Can social support buffer the association between depression and suicidal ideation in adolescent boys and girls?

Association Between Internet Gaming Disorder and Suicidal Ideation Mediated by Psychosocial Resources and Psychosocial Problems Among Adolescent Internet Gamers in China: Cross-Sectional Study

BACKGROUND

Adolescent internet gaming disorder (IGD) was associated with severe harm, including suicidal ideation. While suicidal ideation was predictive of completed suicides, further research is required to clarify the association between IGD and suicidal ideation among adolescents, as well as the mechanisms involved.

OBJECTIVE

This study aimed to investigate the understudied association between IGD and suicidal ideation, as well as novel mechanisms associated with it, among Chinese adolescent internet gamers through psychosocial coping resources and psychosocial problems.

METHODS

An anonymous, self-administered, cross-sectional survey was conducted among secondary school students who had played internet games in the past year in Guangzhou and Chengdu, China (from October 2019 to January 2020). In total, 1693 adolescent internet gamers were included in this study; the mean age was 13.48 (SD 0.80) years, and 60% (n=1016) were males. IGD was assessed by the 9-item Internet Gaming Disorder Checklist of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]), while a single item assessed suicidal ideation: "Have you ever considered committing suicide in the past 12 months?" Univariate and multivariate logistic regression associations were conducted to test the significance and directions of the potential factors for suicidal ideation. The mediation mechanism was examined by structural equation modeling.

RESULTS

Among all participants, the prevalence of IGD and suicidal ideation was 16.95% (287/1693) and 43.06% (729/1693), respectively. IGD cases were 2.42 times more likely than non-IGD cases to report suicidal ideation (adjusted odds ratio [OR] 2.42, 95% CI 1.73-3.37). Other significant factors of suicidal ideation included psychosocial coping resources (resilience and social support, both adjusted OR 0.97, 95% CI 0.96-0.98) and psychosocial problems (social anxiety: adjusted OR 1.07, 95% CI 1.05-1.09; loneliness, adjusted OR 1.13, 95% CI 1.10-1.16). The association between IGD and suicidal ideation was partially mediated by 3 indirect paths, including (1) the 2-step path that IGD reduced psychosocial coping resources, which in turn increased suicidal ideation; (2) the 2-step path that IGD increased psychosocial problems, which in turn increased suicidal ideation; and (3) the 3-step path that IGD reduced psychosocial coping resources which then increased psychosocial problems, which in turn increased suicidal ideation, with effect sizes of 10.7% (indirect effect/total effect: 0.016/0.15), 30.0% (0.05/0.15), and 13.3% (0.02/0.15), respectively. The direct path remained statistically significant.

CONCLUSIONS

IGD and suicidal ideation were alarmingly prevalent. Evidently and importantly, IGD was a significant risk factor for suicidal ideation. The association was partially explained by psychosocial coping resources of resilience and social support and psychosocial problems of social anxiety and loneliness. Longitudinal studies are needed to confirm the findings. Pilot randomized controlled trials are recommended to evaluate the effectiveness of interventions in reducing suicidal ideation by reducing IGD, improving psychosocial coping resources, and reducing psychosocial problems investigated in this study.

Peer Relationships and Social Media Use in Adolescents with Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a common and debilitating disorder in adolescents, yet there is little research on the disorder in young people. The current study aimed to investigate peer relationship factors in 26 adolescents (aged 12 to 17 years) with BDD, compared to 27 adolescents with anxiety disorders and 25 adolescents without mental disorders. Participants completed self-report measures on peer appearance and general victimisation, peer support, appearance co-rumination and social media use. Adolescents with BDD and anxiety disorders perceived significantly less peer support than adolescents in the non-clinical control group. Although the frequency of perceived appearance and general victimisation did not differ significantly between groups, adolescents with BDD reported significantly more distress due to appearance victimisation than the non-clinical control group. Adolescents with BDD and anxiety disorders reported spending more time on social media than the non-clinical control group, and the BDD group engaged in significantly more online appearance comparisons than both the anxiety and control group. The relationships between BDD, victimisation, social media use, and other peer factors require further empirical investigation.

Friendships and peer relationships and self-harm ideation and behaviour among young people: a systematic review and narrative synthesis

Friendships and peer relationships have an important role in the experience of self-harm ideation and behaviour in young people, yet they typically remain overlooked. This systematic review and narrative synthesis explores the extant literature on this topic to identify important relationships between these constructs. We did a keyword search of peer-reviewed empirical articles relating to friendships and peer relationships and self-harm ideation and behaviour in young people (aged 11-25 years). We identified 90 articles with evidence primarily from adolescents aged 11-18 years, including mixed genders and a majority of White individuals. Findings highlight substantive relationships between the key constructs, showing that: characteristics of friends and peers, including their self-harm ideation and behaviour, relate to and predict ego self-harm ideation and behaviour; friends and peers are important sources of support; and evidence on causal mechanisms is scarce but highlights potential peer selection and influence processes. Studies of the friends and peers of young people with self-harm ideation and behaviour highlight that: friends' attitudes to self-harm and suicide influence their responses to peers with self-harm ideation and behaviour; and friends who are bereaved and friend supporters experience negative outcomes such as symptoms of depression, anxiety, PTSD, and grief, alongside difficult emotions. Despite substantial heterogeneity across samples, study designs, and definition or measurement of the primary constructs, this work presents an initial step in organising a complex literature on a crucially important topic, which can help to inform future research and evidence-based interventions.

