Obsessive-compulsive symptoms and sleep disturbance in college freshmen: a cross-sectional conditional process analysis

Abstract Sleep disturbance is common among college students, but the statistical relationships linking obsessive-compulsive symptoms (OCS), affective symptoms, and problematic Internet use remain unclear in nonclinical freshmen. In this cross-sectional study, 9,418 college freshmen aged 18–23 years (M = 19.60, SD = 0.65; 3,660 females) completed relevant subscales of the Chinese College Students’ Mental Health Screening Scale. Covariate-adjusted conditional process analyses (analytic N = 9,416) estimated separate and serial indirect associations through anxiety and depression and first-stage moderation by Internet addiction (IA). OCS was positively associated with sleep disturbance (B = 0.284, t = 20.58, p < .001, 95% CI [0.257, 0.311]). Indirect associations were observed through anxiety (estimate = 0.263, 95% bootstrap CI [0.232, 0.293]), depression (estimate = 0.098, 95% bootstrap CI [0.084, 0.114]), and anxiety followed by depression (estimate = 0.113, 95% bootstrap CI [0.098, 0.130]). The OCS × IA interaction in the anxiety equation was statistically significant but small (B = 0.0057, SE = 0.0015, t = 3.71, p < .001). Concurrent measurement prevents conclusions about temporal ordering or causality.