Chain mediating effect of cognitive fusion and sleep beliefs between depressive symptoms and sleep quality in adolescents with first episode depressive disorder
Objective To explore the effects of depressive symptoms on sleep quality in adolescents with depressive disorder,and the mediating roles of cognitive fusion and sleep belief.Methods A sample of 210 adolescents with first episode depressive disorder aged 12-18 years were recruited to complete 17-item Hamilton depression scale(HAMD-17),Pittsburgh sleep quality index(PSQI),cognitive fusion question-naire(CFQ),and dysfunctional beliefs and attitudes about sleep scale(DBAS-16)from November 2021 to July 2022.SPSS 26.0 software was used to perform descriptive analysis and correlation analysis.The media-ting effect was tested by Bootstrap analysis using PROCESS V 3.4 Macro program.Results The incidence of low sleep quality in adolescents with depressive disorder was 69.0％(145/210).HAMD-17 score was(22.4±7.9),PSQI score was(9.7±3.7),CFQ score was(51.6±7.8),DBAS-16 score was(43.5±8.4).PSQI was positively correlated with the scores of HAMD-17 and CFQ(r=0.613,0.463,both P＜0.001).HAMD-17 was positively correlated with CFQ score(r=0.488,P＜0.001).DBAS-16 was negatively correla-ted with scores of PSQI,HAMD-17 and CFQ(r=-0.326,-0.284,-0.354,all P＜0.001).The direct effect of depression on sleep quality was 0.230(95％CI=0.169-0.293).The indirect effect of depression on sleep quality through two pathways,the separate mediating effect value of cognitive fusion was 0.041(95％CI=0.011-0.074),and the chain mediating effect value of cognitive fusion and sleep beliefs was 0.008(95％CI=0.001-0.020).Conclusion Depressive symptoms can directly affect sleep quality of depressive disorder adolescents and indirectly through cognitive fusion and sleep beliefs.
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