Abstract / Summary
Abstract Background: The comorbidity of insomnia, depression, and anxiety is prevalent among incarcerated populations. From a correctional mental health perspective, this study aimed to identify core and bridge symptoms in the symptom networks of insomnia, depression, and anxiety among incarcerated men, providing a basis for mental health screening and psychological service interventions.
Methods: This study included 584 incarcerated men in China ( M = 36.50, SD = 9.57). Insomnia, depressive, and anxiety symptoms were assessed using the Athens Insomnia Scale (AIS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7), respectively. Network analysis was used to construct an insomnia symptom network and a comorbidity network of insomnia, depression, and anxiety. Network centrality and bridge centrality were used to identify core and bridge symptoms.
Results: The prevalence of insomnia was 66.1%. Study 1 identified “Awakenings during night” (AIS 2) and “Daytime functioning capacity” (AIS 7) as core hubs within the insomnia network. Study 2 showed that “Restlessness” (GAD 5) had the highest expected influence, suggesting its high centrality in the cross-sectional symptom network. “Sleep” (PHQ 3) and “Sad mood” (PHQ 2) emerged as key bridge symptoms.
Conclusions: Core and bridge symptoms may represent important intervention targets for the comorbidity of insomnia, depression, and anxiety among incarcerated populations. These findings may inform symptom screening and psychological service prioritization in correctional settings. Future longitudinal and intervention studies are needed to further clarify the causal and clinical implications of these symptoms.