The Relationship between Adverse Childhood Experiences and Sleep Problems among Adolescent Students: Mediation by Depression or Anxiety
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measures
2.2.1. Early Trauma Inventory Self Report–Short Form (ETISR-SF)
2.2.2. List of Threatening Experiences Questionnaire (LTE-Q)
2.2.3. Insomnia Severity Index (ISI)
2.2.4. Epworth Sleepiness Scale (ESS)
2.2.5. School Sleep Habits Survey (SSS)
2.2.6. Children’s Depression Inventory (CDI)
2.2.7. Revised Children’s Manifest Anxiety Scale (RCMAS)
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | ETI+ (N = 576) | ETI− (N = 161) | t, F, χ2 | p | p† | |
---|---|---|---|---|---|---|
M (SD), N | M (SD), N | |||||
Age | 15.06 (1.39) | 15.14(1.30) | −0.673 | 0.501 | — | |
Sex | Boys | 356 | 92 | 1.148 | 0.284 | 0.284 |
Girls | 220 | 69 | ||||
Monthly family income 1 | 270.00 (155.46) | 313.03 (182.20) | −1.099 | 0.274 | ||
Parental education (years) | Mother | 12.44 (2.45) | 12.67 (2.50) | 0.656 | 0.513 | |
Father | 12.83 (2.59) | 13.15 (2.69) | 0.765 | 0.445 | ||
ISI | 5.64(4.23) | 4.22 (3.82) | 3.854 | <0.001 *** | <0.001 *** | |
ESS | 6.90 (4.24) | 5.60 (3.58) | 3.883 | <0.001 *** | <0.001 *** | |
SSS_prob | 18.67 (5.78) | 16.61(4.77) | 4.622 | <0.001 *** | <0.001 *** | |
CDI | 15.51 (7.04) | 13.43 (6.70) | 3.230 | 0.001 ** | 0.001 ** | |
RCMAS | 14.88 (6.29) | 11.63 (6.05) | 5.832 | <0.001 *** | <0.001 *** | |
Variables | LTE+ (N = 205) | LTE− (N = 532) | t, F, χ2 | p | p† | |
M (SD), N | M (SD), N | |||||
Age | 15.04 (1.38) | 15.10 (1.36) | −0.520 | 0.603 | — | |
Sex | Boys | 120 | 328 | 0.559 | 0.437 | 0.437 |
Girls | 85 | 204 | ||||
Monthly family income 1 | 252.86 (182.28) | 322.48 (174.20) | 2.034 | 0.044 | ||
Parental education (years) | Mother | 12.51 (2.50) | 12.48 (2.44) | −0.115 | 0.908 | |
Father | 12.90 (2.59) | 12.88 (2.62) | −0.060 | 0.952 | ||
ISI | 6.74 (4.77) | 4.79 (3.79) | 5.233 | <0.001 *** | <0.001 *** | |
ESS | 7.40 (4.00) | 6.30 (4.15) | 3.247 | 0.001 ** | 0.001 ** | |
SSS_prob | 20.11 (5.90) | 17.50 (5.36) | 5.772 | <0.001 *** | <0.001 *** | |
CDI | 16.90 (7.16) | 14.34 (6.84) | 4.345 | <0.001 *** | <0.001 *** | |
RCMAS | 16.56 (6.15) | 13.25 (6.22) | 3.230 | <0.001 *** | <0.001 *** |
Model | Variables | Mediator Variable: CDI | Dependent Variable: ISI | ||||
---|---|---|---|---|---|---|---|
1 | B | S.E | t | B | S.E | t | |
Constant | 12.94 | 0.38 | 34.45 | 2.02 | 0.35 | 5.80 | |
ETI | 0.57 | 0.07 | 7.76 | 0.28 | 0.04 | 6.56 | |
CDI | 0.15 | 0.02 | 6.77 | ||||
= 0.08, F = 60.16, p < 0.001 | = 0.15, F = 62.15, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.0831 | 0.0169 | 0.0536 | 0.1207 | |||
Direct effect | 0.2827 | 0.0431 | 0.1981 | 0.3673 | |||
2 | Mediator Variable: RCMAS | Dependent Variable: ISI | |||||
B | S.E | t | B | S.E | t | ||
Constant | 11.48 | 0.32 | 36.41 | 1.01 | 0.33 | 3.04 | |
ETI | 0.73 | 0.06 | 11.72 | 0.16 | 0.04 | 3.61 | |
