Abstract
OBJECTIVE: This study investigated the association between social anxiety and sleep quality and further explored the potential mediating role of internet addiction in depressed adolescents. METHODS: This study included 440 Chinese depressed adolescents (mean age = 15.0 years, SD = 2.0). Participants completed questionnaires, including Social Avoidance and Social Distress Scale, Internet Addiction Test, and Pittsburgh Sleep Quality Index. A structural equation model was used to analyze the association between social anxiety and sleep quality, with internet addiction as a mediator. Gender differences were examined by multi-group analysis. RESULTS: Among participants, 61.8% reported poor sleep quality. The sleep quality was significantly different on the level of gender (p = 0.016), education level (p = 0.043), and family history (p = 0.002). Sleep quality was positively associated with social anxiety (p < 0.001) and internet addiction (p < 0.001). Furthermore, internet addiction partially mediated the relationship between social anxiety and sleep quality, and the mediation effect ratio was 16.1% (p < 0.001). Finally, no significant differences were found in this mechanism. CONCLUSION: We concluded that both social anxiety and internet addiction were risk factors for depressed adolescents' poor sleep quality. Social anxiety further affected sleep quality through internet addiction.