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Chain mediating effect of insomnia, depression, and anxiety on the relationship between nightmares and cognitive deficits in adolescents.

Li-Gang Zhang, Ling-Fei Cheng, Ting-Ting Wang, Lei-Lei Wang, Shuang-Jiang Zhou, Yan-Hong Luo, Jing-Xu Chen

Journal of Affective Disorders February 1, 2023 DOI: 10.1016/j.jad.2022.10.047 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional study Peer reviewed
Sample size 6,014
Population Adolescents
Topics Anxiety Depression Dreaming
Keywords Adolescents Cognitive deficits Insomnia Nightmares
Key findings Insomnia, depression, and anxiety have a chain mediating effect between nightmares and cognitive deficits in adolescents.

Abstract

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.

Comparable studies

Other cross-sectional and survey studies on dreaming, most cited first.

Study Year Design Participants
Insomnia Symptoms, Nightmares, and Suicidal Ideation in a College Student Sample Undergraduate students at a large, public university in the southeastern United States 2011 Observational cross-sectional survey n = 583
Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Middle-aged Hong Kong Chinese adults from the community, mean age 40.9 years (SD 5.5,... 2010 Cross-sectional survey with subsequent clinical evaluation (two-phase design) n = 8,558
Factors of home dream recall: a structural equation model Adults (general population sample) 2003 Cross-sectional survey with structural equation modeling n = 444
The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams 2014 Online survey n = 684
Frequency of Lucid Dreaming in a Representative German Sample Representative sample of German adults 2011 Cross-sectional survey n = 919

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