Family dysfunction and Adolescents' anxiety and depression: A multiple mediation model

Cultural Dimensions Moderate the Association between Loneliness and Mental Health during Adolescence and Younger Adulthood: A Systematic Review and Meta-Analysis

Cultural factors, such as country or continent, influence the relationship between loneliness and mental health. However, less is known about how cultural dimensions moderate this relationship during adolescence and younger adulthood, even if these dimensions manifest as country or continent differences. This study aims to examine the potential influence of Hofstede's cultural dimensions on this relationship using a three-level meta-analysis approach. A total of 292 studies with 291,946 participants aged 10 to 24 were included in this study. The results indicate that cultural dimensions, such as individualism vs. collectivism, indulgence vs. restraint, power distance, and long-term vs. short-term orientation, moderated the associations between loneliness and social anxiety, stress, Internet overuse, and negative affect. The association between loneliness and mental health was not moderated by cultural dimensions, such as masculinity and uncertainty avoidance. These findings suggest that culture's influence on the association between loneliness and mental health is based on a domain-specific mechanism.

Longitudinal associations between family functioning and generalized anxiety among adolescents: the mediating role of self-identity and cognitive flexibility

BACKGROUND

Generalized anxiety (GA) is showing a high prevalence among adolescents nowadays; investigations on influencing factors and potential mechanisms are important to inform intervention development. The present two-wave study investigated the ways in which family functioning predicted GA six months later among adolescents, by considering the mediating role of self-identity and cognitive flexibility.

METHODS

Adolescents were recruited from 27 randomly selected classes in two secondary schools in Chongqing and Fujian Province, China. Survey questionnaires assessing family functioning, self-identity, cognitive flexibility and GA were obtained from 1223 adolescents (Mage = 13.14, SD = 1.35) at two time points of the 6-month interval.

RESULTS

The association between family functioning (T1) and GA (T2) was significant (r= -0.152, p < 0.01). Self-identity and cognitive flexibility sequentially mediated the relationship between family functioning (T1) and GA (T2) (with the indirect effect = -0.005, 95% CI = -0.007~ -0.002) after controlling for age, gender, and GA at baseline. Cognitive flexibility also showed a significant and direct mediating effect (with the indirect effect = -0.008, 95% CI = -0.012 ~ -0.005).

CONCLUSION

Findings indicated that family functioning can be a protective factor of GA, and self-identity and cognitive flexibility act as a crucial role in the association between family functioning and GA. Future studies should adopt more time points and long-term follow-up assessments using more robust approaches to improve the reliability of the study findings. Findings may offer some implications that building a harmonious, open and warm family and guiding adolescents to develop self-identity as well as more flexible cognitive style could be helpful to prevent and cope with anxious emotion.

Factors Influencing Adolescent Generalized Anxiety Disorder: A Zero-Inflated Negative Binomial Regression Model

The current study used secondary data from the 17th Korea Youth Risk Behavior Survey conducted in 2021 to identify risk factors influencing the frequency with which adolescents in Korea experience generalized anxiety. Participants were 54,848 adolescents. Risk factors for generalized anxiety were analyzed using a zero-inflated negative binomial regression model. Of participants, 23.7% reported no generalized anxiety experiences. Risk factors identified in the count model were being female and having low household economic status as well as perceived stress, sadness, subjective sleep insufficiency, and loneliness. In the logit model, being female, in middle school, having middle and low household economic status, not living with family, having perceived stress, sadness, suicidal ideation, subjective sleep insufficiency, loneliness, and body image distortion were significant predictors of future anxiety among participants without anxiety. These results may be useful for planning nursing interventions to improve and prevent future health problems in adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 46-55.].

The effect of parent-adolescent discrepancies in reports of familial dysfunction and depression on suicidal ideation in adolescents

INTRODUCTION

Parents and adolescents are often discrepant in their reports of adolescent psychosocial factors. Few studies have addressed parent-adolescent discrepancies in subjective ratings of familial dysfunction and depression as longitudinal predictor variables, and none have done so in a treatment setting for adolescents with acute suicidality. This study examined how parent-adolescent discrepancies in familial dysfunction and depression impact adolescent treatment response in an intensive outpatient program for suicidality.

METHODS

Adolescents (N = 315) were assessed at treatment entry and exit for familial dysfunction, depression, and suicidal ideation. Parents received parallel assessments of familial dysfunction and adolescent depression at each time point. A polynomial regression was conducted to determine whether parent-adolescent discrepancies in reports of familial dysfunction and depression at entry related to the treatment outcome of adolescent-reported depression and suicide ideation at exit.

RESULTS

Significant discrepancies were present with on average adolescents reporting more depression and familial dysfunction than parents. Entry discrepancy in familial dysfunction (but not depression) predicted suicide ideation at exit.

CONCLUSIONS

Our results suggest that parent-adolescent discrepancies in perception of familial dysfunction is a risk factor for poor outcomes in suicidal youth and might be a fruitful target in treatment programs.

