Behav Sleep Med. 2025 Nov 19:1-14. doi: 10.1080/15402002.2025.2591682. Online ahead of print.
ABSTRACT
OBJECTIVES: To examine the relationship between insomnia symptoms and self-injurious behaviors (SIB) among adolescents and young adults, with a focus on the mediation effects of depression and anxiety on this association.
METHODS: An online survey among adolescents and young adults was conducted in Xiamen City, Fujian Province, from December 2022 to May 2023. SIB was assessed using two items from Health-Related Risky Behavior Inventory. Insomnia, depressive, and anxiety symptoms were evaluated by Insomnia Severity Index, Patient Health Questionnaire, and Generalized Anxiety Disorder Scale, respectively. A structural equation model was employed to explore the mediating role of depressive and anxiety symptoms in the relationship between insomnia and SIB.
RESULTS: A total of 3436 participants (Mage = 18.12 years; 58.4% female) were included in final analysis, with 707 (20.6%) reporting SIB within the past 12 months. Participants with SIB exhibited higher levels of insomnia, depressive, and anxiety symptoms compared to those without SIB. Insomnia symptoms were significantly associated with SIB (β = 0.343, p < .001). Additionally, depressive (β = 0.093, p < .001) and anxiety (β = 0.026, p = .001) symptoms mediated the relationship between insomnia symptoms and SIB. Total indirect effects accounted for 79.33% of the total effects (insomnia → SIB). However, sex did not moderate the mediation effect. Sensitivity analyses yielded similar results.
CONCLUSION: Depressive and anxiety symptoms mediate the relationship between insomnia and SIB in adolescents and young adults, suggesting that insomnia may act as a transdiagnostic factor contributing to emotional dysregulation and SIB.
PMID:41261886 | DOI:10.1080/15402002.2025.2591682
