Mediating role of mindfulness attention awareness between perceived stress and depressive in patients with concomitant depression and insomnia

CHEN Hui; WANG Zonghua; LIN Hui; HE Wei; Huang Lei; HUI Xiao; CHEN Qing; DONG Jiqiu; ZHANG Qingling

doi:10.16016/j.2097-0927.202508035

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Mediating role of mindfulness attention awareness between perceived stress and depressive in patients with concomitant depression and insomnia

Medical Psychology | 更新时间：2025-11-13

- Mediating role of mindfulness attention awareness between perceived stress and depressive in patients with concomitant depression and insomnia
- Journal of Army Medical University Vol. 47, Issue 21, Pages: 2717-2724(2025)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）第二附属医院：，消化内科，重庆
  3.陆军军医大学（第三军医大学）第二附属医院：，医学心理科，重庆
  4.陆军军医大学（第三军医大学）第二附属医院：，医务处，重庆
  2.陆军军医大学（第三军医大学）护理系临床护理学教研室，重庆
  2.重庆市卫生健康统计信息中心，重庆
  5.Chongqing Health Statistics and Information Center， Chongqing， China
- 作者简介：
  
  ZHANG Qingling， E-mail： 2805604446@qq.com
- 基金信息：
  
  the Medical Scientific Research Projects of Chongqing Municipal Health Commission(2025WSJK104)
- DOI：10.16016/j.2097-0927.202508035
  CLC： R256.23;R395.1;R749.4
- Received：13 August 2025，
  
  Revised：2025-10-21，
  
  Accepted：23 October 2025，
  
  Published：15 November 2025
- 稿件说明：
移动端阅览
陈慧，王宗华，林辉，等.正念注意觉知在抑郁合并失眠患者知觉压力与抑郁情绪间的中介作用［J］.陆军军医大学学报，2025，47（21）：2717-2724.DOI：10.16016/j.2097-0927.202508035.

CHEN H，WANG Z H，LIN H，et al.Mediating role of mindfulness attention awareness between perceived stress and depressive in patients with concomitant depression and insomnia［J］.J Army Med Univ，2025，47（21）：2717-2724.DOI：10.16016/j.2097-0927.202508035.
陈慧，王宗华，林辉，等.正念注意觉知在抑郁合并失眠患者知觉压力与抑郁情绪间的中介作用［J］.陆军军医大学学报，2025，47（21）：2717-2724.DOI：10.16016/j.2097-0927.202508035. DOI：

CHEN H，WANG Z H，LIN H，et al.Mediating role of mindfulness attention awareness between perceived stress and depressive in patients with concomitant depression and insomnia［J］.J Army Med Univ，2025，47（21）：2717-2724.DOI：10.16016/j.2097-0927.202508035. DOI：

摘要

目的

探究正念注意觉知对抑郁合并失眠患者抑郁情绪和失眠严重程度的中介作用。

方法

采用横断面研究，选取2024年3—5月于陆军军医大学第二附属医院医学心理科门诊就诊的267例抑郁合并失眠患者为研究对象。采用一般资料调查表收集患者基本人口学及临床资料，患者健康问卷抑郁量表（patient health questionnaire，PHQ-9）测量抑郁情绪水平，失眠严重指数量表（insomnia severity index scale，ISI）测量失眠症状严重程度，知觉压力量表-10（perceived stress scale-10，PSS-10）测量知觉压力水平，正念注意觉知量表（mindful attention awareness scale，MAAS）测量正念注意觉知水平。采用Pearson相关法分析患者抑郁、失眠严重程度与知觉压力、正念注意觉知的相关性；采用Process 4.1进行中介效应分析。

结果

267例抑郁合并失眠患者PHQ-9得分为13.80±5.98，ISI得分为17.10±5.56。Pearson 相关分析结果显示：抑郁、失眠严重程度均与知觉压力呈正相关（

=0.531、0.351，

0.001），与正念注意觉知呈负相关（

=-0.373、-0.350，

0.001）。Process 4.1中介效应分析提示：正念注意觉知和失眠在患者知觉压力水平与抑郁情绪水平之间的中介效应值为0.157，95%

为0.102~0.217，总中介效应显著（

0.001）。

结论

知觉压力既直接正向影响抑郁，又通过失眠中介间接加剧抑郁；正念注意觉知可削弱知觉压力对失眠的促进作用。

Abstract

Objective

To explore the mediating role of mindful attention and awareness in depressive symptoms and insomnia severity among patients with comorbid depression and insomnia.

Methods

A cross-sectional study was conducted

enrolling 267 patients with comorbid depression and insomnia who were treated in the outpatient Department of Medical Psychology of Second Affiliated Hospital of Army Medical University

from March to May 2024. Basic demographic and clinical data were collected using a general information questionnaire. Depressive symptom severity was measured

via

the Patient Health Questionnaire-9 (PHQ-9)

insomnia severity

via

the Insomnia Severity Index (ISI)

perceived stress

via

the Perceived Stress Scale-10 (PSS-10)

and mindful attention and awareness

via

the Mindful Attention Awareness Scale (MAAS). Pearson correlation analysis was used to examine the correlations between depressive severity

insomnia severity

perceived stress

and mindful attention and awareness. Mediation analysis was performed using Process 4.1.

Results

The PHQ-9 score was (13.80±5.98) and the ISI score was (17.10±5.56) in the 267 patients. Pearson correlation analysis showed that depressive severity and insomnia severity were positively correlated with perceived stress (

=0.531

0.351

0.001) and negatively correlated with mindful attention and awareness (

=-0.373

-0.350

0.001). Mediation analysis using Process 4.1 indicated that the combined mediating effect of mindful attention and awareness and insomnia between perceived stress level and depressive level was 0.157

with a 95% confidence interval (CI) of 0.102~0.217

and the total mediating effect was significant (

0.001).

Conclusion

Perceived stress directly positively affects depression and indirectly exacerbates depression through insomnia as a mediator

and mindful attention and awareness can weaken the promoting effect of perceived stress on insomnia.

关键词

Keywords

references

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