Experience of psychosocial rehabilitation; perspectives of depressed adolescents

Given the multifaceted character of depression and its related symptoms, an adolescent living with it is at increased risk for a wide range of adverse events. This research aimed to understand and characterize the psychosocial rehabilitation experiences of depressed teenage participants in the Greater Accra Region of Ghana. A cross-sectional semi-structured interview design influenced by an interpretive phenomenological analysis (IPA) technique was adopted. We employed a nonprobability, purposeful sampling approach to recruit twenty-one adolescents (6 males, 15 females) diagnosed with depression from the community after one month of discharge from admission and undergoing psychosocial rehabilitation. Using separate interviews, we gathered and analyzed data using interpretive phenomenological analysis to produce themes and sub-themes. These were presented with the participants' direct quotations. We discovered that the perspectives of adolescents' psychosocial rehabilitation experience include hopelessness and suicide ideation, coping difficulties, undesirable attitudes from support networks, challenges related to school, and isolation. Participants suggested appropriate therapeutic environments, encouraging support systems, and the media's role in preventing and treating depression among young people as rehabilitation approaches that could assist adolescents to remain lucid for longer intervals. These results shed light on the tragic realities faced by depressed adolescents. There is an urgent need to put well-defined structures in place to aid their rehabilitation and develop coping strategies for a better life.

Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis

This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.

Depression, stress, and anxiety versus internet addiction in early and middle adolescent groups: the mediating roles of family and school environments

BACKGROUND

Family and school environment play a crucial role across the different developmental stages of adolescence. This paper investigates the potential mediating role of family and school environments in the relationship between the three psychosocial predictors of depression, anxiety, stress, and Internet addiction (IA). Specifically, it focuses on the two stages of early and middle adolescence.

METHODS

The study involved a survey of 407 adolescents from Qatar, comprising 250 early adolescents and 157 middle adolescents. Inclusion criteria for the study included adolescents between the ages of 10 to 17 years old, residents of Qatar and studying in a Qatar-based school. To assess the constructs of the three psychosocial predictors, IA, family environment, the study utilized the Depression, Stress, and Anxiety Scale (DASS), the Internet Addiction Diagnostic Questionnaire (IADQ), and the Brief Family Relationship Scale, respectively. School environment was measured using questions from the "Health Behavior in School-aged Children: WHO Collaborative Cross-National survey/study (HBSC) 2013-2014. The study applied standard mediation analysis between the DASS components and IA with family and school environment as the mediators.

RESULTS

Results from the mediation analysis reveal insights into the relationships between psychosocial predictors and IA. The findings indicate that family and school environments partially mediated the relationship with regards to depression, stress, and anxiety in early adolescents. In middle adolescents, family environment partially mediated the relationship with depression and stress and fully mediating the relationship with anxiety. Meanwhile, school environment only exhibited partial mediation in the relationship with anxiety in middle adolescence.

CONCLUSIONS

These results highlight the crucial role parents and schools play in addressing problematic technology usage that develops as a response to depression, anxiety, and stress among adolescents. Moreover, the study reveals nuances in the mediating role of family and school environment in early and middle adolescence. This highlights the evolving nature of these influences across the different stages of development. Notably, this study contributes to the literature by moving beyond the conventional focus on the so-called WEIRD population, and offering valuable insights from a region that is underrepresented in current research.

The Research on Risk Factors for Adolescents' Mental Health

There is a growing tendency for mental health disorders to emerge during adolescence. These disorders impair emotional, cognitive, and behavioral functioning, such as unsatisfying peer relationships, disruptive behavior, and decreased academic performance. They also contribute to vulnerability in later adulthood which negatively influences life-long well-being. Thus, research into etiology is imperative to provide implications for prevention and intervention within family and school practices. It is suggested that the onset of psychological disorders, such as depression and anxiety, is closely related to stress levels and patterns of stress reaction. Therefore, considerable research has investigated the link between hereditary factors, economic status, dispositional vulnerability, social relationships, and stress levels. The current study examines existing evidence and identifies multifaceted risk factors for adolescents' mental problems across three layers, including individual traits and personality, family status and practices, as well as peer relationships, and school climate. It is also suggested that factors from these three perspectives interact and are closely interconnected, directly or indirectly contributing to adolescent psychopathology. The implications for future development of prevention and intervention programs, as well as therapy, are discussed.

Longitudinal relations among family dysfunction, depressive symptoms, and cyberbullying involvement in Chinese early adolescents: Disentangling between- and within-person associations

Family dysfunction plays an important role in cyberbullying and cybervictimization. However, little research has investigated the longitudinal relations and the mediating mechanisms between them during adolescence. This study examined the longitudinal relations between family dysfunction and cyberbullying and cybervictimization, along with whether depressive symptoms function as mediators between them at the within-person level. A total of 3,743 Chinese adolescents (46.2% females; Mage = 9.92 years; SD = 0.51) participated a five-wave longitudinal study with a 6-month time interval. The results of random intercept cross-lagged panel model found that: (1) family dysfunction directly predicted depressive symptoms and vice versa at the within-person level; (2) depressive symptoms directly predicted cyberbullying and cybervictimization at the within-person level, but not vice versa; (3) family dysfunction indirectly predicted cyberbullying and cybervictimization via depressive symptoms at the within-person level; (4) at the between-person level, there were significant associations among family dysfunction, depressive symptoms, cyberbullying and cybervictimization. The results are discussed on the basis of the mechanisms that lead to cyberbullying and cybervictimization.