RCMAS | 0.26 | 0.02 | 11.34 | ||||
= 0.16, F = 137.43, p < 0.001 | = 0.22, F = 103.42, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.1936 | 0.0240 | 0.1496 | 0.2439 | |||
Direct effect | 0.1552 | 0.0430 | 0.0709 | 0.2396 | |||
3 | Mediator Variable: CDI | Dependent Variable: ISI | |||||
B | S.E | t | B | S.E | t | ||
Constant | 14.45 | 0.30 | 47.82 | 2.32 | 0.35 | 6.71 | |
LTE | 1.63 | 0.39 | 4.16 | 1.12 | 0.22 | 5.15 | |
CDI | 0.17 | 0.02 | 7.95 | ||||
= 0.02, F = 17.27, p < 0.001 | = 0.13, F = 52.59, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.2728 | 0.0725 | 0.1434 | 0.4229 | |||
Direct effect | 1.1281 | 0.2184 | 0.6993 | 1.5570 | |||
4 | Mediator Variable: RCMAS | Dependent Variable: ISI | |||||
B | S.E | t | B | S.E | t | ||
Constant | 13.28 | 0.26 | 51.19 | 1.12 | 0.33 | 3.37 | |
LTE | 2.38 | 0.34 | 7.10 | 0.76 | 0.21 | 3.68 | |
RCMAS | 0.28 | 0.02 | 12.55 | ||||
= 0.06, F = 50.34, p < 0.001 | = 0.22, F = 103.87, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.6604 | 0.1071 | 0.4602 | 0.8824 | |||
Direct effect | 0.7686 | 0.2078 | 0.3606 | 1.1766 | |||
5 | Mediator Variable: CDI | Dependent Variable: ESS | |||||
B | S.E | t | B | S.E | t | ||
Constant | 12.94 | 0.38 | 34.49 | 4.78 | 0.36 | 13.14 | |
ETI | 0.57 | 0.07 | 7.76 | 0.16 | 0.04 | 3.51 | |
CDI | 0.08 | 0.02 | 3.57 | ||||
= 0.08, F = 60.26, p < 0.001 | = 0.05, F = 17.53, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.0457 | 0.0150 | 0.0186 | 0.0776 | |||
Direct effect | 0.1576 | 0.0449 | 0.0694 | 0.2458 | |||
6 | Mediator Variable: RCMAS | Dependent Variable: ESS | |||||
B | S.E | t | B | S.E | t | ||
Constant | 11.48 | 0.31 | 36.49 | 3.86 | 0.36 | 10.84 | |
ETI | 0.73 | 0.06 | 11.74 | 0.09 | 0.05 | 1.88 | |
RCMAS | 0.17 | 0.02 | 6.89 | ||||
= 0.15, F = 137.79, p < 0.001 | = 0.09, F = 36.37, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.1258 | 0.0224 | 0.0845 | 0.1727 | |||
Direct effect | 0.0862 | 0.0459 | −0.0040 | 0.1764 | |||
7 | Mediator Variable: CDI | Dependent Variable: ESS | |||||
B | S.E | t | B | S.E | t | ||
Constant | 14.45 | 0.30 | 47.90 | 4.91 | 0.36 | 13.71 | |
LTE | 1.63 | 0.39 | 4.16 | 0.70 | 0.23 | 3.13 | |
CDI | 0.09 | 0.02 | 4.26 | ||||
= 0.02, F = 17.31, p < 0.001 | = 0.05, F = 16.44, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.1486 | 0.0531 | 0.0591 | 0.2686 | |||
Direct effect | 0.0717 | 0.2255 | 0.2589 | 1.1446 | |||
8 | Mediator Variable: RCMAS | Dependent Variable: ESS | |||||
B | S.E | t | B | S.E | t | ||
Constant | 13.28 | 0.26 | 51.33 | 3.92 | 0.36 | 11.00 | |
LTE | 2.38 | 0.34 | 7.10 | 0.27 | 0.22 | 1.20 | |
RCMAS | 0.18 | 0.02 | 7.73 | ||||
= 0.06, F = 50.39, p < 0.001 | = 0.08, F = 35.17, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.4364 | 0.0826 | 0.2876 | 0.6130 | |||
Direct effect | 0.2614 | 0.2226 | −.1756 | 0.6984 | |||
9 | Mediator Variable: CDI | Dependent Variable: SSS_prob | |||||
