Prediction of Sleep Disorders Based on Psychological Distress and Emotional Dysregulation in Adolescent Girls
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Abstract
Objective: The present study aimed to predict sleep disorders based on psychological distress and emotional dysregulation among adolescent girls.
Materials and methods: This research employed a descriptive-correlational design. The statistical population included all adolescent girls studying in secondary high schools in Tehran during the first semester of the 2024–2025 academic years, totaling 87,222 students. A sample size of 300 participants was determined and selected using a multistage cluster random sampling method. Data were collected using the Sleep Disorders Questionnaire, the Psychological Distress Scale and the Emotional Dysregulation Questionnaire. Statistical analyses were performed using SPSS version 27.
Results: The results showed that 45.3% of the variance in sleep disorders was predicted by psychological distress and emotional dysregulation. There was a positive and significant relationship between psychological distress and sleep disorders (β = 0.645). Moreover, emotional dysregulation was positively and significantly related to sleep disorders (β = 0.576). Additionally, stress (β = 0.669), anxiety (β = 0.630), and depression (β = 0.450) showed positive and significant associations with sleep disorders.
Conclusion: Based on the findings, psychological distress and emotional dysregulation play significant roles in predicting sleep disorders and explain a considerable proportion of their variance. Therefore, interventions targeting these psychological variables may help improve sleep quality and enhance mental health among individuals.
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8. Saalwirth C, Leipold B. Well-being and sleep in stressful times of the COVID-19 pandemic: Relations to worrying and different coping strategies. Stress Health. 2021;37(5):973-85.
9. Yang H, Wang Z, Elhai JD, Montag C. The relationship between adolescent emotion dysregulation and problematic technology use: Systematic review of the empirical literature. J Behav Addict. 2022;11(2):290-304.
10. Yang CC, Llamas-Díaz D, Bahena YA, Cabello R, Dahl RE, Magis-Weinberg L. Emotion regulation difficulties and sleep quality in adolescence during the early stages of the COVID-19 lockdown. J Affect Disord. 2023;338:92-9.
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12. Shi C, Wang S, Tang Q, Liu X, Li Y. Cross-lagged relationship between anxiety, depression, and sleep disturbance among college students during and after collective isolation. Front Public Health. 2022;10:1038862.
13. Tabachnick BG, Fidell LS. Using multivariate statistics. 5th ed. Allyn & Bacon/Pearson Education, 2007.
14. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
15. Afkham Ebrahimi A, Ghale Bandi M, Salehi M, Kafian Tafti A, Vakili Y, Akhlaghi Farsi E. Sleep parameters and factors affecting the quality of sleep in patients attending selected clinics of Rasoul-e-Akram Hospital. RJMS. 2008;15:31-8.
16. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
17. Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychol Assess. 1998;10(2):176-81.
18. Samani S, Joukar B. A study on the reliability and validity of the short form of the Depression Anxiety Stress Scale (DASS-21). J Soc Sci Humanit Shiraz Univ. 2007;26(3):65-77.
19. Bjureberg J, Ljótsson B, Tull MT, Hedman E, Sahlin H, Lundh LG, et al. Development and Validation of a Brief Version of the Difficulties in Emotion Regulation Scale: The DERS-16. J Psychopathol Behav Assess. 2016;38(2):284-96.
20. Fallahi V, Narimani M, Atadokht A. Psychometric properties of the Difficulties in Emotion Regulation Scale: Brief Form (DERS-16) in adolescents. J Shaheed Sadoughi Yazd Univ Med Sci. 2021;29(5):3721-35.
21. Sharifian N, Khoda-Rahimi S. Developing a model of sleep quality based on depression with the mediating role of anxiety sensitivity among students in Behbahan City. Proc 8th Natl Conf New Res Educ Psychol Sci Iran, Tehran, 2023.
22. Askari A, Hajloo N, Basharpoor S. The role of depression and social anxiety in predicting quality of life and sleep quality through the mediating role of internet addiction [Master’s thesis]. University of Mohaghegh Ardabili, Ardabil, 2023.
23. Talebi-Ashleghi S, Ghodrati-Mirkouhi M. Study of academic stress, depression, and sleep disorders among first-grade female students during the COVID-19 quarantine in Miyaneh County [Master’s thesis]. Payame Noor University, Qazvin, 2022.
24. Karimi-Rad S, Zahraei Sh, Hosseini E. The relationship between anxiety and depressive symptoms and sleep quality among students during the COVID-19 pandemic [Master’s thesis]. Alzahra University, Tehran, 2022.
25. Mesbahi M, Saraei A. The relationship between
self-criticism, negative emotions, and sleep disorders [Master’s thesis]. Motahar Institute of Higher Education, 2022.