The effect of duration of youth/parent communication on depression and anxiety during COVID-19 isolation in China

The current study examines the mediating roles of self-efficacy and sleep disturbance and the moderating role of gender in the association between the duration of youth/parent communication on depression and anxiety during the COVID-19 isolation period in China. We used the self-designed demographic variable questionnaire, General Self-Efficacy Scale, the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, and the Self-Rating Anxiety Scale with 1,772 youths aged 15-24 from 26 provinces in China during the COVID-19 lockdown. We performed demographic variable analysis, correlation analysis, mediation analysis, and moderated analysis. The duration of daily communication with parents was significantly positively correlated with self-efficacy and significantly negatively correlated with sleep disturbance, depression, and anxiety. The chain mediation analysis revealed that the duration of communication with parents directly affected depression and anxiety. Self-efficacy, sleep disturbance, and self-efficacy sleep disturbance had significant mediating and chain-mediating effects on the duration of communication with parents, depression, and anxiety. The interactions between sleep disturbance and gender (B = 0.35, 95% CI 0.06 to 0.64, p = .02 < .05) were significant. The duration of parent/youth communication directly affected depression and anxiety and indirectly affected depression and anxiety via the chain-mediating effect of self-efficacy and sleep disturbance. Gender moderates the relationships between sleep disturbance and depression.

Peer attachment and self-esteem mediate the relationship between family function and social anxiety in migrant children in China

BACKGROUND

Social anxiety is a frequently reported symptom in children and adolescents. The literature suggests that family function is related to symptoms of social anxiety in children. However, relatively little is known about the potential mechanisms underlying the relationship between family function and social anxiety. Thus, the purpose of the present study is to examine the roles of peer attachment and self-esteem in the relationship between family function and social anxiety in a sample of migrant children in China.

METHODS

A total of 437 participants (54.9% male; meanage  = 10.87 years) were selected from two public schools of migrant children in two areas of Hangzhou and Jiaxing, the major labor-importing cities in China, in May 2016. All participants completed four questionnaires assessing family function, peer attachment, self-esteem, and social anxiety.

RESULTS

The results showed that family function was bivariately and significantly related to symptoms of social anxiety. Additionally, self-esteem fully mediated the relationship between family function and social anxiety peer attachment. Moreover, the relationship between family function and social anxiety was fully mediated by peer attachment and self-esteem (in that order).

CONCLUSIONS

Peer attachment and self-esteem serve as critical pathways linking family function and social anxiety. Thus, tailored interventions should consider the roles of peer attachment and self-esteem to alleviate symptoms of social anxiety in migrant children.

The role of self-esteem as moderator of the relationship between experienced stigma and anxiety and depression among tuberculosis patients

Anxiety and depression are very common in tuberculosis (TB) patients and can adversely affect TB treatment adherence, ultimately leading to higher morbidity, mortality and drug resistance. Therefore, the aim of this study was to identify the association among experienced stigma, self-esteem and anxiety and depression, and to further explore whether self-esteem could be a moderator in the association between experienced stigma and anxiety and depression in TB patients. A total of 473 TB patients from Dalian, Liaoning Province, Northeast China participated in a cross-sectional survey. A structured questionnaire was developed to collect data. Hierarchical multiple regression was used to analyze the association among experienced stigma, self-esteem and experienced stigma × self-esteem interaction with anxiety and depression. Simple slope analysis was applied to visualize the interaction. Experienced stigma was positively associated with anxiety (B = 0.307, P < 0.01) and depression (B = 0.277, P < 0.01), and self-esteem was negatively associated with anxiety (B = - 0.215, P < 0.01) and depression (B = - 0.351, P < 0.01) in TB patients. The association between experienced stigma and anxiety was different in the low (1 standard deviation (SD) below the mean, B = 0.376, standard error (SE) = 0.056, P < 0.01) and high (1 SD above the mean, B = 0.228, SE = 0.060, P < 0.01) groups of self-esteem. Additionally, the association between experienced stigma and depression was also different in the low (1 SD below the mean, B = 0.363, SE = 0.053, P < 0.01) and high (1 SD above the mean, B = 0.179, SE = 0.056, P < 0.01) groups of self-esteem. Self-esteem could moderate the association between experienced stigma and anxiety and depression. In addition to reducing experienced stigma, enhancing self-esteem as a way to reduce the impact of experienced stigma on anxiety and depression can also help improve the mental health of TB patients.

Levels of Physical Activity, Family Functioning and Self-Concept in Elementary and High School Education Students: A Structural Equation Model

In the adolescent population there is great concern about low levels of physical activity and low levels of family awareness of the benefits of physical exercise on physical and mental health. This study aims to determine the influence of physical activity levels, family functioning and self-concept in primary and secondary school students, as well as to develop a structural equation model as a function of weekly physical activity time. A descriptive, cross-sectional, comparative study was conducted on whether students engage in more than three hours of physical activity per week. To collect the data, instruments validated by the scientific community were used, such as the Adaptability, Partnership, Growth, Affection, and Resolve family questionnaire (APGAR) and the self-concept questionnaire form 5. The results show that those students who engage in more than 3 h of physical activity per week have higher levels of family functioning than those who do not meet this sport criterion. In addition, physically active students show higher scores on all dimensions of self-concept than those who practice less than 3 h of physical activity per week. Finally, as a conclusion, it can be affirmed that the amount of physical activity practice brings benefits to student's mental health.

