Maltreatment and depression among left-behind adolescents in rural China: The moderating roles of food security and depression literacy

Do movement behaviours influence the association between early menarche and depression symptoms among Brazilian adolescents?

Early menarche has been associated with adverse health outcomes, such as depressive symptoms. Discovering effect modifiers across these conditions in the pediatric population is a constant challenge. We tested whether movement behaviours modified the effect of the association between early menarche and depression symptoms among adolescents. This cross-sectional study included 2031 females aged 15-19 years across all Brazilian geographic regions. Data were collected using a self-administered questionnaire; 30.5% (n = 620) reported having experienced menarche before age 12 years (i.e., early menarche). We used the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Accruing any moderate-vigorous physical activity during leisure time, limited recreational screen time, and having good sleep quality were the exposures investigated. Adolescents who experienced early menarche and met one (B: -4.45, 95% CI: (-5.38, -3.51)), two (B: -6.07 (-7.02, -5.12)), or three (B: -6.49 (-7.76, -5.21)), and adolescents who experienced not early menarche and met one (B: -5.33 (-6.20; -4.46)), two (B: -6.12 (-6.99; -5.24)), or three (B: -6.27 (-7.30; -5.24)) of the movement behaviour targets had lower PHQ-9 scores for depression symptoms than adolescents who experienced early menarche and did not meet any of the movement behaviours. The disparities in depressive symptoms among the adolescents (early menarche vs. not early menarche) who adhered to all three target behaviours were not statistically significant (B: 0.41 (-0.19; 1.01)). Adherence to movement behaviours modified the effect of the association between early menarche and depression symptoms.

Research in China about the biological mechanisms that potentially link socioenvironmental changes and mental health: a scoping review

China's rapid socioeconomic development since 1990 makes it a fitting location to summarise research about how biological changes associated with socioenvironmental changes affect population mental health and, thus, lay the groundwork for subsequent, more focused studies. An initial search identified 308 review articles in the international literature about biomarkers associated with 12 common mental health disorders. We then searched for studies conducted in China that assessed the association of the identified mental health related-biomarkers with socioenvironmental factors in English-language and Chinese-language databases. We located 1330 articles published between 1 January 1990 and 1 August 2021 that reported a total of 3567 associations between 56 specific biomarkers and 11 socioenvironmental factors: 3156 (88·5%) about six types of environmental pollution, 381 (10·7%) about four health-related behaviours (diet, physical inactivity, internet misuse, and other lifestyle factors), and 30 (0·8%) about socioeconomic inequity. Only 245 (18·4%) of the papers simultaneously considered the possible effect of the biomarkers on mental health conditions; moreover, most of these studies assessed biomarkers in animal models of mental disorders, not human subjects. Among the 245 papers, mental health conditions were linked with biomarkers of environmental pollution in 188 (76·7%), with biomarkers of health-related behaviours in 48 (19·6%), and with biomarkers of socioeconomic inequality in 9 (3·7%). The 604 biomarker-mental health condition associations reported (107 in human subjects and 497 in animal models) included 379 (62·7%) about cognitive functioning, 117 (19·4%) about anxiety, 56 (9·3%) about depression, 21 (3·5%) about neurodevelopmental conditions, and 31 (5·1%) about neurobehavioural symptoms. Improved understanding of the biological mechanisms linking socioenvironmental changes to community mental health will require expanding the range of socioenvironmental factors considered, including mental health outcomes in more of the studies about the association of biomarkers with socioenvironmental factors, and increasing the proportion of studies that assess mental health outcomes in humans.

Low depression literacy exacerbates the development and progression of depressive mood in Chinese adult social media users during COVID-19: A 3-month observational online questionnaire-based study with multiple cross-sectional analyses

Background

The main purpose of this study was to explore the relationship between depression literacy (D-Lit) and the development and progression of depressive mood.

Methods

This longitudinal study with multiple cross-sectional analyses used data from a nationwide online questionnaire administered via the Wen Juan Xing survey platform. Eligible participants were 18 years or older and had subjectively experienced mild depressive moods at the time of their initial enrollment in the study. The follow-up time was 3 months. Spearman's rank correlation test was used to analyze the predictive role of D-Lit on the later development of depressive mood.

Results

We included 488 individuals with mild depressive moods. No statistically significant correlation between D-Lit and Zung Self-rating Depression Scale (SDS) at baseline was observed (adjusted rho = 0.001, p = 0.974). However, after 1 month (adjusted rho = -0.449, p < 0.001) and after 3 months (adjusted rho = -0.759, p < 0.001), D-Lit was significantly and negatively correlated with SDS.

