Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene

Abstract Background Evidence on psychological outcomes of gaming disorder (GD) is still scarce. This study aimed to investigate the mediating role of sleep hygiene in the relationship between GD and psychological distress (depression and anxiety) among Iranian adolescents. Methods This was a cross-s...

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Main Authors: Leila Molaeipour, Reza Jabarbeigi, Tina Lari, Mehdi Osooli, Elahe Jafari
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22040-8
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author Leila Molaeipour
Reza Jabarbeigi
Tina Lari
Mehdi Osooli
Elahe Jafari
author_facet Leila Molaeipour
Reza Jabarbeigi
Tina Lari
Mehdi Osooli
Elahe Jafari
author_sort Leila Molaeipour
collection DOAJ
description Abstract Background Evidence on psychological outcomes of gaming disorder (GD) is still scarce. This study aimed to investigate the mediating role of sleep hygiene in the relationship between GD and psychological distress (depression and anxiety) among Iranian adolescents. Methods This was a cross-sectional study among school students in Qazvin city, Iran. We administered GD, anxiety, and depression questionnaires in a paper-and-pencil format. GD was measured using the GD S4-SF scale, and anxiety and depression were evaluated using the DASS-21. We assessed sleep health as a mediator using the Sleep Hygiene Behaviors scale. Covariance-Based Structural Equation Modeling (CB-SEM) was employed for data analysis, accounting for sex and physical activity as the main confounders. Statistical significance was determined using various fit indices and confidence intervals. Results The sample consisted of 600 adolescents (41% female). CB-SEM revealed a positive but not statistically significant association between GD and depression, along with a negative statistically significant association with anxiety. Notably, sleep hygiene was identified as a partial mediator in the relationship between GD and depression, indicating that poor sleep practices may exacerbate depressive symptoms among adolescents with GD. However, no mediating effect was observed for anxiety. Conclusion Our data supported a mediating role for sleep hygiene in the association between GD and depression among participants. Our results highlight the critical need for targeted policy interventions to improve sleep hygiene among adolescents with GD.
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spelling doaj-art-13ff10262a5b4892a115b5d4cf8bcaf42025-08-20T01:57:40ZengBMCBMC Public Health1471-24582025-03-012511810.1186/s12889-025-22040-8Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygieneLeila Molaeipour0Reza Jabarbeigi1Tina Lari2Mehdi Osooli3Elahe Jafari4Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical SciencesNon-Communicable Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical SciencesDepartment of Epidemiology, School of Public Health, Iran University of Medical SciencesDivision of Clinical Epidemiology and Pharmacoepidemiology, Department of Medicine Solna, Karolinska InstitutetNon-Communicable Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical SciencesAbstract Background Evidence on psychological outcomes of gaming disorder (GD) is still scarce. This study aimed to investigate the mediating role of sleep hygiene in the relationship between GD and psychological distress (depression and anxiety) among Iranian adolescents. Methods This was a cross-sectional study among school students in Qazvin city, Iran. We administered GD, anxiety, and depression questionnaires in a paper-and-pencil format. GD was measured using the GD S4-SF scale, and anxiety and depression were evaluated using the DASS-21. We assessed sleep health as a mediator using the Sleep Hygiene Behaviors scale. Covariance-Based Structural Equation Modeling (CB-SEM) was employed for data analysis, accounting for sex and physical activity as the main confounders. Statistical significance was determined using various fit indices and confidence intervals. Results The sample consisted of 600 adolescents (41% female). CB-SEM revealed a positive but not statistically significant association between GD and depression, along with a negative statistically significant association with anxiety. Notably, sleep hygiene was identified as a partial mediator in the relationship between GD and depression, indicating that poor sleep practices may exacerbate depressive symptoms among adolescents with GD. However, no mediating effect was observed for anxiety. Conclusion Our data supported a mediating role for sleep hygiene in the association between GD and depression among participants. Our results highlight the critical need for targeted policy interventions to improve sleep hygiene among adolescents with GD.https://doi.org/10.1186/s12889-025-22040-8Sleep hygieneDepressionAnxietyAdolescenceGaming disorder
spellingShingle Leila Molaeipour
Reza Jabarbeigi
Tina Lari
Mehdi Osooli
Elahe Jafari
Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene
BMC Public Health
Sleep hygiene
Depression
Anxiety
Adolescence
Gaming disorder
title Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene
title_full Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene
title_fullStr Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene
title_full_unstemmed Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene
title_short Gaming disorder and psychological distress among Iranian adolescents: the mediating role of sleep hygiene
title_sort gaming disorder and psychological distress among iranian adolescents the mediating role of sleep hygiene
topic Sleep hygiene
Depression
Anxiety
Adolescence
Gaming disorder
url https://doi.org/10.1186/s12889-025-22040-8
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