Child maltreatment mediates the relationship between HIV/AIDS family dysfunction trajectories and psychosocial problems among adolescents

The relationship between parental HIV/AIDS status or death and child mental health is well known, although the role of child maltreatment as a confounder or mediator in this relationship remains uncertain. This study examined the potential path mechanism through child maltreatment mediating the link between HIV/AIDS family dysfunction trajectories and psychosocial problems. A cross-sectional survey was conducted in the Lower Manya Municipal Assembly of Ghana. A questionnaire which consisted of the Strengths and Difficulties Questionnaire (SDQ), Social and Health Assessment (SAHA), Rosenberg Self-Esteem Scale (RSES) and the Conflict Tactics Scale (CTS) was completed by 291 adolescents. Controlling for relevant sociodemographic confounders, mediation analyses using linear regression were fitted to examine whether the association between family dysfunction and psychosocial problems is mediated by child maltreatment. The results indicate that, among adolescents, child maltreatment fully mediated the association between being orphaned by AIDS and self-esteem (b = .59 [95%CI .32, .91]), delinquency and risky behaviours (b = .56 [95%CI .31, .86]) and peer problems (b = .74 [95%CI .48, 1.03]). Similarly, child maltreatment fully mediated the association between living with an HIV/AIDS-infected parent and self-esteem (b = .78 [95%CI .43, 1.23]), delinquency and risky behaviours (b = .76 [95%CI .45, 1.11]), depression/emotional problems (b = .64 [95%CI .40, .92]) and peer problems (b = .94 [95%CI .66, 1.26]). Partial mediation was found for hyperactivity. Child maltreatment mediates the association between the family dysfunction trajectories of parental HIV/AIDS or death and psychosocial problems among adolescents. This implies that efforts to address child maltreatment among families affected by HIV/AIDS may be helpful in the prevention of psychosocial problems among these children, thus enhancing their wellbeing. The findings therefore underscore the need for comprehensive psychosocial interventions that addresses both the unique negative exposures of HIV/AIDS and maltreatment for children affected by HIV.

Mental health, suicide attempt, and family function for adolescents' primary health care during the COVID-19 pandemic

Background: The study's purpose was to identify associations between mental health risk, suicide attempts, and family function.   Methods: A correlational, descriptive, and cross-sectional study was carried out in a group of adolescents in the last grade of secondary school to establish the association between mental health risk, suicide attempt, and family functionality. The instruments used were the self-report questionnaire, the suicide risk assessment scale, and the family APGAR. Data analysis was performed using the artificial intelligence algorithm (gower clustering).  Results: 246 adolescents responded to the three instruments, which made it possible to select those with correlations of sensitive interest and, based on these, an intervention plan. Psychological distress was found in 28%, psychotic symptoms in 85%, and problematic alcohol use in 9%. Good family functioning was identified in 34% and some type of family dysfunction in 66%. In terms of suicide risk, there was a low suicide risk of 74%, 24% medium risk, and 2% high risk. It could be shown that there is a correlation in a group of 15% of the respondents.  Conclusions: The risk of suffering mental health deterioration and the suicide risk, during this pandemic period, seems to be related to family functionality.

Family Dysfunction and Cyberchondria among Chinese Adolescents: A Moderated Mediation Model

Cyberchondria has become a severe health problem and a significant public concern. In addition to the impacts that cyberchondria involves, individual psychological and behavioral factors have been identified. However, the role of family function and the mediating and moderating mechanisms underlying these relations are not understood well, especially among adolescents. Based on family functioning and cognitive-behavioral theory, this study sought to examine whether family dysfunction was associated with cyberchondria, and a moderated mediation model was prepared as a means of exploring whether health anxiety was a mediator of relationships between family dysfunction and cyberchondria, as well as whether optimism moderated these mediating processes. A total of 2074 Chinese adolescents (mean = 15.08 years, SD = 1.79) reported their demographic information, family dysfunction, health anxiety, optimism, and cyberchondria. The findings showed that family dysfunction was positively related to cyberchondria. Moreover, health anxiety partially mediated the relationship between family dysfunction and cyberchondria. Finally, optimism moderated the interplay among health anxiety and cyberchondria. Consistent with the expectancy-value models, this positive relationship was weaker for adolescents with a higher level of optimism. These results suggest that it is vital to simultaneously consider individual and family factors as a means of understanding adolescent cyberchondria when performing cyberchondria intervention programs.

Family cohesion, shame-proneness, expressive suppression, and adolescent mental health-A path model approach

Objective

The family remains one of the most important relationship systems into early adulthood and provides an important foundation for lifelong mental health. Dysfunctional family cohesion can promote adjustment problems in adolescents and might also affect adolescents' self-concept and strategies for coping with emotional distress. To test these relationships and the underlying mechanisms, we proposed a dual mediation model describing the associations between family cohesion and internalizing and externalizing problems, mediated by shame-proneness and expressive suppression.

Methods

A sample of 526 German-speaking adolescents aged 14 to 18 years from Austria, Germany, and Switzerland participated in an online self-report survey encompassing questionnaires on family cohesion, shame-proneness, expressive suppression, and psychological problems. We tested a path model to examine the indirect pathways of the associations between family cohesion and internalizing and externalizing problems via shame-proneness and expressive suppression, while controlling for age, gender, and guilt-proneness.

