The Relationship Between Family Function And Anxiety Symptoms,Depression Symptoms In Primary And Secondary School Students:the Mediating Effect Of Sleep Quality And Resilience

Objective Previous studies on family function and anxiety symptoms,depression symptoms in children and adolescents in Anhui Province are still few,and the potential mediating mechanism between family function and anxiety symptoms,depression symptoms remains to be explored.Therefore,this study explored the relationship between family function and anxiety symptoms,depression symptoms of primary and secondary school students,as well as the mediating effect of sleep quality and resilience between them,and according to different genders and grades to explore whether there were differences in the mediating effect between different groups.Methods From October to December 2020,6363 students from Grade 4 to Grade 9 in some areas of Anhui Province were surveyed by self-filling questionnaire.Family function,sleep quality,resilience,anxiety symptoms and depression symptoms were measured by the Family APGAR Scale,the Pittsburgh Sleep Quality Index Scale,the Child and Youth Resilience Measure,the Screen for Children Anxiety Related Emotional Disorders and the Center for Epidemiologic Studies Depression Scale.SPSS23.0 software was used for descriptive analysis,demographic difference analysis,Spearman correlation analysis,and model was established to analyze the mediating effect of the sleep quality and resilience.Results1.The median(IQR)of family function score,sleep quality score,resilience score,anxiety symptoms score and depression symptoms score were 8(4)points,4(3)points,108(20)points,15(18)points and 11(13)points,respectively.2.There are significant statistical differences in family function,anxiety symptoms and depression symptoms of primary and secondary school students between the group comparison in terms of different gender,grade,whether they are the only child,whether their parents are divorced,family location,family economic status and parents’ education level.In addition,there is also significant statistical difference in sleep quality between the groups of whether the father died or not.There are significant statistical differences in resilience between the groups of different grade,nationality,whether the only child,whether the mother died,whether the parents divorced,different family location,family economic status,and parents’ education level.3.There was a significant negative correlation between family function and sleep quality,anxiety symptoms and depression symptoms(r=-0.322,p<0.01;r=-0.288,p<0.01;r=-0.467,p<0.01).There is a significant positive correlation between family function and resilience(r=0.591,p<0.01).Sleep quality has a significant positive correlation with anxiety symptoms and depression symptoms(r=0.442,p<0.01;r=0.499,p<0.01),and a significant negative correlation with resilience(r=-0.296,p<0.01).There is a significant negative correlation between resilience and anxiety symptoms,depression symptoms(r=-0.257,p<0.01;r=-0.483,p<0.01).There is a significant positive correlation between anxiety symptoms and depression symptoms(r=0.633,p<0.01).4.Sleep quality and resilience play partial and sequence mediating effects in the relationship between family function and anxiety symptoms of primary and secondary school students.The total effect was-0.218(95%CI:-0.242--0.194),the total indirect effect was-0.125(95%CI:-0.145--0.105),and the proportion of indirect effect was57.3%.Sleep quality and resilience play partial and sequence mediating effects in the relationship between family function and depression symptoms of primary and secondary school students.The total effect was-0.397(95%CI:-0.419--0.374),the total indirect effect was-0.185(95%CI:-0.204--0.166),and the proportion of indirect effect was 46.6%.5.In the analysis of family function and anxiety symptoms,depression symptoms of primary and secondary school students,the partial mediating effect of sleep quality and resilience and the sequence mediating effect of sleep quality and resilience have significant significance in both boys and girls.In the analysis of family function to anxiety symptoms of primary and secondary school students,the partial mediating effect of resilience and the sequence mediating effect of sleep quality and resilience have significant significance in secondary school students,but not in primary school students.In the analysis of family function and depression symptoms in primary and secondary school students,the partial mediating effect of sleep quality and resilience and the sequence mediating effect of sleep quality and resilience are significant in primary and secondary school students.Conclusion Sleep quality and resilience partially mediated the relationship between family function and anxiety symptoms,depression symptoms of primary and secondary school students respectively.Meanwhile,sleep quality and resilience also play a sequence mediating effect in the relationship between family function and anxiety symptoms,depression symptoms.These findings suggest that we should pay attention to the individual and family state of primary and secondary school students in time,and take comprehensive intervention measures,so as to effectively reduce the occurrence of anxiety symptoms and depression symptoms.