BMC Public Health. 2025 Mar 3;25(1):838. doi: 10.1186/s12889-025-22040-8.
ABSTRACT
BACKGROUND: Evidence on psychological outcomes of gaming disorder (GD) is still scarce. This study aimed to investigate the mediating role of sleep hygiene in the relationship between GD and psychological distress (depression and anxiety) among Iranian adolescents.
METHODS: This was a cross-sectional study among school students in Qazvin city, Iran. We administered GD, anxiety, and depression questionnaires in a paper-and-pencil format. GD was measured using the GD S4-SF scale, and anxiety and depression were evaluated using the DASS-21. We assessed sleep health as a mediator using the Sleep Hygiene Behaviors scale. Covariance-Based Structural Equation Modeling (CB-SEM) was employed for data analysis, accounting for sex and physical activity as the main confounders. Statistical significance was determined using various fit indices and confidence intervals.
RESULTS: The sample consisted of 600 adolescents (41% female). CB-SEM revealed a positive but not statistically significant association between GD and depression, along with a negative statistically significant association with anxiety. Notably, sleep hygiene was identified as a partial mediator in the relationship between GD and depression, indicating that poor sleep practices may exacerbate depressive symptoms among adolescents with GD. However, no mediating effect was observed for anxiety.
CONCLUSION: Our data supported a mediating role for sleep hygiene in the association between GD and depression among participants. Our results highlight the critical need for targeted policy interventions to improve sleep hygiene among adolescents with GD.
PMID:40033319 | DOI:10.1186/s12889-025-22040-8
