@article{ref1,
title="Sleep quality as a mediator of the relationship between cyber victimization and depression",
journal="Journal of nursing scholarship",
year="2020",
author="Kwon, Misol and Seo, Young S. and Nickerson, Amanda B. and Dickerson, Suzanne S. and Park, Eunhee and Livingston, Jennifer A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: Cyber victimization is a national mental health concern, especially among adolescents who are digital natives. The current study examined sleep quality as a mediator of the association between cyber victimization and depressive symptoms among adolescents.   DESIGN AND METHOD: A prospective study design was utilized with a community sample of adolescents (N = 801; 57% female; mean age = 14.45, SD =.85) from the eastern United States. Participants completed (a) the Pittsburgh Sleep Quality Index; (b) the Cyber Victimization Scale; and (c) the Center for Epidemiologic Studies Depression Scale Revised via online surveys at baseline and 6-month follow-up. The inter-relationship between variables was analyzed by Hayes' mediation approach.   FINDINGS: Cyber victimization was not directly associated with having depressive symptoms 6 months later when controlling for adolescents' poor sleep quality, sex, and age (direct effect [c'] =.012, t(676) = 1.12, p <.05, confidence interval [CI] -.008,.036). The mediation analysis indicated a significant indirect effect of poor sleep quality on the relationship between cyber victimization and depressive symptoms (ab =.005, bootstrapped standard error [SE] =.003, bootstrapped CI.001,.011; a is the effect of cyber victimization on poor sleep quality; b is the effect of poor sleep quality on depressive symptoms). Specifically, adolescents' cyber victimization led to poor sleep quality (a =.039, SE =.041, p <.05), which also led to increased depressive symptoms (b =.116, SE =.019, p <.001), after controlling for depressive symptoms at baseline, sex, and age. The indirect effect of cyber victimization on depressive symptoms was estimated through poor sleep quality (a*b =.039(.116) =.0045).   CONCLUSIONS: The findings suggest that poor sleep quality may be a mechanism through which cyber bullying is related prospectively to depressive symptoms. Interventions for cyber-victimized adolescents should include assessment of sleep quality and incorporate sleep hygiene education.   CLINICAL RELEVANCE: Adolescents should be screened for cyber victimization and sleep quality. Moreover, promotion of sleep hygiene among cyber-victimized adolescents may help to reduce depression.<p /> <p>Language: en</p>",
language="en",
issn="1527-6546",
doi="10.1111/jnu.12569",
url="http://dx.doi.org/10.1111/jnu.12569"
}