A Study on the Impact of Sleep Quality on Depression and Anxiety among Medical University Students: A Mediating Role Based on Positive Mental Characters

A Study on the Impact of Sleep Quality on Depression and Anxiety among Medical University Students: A Mediating Role Based on Positive Mental Characters | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article A Study on the Impact of Sleep Quality on Depression and Anxiety among Medical University Students: A Mediating Role Based on Positive Mental Characters guanheng wang, rongmeng cao, jiansheng he, wenan ye This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4610962/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Exploring the mediating role of positive mental characters between sleep quality and anxiety and depression, in order to prevent mental health problems among medical university students and promote their mental health development. A study was conducted on students from a medical university, using the Insomnia Severity Index, Chinese College Students Positive Psychological Quality Scale, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire Depression Scale for on-site evaluation. The Process macro program developed by Hayes was used for mediation effect analysis. The development of positive mental characters among male students is better than that of female students, and their tendencies towards anxiety and depression are lower than those of female students; The development of positive mental characters among students aged 19–30 is better than that of students aged 18 and below, and their tendency towards anxiety and depression is lower than that of students aged 18; The development of positive mental characters among only child students is better than that of non only child students; The development of positive mental characters among students born in urban areas is better than that of students born in rural areas. The insomnia index is positively correlated with individual anxiety and depression, and the mediating effect of positive mental characters in the association between sleep quality and anxiety and depression accounts for 10.45% of the total effect. The development of positive mental characters partially mediates the relationship between sleep quality and depression and anxiety. High quality sleep and good positive mental characters can help medical school students alleviate anxiety and depression. Biological sciences/Psychology Health sciences/Health care/Quality of life Positive mental characters Medical university students Sleep quality Anxiety Depression INTRODUCTION According to the World Health Organization, depression and anxiety are on the rise in different countries around the world. Anxiety and depression have become common challenges for psychologists, psychiatrists, and behavioral scientists across the globe 1 .Studies show that major depression and anxiety disorders have increased by 28 percent and 26 percent, respectively, globally since 2020, and the impact on women and young people is greater. According to the World Health Organization, depression will be the first global burden of disease by 2030 2 . At present, the detection rate of depression, anxiety, and sleep problems among college students in China is relatively high, with sleep problems accounting for 23.5%, depression accounting for 20.8%, and anxiety accounting for 13.7% 3 . Poor sleep quality can affect the physical and mental state, leading to mental depression, anxiety, and other emotions, thereby damaging the individual's psychological and social adaptation function and increasing the risk of mental illness. Sleep disorders are important influencing factors for depression and anxiety, and a decrease in sleep quality increases the risk of depression and anxiety 4–6 . The sleep 3P model proposed by sleep scholar Spielman (including Predisposing Factor, Inducing Factor Precipitating Factor, and Persisting Factor) suggests that some people with poor sleep tend to overly focus or worry about sleep, have many irrational understandings of sleep, and develop negative emotions and bad sleep habits, leading to chronic insomnia 7 . The stress cognitive insomnia model suggests that adolescents under stress are more likely to overly focus on their sleep and outcomes, subjectively exaggerating occasional negative sleep problems and forming an irrational cognition of "I don't sleep well". Such cognitive biases can activate negative emotions such as depression and anxiety, and the resulting irrational beliefs and negative emotions about sleep will continue to worsen insomnia, forming a vicious cycle 8 . The father of positive psychology, Seligman, believed that positive mental characters are composed of subjective well-being, happiness, optimism, and self-determination. He also proposed the ABCDE rule for optimistic parenting based on the ABC theory, emphasizing the training of individual positive thinking patterns and cultivating positive mental characters 9,10 . Positive mental characters play a partial mediating role in the relationship between cumulative family risk and adolescent depression, allowing individuals to alleviate depressive emotions when facing adverse external stimuli 11 . Although there have been studies on sleep quality, anxiety, and depression, there is relatively little research on the mediating role of positive mental characters. This study takes students from a medical university as the research object, explores the impact of sleep quality on anxiety and depression, and explores the mediating role of positive mental characters, providing a basis for preventing mental health problems among medical university students and promoting their mental health development. MATERIALS AND METHODS Participants This study takes students from a certain medical university as the research object, adopts cluster sampling method, and conducts a questionnaire survey on students in a certain grade by class. A total of 2198 questionnaires were distributed in this survey, and 2194 valid questionnaires were collected, with an effective rate of 99.8%. Measures Using current research methods, information is collected through questionnaire surveys. The questionnaire includes general demographic characteristics, sleep quality, positive mental characters, anxiety, and depression. The scales used in the survey include: (1) Insomnia Severity Index (ISI): The scale consists of 7 items and