B | S.E | t | B | S.E | t | ||
Constant | 12.93 | 0.37 | 34.54 | 15.12 | 0.49 | 30.68 | |
ETI | 0.57 | 0.07 | 7.73 | 0.36 | 0.06 | 5.96 | |
CDI | 0.11 | 0.03 | 3.60 | ||||
= 0.08, F = 59.72, p < 0.001 | = 0.09, F = 32.98, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.0621 | 0.0198 | 0.0247 | 0.1031 | |||
Direct effect | 0.3629 | 0.0609 | 0.2434 | 0.4824 | |||
10 | Mediator Variable: RCMAS | Dependent Variable: SSS_prob | |||||
B | S.E | t | B | S.E | t | ||
Constant | 11.48 | 0.31 | 36.55 | 14.32 | 0.48 | 29.78 | |
ETI | 0.74 | 0.06 | 11.79 | 0.25 | 0.06 | 3.96 | |
RCMAS | 0.21 | 0.03 | 6.28 | ||||
= 0.16, F = 139.05, p < 0.001 | = 0.11, F = 44.60, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.1554 | 0.0298 | 0.1000 | 0.2153 | |||
Direct effect | 0.2454 | 0.0620 | 0.1237 | 0.3671 | |||
11 | Mediator Variable: CDI | Dependent Variable: SSS_prob | |||||
B | S.E | t | B | S.E | t | ||
Constant | 14.42 | 0.30 | 47.88 | 15.51 | 0.49 | 31.77 | |
LTE | 1.65 | 0.39 | 4.21 | 1.52 | 0.31 | 4.95 | |
CDI | 0.14 | 0.03 | 4.59 | ||||
= 0.03, F = 17.76, p < 0.001 | = 0.07, F = 27.07, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.2242 | 0.0736 | 0.0976 | 0.3873 | |||
Direct effect | 1.5213 | 0.3073 | 0.9179 | 2.1247 | |||
12 | Mediator Variable: RCMAS | Dependent Variable: SSS_prob | |||||
B | S.E | t | B | S.E | t | ||
Constant | 13.30 | 0.26 | 51.34 | 14.48 | 0.48 | 30.19 | |
LTE | 2.37 | 0.34 | 7.08 | 1.13 | 0.30 | 3.78 | |
RCMAS | 0.23 | 0.03 | 7.34 | ||||
= 0.06, F = 50.06, p < 0.001 | = 0.11, F = 43.90, p < 0.001 | ||||||
Effect | Boot SE | 95% Boot LLCI | 95% Boot ULCI | ||||
Indirect effect | 0.5554 | 0.1113 | 0.3540 | 0.7881 | |||
Direct effect | 1.1323 | 0.2996 | 0.5441 | 1.7204 |
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Park, E.-J.; Kim, S.-Y.; Kim, Y.; Sung, D.; Kim, B.; Hyun, Y.; Jung, K.-I.; Lee, S.-Y.; Kim, H.; Park, S.; et al. The Relationship between Adverse Childhood Experiences and Sleep Problems among Adolescent Students: Mediation by Depression or Anxiety. Int. J. Environ. Res. Public Health 2021, 18, 236. https://doi.org/10.3390/ijerph18010236
Park E-J, Kim S-Y, Kim Y, Sung D, Kim B, Hyun Y, Jung K-I, Lee S-Y, Kim H, Park S, et al. The Relationship between Adverse Childhood Experiences and Sleep Problems among Adolescent Students: Mediation by Depression or Anxiety. International Journal of Environmental Research and Public Health. 2021; 18(1):236. https://doi.org/10.3390/ijerph18010236
Chicago/Turabian StylePark, E-Jin, Shin-Young Kim, Yeeun Kim, Dajung Sung, Bora Kim, Yerin Hyun, Kyu-In Jung, Seung-Yup Lee, Hayeon Kim, Subin Park, and et al. 2021. "The Relationship between Adverse Childhood Experiences and Sleep Problems among Adolescent Students: Mediation by Depression or Anxiety" International Journal of Environmental Research and Public Health 18, no. 1: 236. https://doi.org/10.3390/ijerph18010236