A network analysis of depressive symptoms, psychosocial factors, and suicidal ideation in 8686 adolescents aged 12-20 years

Suicide has aroused global concern, and a better understanding of the complex interactions between suicide ideation and various psychopathological features is critical. We aimed to explore the complex interplays among adolescents. This study adopted a multistage stratified cluster sampling method and recruited adolescents aged 12 to 20 year-old from 8 middle and high schools between December 2020 and September 2021 in Guangzhou, China. We assessed loneliness, social support, bullying victimization, depressive symptoms, and suicidal ideation. We used network analysis to examine the network structure of the correlates of suicidal ideation and identify central symptoms and bridge symptoms. We used case-drop bootstrapping and correlation stability coefficients to examine the stability of the network. Among 8686 adolescents, 347 (4 %) adolescents reported suicidal ideation in the past two weeks. Network analyses identified 'hopeless', 'psychomotor', and 'failure' were the three strongest edges linked to suicidal ideation. The most central nodes were identified as 'hopeless' being the most central node, followed by loneliness and verbal bullying victimization, while sexual bullying victimization, sex, and relational bullying were the strongest bridging symptoms. The findings shed light on the complexity of associations of suicidal ideation and could provide insight into school-based suicide risk assessment and prevention for adolescents.

Why Haven't You Texted Me Back? Adolescents' Digital Entrapment, Friendship Conflict, and Perceived General Health

OBJECTIVE

Many adolescents feel pressure to be constantly available and responsive to others via their smartphones and social media. This phenomenon has been understudied using quantitative methods, and no prior study has examined adolescents' specific stress about meeting digital availability expectations within a best friendship, or entrapment. The present study offers an important preliminary examination of this unique digital stressor in a developmental context by examining prospective associations between digital entrapment, psychosocial adjustment, and health in adolescence.

METHOD

Students in a rural, lower-income school district in the southeastern US (n = 714; 53.8% female; 45.9% White, 22.7% Black, 24.0% Hispanic/Latino) completed self-report measures of digital entrapment, perceived general health, friendship conflict, and depressive symptoms at two timepoints, one year apart.

RESULTS

Digital entrapment, which 76.3% of the sample reported experiencing, was associated prospectively with higher levels of friendship conflict and worse perceived general health one year later among boys, but not girls. Findings suggest that digital entrapment is an extremely common experience for adolescents that may disproportionally affect boys. Entrapment was not prospectively associated with depressive symptoms.

CONCLUSIONS

Results offer insight into how boys may have different social media experiences significant to their development and health, while much work exploring gender differences in social media use thus far has elucidated negative effects for girls. Boys may perceive and respond to novel social norms of digital environments differently such that digital entrapment has the potential to be detrimental to their friendships and health.

Why is Korean girls' suicidal ideation rate higher than boys' rate? The role of gender heterogeneity in peer groups

Girls typically show much lower suicide rates than boys in most OECD countries. However, in South Korea, the suicide rate of girls almost reaches that of boys. Moreover, Korean girls' suicide rate is remarkable even among other advanced countries. One potential approach to explaining Korean girls' relatively high suicide rate is to investigate how their peer groups affect suicidal ideation, but this approach has rarely been explored in Korean adolescents. We tested how the gender heterogeneity of peer groups is associated with suicidal ideation by analyzing 2,990 adolescents from the 2018 Korean Children and Youth Well-Being Index Survey. For the analysis, logistic regression models with survey weights were used. The analysis revealed that adolescents with different-gender friends were associated with a higher likelihood of suicidal ideation than those with exclusively same-gender friends when adjusting for covariates. In addition, an analysis stratified by gender found that this association was significant only among girls. Furthermore, the protective power of having a mentor against suicidal ideation was significantly lower in girls with male and female friends than in girls with only female friends. The findings suggest a less protective role of different-gender peer groups for suicidal ideation among girls. During adolescent suicidality consultations, school counselors and practitioners should pay attention to the characteristics of adolescents' peers, particularly their gender.

Relations between youths' community violence exposure and their physical aggression: The protective role of adults

The purpose of this study was to examine whether adults moderated the relations between youths' community violence exposure and subsequent physical aggression. Participants were 2575 middle school students (Mage  = 12.3, SD = 1.00; 52% female) in the southeastern U.S. who completed surveys collected in the fall, winter, spring, and summer. The sample was predominantly African American (72%). High adult support was associated with weaker relations between exposure to violence in the fall and aggression in the winter among male adolescents. High adult support was related to weaker relations between victimization in the fall and aggression in the winter among female adolescents. Strategies promoting supportive adult relationships may benefit male adolescents by buffering the adverse impact of community violence exposure.

A moderated mediation analysis of the association between smoking and suicide attempts among adolescents in 28 countries

Globally, evidence has shown that many adolescents are victims of substance use, mainly cigarette smoking, and it has been associated with suicidal ideation. However, the mechanisms underlying this association are poorly understood. This study examines whether truancy mediates and gender moderates the association of cigarette smoking with suicide attempts among adolescents in 28 countries. Data from the Global School-Based Student Health Survey were used. Hierarchical multiple logistic regression analyses were used to estimate the effect-modification of gender on cigarette smoking and suicide attempt. The mediating effect of truancy on the association between cigarette smoking and suicidal attempt was assessed using the generalized decomposition method. Cigarette smoking was associated with suicide attempts after adjusting for several confounding variables (aOR = 1.21; 95% CI = 1.09-1.33). The bootstrap results from the generalized decomposition analysis indicated that truancy partially mediated the association of cigarette smoking with a suicide attempt, contributing 21% of the total effect among in-school adolescents. Hierarchical regression analyses suggested that gender moderated the effect of cigarette smoking on suicidal attempts: female adolescents who smoked had 36% higher odds of suicidal attempts compared to male adolescents. The findings suggest possible pathways for designing and implementing interventions to address adolescents' cigarette smoking and truancy to prevent suicidal attempts.

