Insomnia partially mediated the association between problematic Internet use and depression among secondary school students in China

J Behav Addict. 2017 Dec 1;6(4):554-563. doi: 10.1556/2006.6.2017.085.

Abstract

Background and aims This study aims to examine the mediating effects of insomnia on the associations between problematic Internet use, including Internet addiction (IA) and online social networking addiction (OSNA), and depression among adolescents. Methods A total of 1,015 secondary school students from Guangzhou in China participated in a cross-sectional survey. Levels of depression, insomnia, IA, and OSNA were assessed using the Center for Epidemiological Studies-Depression Scale, Pittsburgh Sleep Quality Index, Young's Diagnostic Questionnaire, and Online Social Networking Addiction Scale, respectively. Logistic regression models were fit to test the associations between IA, OSNA, insomnia, and depression. The mediation effects of insomnia were tested using Baron and Kenny's strategy. Results The prevalence of depression at moderate level or above (CES-D ≥ 21), insomnia, IA, and OSNA were 23.5%, 37.2%, 8.1%, and 25.5%, respectively. IA and OSNA were significantly associated with depression (IA: AOR = 2.79, 95% CI: 1.71, 4.55; OSNA: AOR = 3.27, 95% CI: 2.33, 4.59) and insomnia (IA: AOR = 2.83, 95% CI: 1.72, 4.65; OSNA: AOR = 2.19, 95% CI: 1.61, 2.96), after adjusting for significant background factors. Furthermore, insomnia partially mediated 60.6% of the effect of IA on depression (Sobel Z = 3.562, p < .002) and 44.8% of the effect of OSNA on depression (Sobel Z = 3.919, p < .001), respectively. Discussion The high prevalence of IA and OSNA may be associated with increased risk of developing depression among adolescents, both through direct and indirect effects (via insomnia). Findings from this study indicated that it may be effective to develop and implement interventions that jointly consider the problematic Internet use, insomnia, and depression.

Keywords: Internet addiction; depression; insomnia; mediation; online social networking addiction.

MeSH terms

  • Adolescent
  • Behavior, Addictive / epidemiology*
  • Behavior, Addictive / psychology
  • Child
  • China / epidemiology
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Depression / psychology
  • Female
  • Humans
  • Internet*
  • Logistic Models
  • Male
  • Prevalence
  • Schools
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Social Media*
  • Social Networking*
  • Students / psychology
  • Students / statistics & numerical data*
  • Surveys and Questionnaires

Grants and funding

Funding sources: This study was supported by the Jockey Club School of Public Health and Primary Care Research Postgraduate Students’ Research Grants and CUHK research Postgraduate Student Grants for Overseas Academic Activities in the Chinese University of Hong Kong, and the study was also partially supported by National Science Foundation of China (no.: 81373021).