Complete mediation of depression in the association between sleep disturbance and suicidal ideation among doctoral students: a cross-sectional study of 2 300 participants

Luo Gui

doi:10.16016/j.2097-0927.202606051

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Complete mediation of depression in the association between sleep disturbance and suicidal ideation among doctoral students: a cross-sectional study of 2 300 participants

Medical Psychology | 更新时间：2026-10-30

- Complete mediation of depression in the association between sleep disturbance and suicidal ideation among doctoral students: a cross-sectional study of 2 300 participants
- Journal of Army Medical University Vol. 48, Issue 20, Pages: 2957-2965(2026)
- 作者机构：
  
  1.华中师范大学：大学生心理健康教育中心，湖北武汉
  2.华中师范大学：心理学院，湖北武汉
- 作者简介：
  
  Luo Gui， E-mail： luogui@ccnu.edu.cn
- 基金信息：
  
  the Philosophy and Social Sciences Research Project of Hubei Provincial Department of Education(25XZ075);the Comprehensive Reform and Quality Enhancement Project for Improving the Quality of Ideological and Political Work of Central China Normal University(SZZX202628)
- DOI：10.16016/j.2097-0927.202606051
  CLC： B846;R338.63;R749.4
- Received：11 June 2026，
  
  Revised：2026-08-31，
  
  Accepted：06 September 2026，
  
  Published：30 October 2026
- 稿件说明：
移动端阅览
骆贵.博士生自杀意念受睡眠障碍影响与抑郁完全中介：一项2 300例横断面研究［J］.陆军军医大学学报，2026，48（20）：2957-2965.DOI：10.16016/j.2097-0927.202606051.

Luo G.Complete mediation of depression in the association between sleep disturbance and suicidal ideation among doctoral students： a cross-sectional study of 2 300 participants［J］.J Army Med Univ，2026，48（20）：2957-2965.DOI：10.16016/j.2097-0927.202606051.
骆贵.博士生自杀意念受睡眠障碍影响与抑郁完全中介：一项2 300例横断面研究［J］.陆军军医大学学报，2026，48（20）：2957-2965.DOI：10.16016/j.2097-0927.202606051. DOI：

Luo G.Complete mediation of depression in the association between sleep disturbance and suicidal ideation among doctoral students： a cross-sectional study of 2 300 participants［J］.J Army Med Univ，2026，48（20）：2957-2965.DOI：10.16016/j.2097-0927.202606051. DOI：

摘要

目的

在社会转型和教育改革不断深化的背景下，博士生心理健康问题备受关注。本研究旨在探讨博士生焦虑、抑郁、睡眠障碍与自杀意念的关联，筛查博士生自杀意念的独立影响因素，并分析抑郁在睡眠障碍与自杀意念之间的中介效应。

方法

采用整群抽样法，于2026年3—4月选取华中地区2 300名博士生为研究对象。采用广泛性焦虑量表（Generalized Anxiety Disorder-7，GAD-7）、患者健康问卷抑郁量表（Patient Health Questionnaire Depression Scale-9，PHQ-9）、失眠严重程度指数量表（Insomnia Severity Index，ISI）、自杀行为问卷-修订版（Suicidal Behaviors Questionnaire-Revised，SBQ-R）进行问卷调查。计算博士生焦虑、抑郁、睡眠障碍及自杀意念状况的检出率及共存检出率。采用Mann-Whitney

秩和检验和Kruskal-Wallis

秩和检验比较不同组别间症状得分的分布差异。采用Spearman秩相关分析探讨焦虑、抑郁、睡眠障碍与自杀意念的相关性。采用二元Logistic回归分析探讨博士生自杀意念的影响因素。采用Process宏程序中的模型4及Bootstrap法，检验抑郁在睡眠障碍与自杀意念之间的中介作用。采用Process宏程序中的模型59及Bootstrap法，检验性别和年级在中介效应中的调节作用。

结果

博士生焦虑、抑郁、睡眠障碍、自杀意念的检出率分别为25.6%、27.3%、22.7%和7.8%，焦虑-抑郁共存检出率为18.7%，焦虑-睡眠障碍共存检出率为14.1%，抑郁-睡眠障碍共存检出率为16.2%。女性焦虑（

