Shuang-Jiang Zhou

Background: Sleep is essential for the physical and mental health of adolescents. Previous international studies have indicated a strong association between adverse childhood experiences (ACEs) and insomnia, although relevant reports focusing on Chinese adolescents remain limited. Methods: This online cross-sectional study ultimately included 6670 adolescents aged 12– 18 years. Childhood adversity and insomnia symptoms were assessed using the Adverse Childhood Experiences Questionnaire and the Insomnia Severity Index (ISI), respectively. Statistical analyses included chi-square tests to compare ACE prevalence between groups, binary logistic regression to identify risk factors for insomnia symptoms, and Network analysis explored interrelationships among specific ACEs and insomnia symptoms, using centrality indices (strength, closeness, betweenness) to evaluate symptom influence. Results: The prevalence of ACEs was 47.6% and insomnia symptoms was 20.6%. ACEs showed a cumulative dose-effect relationship with insomnia. Adolescents with ACEs had a significantly higher incidence of insomnia than those without. Physical abuse (OR = 1.41), emotional neglect (OR = 1.32), social isolation or exclusion (OR = 2.52), and witnessing community violence (OR = 1.57) were identified as significant risk factors for insomnia symptoms. Network analysis showed that ACE10 (family crime, strength z = 2.084) and ACE12 (Isolated or excluded, betweenness z = 3.594) were the most central ACE nodes. The strongest cross-domain connections were ISI4 (sleep dissatisfaction) and ACE12 (edge weights = 0.081), and between ISI1 (difficulty falling asleep) and ACE12 (edge weights = 0.077). Conclusion: ACEs and insomnia symptoms are prevalent and closely interrelated among Chinese adolescents. These findings highlight the need to strengthen the assessment of ACEs in this population and implement timely interventions to reduce the incidence of insomnia. However, as this is a cross-sectional study from a single province, further research is needed in terms of its generalizability.

Background: Major depressive disorder (MDD) in adolescents represents a significant global public health challenge. Moreover, metacognitive dysfunction plays a critical role in its onset, progression, and prognosis, but research on the metacognitive characteristics of Chinese adolescents with MDD remains highly limited. Methods: The study was conducted from January 2024 to January 2025 and employed a cross-sectional design with convenience sampling. The participants included 202 adolescents who were diagnosed with MDD, with a mean age of 15 years. All the subjects completed a self-administered general information questionnaire to collect demographic information. The Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Adverse Childhood Experience Questionnaire-Revised (ACE), Rumination Response Scale Chinese Version (RRS), and Metacognitive Questionnaire-30 (MCQ) were utilized to evaluate the psychological well-being of adolescents diagnosed with MDD. Results: Multiple linear regression analyses demonstrated the potential of the RRS total score, reflective pondering and household dysfunction as predictors of metacognitive deficits in adolescents diagnosed with MDD, with statistical significance at p < 0.05. Furthermore, the total ACE scores of adolescents diagnosed with MDD were significantly positively correlated with the MCQ (β = 0.189, p < 0.001) and RRS (β = 0.380, p < 0.001) scores. Additionally, the total RRS score was positively correlated with the MCQ score (β = 0.675, p < 0.001). Mediation analyses demonstrated that rumination mediated the association between adverse childhood experiences and metacognitive deficits, with a mediating effect value of 1.136 and a 95% confidence interval of [0.639, 1.635], explaining 57.32% of the total effect. Conclusion: Rumination mediates the relationship between adverse childhood experiences and metacognitive deficits in adolescents with MDD. Rumination, reflective pondering and household dysfunction in adolescents with MDD can predict metacognitive dysfunction to varying degrees. Our study highlights that interventions targeting rumination may be particularly effective in mitigating the negative impact of ACEs on metacognitive functioning in adolescents with MDD.

