How does parental psychological control influence adolescent depression? A sequential mediation and network analysis...

The rising prevalence of depression among children and adolescents has become a critical global public health challenge requiring urgent attention. Emerging evidence suggests that parental psychological control (PPC) may be a significant risk factor for the development of depression in adolescents. Nevertheless, the intricate mechanisms linking parental psychological control to adolescent depression remain largely unresolved. This study aims to explore the association between parental psychological control and depression using a large sample of adolescents, and to determine whether parental psychological control relates to adolescent depression through a sequential pathway involving smartphone addiction and compromised sleep quality. Furthermore, network analysis is employed to identify the core and bridging symptoms within the network of parental psychological control, smartphone addiction, sleep disturbances, and depression in adolescents, providing a basis for targeted interventions.

A cross-sectional questionnaire study was administered to 4,416 adolescents (63.56% females; mean age of 16.24 ± 0.92 years) between September and November 2024. Participants completed a battery of standardized measures, including self-reported demographic questionnaires, the Parental Psychological Control Scale, the Short Version Smartphone Addiction Scale, the Pittsburgh Sleep Quality Index, and the Patient Health Questionnaire 9-Item Scale. Data were analyzed using the SPSS 26.0 and R statistical software packages.

Our study revealed a significant positive association between parental psychological control and adolescent depression. Parental psychological control significantly predicted both smartphone addiction and poor sleep quality in adolescents. Importantly, smartphone addiction and sleep quality served as a serial mediator in the relationship between parental psychological control and adolescent depression. Network analysis further revealed that three central symptoms-"Energy" (PHQ4), "Love withdrawal" (LW), and "Sleep" (PHQ3)-and two key bridge symptoms-"Smartphone addiction" (SASall) and "Daytime dysfunction" (DD)-emerged as critical connectors linking parental psychological control to depression in adolescents.

These findings elucidate the mechanisms through which parental psychological control contributes to adolescent depression, yielding significant theoretical and practical implications for adolescent mental health preventive interventions. Specifically, interventions targeting maladaptive smartphone use and poor sleep hygiene, particularly those addressing intermediary symptoms such as daytime dysfunction, may effectively mitigate the risk of depression in adolescents under high parental psychological control.