Background: High prevalence and strong relationships among suicidal ideation, Internet gaming disorder (IGD), insomnia, and depression have been reported for adolescents worldwide, but the mechanism underlying these psychological problems remains unclear. This cross-sectional study explored the mediating effect of insomnia and depression on the association between IGD and suicidal ideation. Methods: Participants were 1066 adolescents (median age = 13.0 years) with Internet games exposure in the previous 12 months from junior high schools in Shanghai, China. Questionnaire measures of suicidal ideation, IGD, insomnia, depressive symptoms, and background characteristics were obtained. Path analysis was conducted to test the multiple mediating roles of insomnia and depression. Results: Suicidal ideation, IGD, insomnia, and depression prevalence was 27.2, 13.6, 9.2, and 17.0%, respectively. A serial multiple mediation model was generated. The mediation effect of insomnia and depression on the pathway from IGD to suicidal ideation was 45.5% (direct effect: standardized estimate [Std. estimate] = 0.186; total indirect effect: Std. estimate = 0.155). The association between IGD and depression was partially mediated by insomnia (direct effect: Std. estimate = 0.211; indirect effect: Std. estimate = 0.135). The proposed model fit the data well. Conclusions: Insomnia and depression may serially mediate the association between IGD and suicidal ideation. IGD was positively associated with insomnia, then with depression, which in turn positively contributed to suicidal ideation. We suggest greater monitoring of Internet use and prevention of insomnia and depression to mitigate the risk of suicidal ideation among Chinese adolescents.

Objective: This three-wave longitudinal study tested the prospective relationships between college adjustment, self-esteem, and mental health status (ie, subjective well-being, anxiety, and depression). Participants: The study recruited 265 Chinese undergraduate students. Methods: Demographic, college adjustment, self-esteem, and mental health status data were collected. Results: College adjustment and self-esteem were moderate in magnitude and maintained a reasonable stability over time. College adjustment and self-esteem at Year 1 and Year 2, and mental health status at Year 3, were significantly correlated with each other. College adjustment at Year 1 and Year 2, and self-esteem at Year 1 significantly predicted mental health status at Year 3. Conclusions: Interventions to improve self-esteem and college adjustment may benefit long-term mental health outcomes.