BACKGROUND Internet gaming disorder (IGD) has become increasingly prevalent among college students, while the prevalence of insomnia and social jet lag has also gradually increased in this population. Comorbidity among these conditions is common in young adults. Nevertheless, the internal correlational architecture underlying individual symptom indicators remains unclear. OBJECTIVE This study aimed to investigate the central and bridge symptoms of IGD, social jet lag, and insomnia among college students; to explore the network structure and cross-symptom connectivity among them; and to provide evidence for targeted interventions for comorbid insomnia and IGD. METHODS This cross-sectional study targeted a national sample of Chinese college students. A total of 1346 participants were included in this study, with a mean age of 19.35 (SD 1.35) years, including 668 (49.6%) male participants and 678 (50.4%) female participants. All participants completed a general information questionnaire, the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI). Network analysis was used to investigate the network structure, identify central and bridge symptoms, quantify the correlation intensity between indicators, and assess network stability. Expected influence (EI) and bridge expected influence (BEI) were used to measure centrality. RESULTS Three distinct variable clusters were extracted from the overall network: the insomnia factor cluster, the IGD symptom cluster, and social jet lag. The insomnia symptom “subjective sleep quality” (P1; strength=0.903) and the IGD symptom “loss” (I9; strength=2.463) were the most central nodes in the network, constituting the key indicators of this study. The bridge strength of all nodes ranged from 0.029 to 1.295. “Withdrawal” (I2) exhibited markedly higher bridge strength than all other nodes (1.295, 95% CI 1.162-1.428), followed by “social jet lag” (S1; 0.522, 95% CI 0.384-0.690) and “preoccupation” (I1; 0.519, 95% CI 0.364-0.718). As the key bridging symptom between the insomnia and IGD clusters, I2 had the strongest edge connection with “daytime dysfunction” (P7), with an edge weight of 0.329 (95% CI 0.246-0.450). Connections involving the social jet lag cluster (S1) were concentrated on “continue despite problems” (I6; 0.182, 95% CI 0.012-0.364), while the connections between the insomnia symptom cluster and S1 were all low. CONCLUSIONS Unlike previous studies that focused on bivariate associations or single disorders, our findings reveal that I2 serves as the key bridging symptom connecting insomnia and IGD, while P1 and I9 are central nodes within their respective structural communities. These findings provide a novel perspective on the comorbidity of insomnia and IGD. In real-world practice, interventions targeting withdrawal symptoms should be prioritized, as they may alleviate comorbid symptoms simultaneously. The role of S1 was relatively limited, suggesting that managing circadian rhythm disruption may indirectly reduce the risk of IGD. These findings provide actionable symptom targets for prevention and treatment programs in university settings.

Background: Internet gaming disorder (IGD) has become increasingly prevalent among college students, while the prevalence of insomnia and social jet lag has also gradually increased in this population. Comorbidity among these conditions is common in young adults. Nevertheless, the internal correlational architecture underlying individual symptom indicators remains unclear. Objective: This study aimed to investigate the central and bridge symptoms of IGD, social jet lag, and insomnia among college students; to explore the network structure and cross-symptom connectivity among them; and to provide evidence for targeted interventions for comorbid insomnia and IGD. Methods: This cross-sectional study targeted a national sample of Chinese college students. A total of 1346 participants were included in this study, with a mean age of 19.35 (SD 1.35) years, including 668 (49.6%) male participants and 678 (50.4%) female participants. All participants completed a general information questionnaire, the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI). Network analysis was used to investigate the network structure, identify central and bridge symptoms, quantify the correlation intensity between indicators, and assess network stability. Expected influence (EI) and bridge expected influence (BEI) were used to measure centrality. Results: Three distinct variable clusters were extracted from the overall network: the insomnia factor cluster, the IGD symptom cluster, and social jet lag. The insomnia symptom “subjective sleep quality” (P1; strength=0.903) and the IGD symptom “loss” (I9; strength=2.463) were the most central nodes in the network, constituting the key indicators of this study. The bridge strength of all nodes ranged from 0.029 to 1.295. “Withdrawal” (I2) exhibited markedly higher bridge strength than all other nodes (1.295, 95% CI 1.162-1.428), followed by “social jet lag” (S1; 0.522, 95% CI 0.384-0.690) and “preoccupation” (I1; 0.519, 95% CI 0.364-0.718). As the key bridging symptom between the insomnia and IGD clusters, I2 had the strongest edge connection with “daytime dysfunction” (P7), with an edge weight of 0.329 (95% CI 0.246-0.450). Connections involving the social jet lag cluster (S1) were concentrated on “continue despite problems” (I6; 0.182, 95% CI 0.012-0.364), while the connections between the insomnia symptom cluster and S1 were all low. Conclusions: Unlike previous studies that focused on bivariate associations or single disorders, our findings reveal that I2 serves as the key bridging symptom connecting insomnia and IGD, while P1 and I9 are central nodes within their respective structural communities. These findings provide a novel perspective on the comorbidity of insomnia and IGD. In real-world practice, interventions targeting withdrawal symptoms should be prioritized, as they may alleviate comorbid symptoms simultaneously. The role of S1 was relatively limited, suggesting that managing circadian rhythm disruption may indirectly reduce the risk of IGD. These findings provide actionable symptom targets for prevention and treatment programs in university settings.