Limitations

The targeted subjects were limited to the Chinese adult social media users; meanwhile, China's current management policies for COVID-19 differ from most of the other countries, limiting the generalizability of this study.

Conclusion

Despite the limitations, our study provided novel evidence supporting that low depression literacy may be associated with exacerbated development and progression of depressive mood, which, if not appropriately and promptly controlled, may ultimately lead to depression. In the future, we encourage further research to explore the practical and efficient ways to enhance public depression literacy.

Direct and Indirect Effects of Child Maltreatment on Suicidal Ideation among Chinese Left-Behind Children: Does Gender Make a Difference?

Previous studies indicate that maltreatment is related to children’s suicidal ideation, but the indirect mechanisms of left-behind children have been rarely investigated in the Chinese context. On the basis of a left-behind children sample (N = 1355; 57.1% females), this study aims to investigate the direct and indirect effects of maltreatment on suicidal ideation among Chinese left-behind children. The results of structural equation modeling (SEM) demonstrate that child maltreatment not only directly affects the suicidal ideation of left-behind children, but can also indirectly affect their suicidal ideation through the partially mediating role of self-efficacy. Moreover, a significant gender difference was found in the direct effect of maltreatment on suicidal ideation, with females experiencing stronger influence than males. Findings suggest that the effect of maltreatment on the suicidal ideation of left-behind children is mediated by self-efficacy and moderated by gender. Findings also highlight intervention directions for risk behaviors among left-behind children.

A chain multiple mediation model reveals the association between abuse and depression in Chinese adolescents

Background

Depression is a common mental disorder in Chinese adolescents. Identifying its risk factors will facilitate early prevention. As abuse is reported to be a great risk factor of depression, it is necessary to identify factors mediating the relation between abuse and depression.

Objective

This study aims to investigate the association between abuse and depression by investigating the mediating role of academic stress, social anxiety, and generalized anxiety to offer insights for depression prevention.

Participants and setting

We investigated adolescents in urban and rural areas in Wansheng District of Chongqing city in China. This study included a total of 14,108 students from secondary and primary schools, among whom 7,086 were men (50.2%) and 7,022 were women (49.8%). The participants aged from 11 to 17 with an average age of 13.58 (M = 13.58, SD = 1.86).

Methods

A questionnaire survey was conducted among the participants between October and December in 2020. The following questionnaires were adopted: DSM-5 Patient Health Questionnaire for Adolescents, DSM-5 Severity Measure for Generalized Anxiety Disorder, The International Society for Prevention of Child Abuse and Neglect Child Abuse Screening Tool, DSM-5 Severity Measure for Social Anxiety Disorder (Social Phobia), and Study Stress Scale.

Results

The lifetime prevalence of abuse was high in Chinese adolescents. The direct effect value from abuse to depression was 0.05, the total mediating effect value was 0.14, and the overall effect value was 0.19. According to the mediating effect analysis, the direct and indirect effects from abuse to depression were significant, and the mediating effect accounted for 73.68% of the total effect, suggesting that 73.68% of the effects of abuse to depression are mediated by academic stress, social anxiety, and generalized anxiety.

Conclusions

Academic stress, social anxiety and generalized anxiety play a chain multiple mediating role in the association between abuse and depression, which sheds light on the prevention of depression in the future.

Affective well-being of Chinese urban postpartum women: predictive effect of spousal support and maternal role adaptation

Due to shortage of childcare facilities while high social expectations for mothering, becoming a mother is a big life challenge for most women in urban China. The understandings on Chinese postpartum women's affective well-being and its relation with spousal support and maternal role adaptation remain limited. This study aims to investigate the affective well-being (including both positive and negative affect) of Chinese urban postpartum women and how it is associated with spousal support and maternal role adaptation. A cross-sectional survey was conducted in Shanghai, China, between June and July 2019. A total of 498 urban mothers whose babies were 0 to 1 year old participated in this survey. They completed the Postpartum Social Support Questionnaire (PSSQ), the Maternal Role Adaptation Scale, and the Positive and Negative Affect Scale (PANAS), and reported socio-demographic information. Results showed that positive and negative affect of postpartum women were not significantly associated with each other. Positive affect had a positive correlation with spousal support and maternal role adaptation. Negative affect was negatively associated with maternal role adaptation, while not significantly associated with spousal support. Maternal role adaptation partially mediated the relationship between spousal support and positive affect of the participants, controlling for age, household income, education, birth order, and inter-generational support. The findings indicate that intervention programs towards mental health of postpartum women should focus more on positive affect cultivation; moreover, clinical services should help postpartum women to adapt to maternal role by encouraging new fathers' or partners' involvement in daily childcare-giving.

