J Affect Disord. 2025 Nov 30:120786. doi: 10.1016/j.jad.2025.120786. Online ahead of print.
ABSTRACT
BACKGROUND: Adolescent depression represents a significant public health challenge worldwide. While adverse life events (ALEs) are established predictors of depressive symptom, the mediating role of sleep quality remain underexplored in multi-ethnic contexts like Xinjiang, China.
METHODS: A cross-sectional study was conducted among 2217 adolescents (mean age, 19.13 ± 1.37 years; 57.24 % females; 53.98 % rural residents) in Southern Xinjiang. Participants completed the Adolescent Self-Rating Life Events Checklist (ASLEC), The Chinese version of the Center for Epidemiologic Studies Depression Scale (CESD), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using Hayes’ PROCESS macro to test a mediation framework.
RESULTS: Mediation analyses demonstrated that sleep quality significantly mediated 32.74 % (β = 0.116, 95 % CI: 0.187-0.241) of the adverse life events (ALEs)-depressive symptom association among Southern Xinjiang adolescents, with the full model explaining 54.4 % of depressive symptom variance (adj. R2 = 0.544, p < 0.001). Sleep disturbances (26.25 %) and daytime dysfunction (24.32 %) dominated mediation pathways, while habitual sleep efficiency showed non-significant mediation (b-path 95 % CI: -0.066-1.667). Females exhibited stronger total effects (β = 0.377 vs. males’ 0.333) and greater indirect mediation (β = 0.124 vs. 0.108), and rural residency amplified depressive symptom risk (β = -0.985 to -1.065, p < 0.01).
CONCLUSION: Fragmented sleep continuity mediates 32.74 % of ALEs-depressive symptom associations in Xinjiang adolescents, necessitating culturally adapted sleep-focused interventions-particularly for females and rural residents-to disrupt this pathway.
PMID:41330511 | DOI:10.1016/j.jad.2025.120786