Parent-child perception differences in home-based parental involvement and children's mental health in China: The effects of peer support and teacher emotional support

Parents' perception of parental involvement or that of children has been found to be associated with the mental health of children. Rather than scrutinizing whether parents' perception or children's perception matters more, this study investigated whether and how parent-child perception differences (parents' perceptions minus their children's perceptions) in home-based parental involvement were related to anxiety, depression, and stress in children. We surveyed 2219 adolescents (approximately 12-14 years old) and their parents in nine middle schools in eastern China. Findings indicate that parent-child perception differences in parental daily involvement (e.g., Depression: β = .065, p < .01) and parent-child communication (e.g., Depression: β = .107, p < .001) were detrimental to the mental health of children, and that perceived peer support and perceived teacher emotional support might mitigate the adverse effects.

Self-reported anxiety and depression problems and suicide ideation among black and latinx adults and the moderating role of social support

Suicide is a critical public health problem. Over the past decade, suicide rates have increased among Black and Latinx adults in the U.S. Though depression is the most prevalent psychiatric contributor to suicide risk, Black and Latinx Americans uniquely experience distress and stress (e.g., structural adversity) that can independently operate to worsen suicide risk. This makes it important to investigate non-clinical, subjective assessment of mental health as a predictor of suicide ideation. We also investigate whether social support can buffer the deleterious impact of poor mental health on suicide ideation.We analyzed data from 1,503 Black and Latinx participants of the Washington Heights Community Survey, a 2015 survey of residents of a NYC neighborhood. Multivariable logistic regression was conducted to examine the effect of subjectively experienced problems with anxiety and depression on suicide ideation independent of depression diagnosis, and the role of social support as a moderator.Estimated prevalence of past two-week suicide ideation was 5.8%. Regression estimates showed significantly increased odds of suicide ideation among participants reporting moderate (OR = 8.54,95% CI = 2.44-29.93) and severe (OR = 16.84,95% CI = 2.88-98.46) versus no problems with anxiety and depression, after adjustment for depression diagnosis. Informational support, i.e., having someone to provide good advice in a crisis, reduced the negative impact of moderate levels of anxiety and depression problems on suicide ideation.Findings suggest that among Black and Latinx Americans, subjective feelings of anxiety and depression account for a significant portion of the suicide ideation risk related to poor mental health. Further, social support, particularly informational support, may provide protection against suicide ideation.

Detecting negative valence symptoms in adolescents based on longitudinal self-reports and behavioral assessments

BACKGROUND

Given the high prevalence of depressive symptoms reported by adolescents and associated risk of experiencing psychiatric disorders as adults, differentiating the trajectories of the symptoms related to negative valence at an individual level could be crucial in gaining a better understanding of their effects later in life.

METHODS

A longitudinal deep learning framework is presented, identifying self-reported and behavioral measurements that detect the depressive symptoms associated with the Negative Valence System domain of the NIMH Research Domain Criteria (RDoC).

RESULTS

Applied to the annual records of 621 participants (age range: 12 to 17 years) of the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA), the deep learning framework identifies predictors of negative valence symptoms, which include lower extraversion, poorer sleep quality, impaired executive control function and factors related to substance use.

LIMITATIONS

The results rely mainly on self-reported measures and do not provide information about the underlying neural correlates. Also, a larger sample is required to understand the role of sex and other demographics related to the risk of experiencing symptoms of negative valence.

CONCLUSIONS

These results provide new information about predictors of negative valence symptoms in individuals during adolescence that could be critical in understanding the development of depression and identifying targets for intervention. Importantly, findings can inform preventive and treatment approaches for depression in adolescents, focusing on a unique predictor set of modifiable modulators to include factors such as sleep hygiene training, cognitive-emotional therapy enhancing coping and controllability experience and/or substance use interventions.

The relationship between real-life social support and Internet addiction among the elderly in China

Internet addiction among the elderly is a novel issue in many countries. However, extant research about excessive use of the Internet is focusing on adolescents and younger adults. There are few studies to explore the topic of the elderly's Internet addiction. The purpose of this study is to investigate the relationship between real-life social support and Internet addiction among older adults during the COVID-19 pandemic. This article adopted a self-reported questionnaire via internet links to collect data. A total of 303 valid samples about Internet addiction for the elderly were obtained in China. The results suggested that real-life social support is significantly and negatively related to Internet addiction among the aged. Moreover, the findings revealed that real-life social support could mitigate Internet addiction by increasing the levels of hopefulness and decreasing the feeling of loneliness. We expect that this study can enrich the understanding of the problematic Internet usage within older populations. Finally, the contributions, practical significance, and limitations of this study were discussed.

Days with and without self-injurious thoughts and behaviors: Impact of childhood maltreatment on adolescent online social networking

INTRODUCTION

Among adolescents, an increasing rate of interpersonal interactions occurs online. Previous research has shown that interpersonal context exerts a robust impact on suicidal thoughts or behaviors, yet little attention has focused on examining the content of online interactions surrounding self-injurious thoughts or behaviors. As such, the present study sought to compare online social networking behaviors among adolescents on days with and without experiencing self-injurious thoughts or behaviors, as influenced by childhood maltreatment history.

METHOD

Adolescents aged 13-18 hospitalized for self-injurious thoughts or behaviors were recruited as part of an ongoing longitudinal study. A subsample (N = 22) of adolescents provided data from their online social networking platforms (i.e., text messages, Facebook, Instagram, and Twitter). Using a mixed-methods approach, online social networking data on days of experiencing self-injurious thoughts or behaviors and days of not experiencing self-injurious thoughts or behaviors were compared.

RESULTS

Results indicate the frequency and content of online social networking messaging do not change by day of self-injurious thoughts or behaviors or history of childhood maltreatment. However, childhood maltreatment predicts received conflictual messages as well as sent symptomatic messages on days of experiencing self-injurious thoughts or behaviors.

CONCLUSIONS

Childhood maltreatment may play a role in the content of adolescent online behaviors, particularly on days when they experience self-injurious thoughts or behaviors. Implications for intervention are discussed.