Results

We found a significant dual mediation of the associations between family cohesion and internalizing and externalizing problems by shame-proneness and expressive suppression. The indirect pathways were all significant, except for the indirect pathway from family cohesion to externalizing problems via shame-proneness.

Discussion

Our results provide a model for the mechanisms by which disrupted family cohesion can be related to psychological problems in adolescents. Expressive suppression emerged as crucial when considering the consequences of shame-proneness in adolescents, as it was only indirectly related to externalizing problems via expressive suppression.

Loneliness and depressive symptoms among Australian female boarding school students

Loneliness in adolescence is a risk factor for the development and maintenance of a myriad of mental health conditions, especially among females. Adolescent females in boarding schools spend prolonged periods away from family and may therefore be more prone to experiencing loneliness and depression. Research into this significant issue is limited, however. The present study compared the levels of loneliness and depressive symptoms of 403, 13–17 year old adolescent females from a range of boarding and non-boarding secondary schools. Confirmatory Factor Analyses established the fit of the loneliness and depressive symptom measures. Multivariate Analysis of Variance revealed boarding school students scored significantly higher than non- boarding school students on levels of depressive symptoms and having a positive attitude to being alone. These differences remained significant when age was covaried. There were no differences in quality of friendships, feelings of isolation, and having a negative attitude to being alone. The implications of these findings for boarding schools are discussed.

Experiences of adolescents and parents on the mental health management of depression in adolescents, North West province, South Africa

Background

Living with or managing an adolescent suffering from depression predisposes the adolescent and parents to various experiences, considering the multifactorial nature of depression and associated symptoms.

Objective

This study explored and described the experiences of adolescents and their parents on the mental health management of depression in the North West province (NWP), South Africa.

Method

A qualitative, exploratory, descriptive, contextual research design was adopted. Data was collect from two mental health care institutions and two mental health care units attached to two general hospitals in the NWP, SA. Thirty-two participants (18 adolescents and 14 parents) were purposefully selected for the study. Data were collected through individual interviews and analysed using Tesch’s open-coding method to generate themes and categories which were presented with the concurrent support of participants direct quotations.

Results

The study revealed that the experiences of adolescents with depression and their parents taking care of them at homes include the following: emotional distress, poor coping mechanisms, financial burden, repeated suicidal attempts, negative attitudes from support systems and withdrawal behaviours. Appropriate therapeutic environments, ongoing monitoring by mental healthcare practitioners and adequate support systems were suggested by participants as management approaches that could enhance the recovery of adolescents from depression.

Conclusion

The findings revealed the devastating experiences of adolescents with depression and their parents taking care of them in their various homes which confirms the dire need for attention on the plights of these groups in order to facilitate adolescents’ recovery and strengthen the adolescents’ and parents’ coping mechanisms for a healthier family.

The Association Between Family Function and Adolescents' Depressive Symptoms in China: A Longitudinal Cross-Lagged Analysis

The complex interrelationships between family function and adolescents' depressive symptoms are not yet fully clarified, especially in China. Based on the family systems theory, this study explored the relationships between family function and Chinese adolescents' depressive symptoms by a 3-year longitudinal study design. Three waves of data were collected from 1,301 Chinese middle school students in Grade 7 to Grade 9. All participants completed the Chinese Family Assessment Instrument (CFAI) and the Center for Epidemiologic Studies Depression Scale (CES-D) once a year during the junior middle school period. Our results showed that both family function and adolescent depressive symptoms were stable in Grade 7 and Grade 8, but in Grade 9, family function increased and depressive symptoms declined. Furthermore, we found that the family function in Grade 7 negatively influenced depressive symptoms of adolescents in Grade 8, while adolescent depressive symptoms in Grade 8 negatively impacted subsequent family function in Grade 9, namely there was a circular effect between family function and adolescent depressive symptoms. These findings suggest that the associations between family function and adolescents' depressive symptoms are dynamic and time-dependent. Our study contributes to the intervention aimed at the reduction of adolescent depressive symptoms from the family perspective.

Examining social context and the pathways to mental wellness in young adults during social movement: A parallel mediation analysis

BACKGROUND

Good family relationships are important for mental health. However, the mechanism linking family perceptions to mental wellness during political and social turmoil remains unclear. This study aimed to examine whether psychological and social factors could protect university students from detrimental mental health conditions in a time of social chaos.

METHODS

Participants included young adults (n = 1874, mean age = 22.19 years) who had been enrolled in Hong Kong local tertiary intuitions during Hong Kong's 2019 social movement. An online survey assessing various conditions, including family satisfaction, social support, personal resilience, negative moods, sense of school belonging, and mental health conditions before and during the movement, was administered to these students. Mediation analyses were performed to examine the role of negative affect, support from family, and school belongingness as mediators of the association between family satisfaction and mental health condition during the movement overall and by resilience subgroups.

RESULTS

Higher levels of satisfaction with family relationships before the onset of movement was associated with lower levels of negative affect and higher levels of support from family and school belongingness during the movement, in turn benefiting the student's mental health. The links of family satisfaction and school belongingness with mental wellness were particularly strong among low-resilient students.

LIMITATIONS

Mediation analysis using retrospective survey data CONCLUSIONS: Family conditions would interact with personal resilience to influence mental health status during social turmoil. The findings underscore the importance of early interventions particularly for those students facing family difficulties to enhance their social chaos and emergency preparedness.