uses the Likert 5-point scoring method. The higher the total score, the more severe the insomnia. (2) The Chinese College Student Positive Psychological Quality Scale consists of 62 items and adopts the Likert 5-point scoring method. The lower the total score, the better the development of positive psychological quality. (3) Generalized Anxiety Disorder Scale (GAD-7): The scale consists of 7 items and uses the Likert 4-point scoring method. The higher the total score, the higher the level of anxiety. (4) Patient Health Questionnaire Depression Scale (PHQ-9): The scale consists of 9 items and uses the Likert 4-point scoring method. The higher the total score, the higher the level of depression. Data Analysis This study used SPSS 22.0 statistical software to conduct descriptive statistics and mediation analysis using the Process macro program (Model 4) developed by Hayes. RESULTS General Characteristics The descriptive analysis results are shown in Table 1 . (Note: Medical majors include: Clinical Medicine, Stomatology, Pediatrics, Psychiatry, Anesthesiology, Medical Imaging, Clinical Chinese and Western Medicine, Preventive Medicine, Basic Medicine, Nursing, Medical Laboratory Technology, Pharmacy, Clinical Pharmacy, Medical Technology, Food Hygiene and Nutrition. Non medical majors include: Biotechnology, Applied Psychology, Public Utility Management, Biomedical Engineering, and Law.) Table 1 Sample Descriptive Statistics Variable Group No. of participants (N = 2194) Percentage (%) Anxiety t Depression t Positive Mental Character t Gender Male 895 40.79 1.83 ± 0.75 -2.385 * 1.73 ± 0.62 − .3.544 *** 117.91 ± 30.37 -4.438 *** Female 1299 59.21 1.90 ± 0.72 1.85 ± 0.62 122.46 ± 28.40 Age aged 18 and below 1402 63.90 1.90 ± 0.74 2.557 * 1.82 ± 0.64 2.199 * 121.64 ± 29.61 2.411 * 18 to 30-year-old 792 36.10 1.82 ± 0.73 1.76 ± 0.60 118.77 ± 28.68 Major Medical majors 1733 78.99 1.87 ± 0.74 0.033 1.79 ± 0.62 -1.661 120.57 ± 29.25 -0.111 Non-medical majors 461 21.01 1.87 ± 0.72 1.84 ± 0.64 120.74 ± 29.52 Only-child family Yes 553 25.21 1.89 ± 0.74 0.890 1.81 ± 0.64 0.412 117.74 ± 29.47 -2.657 ** No 1641 74.79 1.86 ± 0.73 1.80 ± 0.62 121.57 ± 29.19 Birthplace Urban area 1835 83.63 1.87 ± 0.74 -0.261 1.79 ± 0.63 -0.862 119.60 ± 29.44 -3.634 *** Rural area 359 16.36 1.88 ± 0.71 1.83 ± 0.58 125.72 ± 28.04 Note: * P < 0.05, * * P < 0.01, * * * P < 0.001, the same below. The mediating role of positive mental characters in the impact of sleep quality on individual anxiety The reliability test was conducted on the positive mental characters of the subjects, and the Cronbach's coefficient was 0.9 > 0.7, indicating that the test passed. Take the mean of 62 measurements of the positive mental characters of the participants towards the demand side as the positive psychological quality value. Next, the macro process model 4 in SPSS was used to test the mediating effect of positive mental characters of participants on the impact of sleep quality on individual anxiety, while controlling for gender and age. The results (as shown in Tables 2 and 3 ) indicate that sleep quality has a significant positive predictive effect on individual anxiety (B = 0.474, t = 20.975, p < 0.001). However, when the mediator variable is added, the direct positive predictive effect of sleep quality on individual anxiety remains significant (B = 0.421, t = 18.406, p < 0.001). The positive predictive effect of positive mental characters is significant (B = 11.404, t = 11.935, p < 0.001), and the predictive effect of positive mental characters on individual anxiety is also significant (B = 0.005, t = 9.379, p < 0.001). However, by analyzing the data, the upper and lower limits of the confidence interval (Bootstrap 95%) for the mediating effect of positive mental characters do not include zero, indicating that sleep quality can not only directly predict individual anxiety positively, but also predict individual anxiety through the mediating effect of positive mental characters. The direct effect (0.470) and mediating effect (0.068) account for 88.809% and 11.191% of the total effect (0.523), respectively. Therefore, the mediating role of positive mental characters in the impact of sleep quality on individual anxiety is established Table 2 A test of mediation modeling of positive mental characters Variable PPQS GAD GAD B se t B se t B se t Age -2.179 ** 0.831 -2.623 -0.057 ** 0.020 -2.891 -0.047 * 0.019 -2.418 Gender 2.821 * 1.241 2.272 0.010 0.029 0.334 -0.003 0.029 -0.115 ISI 11.401 *** 0.955 11.935 0.474 *** 0.023 20.975 0.421 *** 0.023 18.406 PPQS 0.005 *** 0.001 9.379 R-sq 0.070 0.173 0.205 F 54.982 152.966 141.274 Table 3 Summary Table of Intermediary, Direct and Total Effects Effect BootSE BootLLCI BootULCI Percentage The mediating effect of positive mental characters 0.053 0.007 0.039 0.068 11.191% Direct effects 0.421 0.025 0.372 0.470 88.809% Total effect 0.474 0.025 0.425 0.523 The mediating role of positive mental characters in the impact of sleep quality on individualdepression The reliability test was conducted on the positive mental characters of the subjects, and the Cronbach's coefficient was 0.9 > 0.7, indicating that the test passed. Take the mean of 62 measurements of the positive mental characters of the participants towards the demand side as the positive psychological quality value. Next, the macro process model 4 in SPSS was used to test the mediating effect of positive mental characters of participants on the impact of sleep quality on individual depression, while controlling for gender and age. The results are shown in Tables 4 and 5 . It indicates that sleep quality has a significant positive predictive effect on individual depression (B = 0.456, t = 24.576, p < 0.001), and even after adding mediating variables, the direct positive predictive effect of sleep quality on individual depression remains significant (B = 0.409, t = 21.832, p < 0.001). The positive predictive effect of positive mental characters is significant (B = 11.401, t = 11.935, p < 0.001), and the predictive effect of positive mental characters on individual anxiety is also significant (B = 0.004, t = 10.309, p < 0.001). However, by analyzing the data, the upper and lower limits of the confidence interval (Bootstrap 95%) for the mediating effect of positive mental characters do not include zero, indicating that sleep quality can not only directly predict individual depression positively, but