Predicting multicultural adolescents' depression in South Korea: Roles of ego-resilience and social support

PURPOSE

Depressive symptoms among adolescents are a major concern for increased risk of adverse health condition outcomes later in life. Specifically, previous studies have reported that multicultural adolescents experience more depressive symptoms than non-multicultural ones. Using the Korean Children and Youth Panel Survey, this study examined the relationships between ego-resilience, social support, and depression among multicultural adolescents in South Korea, as well as the moderating effect of social support on the association between ego-resilience and depression.

DESIGN AND METHODS

A total of 1500 multicultural adolescents were included in the analyses, where generalized estimating equation models were employed.

RESULTS

Depression scores increased slightly from 2012 to 2015. Higher levels of ego-resilience, family support, and friend support were associated with lower levels of depression, while teacher support was not a significant predictor. The moderating effect of friends and family support on the association between ego-resilience and depression was not statistically significant.

CONCLUSIONS

To reduce the level of depression among multicultural adolescents, future research should develop interventions that enhance ego-resilience ability, as well as necessary social systems that strengthen family and friend support.

PRACTICE IMPLICATIONS

Supportive interventions, such as enhancing ego-resilience to reduce depression should be provided to multicultural adolescents. It is recommended to include family and friends to develop effective intervention programs for multicultural adolescents who are suffering from depression.

Risk Factors for Depression in Tuberculosis Patients: A Meta-Analysis

Purpose

Tuberculosis (TB) is a life threatening global infection. However, not only does TB have a high global prevalence, but it is also associated with several comorbidities. Depression is one of the most common and lethal comorbidities of TB patients. Therefore, in order to prevent depression in TB patients more effectively, it is necessary to investigate the factors associated with depression in TB patients by studying the pooled effect of each factor statistically. By concluding the associated factors through statistical analysis, it not only offers accurate guidance for further studies about programs targeted at preventing depression in TB patients, but provides health-care workers useful suggestions and warnings when treating TB patients.

Methods

We searched the published literatures from PubMed, Web of Science, EMBASE, and Cochrane Library to collect studies. The meta-analysis included articles from observational studies, including cross-sectional studies, cohort studies and case control studies that had information about factors associated with depression in tuberculosis patients. When the heterogeneity is defined as significant (I2>50%), a random-effect model with 95% confidence interval (CI) was used to estimate risk factors; otherwise, a fixed-effect model was used to combine the effect. A sensitivity test was conducted to examine which one of the studies may have potential bias that can affect the validity and reliability of the result. The funnel plots and Begg's and Egger's statistical tests were performed to assess the publication bias. Subgroup analysis was performed according to the prespecified variables in each group.

Results

Totally, 25 studies were included in the meta-analysis. The studies were conducted in various countries around the world between 2011 and 2021, representing the situation in the previous ten years. The final associated factors include female gender [OR=1.319, 95% CI=1.132-1.536, p<0.001], poor social support [OR=4.109, 95% CI=1.431-11.799, p<0.01], marriage status [OR=1.362, 95% CI=1.154-1.608, p<0.001], low education level [OR=1.921, 95% CI=1.475-2.503, p<0.001], residence in rural areas [OR=1.408, 95% CI=1.122-1.767, p<0.01], retreatment status [OR=2.515, 95% CI=1.226-5.159, p<0.01], and having perceived stigma[OR=4.131, 95% CI=1.412-12.088, p<0.05].

Conclusion

Depression prevention programs targeted at women TB patients are supposed to be carried out. Patients in retreatment status are supposed to be paid more attention of their psychological health by caring about their mental status. More social support is ought to be given to tuberculosis patients to reduce their chance of getting depressed. It is necessary to provide patients with a lower education level with psychological related courses to help them learn about their mental status. For patients living in rural areas, governments are supposed to offer psychotherapy for treatment as well as enhancing living condition. Suitable psychotherapy programs and plans is ought to be studied to eradicate perceived stigma of TB patients.

Childhood maltreatment and suicide ideation: A possible mediation of social support

BACKGROUND

Existing literature suggests a positive link between childhood maltreatment (CM) and suicide ideation (SI). Nevertheless, whether social support significantly mediates this association remains unknown.

AIM

To investigate whether social support significantly mediates the association between CM and SI.

METHODS

In this cross-sectional study of 4732 adolescents from southwest China, we intended to discuss the association between CM and multiple types of SI. In addition, the mediation of major types of social support in this association was also investigated. A self-administrated questionnaire was used to collect the data. A series of multivariate logistic regression models were employed to estimate the association between different types of CM, social support, and SI. The possible mediation of social support in the association between CM and SI was assessed using the path model.

RESULTS

Based on the cutoffs for subscales of Childhood Trauma Questionnaire, 928 (19.61%), 1269 (26.82%), 595 (12.57%), 2337 (49.39%), and 3067 (64.81%) respondents reported physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect, respectively. Among all the social sources, parental support presented as a significant mediator in the association between emotional maltreatment, both abuse and neglect, and all three types of SI: 1-wk, 1-year, and lifetime. Parental social support mediated 5.31% and 29.23%, 4.80% and 24.50%, and 7.04% and 44.42% of the overall emotional abuse-SI and emotional neglect-SI associations, respectively.

CONCLUSION

Our findings suggest that improving parental social support might be effective in preventing suicidal risk related to childhood emotional maltreatment in adolescents.

