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目的:探讨不同特征的青少年失眠、疲乏、抑郁焦虑、认知缺陷的情况,以及疲乏、抑郁焦虑情绪在青少年失眠和认知缺陷间的链式中介作用。方法:收集6 014名青少年的一般人口学资料、并采用失眠严重指数量表(insomnia severity index,ISI)、多维度疲乏量表(the multidimensional fatigue inventory,MFI-20)、病人健康问卷(patient health questionnaire-9,PHQ-9)、广泛性焦虑量表(generalized anxiety disorder-7,GAD-7)、认知缺陷问卷(perceived deficits questionnaire-depression,PDQ-D)进行量表评估,比较不同特征青少年失眠、疲乏、抑郁焦虑、认知缺陷情况。采用SPSS 20.0进行Spearman相关分析。采用SPSS PROCESS宏程序偏差矫正的非参数百分位Bootstrap方法进行中介效应显著性的检验。结果:失眠、疲乏、抑郁焦虑、认知缺陷在不同性别、不同年级、不同学习成绩的青少年中的检出率不同。认知缺陷与失眠(n r=0.654,n P<0.01)、疲乏(n r=0.476,n P<0.01)、抑郁(n r=0.677,n P<0.01)、焦虑(n r=0.655,n P<0.01)均呈显著正相关,适合行中介效应检验。青少年疲乏、抑郁焦虑情绪在失眠与认知缺陷之间存在链式中介作用。失眠通过影响疲乏,进而影响抑郁症状,间接影响认知,中介效应值为1.253,效果量为55.60%,总效应为2.254。失眠通过影响疲乏,进而影响焦虑症状,间接影响认知,中介效应值为1.161,效果量为51.50%,总效应为2.254。n 结论:青少年失眠可以直接影响其认知缺陷,也可以通过疲乏、抑郁焦虑情绪的链式中介作用间接影响青少年的认知缺陷。“,”Objective:To explore the situation of insomnia, fatigue, depression, anxiety and cognitive impairment in adolescents with different characteristics, and the chain mediating effect of fatigue, depression and anxiety on insomnia and cognitive impairment.Methods:The general demographic data of 6 014 adolescents were collected.Insomnia severity index (ISI), the multidimensional fatigue inventory (MFI-20), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and perceived deficits questionnaire-depression(PDQ-D) were used to compare the insomnia, fatigue, depression, anxiety and cognitive impairment of adolescents with different characteristics.Spearman correlation analysis was conducted by SPSS 20.0 software.The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The detection rates of insomnia, fatigue, depression, anxiety and cognitive impairment were different in adolescents with different genders, grades and academic achievements.Cognitive impairment was significantly positively correlated with insomnia (n r=0.654, n P<0.01), fatigue (n r=0.476, n P<0.01), depression (n r=0.677, n P<0.01), anxiety (n r=0.655, n P<0.01), which was suitable for mediating effect test.Fatigue, depression and anxiety in adolescents had a chain mediating effect between insomnia and cognitive impairment.Insomnia indirectly affects cognition by affecting fatigue and depressive symptoms.The intermediary effect value was 1.253, the effect amount was 55.60%, and the total effect was 2.254.Insomnia indirectly affects cognition by affecting fatigue and anxiety symptoms.The intermediary effect value was 1.161, the effect amount was 51.50%, and the total effect was 2.254.n Conclusion:Insomnia can not only directly affect their cognitive impairment, but also indirectly affect their cognitive impairment through the chain mediation of fatigue, depression and anxiety of adolescents.