also predict individual depression through the mediating effect of positive mental characters. The direct effect (0.409) and mediating effect (0.048) account for 89.546% and 10.454% of the total effect (0.456), respectively. Therefore, the mediating role of positive mental characters in the impact of sleep quality on individual depression is established. Table 4 A test of mediation modeling of positive mental characters Variable PPQS PHQ PHQ B se t B se t B se t Age -2.179 ** 0.831 -2.623 -0.044 ** 0.016 -2.696 -0.034 * 0.016 -2.179 Gender 2.821 * 1.241 2.272 0.058 * 0.024 2.402 0.046 0.024 1.956 ISI 11.401 *** 0.955 11.935 0.456 *** 0.019 24.576 0.409 *** 0.019 21.832 PPQS 0.004 *** 0.000 10.309 R-sq 0.070 0.226 0.262 F 54.982 213.551 194.432 Table 5 Summary Table of Intermediary, Direct and Total Effects Effect BootSE BootLLCI BootULCI Percentage The mediating effect of positive mental characters 0.048 0.006 0.036 0.060 10.454% Direct effects 0.409 0.021 0.367 0.450 89.546% Total effect 0.456 0.020 0.417 0.496 DISCUSSION In this study, male students had a better development of positive mental characters than female students, with lower tendencies towards anxiety and depression compared to female students, which is consistent with Yan Han's research results and inconsistent with Pan Lili's research results 12,13 . The development of positive mental characters among students aged 19–30 is better than that of students aged 18 and below, and their tendency towards anxiety and depression is lower than that of students aged 18. According to Erikson's personality development theory, college students aged 18 and below may still be in conflict with self-identity and role confusion, experiencing more internal conflicts 14 .Older students may have completed the challenge of identity crisis, have more extensive life experience, and have more mature emotional management abilities. There is no difference in anxiety, depression, and positive psychological development qualities among students of different professional types. The reason may be that the sampling grade is freshman year, and the differences in different majors have not yet been shown. The development of positive mental characters among only child students is better than that of non only child students, possibly due to the superior educational environment of only child families, which can receive more attention and emotional satisfaction from parents 15 . The development of positive mental characters among students born in urban areas is better than that of students born in rural areas. The reason may be that students from urban areas have a superior personal living environment and development opportunities, and their comprehensive qualities can be well cultivated. In this study, the insomnia index was positively correlated with individual anxiety and depression. The worse the sleep quality, the more severe the depression and anxiety, which is consistent with previous research results 16 . Positive psychological quality is a key factor for people to cope with stress, alleviate negative emotions, improve life satisfaction, and maintain mental health 17 . It is the sum of positive indicators for measuring the coordinated development of individual physical and mental health. The results of this study show that the worse the development of positive mental characters, the more severe the anxiety and depression emotions. Meanwhile, the worse the sleep quality, the worse the development of positive mental characters. This study found that there is a partial mediating effect between the development of positive mental characters and sleep quality, depression, and anxiety. That is, the sleep quality of college students can not only directly affect symptoms of depression and anxiety, but also indirectly affect the occurrence of symptoms of depression and anxiety by influencing the development of positive mental characters. Related studies have shown that adolescents with poor sleep quality have weaker cognitive and emotional qualities 18 . The decline in sleep quality can have a negative impact on an individual's daily learning and life, which may lead to poor performance such as lack of concentration, decreased memory, lack of vitality and patience, making it easier to bring negative feedback. In this negative physical and mental state, an individual's positive mental characters are weakened, making it difficult to fully utilize their positive mental characters to cope with stress and alleviate negative emotions, leading to negative cognition of events and even oneself, resulting in anxiety and depression. This is a situation that medical school students with heavy learning tasks need to avoid, so individuals may feel anxious and depressed about whether they will continue to experience similar situations. Anxiety and depression will further have a negative impact on sleep quality, and individuals' positive mental characters will also be continuously challenged. IMPLICATIONS This study offers both theoretical and practical implications. Theoretically, the study delves into the sleep quality, depression, and anxiety of medical college students, with a particular focus on the mediating role of positive psychological qualities in this process. We have revealed through carefully designed experiments and data analysis the significant impact of sleep quality on the mental health of medical school students, as well as the positive role of positive psychological qualities in alleviating negative emotions. Practically, research results have shown that by improving sleep quality and cultivating positive psychological qualities, it is possible to effectively alleviate depression and anxiety among medical college students. This has important practical significance for the psychological health education and intervention of medical college students. CONCLUSION Sleep quality can not only directly affect mental health, but also indirectly affect mental health through positive mental characters. On the one hand, sleep quality can be improved by increasing physical exercise, listening to environmental music, adjusting sleep cognition and improving mental health levels 19 . On the other hand, group psychological counseling and increased physical exercise can be used to enhance students' positive mental characters and improve their mental health levels 20 . The subjects of this study are all first-year students from medical universities, and there are certain limitations in the sampling range. Further expansion of the sampling range is needed. Declarations ETHICS APPROVAL This study was conducted in accordance with local laws, regulations, and institutional requirements, and has been approved by the Medical Ethics Committee of Guangzhou Medical University. INFORMED CONSENT The individuals taking part in this research manifested their informed permission. DATA AVAILABILITY Raw data generated during this study are included in the supplementary file. References Vilagut G, Forero CG, Barbaglia G, et al.Screening for Depression in the General Population with the Center for Epidemiologic Studies Depression (CES-D): A Systematic Review with Meta-Analysis[J].PLoS One,2016,11(5):e0155431. Smith, A.M., Willroth, E.C., Gatchpazian, A., Shallcross, A.J., Feinberg, M., & Ford, B.Q.