Perceived Social Support and Symptoms of Depression and Anxiety among Chinese Adolescents: A Moderated Chain Mediation Model

Background: Although previous studies indicate that perceived social support might be associated with adolescent psychological problems, the specific mechanism has not been thoroughly discussed. Based on theoretical and empirical research on problematic Internet use (PIU) and sleep quality, this study explored whether they play a mediating role between perceived social support and symptoms of depression and anxiety among adolescents. Furthermore, we investigated whether these relationships varied by place of residence. Methods: A sample of 2115 Chinese adolescents was included, and analyzed data related to perceived social support, PIU, sleep quality, symptoms of depression and anxiety, and sociodemographic variables. Correlation analysis, mediation, and moderation analysis were mainly used. Results: Perceived social support was negatively correlated with depressive symptoms (r = -0.22, p < 0.001) and anxiety symptoms (r = -0.20, p < 0.001) among adolescents. PIU and sleep quality played a chain mediating role in the relationship between perceived social support and symptoms of depression and anxiety in adolescents. Additionally, the place of residence moderated the relationships between perceived social support and PIU and symptoms of depression and anxiety. Perceived social support was a significant negative predictor of PIU and symptoms of depression and anxiety among adolescents in urban areas but not in rural areas. Conclusion: The findings suggest that low levels of perceived social support may lead to more PIU and poorer sleep quality, which may further increase the risk of symptoms of depression and anxiety in adolescents, especially in urban areas.