青少年睡眠质量在冗思与抑郁症状间的中介作用

doi:10.3969/j.issn.1006-5725.2026.03.018

Abstract

Abstract:

Objective To explore the mediating role of sleep quality in adolescents between rumination and depressive symptoms. Methods From October 2023 to September 2024， 300 adolescents were selected for investigation and analysis by simple random sampling. All subjects were evaluated using the Pittsburgh Sleep Quality Index （PSQI）， the Redundancy Response Scale （RRS-C）， and the Center for Epidemiological Investigation Depression Scale （CES-D）. Pearson correlation analysis was employed to examine the correlations among the CES-D depression symptoms， PSQI　sleep quality， and RRS-C rumination scores in adolescents. Hierarchical regression analysis was utilized to explore the influencing factors of depressive symptoms in adolescents. Furthermore， the mediating role of sleep quality in the relationship between rumination and depressive symptoms was tested using Model 4 of the mediation model from the SPSS Process program developed by Hayes. The significance of the mediating effect was examined using the Bootstrap sampling method. Results The PSQI， RRS-C and CES-D scores of 300 adolescents were （12.06 ± 2.14） points，（34.03 ± 6.17） points and （24.30 ± 4.37） points respectively. The CES-D score was positively correlated with the RRS-C and PSQI scores （r = 0.513， P < 0.001； r = 0.526， P < 0.001）， and the PSQI score was positively correlated with the RRS-C score （r = 0.440， P < 0.001）. After controlling for confounding factors， the PSQI score could explain 51.3% of the CES-D score. After introducing the RRS-C score， the RRS-C score could explain 50.9% of the CES-D score. In the final model， gender， being an only child， suffering from school bullying， RRS-C score， and PSQI score entered the regression equation. The above influencing factors could explain 60.7% of the CES-D score of adolescents. Rumination could positively predict depressive symptoms and sleep quality. After increasing the mediating variable sleep quality， rumination and sleep quality had a positive predictive effect on depressive symptoms. The mediating effect of sleep quality between rumination and depressive symptoms in adolescents accounted for 31.64%. Conclusion There exists a significant association between rumination and depressive symptoms in adolescents， in which sleep quality serves as a mediating role. This suggests that focusing on and implementing combined interventions targeting both rumination and sleep quality may hold significant potential value in future research.

Key words: sleep quality, teenagers, rumination, depressive symptoms, mediating effect

CLC Number:

R844.2

Qiaolin ZHANG,Guihong XU,Cheng HANG,Mingming DING,Lamei YU. The mediating role of sleep quality in adolescents between rumination and depressive symptoms[J]. The Journal of Practical Medicine, 2026, 42(3): 497-503.

Figures/Tables 6

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Tab.5

Fig.1

References 29

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项目	得分	条目均分	分类或条目均分排序
PSQI	12.06 ± 2.14	1.72 ± 0.23	睡眠质量良好92例（30.67%）；睡眠质量差208例（69.33%）
RRS-C
抑郁相关（11个条目）	18.11 ± 3.73	1.65 ± 0.26	1
强迫冥想（5个条目）	8.06 ± 1.22	1.61 ± 0.29	2
反思（5个条目）	7.86 ± 1.14	1.57 ± 0.25	3
总计（21个条目）	34.03 ± 6.17	1.62 ± 0.30
CES-D
抑郁情绪（8个条目）	10.26 ± 2.11	1.28 ± 0.23	2
积极情绪（4个条目）	5.15 ± 1.01	1.29 ± 0.24	1
躯体症状与活动迟滞（6个条目）	6.87 ± 1.29	1.15 ± 0.20	3
人际关系（2个条目）	2.02 ± 0.31	1.01 ± 0.15	4
总计（20个条目）	24.30 ± 4.37	1.22 ± 0.22	存在抑郁症状132例（88.00%）