=-3.962，

0.001）、抑郁（

=-2.732，

=0.006）得分分布显著高于男性，高年级博士生焦虑（

=42.732，

0.001）、抑郁（

=24.093，

0.001）、睡眠障碍（

=11.187，

=0.011）得分分布显著高于低年级，≥35岁组自杀意念得分分布显著高于30~

35岁组（

=2.458，

=0.042）。相关分析显示，焦虑、抑郁、睡眠障碍与自杀意念两两之间均呈正相关（

=0.247~0.744，

0.001）。二元Logistic回归分析显示，抑郁是博士生自杀意念的独立影响因素（

=1.269，95%

：1.179~1.365，

0.001）。中介效应模型显示，抑郁在睡眠障碍与自杀意念之间起完全中介作用，间接效应值为0.032（95%

：0.024~0.040）。年级在中介模型的前半路径“睡眠障碍-抑郁”中起调节作用（

=0.038，

0.001），性别在中介模型的后半路径“抑郁-自杀意念”中起调节作用（

=0.015，

0.05）。

结论

焦虑、抑郁、睡眠障碍与自杀意念之间存在显著正相关关系，抑郁是自杀意念的显著预测因素，抑郁在睡眠障碍与自杀意念之间发挥完全中介作用。高校可构建“睡眠健康管理-抑郁症状筛查-自杀风险防控”的层级化干预体系，通过改善博士生睡眠质量来降低博士生抑郁水平，减弱睡眠障碍对自杀意念的影响，从而实现博士生心理危机的前置预防与精准干预。

Abstract

Objective

In the context of ongoing social transformation and educational reforms

mental health issues among doctoral students have attracted considerable attention. This study aims to explore the association of anxiety

depression and sleep disturbance with suicidal ideation among doctoral students

identify the independent influencing factors for suicidal ideation

and examine the mediating effect of depression on the relationship between sleep disturbance and suicidal ideation.

Methods

A total of 2 300 doctoral students from Central China were selected using cluster sampling between March and April 2026. Generalized Anxiety Disorder Scale (GAD-7)

Patient Health Questionnaire Depression Scale-9 (PHQ-9)

Insomnia Severity Index (ISI)

and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were used for survey. The detection rates of anxiety

depression

sleep disturbance and suicidal ideation and their co-occurrence rates were calculated among the participants. Mann-Whitney

test and Kruskal-Wallis

test were employed to compare the distribution differences of symptom scores across groups. Spearman rank correlation analysis was used to explore the correlations of anxiety

depression and sleep disturbance with suicidal ideation. Binary logistic regression analysis was applied to identify the influencing factors for suicidal ideation. PROCESS Macro Model 4 and Bootstrap method were carried out to test the mediating effect of depression between sleep disturbance and suicidal ideation

whereas PROCESS Macro Model 59 was conducted to examine the moderating effect of gender and grade on the mediating effect.

Results

The detection rates of anxiety

depression

sleep disturbance and suicidal ideation were 25.6%

27.3%

22.7% and 7.8%

respectively

among the participants. The co-occurrence rates were 18.7% for anxiety and depression

14.1% for anxiety and sleep disturbance

and 16.2% for depression and sleep disturbance. Female doctoral students had significantly higher distributions of anxiety (

=-3.962

0.001) and depression (

=-2.732

=0.006) scores than male students. Doctoral students in higher grades had significantly higher distributions of anxiety (

=42.732

0.001)

depression (

=24.093

0.001)

and sleep disturbance (

=11.187

=0.011) scores than those in lower grades. Doctoral students aged ≥35 years had significantly higher distributions of suicidal ideation scores than those aged 30－

35 years (

=2.458

=0.042). Correlation analyses revealed that anxiety

depression

sleep disturbance and suicidal ideation were positively correlated pairwise (

=0.247 to 0.744

0.001). Binary logistic regression analysis showed that depression was an independent influencing factor for suicidal ideation (

=1.269

95%

: 1.179 to 1.365

0.001). Mediation analysis demonstrated that depression played a complete mediating role between sleep disturbance and suicidal ideation (indirect effect size=0.032

95%

: 0.024 to 0.040). Grade played a moderating role in the first-stage path from sleep disturbance to depression (

=0.038

0.001)

whereas gender moderated the second-stage path from depression to suicidal ideation (

=0.015

0.05).

Conclusion

Anxiety

depression

and sleep disturbance are significantly positively correlated with suicidal ideation. Depression is a significant predictor of suicidal ideation

and plays a complete mediating role between sleep disturbance and suicidal ideation. Universities may construct a hierarchical intervention system covering sleep health management

depressive symptom screening

and suicide risk prevention and control. Improving the sleep quality may reduce depressive symptoms

weaken the impact of sleep disturbance on suicidal ideation

so as to facilitate the pre-emptive prevention and targeted intervention for psychological crises among doctoral students.

关键词

Keywords

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