At present, insomnia, fatigue and mental health problems of researchers are increasingly prominent, and they are facing great perceived stress. However, there are relatively few studies on Chinese researchers, and the relationship between them is not clear. This study mainly explores the current status of insomnia and fatigue symptoms of Chinese researchers, and the relationship with perceived stress and anxiety symptoms. A Total of 961 Chinese researchers participated in this nationwide cross-sectional survey. The Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Perceived Stress Scale (PSS) and Generalized Anxiety Disorder Scale (GAD-7) were used for evaluation. The count data were analyzed by chi-square analysis, the measurement data were analyzed by independent sample t test, and the chain mediation analysis was used to explore the relationship between insomnia, fatigue symptoms, perceived stress and anxiety symptoms. The prevalence of insomnia symptoms was 36.9% and The prevalence of fatigue symptoms was 68.7% among Chinese researchers. The multivariate covariance analysis showed that the scores of anxiety symptoms, perceived stress, and fatigue symptoms of the researchers with insomnia symptoms were higher than those of the researchers without insomnia symptoms (p<0.001). Insomnia and fatigue symptoms were related to lifestyle and exercise. Fatigue and anxiety symptoms played a chain mediating role between perceived stress and insomnia symptoms (Total indirect effect: 0.180(0.146,0.211), Direct effect: 0.036(-.0.001,0.079), Total effect: 0.216(0.190,0.242)). Insomnia and fatigue symptoms are serious among Chinese researchers. We should pay attention to the sleep and mental health problems of researchers, strengthen psychological intervention, and reduce their perceived stress level. The online version contains supplementary material available at 10.1186/s12889-025-24800-y.

Purpose: Bruxism is relatively common among adolescents; however, the psychological factors affecting its occurrence remain unclear. This study explored the incidence of bruxism in adolescents, and the role of childhood trauma and perceived stress in the occurrence of bruxism. Patients and Methods: This was an online cross-sectional survey of 7794 adolescents aged 12– 18 years, with 6780 adolescents meeting the inclusion criteria. We used the Adverse Childhood Experiences Questionnaire (ACEQ) to assess childhood trauma experiences, the Perceived Stress Scale (PSS) to evaluate stress in adolescents, and three items to assess bruxism. The chi-square test was used for demographic data and t-test was used for continuous variables. A mediation analysis was used to explore the mechanism of childhood trauma as it relates to bruxism. Results: Our research shows that about 21.6% of sampled adolescents had bruxism. Being in adolescents, childhood trauma, and high levels of perceived stress were risk factors for bruxism, and good academic performance was a protective factor against bruxism. Adolescents with bruxism had higher levels of childhood trauma and perceived stress. Perceived stress levels played a mediating role in the relationship between childhood trauma and the development of bruxism. Conclusion: Bruxism is common in adolescents, and its occurrence is related to childhood trauma and perceived stress levels. Childhood trauma mediates bruxism through perceived stress levels. Attention should be paid to the childhood trauma experiences and perceived stress levels of adolescents with bruxism, and timely interventions should be provided that are conducive to reducing the occurrence of bruxism.