(2021).Coping with health threats: the costs and benefits of managing emotions.Psychological science, 32(7), 1011–1023. Wang,M.Y.,Liu,J.,Wu,X.,Li,L.,Hao,X.D.,Shen,Q.,Huang,M.T.,Sun,R.H.(2020).The prevalence of depression among students in Chinese universities over the past decade: A meta-analysis. 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Chin J Public Health .35(7):857–860.doi: 10.11847/zgggws1119840 Mitchell,L.L.,Lodi-Smith,J.,Baranski,E.N.,Whitbourne,S.K.(2021).Implications of Identity Resolution in Emerging Adulthood for Intimacy,Generativity,and Integrity Across the Adult Lifespan. Psychol Aging .36(5):545–556.doi: 10.1037/pag0000537 Tan,R.,Yang,Y.Z.,Huang,T.,Lin,X.X.,Gao,H.(2023).Parent-child attachment and mental health in young adolescents: a moderated mediation analysis. Front. Psychol .14:1298485.doi: 10.3389/fpsyg.2023.1298485 Su,Y.Y.,Wang,S.B.,Zheng,H.R.,Tan,W.Y.,Li,X.L.,Huang,Z.H.,Hou,G.L.,Jia,F.J.(2021).The role of anxiety and depression in the relationship between physical activity and sleep quality: A serial multiple mediation model. Journal of Affective Disorders. 290:219–226.doi: 10.1016/j.jad.2021.04.047 Vulpe,A.,Dafioiu,I.(2012).Positive emotions, coping strategies and ego-resiliency: A mediation model. Procedia-Social and Behavioral Science . 33:308–312.doi: 10.1016/j.sbspro.2012.01.133 Cui,Y.C.(2022).The Relationship Between the Present Situation of Adolescent Positive Psychological Quality and Their Coordinated Development of Body and Mind. Educational Measurement and Evaluation. 4:92–101.doi: 10.16518/j.cnki.emae.2022.04.009 Lin,P.H.,Fu,S.H.,Lee,Y.C.,Yang,S.Y.,Li,Y.L.(2024).Examining the effects of binaural beat music on sleep quality,heart rate variability, and depression in older people with poor sleep quality in a long-term care institution:A randomized controlled trial. Geriatr.Gerontol.Int. 24:297–304.doi: 10.1111/ggi.14827 Jennifer,L.,Pereira,L.C.,Talwar,V.(2016).Children's Physical Resilience Outcomes: Meta-Analysis of Vulnerability and Protective Factors. Journal of Pediatric Nursing. 31:701–711.doi: 10.1016/j.pedn.2016.07.011 Additional Declarations No competing interests reported. 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Anxiety and depression have become common challenges for psychologists, psychiatrists, and behavioral scientists across the globe\u003csup\u003e1\u003c/sup\u003e.Studies show that major depression and anxiety disorders have increased by 28 percent and 26 percent, respectively, globally since 2020, and the impact on women and young people is greater. According to the World Health Organization, depression will be the first global burden of disease by 2030\u003csup\u003e2\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAt present, the detection rate of depression, anxiety, and sleep problems among college students in China is relatively high, with sleep problems accounting for 23.5%, depression accounting for 20.8%, and anxiety accounting for 13.7%\u003csup\u003e3\u003c/sup\u003e. Poor sleep quality can affect the physical and mental state, leading to mental depression, anxiety, and other emotions, thereby damaging the individual's psychological and social adaptation function and increasing the risk of mental illness. Sleep disorders are important influencing factors for depression and anxiety, and a decrease in sleep quality increases the risk of depression and anxiety\u003csup\u003e4\u0026ndash;6\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe sleep 3P model proposed by sleep scholar Spielman (including Predisposing Factor, Inducing Factor Precipitating Factor, and Persisting Factor) suggests that some people with poor sleep tend to overly focus or worry about sleep, have many irrational understandings of sleep, and develop negative emotions and bad sleep habits, leading to chronic insomnia\u003csup\u003e7\u003c/sup\u003e. The stress cognitive insomnia model suggests that adolescents under stress are more likely to overly focus on their sleep and outcomes, subjectively exaggerating occasional negative sleep problems and forming an irrational cognition of \"I don't sleep well\". Such cognitive biases can activate negative emotions such as depression and anxiety, and the resulting irrational beliefs and negative emotions about sleep will continue to worsen insomnia, forming a vicious cycle\u003csup\u003e8\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe father of positive psychology, Seligman, believed that positive mental characters are composed of subjective well-being, happiness, optimism, and self-determination. He also proposed the ABCDE rule for optimistic parenting based on the ABC theory, emphasizing the training of individual positive thinking patterns and cultivating positive mental characters\u003csup\u003e9,10\u003c/sup\u003e. Positive mental characters play a partial mediating role in the relationship between cumulative family risk and adolescent depression, allowing individuals to alleviate depressive emotions when facing adverse external stimuli\u003csup\u003e11\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAlthough there have been studies on sleep quality, anxiety, and depression, there is relatively little research on the mediating role of positive mental characters. This study takes students from a medical university as the research object, explores the impact of sleep quality on anxiety and depression, and explores the mediating role of positive mental characters, providing a basis for preventing mental health problems among medical university students and promoting their mental health development.