The mediating effect of internet addiction on the relationship between exposure to extra familial violence and sleep disorder among youth
Imen Mlouki 1,2,3
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Department of Preventive and Community Medicine, University Hospital Tahar Sfar Mahdia, Tunisia
Research laboratory “Epidemiology Applied to Maternal and Child Health” 12SP17, Tunisia
Department of Community Medicine, Faculty of Medicine of Monastir, Tunisia
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1223
Background and Objective: Recent researches showed short and long term deleterious consequences of Adverse Childhood Experiences (ACEs) on mental as well as physical health. Sleep disorder is one of the harmful well-known ACEs outcomes that should be considered. The real knowledge gap consists in the mechanisms by which ACEs lead to sleep disorders later on in life. Specifically, we aimed at investigating the mediating role of internet addiction in the link between exposure to extra familial ACEs and sleep disorders among schooled adolescents in Gafsa city (Tunisia). Methods: We conducted a cross-sectional study, in February 2020, including youth registered in all secondary schools of Gafsa city. Sleep disorders were evaluated via the Pittsburgh Sleep Quality Index, internet addiction via the Internet Addiction Test and Social ACEs via the Adverse Childhood Experiences-International Questionnaire. Results: Overall 650 schooled youth were initially included. Among them, 414 returned the questionnaire (response rate=63.7%). Girls represented 63% of the studied population. Social violence exposure was higher in males (91.9% vs 79.6%, p=0.002). The majority of students (76.8%) revealed being victim of community violence. Peer violence was reported by 57.1% of adolescents. Sleep disorders were more prevalent among females (95.4% vs 91%, p=0.001). Males presented highest rates of internet addiction (82.9% vs 78.3%, p=0.001). We found a statistically significant partial mediation effect by internet addiction for social ACEs as the exposure variables and sleep disturbances as the outcome variable (p=0.005, % mediated =28.7%). Conclusions: Our study is the first in Tunisia and in the Arab countries to demonstrate the role of internet addiction in the association between social ACEs and sleep disorders.
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