Background: To explore the prevalence and determinants of depressive and anxious symptoms among adolescents in China, focusing on regional disparities, cognitive function, psychological resilience, and family functioning. Methods: A total of 39854 adolescents, aged 12– 18 years, participated in this survey. Data were collected using SoJump software between January 8 and January 25, 2023. The Patient Health Questionnaire-9, Generalized Anxiety Disorder Questionnaire-7, Cognitive Deficits Questionnaire-5, Connor–Davidson Resilience Scale-10, and Family APGAR Questionnaire were completed. Statistical analyses, including descriptive statistics, correlation analysis, and multivariate linear regression, were conducted to explore the relationships between variables. Results: Significant regional differences were observed in depression (6.16 ± 6.16 versus [vs] 5.18 ± 5.77; P < 0.001) and anxiety symptoms (4.15 ± 5.18 vs 3.34 ± 4.82, P < 0.001), with adolescents in the western regions exhibiting higher scores. Depressive symptoms were positively correlated with cognitive function (r = 0.577, P < 0.05), as were anxious symptoms (r = 0.533, P < 0.05). Both depressive (r = – 0.339, P < 0.05) and anxious symptoms (r = – 0.321, P < 0.05) were negatively correlated with psychological resilience, as well as with family functioning (r = – 0.302 and r = – 0.284, respectively; P < 0.05). In addition, compared to adolescents who lived with their parents, those who lived with others had more severe depressive and anxious symptoms. Conclusion: Our study revealed significant regional disparities in depressive and anxious symptoms among Chinese adolescents, with higher levels observed in Western China. Cognitive function showed a positive association, while psychological resilience and family functioning were negatively linked to these symptoms. By comprehending and targeting these factors through specific interventions and policies, we can ease the mental health burden on this vulnerable population.

Alcohol Use Disorder (AUD), encompassing Alcohol Abuse (AA) and Alcohol Dependence (AD), is a chronic, relapsing brain condition that can cause mental and physical issues. Confusion between AA and AD can lead to ineffective or even excessively aggressive treatments, but distinguishing them is difficult due to similar symptoms and physiological indicators. Fortunately, from a psychological perspective, AA is closely linked to poor behavioral control, while AD is associated with affective lability. These psychological mechanisms are differently featured in the activity of patients' brain regions. Inspired by this, we propose a model called Multiscale and Hybrid Spatial Temporal Graph Convolutional Network (MuST-GCN) that enables to extract the features of electroencephalogram (EEG) signals for accurate identification of AA and AD within AUD. It includes two modules: Multiscale Feature Extraction (MSFE) module with GCN concurrently analyzes inter-regional and intra-regional connectivity of brain regions to extract EEG features, exploring functional connectivity differences in AA and AD patients; Hybrid Spatial Temporal Memory (HSTM) module integrates spatial and temporal attention mechanisms to refine the significant features extracted from MSFE, targeting the key brain regions and temporal dynamics. The HSTM module yields a refined feature representation reducing overfitting and improving multiclass classification accuracy. MuST-GCN is evaluated using five-fold cross-validation on two datasets, achieving classification accuracies of 90.74% and 99.99%, respectively, and demonstrating superior performance in identifying AA, AD, and AUD compared to existing methods. Our codes are publicly accessible at https://github.com/SunYule123/MuST-GCN.

Owing to their vulnerability to public health crises, adolescents’ mental health status, and related risk factors in the post-pandemic era in China require examination. This study aimed to lay a foundation for subsequent interventions and mental disorder prevention among adolescents. An anonymous online survey was conducted January 8–18, 2023. The survey comprised two parts. The first part collected personal information. The second part included the nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder Scale, and Pittsburgh Sleep Quality Index. Of 50,666 adolescent participants, 46.8% displayed depressive symptoms, 31.5% showed anxiety symptoms, and 47.9% experienced difficulties initiating sleep within 30 min, while 4.9% manifested depressive, anxiety, and insomnia symptoms simultaneously. Chi-square tests revealed significant variations in the prevalence of these conditions according to age, sex, coronavirus disease-2019 (COVID-19) infection status, family infection status, and increased screen time (P < 0.001). Logistic regression analysis indicated heightened rates of depression, anxiety, and insomnia symptoms among rural adolescents, females, those aged 16–18 years, individuals with a history of COVID-19, those with a long COVID-19 illness, and those with increased screen time (all P < 0.001). The mental health status of adolescents in the post-pandemic era should be taken seriously, particularly that of females, high school students, and adolescents with increased use of electronic screens. Among such efforts, school administrators should strengthen their connection with psychologists, as early identification and intervention in adolescents are important for preventing school crises.

The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12-18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children's Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents' QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events.