Abstract
BACKGROUND: To explore the mediating effect of smartphone addiction between psychological resilience and insomnia among university students. METHODS: This study included 581 clinical medical students from the Dalian Medical University, enrolled between September 2020 and May 2023. The Smartphone Addiction Scale (SAS-SV), Insomnia Severity Index (ISI), and Connor-Davidson Resilience Scale (CD-RISC) were used to assess smartphone addiction, insomnia, and psychological resilience among the students. The Process macro and Bootstrap methods were employed to analyze the mediating effect of smartphone addiction between psychological resilience and insomnia. RESULTS: The detection rate of smartphone addiction was 28.06% (163/581), and the detection rate of insomnia was 26.17% (152/581). The total SAS-SV score was 27.60 ± 14.27, the total ISI score was 6.60 ± 5.33, and the total CD-RISC score was 72.86 ± 6.88. There was a significant negative correlation between the total CD-RISC score and the total SAS-SV score (r = -0.4129, P < .0001), and a significant negative correlation between the total CD-RISC score and the total ISI score (r = -2.942, P < .0001). The total SAS-SV score and the total ISI score were significantly positively correlated (r = 0.5687, P < .0001). Psychological resilience was used as the independent variable, insomnia as the dependent variable, and smartphone addiction as the mediating variable in the mediation effect analysis. Psychological resilience negatively predicted insomnia (β = -0.0940, P < .0001), smartphone addiction positively predicted insomnia (β = 0.1564, P < .0001), and smartphone addiction mediated the relationship between psychological resilience and insomnia (effect value = -0.1339, 95% CI: -0.1680 to -0.1034), with an effect size of 58.75%. CONCLUSION: Psychological resilience directly affects insomnia and also indirectly affects insomnia through the mediating effect of smartphone addiction.