Wang Jingyi, Wang Ziyao, Yang Yuting, Wang Tingting, Lin Haijiang, Zhang Wei, Chen Xiaoxiao, Fu Chaowei
School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
Taizhou City Center for Disease Control and Prevention, Taizhou, China.
J Adolesc. 2025 Jun;97(4):989-1001. doi: 10.1002/jad.12471. Epub 2025 Jan 21.
Existing research indicates high prevalence of emotional problems among adolescents with excessive academic burden, yet the underlying reasons are not well understood. This study aimed to explore loneliness, physical activity, and sleep as potential mediating pathways between academic burden and emotional problems in adolescents.
A longitudinal cohort study was conducted among middle and high school students in Taizhou City, Zhejiang Province, China, with data collected at three time points. The study included 2965 adolescents, with a mean age of 15.2 years (SD = 1.7), of whom 48.0% were female. Most participants came from families with middle to high economic status (94.8%). Structural equation modeling was employed to analyze the direct associations between academic burden (measured by study time and academic stress) and depressive and anxiety symptoms. Additionally, the indirect associations were explored through three mediators: loneliness, physical activity, and sleep.
Higher academic stress at T1 was directly associated with more severe depressive symptoms at T3. Sleep (indirect effect 0.11, 95% CI 0.09-0.13), loneliness (0.10, 0.08-0.11) and physical activity (0.01, 0.002-0.012) at T2 mediated the relationship, accounting for 31.0%, 26.8%, and 1.8% of the total association of academic stress, respectively. For anxiety symptoms, sleep (0.11, 0.09-0.14) and loneliness (0.07, 0.05-0.08) mediated the association of academic stress with longitudinal mediation effect sizes of 34.1% and 20.6%, respectively. Study time was only associated with the outcomes indirectly via academic stress.
Our results highlight the importance of behavioral and psychosocial differences related to academic burden in understanding the severity of mental health problems in adolescents.
现有研究表明，学业负担过重的青少年中情绪问题的患病率很高，但其潜在原因尚不清楚。本研究旨在探讨孤独感、体育活动和睡眠作为青少年学业负担与情绪问题之间潜在的中介途径。
在中国浙江省台州市的中学生中进行了一项纵向队列研究，在三个时间点收集数据。该研究包括2965名青少年，平均年龄为15.2岁（标准差=1.7），其中48.0%为女性。大多数参与者来自经济状况中高的家庭（94.8%）。采用结构方程模型分析学业负担（以学习时间和学业压力衡量）与抑郁和焦虑症状之间的直接关联。此外，还通过孤独感、体育活动和睡眠这三个中介因素探讨了间接关联。
T1时较高的学业压力与T3时更严重的抑郁症状直接相关。T2时的睡眠（间接效应0.11，95%置信区间0.09-0.13）、孤独感（0.10，0.08-0.11）和体育活动（0.01，0.002-0.012）介导了这种关系，分别占学业压力总关联的31.0%、26.8%和1.8%。对于焦虑症状，睡眠（0.11，0.09-0.14）和孤独感（0.07，0.05-0.08）介导了学业压力的关联，纵向中介效应大小分别为34.1%和20.6%。学习时间仅通过学业压力与结果间接相关。
我们的结果强调了与学业负担相关的行为和心理社会差异在理解青少年心理健康问题严重程度方面的重要性。