Coping strategies, stigmatizing attitude, and cyberbullying among Chinese college students during the COVID-19 lockdown

The ongoing COVID-19 pandemic provides hotbed for hatred and violence, which could be especially true among college students, the most active users of internet and social media. Based on a national sample of Chinese college students (N = 1,673), the present study aims to explore the clustered nature of stress coping strategies, as well as its associations with the participants' stigmatizing attitude and cyberbullying behaviors towards people in Hubei Province, the place where the first COVID-19 case was reported and recognized as China's epicenter of the pandemic. Four latent subgroups were first identified among the participants based on type and comparative adoption rate of their coping strategies, namely the emotional coping group, the inactive coping group, the support-seeking and positive coping group, and the independent and positive coping group. The significant associations between coping strategy patterns and stigmatizing attitude and cyberbullying behaviors were reported, respectively. The two were most likely to happen among the participants using emotional coping while the least likely among the independent and positive coping group. This study provides empirical supports for combating the secondary disasters of the pandemic, namely stigma and cyberbullying, by identifying the role of emotional and positive coping strategies.

The Association of Abuse and Depression With Suicidal Ideation in Chinese Adolescents: A Network Analysis

BACKGROUND

Abuse experiences in adolescents are associated with the risk of depression and suicide. Thus, there is an urgent need to develop prevention and intervention measures for clinicians, policymakers, and researchers.

METHODS

Network analysis method was used to analyze the cross-sectional data of Chinese adolescents in this study. The Patient Health Questionnaire for Adolescents (PHQ-A) was used for assessing depression, in which item 9 of the PHQ-A was used to assess suicide ideation, and International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-Children's Home Version (ICAST-CH) was used for assessing abuse.

RESULTS

The prevalence of suicidal ideation among Chinese adolescents was 21.46% (95% CI, 20.79-22.16%). The prevalence of moderate or severe depression was 16.76%, and the prevalence of violence exposure, psychological victimization, neglect, and physical victimization was 33.5%, 59.5%, 28.37%, and 31.51% in the past years, respectively. Network analysis results showed that the most central nodes in the network of abuse and depression were "unimportant," "not cared," and "pushed." The bridge nodes were "suicidal ideation" and "unimportant." The nodes "sadness," "failure," and "unimportant" explained the largest proportion of the variance of suicidal ideation in our network. Differences were found in the structure of both abuse and depression networks between adolescents with or without suicidal ideation.

LIMITATIONS

The self-reporting-based cross-sectional surveys and community sample groups limit the inference of causality and the generalization of the results.

CONCLUSION

This study shows that "unimportant" is the central and bridge nodes in the abuse and depression networks and also explains a part of variance of suicidal ideation. The effect of "unimportant" should be considered in the prevention and intervention of depression and suicide in adolescents with abuse experience. Future study is needed to confirm its role in clinical intervention.

Transactional processes between childhood maltreatment and depressive symptoms from middle childhood to early adolescence: Locus of control as a mediator

BACKGROUND

Previous research has identified a significant, positive relation between childhood maltreatment and depressive symptoms. However, the findings required replication at the within-person level. Moreover, the mediating mechanism of locus of control accounting for their relations has yet to be fully evaluated. Thus, this study examined the dynamic longitudinal relations between childhood maltreatment and depressive symptoms including whether locus of control functioned as a mediator between them after separating between-person effects from within-person effects.

METHODS

A sample of 4110 Chinese children (50.60% boys; M_age = 9.89 at Wave 1) covering the transitional period from middle childhood to early adolescence completed a package of self-report measures on 5 occasions across 2.5 years, using 6-month intervals. Random Intercept Cross-Lagged Panel Models were applied to disaggregate between- and within-person effects. Also, alternative Cross-Lagged Panel Models were applied.

RESULTS

Locus of control played a mediating role in the reciprocal relations between childhood maltreatment and depressive symptoms at the within-person level.

LIMITATIONS

Some limitations existed in the measures. Moreover, sexual abuse was not investigated in this study.

CONCLUSIONS

The findings highlighted the mediating role of locus of control in the reciprocal relations between childhood maltreatment and depressive symptoms at the within-person level, suggesting that interventions targeted at promoting internal locus of control may help prevent the developmental pathway from childhood maltreatment to depressive symptoms and vice versa from middle childhood to early adolescence.