AUTHOR=Xiao Shuheng , Liu Shuai , Zhang Puxiao , Yu Jia , A Huaihong , Wu Hui , Zhang Fabin , Xiao Yulan , Ma Naiben , Zhang Xiuqin , Ma Xiaoxia , Li Junfeng , Wang Xiaodun , Shao Xin , Liu Wenjing , Zhang Xiaolin , Wu Wei , Wang Lihua , Wu Rihan , He Yinglian , Xu Zeyu , Chi Luhao , Du Shixu , Zhang Bin 

TITLE=The Association Between Depressive Symptoms and Insomnia in College Students in Qinghai Province: The Mediating Effect of Rumination

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.751411

DOI=10.3389/fpsyt.2021.751411

ISSN=1664-0640

ABSTRACT=Background: This study investigates the mediating effect of rumination on the associations between depressive symptoms and insomnia.
Methods: This is a cross-sectional study. Insomnia Severity Index (ISI), Ruminant Response Scale (RRS) and Beck Depression Inventory (BDI) were determined in 12,178 college students in Qinghai province by a questionnaire network platform. Results: The prevalence of insomnia was 38.6% in the participants. Insomnia symptoms (interquartile range: 6 [3, 9]), depressive symptoms (interquartile range: 5 [1, 9]), and rumination (interquartile range: 22 [20, 26]) were positively correlated (r = 0.25 - 0.46, p < 0.05). Mediation effect analysis showed that the depressive symptoms affected insomnia directly and indirectly. The direct effect and the indirect effect through rumination account for 92.7% and 7.3% of the total effect, respectively. 
Conclusion: Rumination mediates the association between depressive symptoms and insomnia symptoms.