolescents. The findings suggested that family-centered programs should include sleep disturbance intervention for preventing adolescent mental health problems.

Keywords: Adolescent; China; Intrafamily conflict; Mental health; Sleep disturbance.