26. Mousavi N, Ghorbani S. Prediction of sleep disorders based on dark personality traits, emotional schemas, and negative automatic thoughts among university students [Master’s thesis]. Payame Noor University, Isfahan, 2022.
27. Golehdarizadeh S, Mousavi A. The relationship between intrusive thoughts (rumination, worry, obsession) and sleep quality among high school students with sleep disorders in Bandar Lengeh County [Master’s thesis]. Islamic Azad University, Bandar Lengeh, 2020.
28. Cheah YK, Kee CC, Lim KK, Cheong YL. Demographic, lifestyle, social, and psychological factors associated with worry-related sleep problems among school-going adolescents in Timor-Leste. J Child Adolesc Psychiatr Nurs. 2024;37(2):e12468.
29. Sesso G, Guccione F, Pisano S, Valente E, Narzisi A, Berloffa S, et al. Emotional Dysregulation and Sleep Problems: A Transdiagnostic Approach in Youth. Clin Pract. 2024;14(3):934-945
30. Ulrich AK, Full KM, Cheng B, Gravagna K, Nederhoff D, Basta NE. Stress, anxiety, and sleep among college and university students during the COVID-19 pandemic. J Am Coll Health. 2023;71(5):1323-7.
31. Clancy F, Prestwich A, Caperon L, Tsipa A, O'Connor DB. The association between worry and rumination with sleep in non-clinical populations: a systematic review and meta-analysis. Health Psychol Rev. 2020;14(4):427-48.
32. Safary Z, Mohammadi Yousefnejad Y. The role of emotional intelligence and moral intelligence in predicting psychological distress and obsessive thoughts among female high school students in Farashband [Master’s thesis]. Payame Noor University, Bushehr, 2022.
33. Khalafi S, Rasoulzadeh B. The effectiveness of positive psychology-based intervention on reducing perceived stress, psychological distress, and improving academic performance in dyslexic students [Master’s thesis]. University of Isfahan, Isfahan, 2021.
34. Narenji-Kahu A, Rajabpour-Farkhani S. The mediating role of anger and psychological distress in the relationship between sexual satisfaction and attitudes toward extramarital relationships among women attending counseling centers [Master’s thesis]. Hakim Nezami Institute of Higher Education, Mashhad, 2023.
2. Sesso G, Guccione F, Pisano S, Valente E, Narzisi A, Berloffa S, et al. Emotional Dysregulation and Sleep Problems: A Transdiagnostic Approach in Youth. Clin Pract. 2024;14(3):934-45
3. Chai R, Bian WJ. Adolescent sleep and its disruption in depression and anxiety. Front Neurosci. 2024;18:1479420.
4. Johri K, Pillai R, Kulkarni A, Balkrishnan R. Effects of sleep deprivation on the mental health of adolescents: A systematic review. Sleep Sci Pract. 2025;9:9.
5. Ander M, Thorsell Cederberg J, von Essen L, Hovén E. Exploration of psychological distress experienced by survivors of adolescent cancer reporting a need for psychological support. PLoS One. 2018;13(4):e0195899.
6. Bacaro V, Miletic K, Crocetti E. A meta-analysis of longitudinal studies on the interplay between sleep, mental health, and positive well-being in adolescents. Int J Clin Health Psychol. 2024;24(1):100424.
7. Li X, Tu L, Jiang X. Childhood maltreatment affects depression and anxiety: The mediating role of benign envy and malicious envy. Front Psychiatry. 2022;13:924795.
8. Saalwirth C, Leipold B. Well-being and sleep in stressful times of the COVID-19 pandemic: Relations to worrying and different coping strategies. Stress Health. 2021;37(5):973-85.
9. Yang H, Wang Z, Elhai JD, Montag C. The relationship between adolescent emotion dysregulation and problematic technology use: Systematic review of the empirical literature. J Behav Addict. 2022;11(2):290-304.
10. Yang CC, Llamas-Díaz D, Bahena YA, Cabello R, Dahl RE, Magis-Weinberg L. Emotion regulation difficulties and sleep quality in adolescence during the early stages of the COVID-19 lockdown. J Affect Disord. 2023;338:92-9.
11. Yu C, Liu Z, Su T, Li Z, Jiang Z, Zhong W, et al. The effect of anxiety on sleep disorders in medical students: a moderated mediation model. Front Psychol. 2024;15:1338796.
12. Shi C, Wang S, Tang Q, Liu X, Li Y. Cross-lagged relationship between anxiety, depression, and sleep disturbance among college students during and after collective isolation. Front Public Health. 2022;10:1038862.
13. Tabachnick BG, Fidell LS. Using multivariate statistics. 5th ed. Allyn & Bacon/Pearson Education, 2007.
14. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
15. Afkham Ebrahimi A, Ghale Bandi M, Salehi M, Kafian Tafti A, Vakili Y, Akhlaghi Farsi E. Sleep parameters and factors affecting the quality of sleep in patients attending selected clinics of Rasoul-e-Akram Hospital. RJMS. 2008;15:31-8.
16. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
17. Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychol Assess. 1998;10(2):176-81.
18. Samani S, Joukar B. A study on the reliability and validity of the short form of the Depression Anxiety Stress Scale (DASS-21). J Soc Sci Humanit Shiraz Univ. 2007;26(3):65-77.
19. Bjureberg J, Ljótsson B, Tull MT, Hedman E, Sahlin H, Lundh LG, et al. Development and Validation of a Brief Version of the Difficulties in Emotion Regulation Scale: The DERS-16. J Psychopathol Behav Assess. 2016;38(2):284-96.
20. Fallahi V, Narimani M, Atadokht A. Psychometric properties of the Difficulties in Emotion Regulation Scale: Brief Form (DERS-16) in adolescents. J Shaheed Sadoughi Yazd Univ Med Sci. 2021;29(5):3721-35.
21. Sharifian N, Khoda-Rahimi S. Developing a model of sleep quality based on depression with the mediating role of anxiety sensitivity among students in Behbahan City. Proc 8th Natl Conf New Res Educ Psychol Sci Iran, Tehran, 2023.
22. Askari A, Hajloo N, Basharpoor S. The role of depression and social anxiety in predicting quality of life and sleep quality through the mediating role of internet addiction [Master’s thesis]. University of Mohaghegh Ardabili, Ardabil, 2023.
23. Talebi-Ashleghi S, Ghodrati-Mirkouhi M. Study of academic stress, depression, and sleep disorders among first-grade female students during the COVID-19 quarantine in Miyaneh County [Master’s thesis]. Payame Noor University, Qazvin, 2022.
24. Karimi-Rad S, Zahraei Sh, Hosseini E. The relationship between anxiety and depressive symptoms and sleep quality among students during the COVID-19 pandemic [Master’s thesis]. Alzahra University, Tehran, 2022.
25. Mesbahi M, Saraei A. The relationship between
self-criticism, negative emotions, and sleep disorders [Master’s thesis]. Motahar Institute of Higher Education, 2022.
26. Mousavi N, Ghorbani S. Prediction of sleep disorders based on dark personality traits, emotional schemas, and negative automatic thoughts among university students [Master’s thesis]. Payame Noor University, Isfahan, 2022.
27. Golehdarizadeh S, Mousavi A. The relationship between intrusive thoughts (rumination, worry, obsession) and sleep quality among high school students with sleep disorders in Bandar Lengeh County [Master’s thesis]. Islamic Azad University, Bandar Lengeh, 2020.
28. Cheah YK, Kee CC, Lim KK, Cheong YL. Demographic, lifestyle, social, and psychological factors associated with worry-related sleep problems among school-going adolescents in Timor-Leste. J Child Adolesc Psychiatr Nurs. 2024;37(2):e12468.
29. Sesso G, Guccione F, Pisano S, Valente E, Narzisi A, Berloffa S, et al. Emotional Dysregulation and Sleep Problems: A Transdiagnostic Approach in Youth. Clin Pract. 2024;14(3):934-945
30. Ulrich AK, Full KM, Cheng B, Gravagna K, Nederhoff D, Basta NE. Stress, anxiety, and sleep among college and university students during the COVID-19 pandemic. J Am Coll Health. 2023;71(5):1323-7.
31. Clancy F, Prestwich A, Caperon L, Tsipa A, O'Connor DB. The association between worry and rumination with sleep in non-clinical populations: a systematic review and meta-analysis. Health Psychol Rev. 2020;14(4):427-48.
32. Safary Z, Mohammadi Yousefnejad Y. The role of emotional intelligence and moral intelligence in predicting psychological distress and obsessive thoughts among female high school students in Farashband [Master’s thesis]. Payame Noor University, Bushehr, 2022.
33. Khalafi S, Rasoulzadeh B. The effectiveness of positive psychology-based intervention on reducing perceived stress, psychological distress, and improving academic performance in dyslexic students [Master’s thesis]. University of Isfahan, Isfahan, 2021.
34. Narenji-Kahu A, Rajabpour-Farkhani S. The mediating role of anger and psychological distress in the relationship between sexual satisfaction and attitudes toward extramarital relationships among women attending counseling centers [Master’s thesis]. Hakim Nezami Institute of Higher Education, Mashhad, 2023.
| Files | ||
| Issue | Vol 19, No 4 (December 2025) | |
| Section | Original Articles | |
| Keywords | ||
| Sleep Disorders Psychological Distress Emotional Dysregulation | ||
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How to Cite
1.
Abidi M, Fazilati M, Samadi F. Prediction of Sleep Disorders Based on Psychological Distress and Emotional Dysregulation in Adolescent Girls. J Family Reprod Health. 2025;19(4):310-317.