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThis study takes students from a certain medical university as the research object, adopts cluster sampling method, and conducts a questionnaire survey on students in a certain grade by class. A total of 2198 questionnaires were distributed in this survey, and 2194 valid questionnaires were collected, with an effective rate of 99.8%.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003eUsing current research methods, information is collected through questionnaire surveys. The questionnaire includes general demographic characteristics, sleep quality, positive mental characters, anxiety, and depression. The scales used in the survey include: (1) Insomnia Severity Index (ISI): The scale consists of 7 items and uses the Likert 5-point scoring method. The higher the total score, the more severe the insomnia. (2) The Chinese College Student Positive Psychological Quality Scale consists of 62 items and adopts the Likert 5-point scoring method. The lower the total score, the better the development of positive psychological quality. (3) Generalized Anxiety Disorder Scale (GAD-7): The scale consists of 7 items and uses the Likert 4-point scoring method. The higher the total score, the higher the level of anxiety. (4) Patient Health Questionnaire Depression Scale (PHQ-9): The scale consists of 9 items and uses the Likert 4-point scoring method. The higher the total score, the higher the level of depression.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThis study used SPSS 22.0 statistical software to conduct descriptive statistics and mediation analysis using the Process macro program (Model 4) developed by Hayes.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eGeneral Characteristics\u003c/h2\u003e \u003cp\u003eThe descriptive analysis results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. (Note: Medical majors include: Clinical Medicine, Stomatology, Pediatrics, Psychiatry, Anesthesiology, Medical Imaging, Clinical Chinese and Western Medicine, Preventive Medicine, Basic Medicine, Nursing, Medical Laboratory Technology, Pharmacy, Clinical Pharmacy, Medical Technology, Food Hygiene and Nutrition. Non medical majors include: Biotechnology, Applied Psychology, Public Utility Management, Biomedical Engineering, and Law.)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample Descriptive Statistics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo. of participants\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;2194)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ePositive Mental Character\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e895\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-2.385\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.3.544\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e117.91\u0026thinsp;\u0026plusmn;\u0026thinsp;30.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-4.438\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e122.46\u0026thinsp;\u0026plusmn;\u0026thinsp;28.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eaged 18 and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.557\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.199\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e121.64\u0026thinsp;\u0026plusmn;\u0026thinsp;29.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.411\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 to 30-year-old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e792\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e118.77\u0026thinsp;\u0026plusmn;\u0026thinsp;28.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMajor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical majors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1733\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-1.661\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e120.57\u0026thinsp;\u0026plusmn;\u0026thinsp;29.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-0.111\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-medical majors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e461\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e120.74\u0026thinsp;\u0026plusmn;\u0026thinsp;29.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOnly-child family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e553\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.89\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.890\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e117.74\u0026thinsp;\u0026plusmn;\u0026thinsp;29.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-2.657\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1641\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e121.57\u0026thinsp;\u0026plusmn;\u0026thinsp;29.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBirthplace\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban area\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1835\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e83.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-0.261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-0.862\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e119.60\u0026thinsp;\u0026plusmn;\u0026thinsp;29.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e-3.634\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural area\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e1.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c9\"\u003e \u003cp\u003e125.72\u0026thinsp;\u0026plusmn;\u0026thinsp;28.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eNote: * P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, * * P\u0026thinsp;\u0026lt;\u0026thinsp;0.01, * * * P\u0026thinsp;\u0026lt;\u0026thinsp;0.001, the same below.