Systematic Review: The State of Research Into Youth Helplines

OBJECTIVE

Helplines are generally a population-level resource for providing free, timely, easy-to-access, and anonymous counseling and/or information. Helplines have been developed and widely implemented for specific use by young people. The current study aimed to systematically review the literature to determine the status of research into the use of helplines among young people.

METHOD

Following the PRISMA checklist, 5 electronic databases were searched using relevant terms for literature published until May 2020. The extracted studies were summarized with the intention of identifying key themes that highlighted common findings, key implications, and important gaps in understanding.

RESULTS

A total of 52 articles fitting study inclusion criteria were identified. Most studies were quantitative papers from the United States and Australia. The types of helpline interactions studied were a mixture of telephone-based and SMS/text-based interactions. Three major themes were identified: awareness of and engagement with helpline services, nature of problems faced by young people, and service-related factors. Subthemes were use and awareness, barriers to help seeking, psychosocial problems, suicidality, telephone- versus text-based interactions, counselor-caller interaction, and provision of services to historically and systemically marginalized groups.

CONCLUSION

It appears that helplines may provide a beneficial service to youths, and that myriad psychosocial concerns provide the basis for calling. The literature is limited by a lack of controlled trials, on one hand, and complex methodological/ethical barriers preventing such trials, on the other hand. However, more research is needed before conclusions regarding effectiveness in youths can be made, particularly for services provided to systemically marginalized groups and using online text-based approaches.

The Relationship between Family Functioning and Pathological Internet Use among Chinese Adolescents: The Mediating Role of Hope and the Moderating Role of Social Withdrawal

This study constructed a moderated mediation model based on problem behavior theory to explore the psychological mechanism of family functioning interaction with pathological internet use. We used the Adolescent Pathological Internet Use Scale, General Functioning Scale, Trait Hope Scale, and Social Withdrawal Scale to measure internet use in 1223 middle school students. The results showed that (1) pathological internet use was negatively correlated with family functioning and hope, and positively correlated with social withdrawal; family functioning was positively correlated with hope, and negatively correlated with social withdrawal; hope was negatively correlated with social withdrawal; (2) family functioning could not only directly predict pathological internet use, but also indirectly predict pathological internet use through hope; and (3) the mediating effect of family functioning on pathological internet use was moderated by social withdrawal, which was stronger for individuals with low social withdrawal but not significant for individuals with high social withdrawal. This study revealed the internal mechanism of the relation between family functioning and adolescents’ pathological internet use, which has theoretical significance for improving adolescents’ hope and reducing their pathological internet use.

Interactive effects of childhood maltreatment and tonic respiratory sinus arrhythmia on young adults' depressive symptoms

The goal of the current study was to investigate the moderating effect of tonic respiratory sinus arrhythmia (RSA) in the relation between childhood maltreatment and depression symptoms among young adults. A total of 98 participants (70 women) aged 17-22 years completed questionnaires on childhood maltreatment and depressive symptoms. RSA data were obtained during a resting condition in the laboratory. Results indicated that childhood maltreatment interacted with tonic RSA to predict depressive symptoms, even after controlling for age and body mass index (BMI) of each participant. Specifically, higher levels of childhood maltreatment were associated with higher levels of depressive symptoms, but only among young adults who exhibited lower tonic RSA. The results indicated that the association between childhood maltreatment and depressive symptoms depends on young adults' physiological functioning/flexibility. Findings suggest that consideration of external environmental factors in combination with internal physiological factors is critical to understand young adults' mental health.

Anxiety, Loneliness, Drug Craving, and Depression Among Substance Abusers in Sichuan Province, China

Studies have reported that anxiety had a positive effect on depression among substance abusers in males. However, little is known about the mechanism underlying this relationship in substance abusers in males. The purpose of this study was to investigate the mediating effect of loneliness and drug craving between anxiety and depression in substance abusers in males. State-Trait Anxiety Inventory, The UCLA Loneliness Scale, Drug Craving Scale, and The Center for Epidemiologic Studies Depression Scale were employed into this study to investigate 585 substance abusers in males (age range of 20–58 years: M = 33.21, SD = 6.97). Structural equation modeling and the bootstrap approach were used to analyze the mediating effect of loneliness and drug craving on the relationship between anxiety and depression. The results indicated that: Loneliness had a significant positive correlation with anxiety (r = 0.37, p < 0.001) and depression (r = 0.49, p < 0.001); Drug craving had a significant positive correlation with anxiety (r = 0.28, p < 0.001) and depression (r = 0.39, p < 0.001). Loneliness and drug craving mediated the link between anxiety and depression. There was a significant positive correlation between substance abusers in male’s anxiety, loneliness, drug craving, and depression. Loneliness and drug craving had a significant mediating effect on the relationship between anxiety and depression. Therefore, it was suggested that substance abusers in male’s anxiety and depression might be improved and driven by decreasing loneliness and drug craving. Targeted interventions to decrease substance abusers in male’s loneliness and drug craving should be developed, implemented, and help them to recover.

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.

