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. 2023 Oct-Dec;23(4):100406.
doi: 10.1016/j.ijchp.2023.100406. Epub 2023 Aug 25.

Applicability of the cognitive model of generalized anxiety disorder to adolescents' sleep quality: A cross-sectional and longitudinal analysis

Huiwen Xiao  1   2 , Yilin Shen  1 , Weizhong Zhang  1 , Rongmao Lin  1
Affiliations

Applicability of the cognitive model of generalized anxiety disorder to adolescents' sleep quality: A cross-sectional and longitudinal analysis

Huiwen Xiao et al. Int J Clin Health Psychol. 2023 Oct-Dec.

Abstract

Background: Poor sleep quality is a prevalent health issue among adolescents, and few studies have examined the variables affecting adolescents' sleep quality from the perspective of the co-occurrence of sleep issues and anxiety disorders. Therefore, the current study investigated whether the cognitive model of generalized anxiety disorder applies to adolescents' sleep quality.

Method: In Study 1, a total of 2042 adolescents were recruited and they completed questionnaires relating to worry, intolerance of uncertainty (IU), negative problem orientation (NPO), cognitive avoidance (CA), and sleep quality. In Study 2, a total of 379 adolescents participated in a six-month longitudinal survey to verify the model that was obtained in Study 1.

Results: Study 1 showed the modified cognitive model of generalized anxiety disorder can be applied to adolescents' sleep quality. Specifically, IU was a higher-order vulnerability factor that directly affected worry, and indirectly fostered worry via NPO and CA, where worry only mediated the relationships between IU, NPO, and sleep quality. However, CA exerted no independent effect on worry or sleep quality beyond the influences of IU and NPO, therefore, it dropped out of the final model. Study 2 partially confirmed the above model again from the longitudinal perspective.

Conclusion: The present study constructs a new model to explain adolescents' sleep quality, providing a foundation for future interventions.

Keywords: Cognitive model of generalized anxiety disorder; Intolerance of uncertainty; Negative problem orientation; Sleep quality; Worry.

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Conflict of interest statement

The authors have no conflict of interest. The manuscript has been approved by all of the co-authors for publication. Moreover, we would like to declare that (a) our paper is original research, and the same or substantially similar manuscript has not been simultaneously submitted for consideration by another journal; (b) the same or substantially similar manuscript has not already been published in whole or part; (c) data collection complied with current APA Ethical Principles of Psychologists and general ethical guidelines in psychology; (d) the paper does not reproduce any material from other sources.

Figures

Fig 1
Fig. 1
Hypothetical competing models.
Fig 2
Fig. 2
The standardized path coefficients of the cognitive model of adolescents’ sleep quality after excluding the effects of gender and grade in cross-sectional samples (Note: ⁎⁎⁎p < 0.001).
Fig 3
Fig. 3
Cross-lagged panel model regarding the cognitive model of adolescents’ sleep quality after controlling the effects of gender and grade (Note: *p < 0.05; ⁎⁎p < 0.01; ⁎⁎⁎p < 0.001; T1= Time 1, T2 = Time 2).
Fig 4
Fig. 4
The standardized path coefficients of the cognitive model of adolescents’ sleep quality after excluding the effects of gender and grade in longitudinal samples (Note: 0.10 < +p < 0.05; ⁎⁎p < 0.01; ⁎⁎⁎p < 0.001; T1= Time 1, T2 = Time 2).
Fig 5
Fig. 5
Cognitive mechanisms affecting adolescents’ sleep quality.
See this image and copyright information in PMC

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