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThe mediating role of positive mental characters in the impact of sleep quality on individual anxiety\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe reliability test was conducted on the positive mental characters of the subjects, and the Cronbach's coefficient was 0.9\u0026thinsp;\u0026gt;\u0026thinsp;0.7, indicating that the test passed. Take the mean of 62 measurements of the positive mental characters of the participants towards the demand side as the positive psychological quality value. Next, the macro process model 4 in SPSS was used to test the mediating effect of positive mental characters of participants on the impact of sleep quality on individual anxiety, while controlling for gender and age. The results (as shown in Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) indicate that sleep quality has a significant positive predictive effect on individual anxiety (B\u0026thinsp;=\u0026thinsp;0.474, t\u0026thinsp;=\u0026thinsp;20.975, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, when the mediator variable is added, the direct positive predictive effect of sleep quality on individual anxiety remains significant (B\u0026thinsp;=\u0026thinsp;0.421, t\u0026thinsp;=\u0026thinsp;18.406, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The positive predictive effect of positive mental characters is significant (B\u0026thinsp;=\u0026thinsp;11.404, t\u0026thinsp;=\u0026thinsp;11.935, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the predictive effect of positive mental characters on individual anxiety is also significant (B\u0026thinsp;=\u0026thinsp;0.005, t\u0026thinsp;=\u0026thinsp;9.379, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eHowever, by analyzing the data, the upper and lower limits of the confidence interval (Bootstrap 95%) for the mediating effect of positive mental characters do not include zero, indicating that sleep quality can not only directly predict individual anxiety positively, but also predict individual anxiety through the mediating effect of positive mental characters. The direct effect (0.470) and mediating effect (0.068) account for 88.809% and 11.191% of the total effect (0.523), respectively. Therefore, the mediating role of positive mental characters in the impact of sleep quality on individual anxiety is established\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eA test of mediation modeling of positive mental characters\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003ePPQS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eGAD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eGAD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ese\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ese\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ese\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-2.179\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.831\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.057\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-2.891\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.047\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-2.418\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.821\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.115\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eISI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.401\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.474\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.975\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.421\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e18.406\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPQS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.005\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9.379\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR-sq\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e0.173\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003e0.205\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e54.982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e152.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003e141.274\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary Table of Intermediary, Direct and Total Effects\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEffect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBootSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBootLLCI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBootULCI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe mediating effect of positive mental characters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.191%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDirect effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.421\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.372\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.470\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e88.809%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.474\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.523\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThe mediating role of positive mental characters in the impact of sleep quality on individualdepression\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe reliability test was conducted on the positive mental characters of the subjects, and the Cronbach's coefficient was 0.9\u0026thinsp;\u0026gt;\u0026thinsp;0.7, indicating that the test passed. Take the mean of 62 measurements of the positive mental characters of the participants towards the demand side as the positive psychological quality value. Next, the macro process model 4 in SPSS was used to test the mediating effect of positive mental characters of participants on the impact of sleep quality on individual depression, while controlling for gender and age. The results are shown in Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e and \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eIt indicates that sleep quality has a significant positive predictive effect on individual depression (B\u0026thinsp;=\u0026thinsp;0.456, t\u0026thinsp;=\u0026thinsp;24.576, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and even after adding mediating variables, the direct positive predictive effect of sleep quality on individual depression remains significant (B\u0026thinsp;=\u0026thinsp;0.409, t\u0026thinsp;=\u0026thinsp;21.832, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The positive predictive effect of positive mental characters is significant (B\u0026thinsp;=\u0026thinsp;11.401, t\u0026thinsp;=\u0026thinsp;11.935, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the predictive effect of positive mental characters on individual anxiety is also significant (B\u0026thinsp;=\u0026thinsp;0.004, t\u0026thinsp;=\u0026thinsp;10.309, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eHowever, by analyzing the data, the upper and lower limits of the confidence interval (Bootstrap 95%) for the mediating effect of positive mental characters do not include zero, indicating that sleep quality can not only directly predict individual depression positively, but also predict individual depression through the mediating effect of positive mental characters. The direct effect (0.409) and mediating effect (0.048) account for 89.546% and 10.454% of the total effect (0.456), respectively. Therefore, the mediating role of positive mental characters in the impact of sleep quality on individual depression is established.