The mediating role of sleep quality and the moderating role of gender and grade in the association between academic stress and psychological health among adolescents in county-level areas of Liaoning Province, China

TL;DR

This study explores how academic stress affects adolescent psychological health in China, with sleep quality acting as a mediator and gender and grade as moderators.

Contribution

The study identifies sleep quality as a mediator and reveals gender and grade as moderators in the academic stress–psychological health relationship.

Findings

Academic stress is strongly linked to sleep problems and psychological health issues.

Sleep quality partially mediates the relationship between academic stress and psychological health.

Grade and gender moderate the strength of these associations.

Abstract

This study examined how academic stress is associated with psychological health among adolescents in county-level areas of Liaoning Province, China, and tested whether sleep quality mediates this association while gender and grade moderate key pathways. A total of 449 students from Grades 7–9 completed validated measures of academic stress, sleep quality (PSQI), and psychological health. Mediation and moderated mediation analyses were conducted using PROCESS (Model 4 and Model 22) with 5,000 bootstrap samples. Academic stress was positively associated with sleep problems (r = 0.446, p < 0.01) and psychological health problems (r = 0.584, p < 0.01), while sleep quality showed a strong association with psychological health (r = 0.699, p < 0.01). Sleep quality partially mediated the association between academic stress and psychological health [β = 0.55, p < 0.001; 95% CI (0.506, 0.920)]. Grade significantly moderated the stress–health link, with stronger associations observed in Grades 8 and 9 than in Grade 7 (B = −0.60, p < 0.05). Gender moderated the relationship between sleep quality and psychological health (B = −1.59, p < 0.05), indicating a stronger association for females.

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