The Mediating Role of Social Support in the Relationship Between Parenting Styles and Adolescent Drug Abuse Identification

Adolescent drug abuse is a social issue of global concern, causing a serious burden of diseases for individuals, families and society. To design effective prevention and intervention strategies for adolescent drug abusers, the predictive factors associated with drug abuse must be quantified and assessed. This study explores the similarities and differences between the parenting styles of adolescent drug abusers and non-drug abusers and applies a structural equation model to analyze the mechanisms involved between parenting styles, social support and adolescent drug abuse identification. Data were derived from adolescent drug abusers (n = 363) and non-drug abusers (n = 229) between the ages of 18 and 35 in China, and the data were collected and analyzed by SPSS 26 and AMOS 24. The results show that parenting styles significantly predict adolescent drug abuse identification, and different parenting styles have different influencing mechanisms, which further indicates that poor parenting styles are a risk factor for adolescent drug abuse. Additionally, social support plays a mediating role between parenting styles and drug abuse identification (χ²/df = 4.52, CFI = 0.939, TLI = 0.914, RMSEA = 0.077, IFI = 0.939, PCFI = 0.671). The specific pathways involved are as follows: Paternal parenting style → Social support → Drug abuse identification and Maternal parenting style → Social support → Drug abuse identification. However, beyond this, the mediation model of social support shows good adaptability and stability between adolescent drug abusers and non-drug abusers. Since parenting styles and social support are important predictors of adolescent drug abuse, the importance of integrating family-social support antidrug programs into adolescent prevention and intervention strategies should be considered.

Association of social support with negative emotions among Chinese adolescents during Omicron-related lockdown of Shenzhen City: The roles of rumination and sleep quality

OBJECTIVE

Adolescents are likely to suffer from negative emotions such as depression and anxiety due to the rapid development of biological, cognitive and social changes. Previous studies have indicated possible risk (rumination) and protective (good social support and high sleep quality) factors for depression and anxiety among this age group. The present study is the first to investigate the association between social support and negative emotions during the Outbreak of Omicron variant, on this basis, to further determine the mediating role of rumination and sleep quality on this link.

METHOD

A total of 1,065 Chinese middle- and high-school students (51.5% female, M _age = 13.80, SD = 1.20) completed a psychosocial battery, including the Social Support Rating Scale (SSRS), the Pittsburgh Sleep Quality Index (PSQI), the Ruminative Responses Scale (RRS), the Depression Anxiety Stress Scale (DASS). Serial multiple mediation analysis was conducted using PROCESS macro based on SPSS.

RESULTS

Social support, rumination, and sleep quality were significantly negatively correlated with negative emotional states (Ps < 0.05). Further, rumination and sleep quality were found to partially mediate the relationship between social support and negative emotional states.

CONCLUSIONS

For early detection and prevention of depression and anxiety, providing sufficient social support is necessary for adolescents, because rumination and sleep problems are reported during stressful periods, such as the COVID-19 pandemic.

Association of the type of counselor with suicidal ideation and suicide attempts: a survey of South Korean adolescents

BACKGROUND

Counseling for adolescents who consider or attempt suicide may help reduce suicide rates. However, the impact of the type of counselor (e.g., father, mother, sibling, friend, teacher, other) on suicidal ideation/suicide attempts remains unclear. Therefore, we examined this association in Korean adolescents.

METHODS

Using data from the 2015 Korea Youth Risk Behavior Web-based Survey of 65,485 adolescents, we examined risk factors for suicidal ideation/suicide attempts according to sex using a multiple logistic regression analysis. In a subgroup analysis, we investigated the associations between counselor type and suicidal ideation/suicide attempts stratified by the cause of stress for both sexes.

RESULTS

Male participants were less likely to consider suicide when counseled by their mother (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.70-0.90) or friend (OR 0.89; 95% CI 0.80-0.99) and to attempt suicide when counseled by a friend (OR 0.74; 95% CI 0.60-0.92) than were those who did not receive any counseling. Female participants were less likely to attempt suicide when counseled by their mother (OR 0.66; 95% CI 0.53-0.82) or friends (OR 0.70; 95% CI 0.58-0.83) than when not counseled. Furthermore, adolescents with achievement/career choice-related and family problems were at a lower risk of suicide ideation/suicide attempts when counseled by their mother or friend than when they received no counseling.

CONCLUSIONS

Suicidal ideation/suicide attempts showed different associations for both sexes in accordance with the type of counselor. Even if counseling by specialists for issues such as achievement/career choice-related or family matters is needed, the risk of suicide could be reduced through counseling by the people around them. Therefore, adolescents should form mutually supportive relationships through active communication with surrounding people.

The influence of family therapy on psychological stress and social adaptability of depressed patients

BACKGROUND

with the increase of study and life pressure, the number of depressed college students showed an increasing trend year by year, and the drug treatment alone could not achieve a comprehensive recovery of depression patients, so it was more necessary to pay attention to the spiritual treatment.

OBJECTIVE

this research aimed to better understand the relationship between college students' depression and life events, social support, psychological pressure, and coping style, and the influence of systematic family therapy on depression degree, psychological stress, and social adaptability of college students with depression.

METHODS

in this study, 105 college students with depression were selected as the research object, and healthy college students were taken as the control group. Through questionnaire, the differences in life events, social support, psychological stress, and coping styles between the groups were compared. The correlation between the degree of depression and various variables were analyzed, and the impact path of each variable on depression was analyzed using the path analysis model. Depression patients were then divided into a conventional group treating with conventional medications and an observation group treating with systematic family interventions. Differences in Hamilton Depression Scale-17, (HAMD-17), CPSS, and Social Adaptive Functioning Evaluation (SAFE) scores were compared and analyzed between the two groups before treatment (T1), during the treatment (T2), and after treatment(T3).

RESULTS

there were significant differences in scores of life events, social support, psychological stress, and coping styles between the healthy control group and the depressed patients (P < 0.05). There was an obvious correlation between different depression degrees and life events, social support, psychological stress, and coping styles (P < 0.05). Life events, social support, and psychological stress had a direct and significant impact on depression (0.250, 0.218, and 0.392; P < 0.05), and they also had an indirect and significant impact on depression through coping styles (P < 0.05). The systematic family treatment model could significantly reduce HAMD-17 and CPSS scores (P < 0.05), and significantly improve SAFE scores (P < 0.05).

CONCLUSIONS

adverse life events, lack of social support, excessive psychological stress, and negative coping styles can aggravate college students' depression. Systematic family therapy can improve the degree of depression, reduce the psychological stress, and enhance the social adaptability of college students with depression.