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eA test of mediation modeling of positive mental characters\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003ePPQS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003ePHQ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003ePHQ\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ese\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ese\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ese\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-2.179\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.831\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.044\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-2.696\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.034\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-2.179\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.821\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.058\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.956\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eISI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.401\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.456\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.576\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.409\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e21.832\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPQS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.004\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e10.309\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR-sq\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e0.226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003e0.262\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e54.982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e213.551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003e194.432\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary Table of Intermediary, Direct and Total Effects\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEffect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBootSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBootLLCI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBootULCI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe mediating effect of positive mental characters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.454%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDirect effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.409\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.367\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.450\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e89.546%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.417\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/127393_c7e80a1c9bb65875/127393_custom_files/img1721716394.png\" style=\"width: 648px;\"\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn this study, male students had a better development of positive mental characters than female students, with lower tendencies towards anxiety and depression compared to female students, which is consistent with Yan Han's research results and inconsistent with Pan Lili's research results\u003csup\u003e12,13\u003c/sup\u003e. The development of positive mental characters among students aged 19\u0026ndash;30 is better than that of students aged 18 and below, and their tendency towards anxiety and depression is lower than that of students aged 18. According to Erikson's personality development theory, college students aged 18 and below may still be in conflict with self-identity and role confusion, experiencing more internal conflicts\u003csup\u003e14\u003c/sup\u003e.Older students may have completed the challenge of identity crisis, have more extensive life experience, and have more mature emotional management abilities. There is no difference in anxiety, depression, and positive psychological development qualities among students of different professional types. The reason may be that the sampling grade is freshman year, and the differences in different majors have not yet been shown. The development of positive mental characters among only child students is better than that of non only child students, possibly due to the superior educational environment of only child families, which can receive more attention and emotional satisfaction from parents\u003csup\u003e15\u003c/sup\u003e. The development of positive mental characters among students born in urban areas is better than that of students born in rural areas. The reason may be that students from urban areas have a superior personal living environment and development opportunities, and their comprehensive qualities can be well cultivated.\u003c/p\u003e \u003cp\u003eIn this study, the insomnia index was positively correlated with individual anxiety and depression. The worse the sleep quality, the more severe the depression and anxiety, which is consistent with previous research results\u003csup\u003e16\u003c/sup\u003e. Positive psychological quality is a key factor for people to cope with stress, alleviate negative emotions, improve life satisfaction, and maintain mental health\u003csup\u003e17\u003c/sup\u003e. It is the sum of positive indicators for measuring the coordinated development of individual physical and mental health. The results of this study show that the worse the development of positive mental characters, the more severe the anxiety and depression emotions. Meanwhile, the worse the sleep quality, the worse the development of positive mental characters. This study found that there is a partial mediating effect between the development of positive mental characters and sleep quality, depression, and anxiety. That is, the sleep quality of college students can not only directly affect symptoms of depression and anxiety, but also indirectly affect the occurrence of symptoms of depression and