Mediating role of mindfulness attention awareness between perceived stress and depressive in patients with concomitant depression and insomnia
10.16016/j.2097-0927.202508035
- VernacularTitle: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
- Author:
Hui CHEN
1
;
Zonghua WANG
;
Hui LIN
;
Wei HE
;
Lei HUANG
;
Xiao HUI
;
Qing CHEN
;
Jiqiu DONG
;
Qingling ZHANG
Author Information
1. 陆军军医大学(第三军医大学)第二附属医院:消化内科
- Keywords:
depression;
insomnia;
mindfulness;
perceived stress
- From:
Journal of Army Medical University
2025;47(21):2717-2724
- CountryChina
- Language:Chinese
-
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(r=0.531,0.351,P<0.001)and negatively correlated with mindful attention and awareness(r=-0.373,-0.350,P<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(P<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.