Zoom or In-Person: An Ecological Momentary Assessment Study of Time with Friends and Depressive Symptoms on Affect in Emerging Adults

INTRODUCTION

Depression is associated with increased negative affect (NA) and low positive affect (PA), as well as interpersonal difficulties. Although most studies examine symptoms and affect at only one time point, ecological momentary assessment (EMA) captures data on affect and activity in real time and across contexts. The present study used EMA to explore the links between in-person and virtual social interactions, depressive symptoms, and momentary affect.

METHODS

Emerging adults (N=86) completed a self-report measure of both general depression and dysphoria symptoms, followed by EMA surveys 8 times daily for one week, reporting momentary affect (PA and NA) and social context (in-person and virtual interactions with friends).

RESULTS

In-person, but not virtual, presence of friends was associated with increased PA overall. Depressive symptoms were linked to less time with in-person friends and elevated NA. There was also a significant interaction between in-person presence of friends and dysphoria in predicting NA, such that presence of in-person friends was associated with lower NA only for those low in dysphoria.

DISCUSSION

Findings suggest that time with in-person friends is associated with increased PA overall and decreased NA only for those lower in depressive symptoms, but these effects do not generalize to virtual interactions. Those with greater depressive symptoms may be less responsive to positive stimuli and experience less of an effect of friends' presence on affect. Alternatively, maladaptive social behaviors characteristic of depression may influence the effect of social interactions on affect.

Suicide attempt and its associated factors amongst women who were pregnant as adolescents in Bangladesh: a cross-sectional study

Background

Adolescent pregnancy is a risk factor for suicide. We aimed to assess the prevalence of suicide attempts among young women with adolescent pregnancy in Bangladesh and to explore its associated factors.

Methods

In this cross-sectional study, we surveyed young women with adolescent pregnancy in urban and rural areas in Bangladesh to assess suicide attempts, socio-demographic and pregnancy-related characteristics, perceived health status, and perceived social support. Binary logistic regression analysis was conducted to explore the relationship between potentially related factors and suicide attempts.

Results

Of the participants, 6.5% (61/940) reported suicide attempts in the past 12 months, and the majority (88.5%) of the attempts happened within one year after the pregnancy. Participants with more years after first pregnancy (odds ratio (OR) = 0.47, 95% CI: 0.37–0.61) and more perceived social support from friends (OR = 0.69, 95% CI: 0.55–0.86) were less likely to have suicide attempts, and those perceived bad health status compared with good/fair health status (OR = 8.38, 95% CI: 3.08–22.76) were more likely to attempt suicide.

Conclusions

Women with adolescent pregnancy were at high risk of suicide attempts, especially those during the first postnatal year. The risk of suicide attempts attenuated with the time after pregnancy, and perceived social support from friends was a protective factor and perceived bad health status was a risk factor for suicide attempts among young women who have experienced adolescent pregnancy.

Stressful Life Events and Subjective Well-Being in Vocational School Female Adolescents: The Mediating Role of Depression and the Moderating Role of Perceived Social Support

Stressful life events and subjective well-being are negatively related, but there is little research in the current literature exploring the mediating and moderating mechanisms underlying this association, especially for female adolescents in vocational schools who are subjected to undesirable life events. In the present study, we examined the mediating role of depression in the association between stressful life events and female adolescents' subjective well-being, as well as the moderating role of perceived social support in the direct and indirect relations involved. The participants were 1,096 vocational school female adolescents, who completed the questionnaires regarding stressful life events, subjective well-being, depression, and perceived social support. The results showed that depression partially mediated the relation between stressful life events and subjective well-being. Importantly, perceived social support moderated the direct link between stressful life events and subjective well-being, and the indirect link between stressful life events and depression, but not the indirect link between depression and subjective well-being. Especially, female adolescents high in perceived social support displayed higher levels of subjective well-being and lower levels of depression in facing with stressful life events than those low in perceived social support. These findings highlight the mechanisms underlying the relationship between stressful life events and subjective well-being in vocational school female adolescents.

Is the Effect of Body Dissatisfaction on Depressive Symptoms Dependent on Weight Status? A Study with Early-to-Middle Adolescents

Depression is a recognized mental health problem in adolescence and body dissatisfaction is an important risk factor. The main goal of this study is to examine the relationship between body dissatisfaction and depressive symptoms, and whether it depends on adolescents' weight status, an issue that remains understudied. Two hundred and fourteen adolescents (12-16 years) completed self-report measures of depressive symptoms, body dissatisfaction and weight status (i.e., current body weight and height, to compute body mass index z-scores, BMIz). Hierarchical multiple regression and moderation analyses were conducted, accounting for gender and age effects on depressive symptoms. Body dissatisfaction was found to be a predictor of depressive symptoms for the low and median BMIz adolescents, but not for those with high BMIz. In addition, this interaction of body dissatisfaction and BMIz improved the ability of the regression model to explain depressive symptoms´ variance beyond the effect of gender and age. The high-BMIz adolescents presented higher body dissatisfaction but similar levels of depressive symptoms, compared to the lower BMIz adolescents. These findings suggest the influence of body dissatisfaction in the emergence of depressive symptoms in the first half of adolescence, and the importance of weight status throughout this path.