anxiety by influencing the development of positive mental characters. Related studies have shown that adolescents with poor sleep quality have weaker cognitive and emotional qualities\u003csup\u003e18\u003c/sup\u003e. The decline in sleep quality can have a negative impact on an individual's daily learning and life, which may lead to poor performance such as lack of concentration, decreased memory, lack of vitality and patience, making it easier to bring negative feedback. In this negative physical and mental state, an individual's positive mental characters are weakened, making it difficult to fully utilize their positive mental characters to cope with stress and alleviate negative emotions, leading to negative cognition of events and even oneself, resulting in anxiety and depression. This is a situation that medical school students with heavy learning tasks need to avoid, so individuals may feel anxious and depressed about whether they will continue to experience similar situations. Anxiety and depression will further have a negative impact on sleep quality, and individuals' positive mental characters will also be continuously challenged.\u003c/p\u003e\n\u003ch3\u003eIMPLICATIONS\u003c/h3\u003e\n\u003cp\u003eThis study offers both theoretical and practical implications. Theoretically, the study delves into the sleep quality, depression, and anxiety of medical college students, with a particular focus on the mediating role of positive psychological qualities in this process. We have revealed through carefully designed experiments and data analysis the significant impact of sleep quality on the mental health of medical school students, as well as the positive role of positive psychological qualities in alleviating negative emotions. Practically, research results have shown that by improving sleep quality and cultivating positive psychological qualities, it is possible to effectively alleviate depression and anxiety among medical college students. This has important practical significance for the psychological health education and intervention of medical college students.\u003c/p\u003e "},{"header":"CONCLUSION","content":"\u003cp\u003eSleep quality can not only directly affect mental health, but also indirectly affect mental health through positive mental characters. On the one hand, sleep quality can be improved by increasing physical exercise, listening to environmental music, adjusting sleep cognition and improving mental health levels\u003csup\u003e19\u003c/sup\u003e. On the other hand, group psychological counseling and increased physical exercise can be used to enhance students' positive mental characters and improve their mental health levels\u003csup\u003e20\u003c/sup\u003e. The subjects of this study are all first-year students from medical universities, and there are certain limitations in the sampling range. Further expansion of the sampling range is needed.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eETHICS APPROVAL\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with local laws, regulations, and institutional requirements, and has been approved by the Medical Ethics Committee of Guangzhou Medical University.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eINFORMED CONSENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe individuals taking part in this research manifested their informed permission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDATA AVAILABILITY\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRaw data generated during this study are included in the supplementary file.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eVilagut G, Forero CG, Barbaglia G, et al.Screening for Depression in the General Population with the Center for Epidemiologic Studies Depression (CES-D): A Systematic Review with Meta-Analysis[J].PLoS One,2016,11(5):e0155431.\u003c/li\u003e\n \u003cli\u003eSmith, A.M., Willroth, E.C., Gatchpazian, A., Shallcross, A.J., Feinberg, M., \u0026amp; 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A study was conducted on students from a medical university, using the Insomnia Severity Index, Chinese College Students Positive Psychological Quality Scale, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire Depression Scale for on-site evaluation. The Process macro program developed by Hayes was used for mediation effect analysis. The development of positive mental characters among male students is better than that of female students, and their tendencies towards anxiety and depression are lower than those of female students; The development of positive mental characters among students aged 19\u0026ndash;30 is better than that of students aged 18 and below, and their tendency towards anxiety and depression is lower than that of students aged 18; The development of positive mental characters among only child students is better than that of non only child students; The development of positive mental characters among students born in urban areas is better than that of students born in rural areas. The insomnia index is positively correlated with individual anxiety and depression, and the mediating effect of positive mental characters in the association between sleep quality and anxiety and depression accounts for 10.45% of the total effect. The development of positive mental characters partially mediates the relationship between sleep quality and depression and anxiety. High quality sleep and good positive mental characters can help medical school students alleviate anxiety and depression.\u003c/p\u003e","manuscriptTitle":"A Study on the Impact of Sleep Quality on Depression and Anxiety among Medical University Students: A Mediating Role Based on Positive Mental Characters","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-23 06:44:00","doi":"10.21203/rs.3.rs-4610962/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6bfad699-43e2-49b9-91dd-5b8f7de4805b","owner":[],"postedDate":"July 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":34810828,"name":"Biological sciences/Psychology"},{"id":34810829,"name":"Health sciences/Health care/Quality of life"}],"tags":[],"updatedAt":"2024-08-23T08:56:55+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-23 06:44:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4610962","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4610962","identity":"rs-4610962","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}