The associations of chronotype and social jetlag with prosocial behavior problems among Chinese adolescents

Potential relevance between the circadian rhythm and behavioral health has got raising attention in recent years. This study aimed to examine chronotype, social jetlag and their associations with prosocial behavior problems among Chinese adolescents. A total of 4,666 middle school students aged 12-18 years were enrolled in study. Sleep characteristics were collected by the modified Chinese version of Adolescent Sleep Hygiene Scale (M-ASHS); MSFsc and mid-sleep point were calculated to determine chronotypes and social jetlag. Prosocial behavior problems were assessed by the Strength and Difficult Questionnaire (SDQ). Multivariate logistic regression was applied to analyze the relationships between chronotype and social jetlag with prosocial behavior problems. Evening chronotype was associated with higher risk of prosocial behavior problems, whether among male (OR = 1.82, 95%CI:1.27-2.61, P = .001) or female adolescents (OR = 1.83, 95%CI:1.15-2.91, P = .011). Female adolescents with social jetlag of 1-2 hours had 1.60 times the risk of prosocial behavior problems than their peers whose social jetlag was <1 h (P = .028); social jetlag ≥ 2 h was positively associated with prosocial behavior problems in both male and female adolescents (OR = 1.79 and 2.45, respectively, both P < .05). Further, the combination of intermediate chronotype and social jetlag ≥ 2 h was correlated with prosocial behavior problems only in female adolescents (OR = 3.24, 95%CI = 1.40-9.21, P = .004). Evening chronotype and higher social jetlag were risk factors for prosocial behavior problems in adolescents, especially for the female. For the promotion of prosocial behavior in adolescents, the importance of circadian rhythm should be addressed.