Social Support and Substance Use as Moderators of the Relationship Between Depressive Symptoms and Suicidal Ideation in Adolescents

Literature reports that depressive symptoms may precede suicidal ideation. Several studies have identified social support and substance use as moderators of this relationship. However, no study has evaluated these variables together by testing how substance use can affect the moderating effect of social support in this relationship. The purpose of this article is to individually evaluate dimensions of social support (friends, family, significant others, and school) and substance use (alcohol, marijuana, and other illicit drugs), as moderators of the relationship between depressive symptoms and suicidal ideation, as well as analyze the moderating role of substance use in the moderation exerted by social support in this relationship. This study, quantitative and cross-sectional, considered 775 adolescents [Average age = 15.48 (SD = 0.96), 45.9% women], from 20 randomly selected schools in Santiago de Chile. Simple moderation models were used to analyze possible moderators separately, and double moderation models were used to analyze the moderating role of substance use in the moderating effect of social support. The results show that the four dimensions of social support moderate the relationship between depressive symptomatology and suicidal ideation, showing the strongest interaction in the case of family support, followed by support of a significant person, support at school, and support of friends, in that order. On the other hand, alcohol was the only drug that moderated the relationship in question. In addition, the results show that the use of alcohol limits the moderating effect of social support in the fields of family, significant person, and school support, but not in the case of support of friends. The use of marijuana and other illicit drugs did not affect the moderating effects of social support for any of the areas evaluated. The results are discussed according to the different roles that alcohol use can play in adolescence, and how these, together with perceived social support, are related to the emergence of suicidal ideation from depressive symptoms.

Suicidal behaviours among in-school adolescents in Mozambique: Cross-sectional evidence of the prevalence and predictors using the Global School-Based Health Survey data

Introduction

Despite interventions by low and middle-income countries toward the achievement of the global Sustainable Development Goal (SDG) on promoting mental health and well-being of their populace by the year 2030, suicidal behaviours continue to be major causes of premature mortality, especially among young people. This study examined the prevalence and predictors of suicidal behaviours among in-school adolescents in Mozambique.

Materials and methods

This was a cross-sectional study of 1918 in-school adolescents using data from the 2015 Global School-based Health Survey (GSHS) of Mozambique. The outcome variables (suicidal ideation, suicidal plan, and suicidal attempt) were measured with single items in the survey. Both bivariate and multivariate analyses were performed using chi-square test of independence and binary logistic regression respectively. Results are presented as Adjusted Odds Ratios for the binary logistic regression analysis. Statistical significance was set at p<0.05.

Results

The prevalence of suicidal behaviours 12 months prior to the survey were 17.7%, 19.6% and 18.5% for suicidal ideation, suicidal plan, and suicidal attempt respectively. Adolescents who experienced anxiety had higher odds of suicidal ideation [AOR = 1.616, 95%CI = 1.148–2.275], suicidal plan [AOR = 1.507, 95%CI = 1.077–2.108], and suicidal attempt [AOR = 1.740, 95%CI = 1.228–2.467]. Adolescents who were physically attacked in school were also more likely to ideate [AOR = 1.463, 95%CI = 1.115–1.921], plan [AOR = 1.328, 95%CI = 1.020–1.728], and attempt [AOR = 1.701, 95%CI = 1.306–2.215] suicide. Having close friends was, however, an important protective factor against suicidal ideation [AOR = 0.694, 95%CI = 0.496–0.971], plan [AOR = 0.625, 95%CI = 0.455–0.860], and attempt [AOR = 0.529, 95%CI = 0.384–0.729]. Peer support also reduced the risk of suicidal ideation [AOR = 0.704, 95%CI = 0.538,0.920] and plan [AOR = 0.743, 95%CI = 0.572,0.966] among the in-school adolescents.

Conclusion

Suicidal behaviours constitute major public health challenges among in-school adolescents in Mozambique. The behaviours are predominant among adolescents who are physically attacked and those who experience anxiety. Conversely, having close friends serves as a protective factor against suicidal behaviours. To ensure that Mozambique meets the SDG target of promoting the mental health of all by the year 2030, the Government of Mozambique and educational authorities should urgently design and implement innovative interventions and strengthen existing ones that seek to address physical attacks and anxiety among in-school adolescents. School administrations should also incorporate programmes that seek to congregate students and offer platforms for social interaction and cohesion.

Moderating role of social support in the relationship between posttraumatic stress disorder and antisocial behavior in adolescents after the Ya'an earthquake

This study explored whether social support moderated the relationship between various symptoms of posttraumatic stress disorder (PTSD) and antisocial behavior. Participants were 597 adolescents from two middle schools in Lushan county, China, an area severely affected by the Ya'an earthquake. All four symptom clusters of PTSD significantly and positively correlated with antisocial behavior. Of the PTSD symptoms, only social support played a significant moderating role in the effects of intrusion and avoidance symptoms on antisocial behavior. Intrusion and avoidance symptoms were associated with more antisocial behavior for individuals with lower social support.

Fatigue and Suicidal Ideation in People With Multiple Sclerosis: The Role of Social Support

Fatigue and poor sleep quality are among the most common patient-reported problems associated with multiple sclerosis (MS). Social support, on the other hand, is often found to be positively associated with quality of life in patients with neurological diseases. Studies also show that suicidal ideation (SI) levels in MS are elevated compared to the general population. Thus, the aim of this study is to assess the associations between fatigue, social support, and SI in patients with MS. Out of 184 MS patients asked to participate in this cross-sectional study, 156 agreed (RR 69.8%; 75% female; mean age: 39.95 ± 9.97 years). Patients filled-in the Multidimensional Fatigue Inventory-20, the Pittsburgh Sleep Quality Index, the Multidimensional Scale of Perceived Social Support and the subscale of the General Health Questionnaire-28 focused on assessing SI. Models were controlled for age, gender, disease duration, functional disability, and sleep quality. Data were analyzed using multiple linear regressions. SI was positively associated with lower sleep quality and four types of fatigue: general, mental, reduced activity, and reduced motivation (p < 0.05). Physical fatigue was not significantly associated with SI. Social support was negatively associated with SI in all models. The final models under study explained from 24.3 to 29.7% of the total variance in SI. SI yielded associations with both sleep quality and fatigue, with the exception of physical fatigue. Information provided by physicians on sleep management, and a psychosocial intervention focused on people who provide support for patients with MS (family, friends, and significant others) may reduce levels of SI.

