Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China.
School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China.
J Affect Disord. 2023 Feb 1;322:2-8. doi: 10.1016/j.jad.2022.10.047. Epub 2022 Nov 5.
The study explored the differences in nightmare, insomnia, depression, anxiety, and cognitive deficits among adolescents and the chain mediating effects of insomnia, depression, and anxiety on the relationship between nightmares and cognitive deficits in adolescents.
An online survey was used to collect demographic data of 6014 adolescents and assess nightmare, insomnia, depression, anxiety, and cognitive deficits using the Chinese Version of Nightmare Distress Questionnaire, Insomnia Severity Index, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and Perceived Deficits Questionnaire-Depression. Spearman correlation analysis and the SPSS function "PROCESS macro" were used for correlation and mediation analyses, respectively.
Female adolescents, senior high school, and poor academic performance had higher nightmare, insomnia, and cognitive deficit scores; those living in the city had higher depression and anxiety scores. Cognitive deficits were positively correlated with nightmares, insomnia, depression, and anxiety. Further, insomnia, depression, and anxiety had a chain mediating effect between nightmares and cognitive deficits in adolescents. Nightmares indirectly affect cognition deficits by affecting insomnia and then depression and anxiety symptoms.
As this was a cross-sectional study, the causal relationship between the variables could not be determined. Moreover, reporting bias and volunteer bias might be present.
These findings suggest that clinicians should identify adolescents with frequent nightmares early and provide timely treatment to minimize negative outcomes and possibly limit the chronicity of nightmare disorder. It is significant to maintain the physical and mental health development of adolescents to reduce the risk of insomnia, depression, anxiety, and cognitive deficits.
本研究旨在探讨青少年噩梦、失眠、抑郁、焦虑和认知缺陷的差异，以及失眠、抑郁和焦虑对噩梦与认知缺陷之间关系的链式中介作用。
采用在线问卷调查的方式，对 6014 名青少年的人口学资料进行收集，并使用中文版噩梦困扰问卷、失眠严重度指数、患者健康问卷 9 项、广泛性焦虑障碍 7 项、知觉缺陷问卷-抑郁分量表评估其噩梦、失眠、抑郁、焦虑和认知缺陷情况。采用 Spearman 相关分析和 SPSS 函数“PROCESS macro”分别进行相关性和中介效应分析。
女生、高中生和学业成绩差的青少年噩梦、失眠和认知缺陷得分较高；城市青少年抑郁和焦虑得分较高。认知缺陷与噩梦、失眠、抑郁和焦虑呈正相关。进一步研究发现，失眠、抑郁和焦虑在青少年噩梦与认知缺陷之间存在链式中介作用。噩梦通过影响失眠，进而影响抑郁和焦虑症状，从而间接影响认知缺陷。
由于这是一项横断面研究，因此无法确定变量之间的因果关系。此外，可能存在报告偏倚和志愿者偏倚。
这些发现表明，临床医生应早期识别经常做噩梦的青少年，并及时提供治疗，以最小化负面后果，并可能限制噩梦障碍的慢性化。保持青少年身心健康发展对于降低失眠、抑郁、焦虑和认知缺陷的风险具有重要意义。