Depression and anxiety among school adolescent females: A national study from Jordan

Depression and anxiety are major mental health concerns among adolescent females within the school community and inflect many implications for psychological service providers in schools. The aims of this descriptive correlational study are to estimate the prevalence of anxiety and depression among high school adolescent females in Jordan, and to determine the contributing factors associated with depression and anxiety. Data were collected using self-report questionnaires from a clustered stratified sample of 405 high school females attending public schools in Jordan. Severe levels of depression and anxiety were reported by 25.7% and 21% of high school adolescent females, respectively. Education challenges and having a history of health problems contributed to having higher levels of depression and anxiety among the high school adolescent females. School mental health services regarding adolescent females mental health should be activated and supported through policies and legislation in Jordan.

Symptom Checklist-90-Revised: A structural examination in relation to family functioning

The accurate assessment of psychopathological behaviours of adolescents and young adults is imperative. Symptom Checklist-90-Revised (SCL-90-R) is one of the most comprehensive and widely used scales addressing this purpose internationally. Interestingly, associations between the different SCL-90 symptoms and family functioning have been highlighted. Nevertheless, the scale’s factorial structure has often been challenged. To contribute in this area, this study scrutinizes the psychopathological dimensions of the Symptom Checklist-90-Revised (SCL-90-R) in a large cohort of high school students (Mean age = 16.16; SD = .911) from Greece. It addresses this aim by: a) using first order and bi-factor confirmatory factor analysis, and exploratory structural equation models and; b) investigating the factors’ associations with family functioning. A total of 2090 public Greek High School students completed the SCL-90-R and the Family Adaptability and Cohesion Scale IV (FACES-IV) covering family functioning, satisfaction and communication. Six different solutions, yielded by separate permutations of CFA, ESEM, and bifactor models, were evaluated. Based on global fit, the clarity, reliabilities and the family functioning links of the dimensions in the models, the ESEM oblique model with the theorized nine factors emerged as the optimum. This model had adequate fit, and symptom dimensions were well defined. Also six of the nine factors demonstrated external associations with family functioning, satisfaction and communication. The clinical assessment benefits of these results are discussed.

Family function fully mediates the relationship between social support and perinatal depression in rural Southwest China

BACKGROUND

Perinatal depression is the most common complication of gestation and childbearing affecting women and their families, and good social support and family function are considered protective and modifiable factors. This study aimed to investigate depression status and explore inter-relationships between social support and perinatal depression considering the influence of family function in rural areas of Southwest China.

METHODS

This is a cross-sectional study. The following instruments were used: the Edinburgh Postpartum Depression Scale, the APGAR Family Care Index Scale, and the Social Support Rate Scale. A structural equation modelling was used to test the hypothesis relationships among the variables.

RESULTS

A total of 490 rural antenatal (N = 249) and postpartum (N = 241) women (mean age (standard deviation), 28.17 ± 5.12) participated. We found that the prevalence of depression symptoms was 10.4%. Path analysis showed that family function had a direct negative correlation with depression (β = - 0.251, 95%CI: - 0.382 to - 0.118). Social support had a direct positive correlation with family function (β =0.293, 95%CI: 0.147 to 0.434) and had an indirect negative correlation with depression (β = - 0.074, 95%CI: - 0.139 to - 0.032), family function fully mediated the relationship between social support and depression.

CONCLUSIONS

Findings of this study highlight that family function should be considered as the key target for interventions aiming to lower the prevalence of perinatal depression. Family members interventions are critical to reduce depression among antenatal and postpartum women.

Familial aggregation of anxiety disorder subtypes and anxious temperament in the NIMH Family Study of Affective Spectrum Disorders

BACKGROUND

Evidence from family and twin studies suggests that mood and anxiety disorders, and related temperamental factors may share common etiologic factors. We examine the familial aggregation and coaggregation of anxiety disorder subtypes and anxiety-related temperamental traits, and their association with mood disorders.

METHODS

A total of 477 probands and 549 first-degree adult relatives from a large community based family study of affective spectrum disorders completed semi-structured diagnostic interviews and self-reported assessments of temperamental traits including: negative affectivity on the 'Positive and Negative Affect Schedule' (PANAS), neuroticism anxiety on the 'Zuckerman-Kuhlman Personality Questionnaire' (ZKPQ), and anxiety sensitivity on the 'Anxiety Sensitivity Index' (ASI).

RESULTS

The anxiety-related temperamental traits of negative affectivity, neuroticism anxiety and anxiety sensitivity had significant familial specificity, even after controlling for comorbid mood and anxiety disorders in probands and relatives. Yet, these traits in probands did not predict anxiety disorders in relatives. Although some anxiety subtypes were familial, there were no longer familial links between anxiety disorder subtypes (generalized anxiety disorder, social anxiety or panic disorder) after controlling for mood disorder subtypes in probands and relatives.

LIMITATIONS

Cross-sectional interviews were used to estimate disorders, and self-report measures were used for temperamental traits.

CONCLUSIONS

These results confirm previous research regarding familial overlap between anxiety subtypes and mood disorders, however their shared liability cannot be fully explained by anxiety-related temperamental traits. These findings suggest that anxiety-related temperamental traits may indicate a vulnerability for mood and anxiety disorders or a potential consequence of these conditions.