Perceived social support and suicide ideation in Chinese rural left-behind children: A possible mediating role of depression

OBJECTIVE

Psychologically distressed rural Chinese left-behind children (LBC) are at an increased risk of suicide. However, within this population, suicide and potential associated factors are severely under-discussed. This study primarily aims to explore the association between perceived social support and suicide ideation (SI), and to discuss the possible mediating role of depression in this association.

METHOD

A population representative sampling survey was carried out with 2,898 LBC in southwest China. Relevant information was collected by means of face-to-face interviews. Binary and ordinal logistic regression models were employed to screen factors associated with perceived social support, depression and SI. Path analysis was applied to estimate the direct and indirect associations between social support and SI.

RESULTS

Multivariate logistic regression models revealed that, among the four sources, perceived social support from relatives living together, friends, and parents, but not teachers, was inversely associated with SI in LBC. Moreover, depression and SI were strongly associated with each other: Compared with non-depressed LBC, depressed LBC were 6.76 (95%CI: 3.85, 11.87) times more likely to report prominent SI. Path analysis revealed that it is possible that the association between perceived social support and SI was almost entirely mediated by depression.

CONCLUSIONS

Perceived social support from relatives living together, friends, and parents may be a protective factor against SI among rural Chinese LBC. Intervention strategies and measures that are targeted towards improving social support, especially cultivating closeness between LBC and their grandparents, could be effective in reducing SI in LBC.

What is the protective role of perceived social support and religiosity in suicidal ideation in young adults?

Suicide is more effectively prevented when its first manifestations are detected. The first warning sign may be suicidal ideation, so identifying these thoughts and the factors that protect against them is essential if solutions are to be found to this social problem. The purpose of this study, then, is to determine the role of religiosity, perceived social support, and depressive symptomatology in the suicidal ideation of young people. We administered the following questionnaires to a sample of 409 subjects (60.64% women) between 18 and 29 years old: Brief Scale of Religiosity, Beck Depression Inventory, Scale for Suicide Ideation, and Functional Social Support Questionnaire (which includes the subscales Confidential social support and Affective social support). Participants were resident in Spain (84.60%) or Andorra (15.41%). The results show significant correlations between suicidal ideation and the two factors of perceived social support (confidential social support and affective social support). These relationships were still significant after controlling for depressive symptomatology. However, religiosity was not correlated with suicidal ideation. Therefore, the results suggest that perceived social support is a protection factor against suicidal ideas in young men and women. In fact, people who experience suicidal ideation tend to have a greater sense of dissatisfaction in relation to the social support received by such social groups as family and friends. On the other hand, the data of the present investigation suggest that religiosity has an indirect relationship with suicidal ideation in young Spanish and Andorran community populations, through its relationship with social support.

Social Support and Emotional Intelligence as Protective Resources for Well-Being in Moroccan Adolescents

This study aimed to test a structural model to examine the protective role of psychosocial variables, such as social support, emotional intelligence and their interaction, on the cognitive dimension of subjective positive well-being (life satisfaction) and negative well-being (depression) in Moroccan adolescents. The participants consisted of 1277 students (571 men, 694 women and 12 missing values) with a mean age of 16.15 years (SD = 2.22; range = 9 to 23) who attended 26 public schools in different territories of Morocco. These students were in secondary education (n = 893) and high school (n = 378) (6 missing values). The scales for measuring the variables of interest had to be adapted and validated as a previous step for the further proposal of a model of relations. Statistical analyses were conducted using structural equation modeling (SEM) to test the proposed model. The model that optimally adjusted the data confirmed the protective role of social support in the well-being of Moroccan adolescents. Consistent with previous studies, social support was directly related to well-being. However, it also modulated levels of satisfaction with life. Likewise, the inclusion of emotional intelligence as an additional protective factor contributed to the explanation of the well-being mechanisms in adolescents. In addition to direct associations with the levels of social support, satisfaction with life and depression (negative in the latter case), emotional intelligence participated in a complex chain affecting life satisfaction and life satisfaction affecting depression. Moreover, the interaction of emotional intelligence with social support was confirmed to determine levels of life satisfaction in adolescents. Specifically, social support multiplied the effects of the relationship between satisfaction with life and emotional intelligence in cases of moderate and high levels in Moroccan adolescents. This study fills a gap in the literature by adapting and further analyzing several scales with Moroccan samples of adolescents and by proposing and verifying a relational model that can help researchers and teachers to more precisely clarify these relations according to their context. The enhancement of protective factors, such as social support and emotional intelligence, will promote healthy youth development, thus creating healthier societies in the future.

Virtual social support buffers stress response: An experimental comparison of real-life and virtual support prior to a social stressor

BACKGROUND AND OBJECTIVES

Face-to-face and text-based social support have been shown to attenuate stress responses in past studies. Yet as social interactions increasingly take place online by means of virtual humans, our objective was to examine whether different forms of social support (virtual vs. real) prior to the Trier Social Stress Test (TSST) would also decrease stress. Additionally, the effect on subsequent real-life social behaviors (helping and approach) was evaluated while controlling for affective states and social presence.

METHODS

56 participants were either supported by an avatar, an agent, a real human or received no support before completing the TSST and two subsequent social behavior tasks (pen task and seating task).

RESULTS

Results show no difference in agency regarding social presence. Yet, participants with agent support and no support had significantly higher heart rates during the TSST and reported to be more worried. Also, they were more irritated and showed significantly slower helping reactions (picking up pens).

LIMITATIONS

A limitation to this study is that only emotional verbal and non-verbal support were provided by a stranger. Different forms of support as well as a different source (i.e., a friend) may have a more pronounced effect on stress buffering.

CONCLUSIONS

Virtual social support is as effective as face-to-face support in terms of stress buffering, as long as the recipient has the impression that it is provided by another human (via an avatar). This has wide ranging implications not only for health-related application in prevention and treatment but also for further research.