资料	例数（n = 300）	CES-D评分	t/F值	P值
性别			4.089	0.001
男	98	22.72 ± 5.02
女	202	25.07 ± 4.49
年龄			4.083	0.001
12 ~ 15岁	122	25.54 ± 4.56
16 ~ 18岁	178	23.45 ± 4.21
居住地			0.882	0.378
城市	204	24.45 ± 4.19
农村	96	23.98 ± 4.54
家庭年收入			1.427	0.242
< 5年	84	24.10 ± 4.13
5 ~ 10年	116	23.93 ± 4.65
> 10年	100	24.90 ± 4.32
父母婚姻状况			3.945	0.001
在婚	236	23.80 ± 4.13
离异或再婚	64	26.14 ± 4.49
父亲文化程度			0.757	0.470
初中及以下	124	24.67 ± 4.53
高中或中专	80	24.16 ± 4.79
大专及以上	96	23.94 ± 4.28
母亲文化程度			0.823	0.440
初中及以下	120	24.71 ± 4.87
高中或中专	86	24.10 ± 4.54
大专及以上	94	23.96 ± 4.21
独生子女			5.213	< 0.001
是	130	25.86 ± 4.89
否	170	23.11 ± 4.23
学习日住校			3.093	0.002
是	96	25.44 ± 4.61
否	204	23.76 ± 4.28
抑郁症家族史			0.490	0.625
是	32	24.65 ± 4.59
否	268	24.26 ± 4.22
每周锻炼次数			0.811	0.446
< 2次	130	24.67 ± 4.67
2 ~ 4次	100	24.12 ± 4.28
≥ 5次	70	23.87 ± 4.81
遭受校园欺凌			5.154	< 0.001
是	70	27.19 ± 4.62
否	82	23.21 ± 4.85

变量	模型1
变量	β	SE	β′	t值	P值
性别	0.468	0.195	0.449	2.400	0.036
年龄	-0.445	0.202	-0.437	-2.203	0.041
父母婚姻状况	0.434	0.213	0.419	2.038	0.048
独生子女	0.492	0.189	0.468	2.603	0.031
学习日住校	0.403	0.228	0.394	1.768	0.060
遭受校园欺凌	0.496	0.177	0.482	2.652	0.030
R²	0.379
调整后R²	0.358
F值	10.989
P值	< 0.001
变量	模型2
变量	β	SE	β′	t值	P值
性别	0.440	0.191	0.423	2.304	0.038
年龄	-0.428	0.198	-0.413	-2.162	0.042
父母婚姻状况	0.415	0.211	0.402	1.967	0.054
独生子女	0.463	0.196	0.431	2.362	0.038
学习日住校	0.394	0.231	0.388	1.706	0.068
遭受校园欺凌	0.495	0.199	0.482	2.487	0.034
PSQI评分	0.513	0.190	0.502	2.700	0.029
R²	0.499
调整后R²	0.487
F值	18.324
P值	< 0.001
变量	模型3
变量	β	SE	β′	t值	P值
性别	0.421	0.201	0.405	2.095	0.047
年龄	-0.408	0.215	-0.396	-1.898	0.057
父母婚姻状况	0.394	0.217	0.381	1.816	0.060
独生子女	0.439	0.204	0.424	2.152	0.042
学习日住校	0.367	0.229	0.354	1.603	0.072
遭受校园欺凌	0.471	0.198	0.455	2.379	0.036
PSQI评分	0.499	0.199	0.483	2.508	0.031
RRS-C评分	0.509	0.193	0.508	2.637	0.030
R²	0.621
调整后R²	0.607
F值	24.918
P值	< 0.001

回归方程		拟合指标			系数显著性
结果变量	预测变量	R²	调整R²	F	β	t值	P值
抑郁症状		0.329	0.322	12.698
	冗思				0.337	4.002	< 0.001
睡眠质量		0.231	0.219	6.610
	冗思				0.135	2.421	0.030
抑郁症状		0.439	0.418	21.325
	睡眠质量				0.462	4.032	< 0.001
	冗思				0.320	3.349	0.011

效应	效应值	SE	95%CI	效应值占比
总效应	0.493	0.037	0.233 ~ 1.043
直接效应：冗思→抑郁症状	0.337	0.043	0.172 ~ 0.660	68.36%
间接效应：冗思→睡眠质量→抑郁症状	0.156	0.034	0.041 ~ 0.594	31.64%

The mediating role of sleep quality in adolescents between rumination and depressive symptoms

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