Contextual and Psychological Predictors of Militant Extremist Mindset in Youth

The present study aims to identify contextual and psychological factors of proneness to radicalization and violent extremism (RVE) operationalized through the Militant Extremist Mindset scale (MEM) consisting of three distinct aspects: Proviolence (PV), Vile World beliefs (VW), and trust in Divine Power (DP). A community sample of 271 high school students (72% females) from Belgrade and Sandžak regions in Serbia completed: (1) a 24-item MEM scale; (2) contextual measures including a 6-item scale of family dysfunction (FDys) and a 4-item composite measure capturing exposure to a harsh school environment and peer abuse (HSE); (3) psychological measures including the 9-item Right-Wing Authoritarianism scale (RWA), the 5-item Social Dominance Orientation scale (SDO), and the 20-item UCLA Loneliness scale (LON). A path analysis was conducted with contextual factors on the first and psychological factors on the second level of the model predicting the three factors of MEM. LON was positively predicted by FDys and HSE, SDO by HSE only, while RWA was positively predicted by FDys only. Contextual and psychological factors accounted for 27% of the variance in PV (LON, SDO), 15% of the variance in VW (FDys, SDO), and 31% of the variance in DP (RWA). Obtained findings reveal a complex interplay of contextual and psychological drivers in the prediction of different aspects of RVE and build upon existing knowledge on risk factors associated with RVE.

Physical Activity Level, Mediterranean Diet Adherence, and Emotional Intelligence as a Function of Family Functioning in Elementary School Students

(1) Background: Family is considered as one of the most important elements for the transmission of healthy habits that improve the lives of students. For this reason, the present study aims to describe the degree of family functionality, emotional intelligence, Mediterranean diet adherence, and extra-curricular physical activity engagement. A further aim is to perform a correlational analysis between these variables. (2) Methods: To this end, an ad hoc questionnaire was used, alongside the APGAR, KIDMED, and Trait Meta Mood Scale (TMMS-24). (3) Results: Finally, the data suggest that a high percentage of students need to improve their diet. Further, students reporting severe family dysfunction showed worse outcomes. Thus, levels of emotional clarity were lower when family functionality was poor. Poor diet quality was also associated with lower emotional attention, with Mediterranean diet adherence being positively related to emotional clarity and repair, as well as normal family functionality. (4) Conclusions: Boys showed higher levels of adherence to the Mediterranean diet adherence, while girls reported higher family functionality. Thus, compliance with the minimum recommendations for physical activity engagement was associated with adequate adherence to the Mediterranean diet. The importance of diet for obtaining an optimal physical condition, adequate emotional state, and family functionality is highlighted.

Psychosocial Factors and Chronic Illness as Predictors for Anxiety and Depression in Adolescence

Adolescence is a challenging time when emotional difficulties often arise. Self-esteem, good relationships with peers, and emotional competences can buffer the effects of these difficulties. The difficulties can be even greater when coupled with the presence of a chronic physical illness (CD). Our goal is to analyze psychosocial factors and CD as predictors for anxiety and depression. It was compared the results of structural equation models (SEM) with models based on qualitative comparative analysis (QCA) to analyze the possible influence of these variables on levels of anxiety-depression in adolescents with and without CD. The sample consisted of 681 adolescents, between 12 and 16 years old (M = 13.94, SD = 1.32). 61.50% were girls and 13.40% (n = 222) presented a CD (mainly pneumo-allergic and endocrine). They were evaluated by the Hospital Anxiety and Depression Scale, the Self-esteem Questionnaire, the Emotional Competences Questionnaire and the Strengths and Difficulties Questionnaire. The results obtained by SEM show that low self-esteem, problems with peers and low emotional competencies predict anxiety in 41% of the variance and depression in 72%. The results obtained by QCA show that the different combinations of these variables explain between 24 and 61% of low levels of anxiety and depression and 47–55% of high levels. Our data show how the presence of a CD, low self-esteem, problems with peers and problems in emotional skills play a fundamental role in explaining levels of anxiety and depression. These aspects will help provide increased resources for emotional adjustment in the educational context, facilitating the transitions to be made by adolescents.

Burden of depression in China, 1990-2017: Findings from the global burden of disease study 2017

BACKGROUND

Depression in China has risen from the 15th leading cause of all-cause disability-adjusted life years (DALYs) in 1990 to the 10th in 2017. However, the burden of depression and the epidemiological trend in Chinese provinces remain unclear. This study aimed to estimate the prevalence and burden of depression among different sexes, ages, disease types and provincial administrative units in China.

METHODS

Based on a general analysis of the Global Burden of Disease study (GBD) in 2017, we analyzed the age- sex- and province-specific prevalence and DALYs of depression in China from 1990 to 2017.

RESULTS

From 1990 to 2017, the all-age prevalence rate of depression per 100,000 rose from 3224.6 (95% UI:2976.6-3509.1) to 3990.5 (95% UI: 3667.8-4353.0), and the DALY rate per 100,000 rose from 525.1 (95% UI: 373.5-719.0) to 607.4 (95% UI: 427.7-820.2). The prevalence rate decreased in the population aged 5-54 years, and increased in the population aged over 55 years. In 2017, the prevalence rate of females (5039.6, 95% UI: 4630.0-5502.8) was significantly higher than that of males (2984.9, 95% UI: 2736.0-3265.3). The prevalence and DALY rate increased in all provinces. However, the age-standardized prevalence and DALYs rate decreased in 31 provinces.

CONCLUSIONS

Depression has gradually become a major public health issue in China. The government should take measures to prevent the development of depression immediately. Women and the elderly are at high risk for depression.