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Peng PH, Chen YL, Hsiao RC, Yen CF, Chou WJ. Internet Altruistic Behaviors in Adolescents: Roles of Attention-Deficit/Hyperactivity Disorder, Impulsiveness, and Perceived Social Support. Behav Sci (Basel) 2024; 14:433. [PMID: 38920765 PMCID: PMC11201007 DOI: 10.3390/bs14060433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/05/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
This study examined the associations of an attention-deficit/hyperactivity disorder (ADHD) diagnosis, impulsivity, and perceived social support with Internet altruistic behaviors (IABs) in adolescents and the associations of IABs with depression, suicidality, and nonsuicidal self-injury in this group. In total, 176 adolescents aged between 11 and 18 years with ADHD and 173 adolescents without ADHD (matched with the ADHD group by sex and age) participated in this study. The adolescents rated their IABs on the Internet altruistic behavior scale, impulsivity on the Barratt impulsiveness scale version 11, and perceived family and peer support on the family and social relationship domains of the Taiwanese quality of life questionnaire for adolescents. The associations of ADHD, impulsivity, and social support with IABs and the associations of IABs with depression, suicidality, and nonsuicidal self-injury were examined through multivariable linear regression analysis. The present study found that more time spent on the Internet (p < 0.001), greater perceived peer support (p < 0.001), greater impulsiveness characterized by a lack of self-control and perseverance (p < 0.001), poorer ability to plan and look ahead (p < 0.001), and an ADHD diagnosis (p = 0.003) were significantly associated with a higher level of IABs. IABs were not significantly associated with severe depression, suicidality, or nonsuicidal self-injury (all p > 0.05). The results of this study indicated that multiple individual and social factors were associated with IABs in adolescents. IABs were not significantly associated with severe depression, suicidality, or nonsuicidal self-injury in adolescents.
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Affiliation(s)
- Pin-Han Peng
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
- Department of Psychology, Asia University, Taichung 41354, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
- Department of Psychiatry, Children’s Hospital and Regional Medical Center, Seattle, WA 98105, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
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Chen YQ, Huang XJ, Yang F, Yang JJ, Zhong J, Yao KM, Kuang JX, Xu MZ. A Chinese adaptation of the Patient Health Questionnaire for Adolescents (PHQ-A): factor structure and psychometric properties. BMC Psychiatry 2024; 24:331. [PMID: 38689265 PMCID: PMC11061901 DOI: 10.1186/s12888-024-05783-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND To examine the factor structure and psychometric properties of the Patient Health Questionnaire for Adolescents (PHQ-A) in Chinese children and adolescents with major depressive disorder (MDD). METHODS A total of 248 MDD patients aged between 12 and 18 years were recruited and evaluated by the Patient Health Questionnaire for Adolescents (PHQ-A), the Center for Epidemiological Survey Depression Scale (CES-D), the Mood and Feelings Questionnaire (MFQ), and the improved Clinical Global Impression Scale, Severity item (iCGI-S). Thirty-one patients were selected randomly to complete the PHQ-A again one week later. Confirmatory factor analysis (CFA) was used to test the construct validity of the scale. Reliability was evaluated by Macdonald Omega coefficient. Pearson correlation coefficient was used to assess the item-total correlation and the correlation of PHQ-A with CES-D and MFQ respectively. Spearman correlation coefficient was used to assess test-retest reliability. The optimal cut-off value, sensitivity, and specificity of the PHQ-A were achieved by estimating the Receiver Operating Characteristics (ROC) curve. RESULTS CFA reported adequate loadings for all items, except for item 3. Macdonald Omega coefficient of the PHQ-A was 0.87. The Spearman correlation coefficient of the test-retest reliability was 0.70. The Pearson correlation coefficients of the PHQ-A with CES-D and MFQ were 0.87 and 0.85, respectively (p < 0.01). By taking the iCGI-S as the remission criteria for MDD, the optimal cut-off value, sensitivity and specificity of the PHQ-A were 7, 98.7%, 94.7% respectively. CONCLUSION The PHQ-A presented as a unidimensional construct and demonstrated satisfactory reliability and validity among the Chinese children and adolescents with MDD. A cut-off value of 7 was suggested for remission.
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Affiliation(s)
- Yu-Qi Chen
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Xiao-Jie Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Fan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Jing-Jing Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Jing Zhong
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Kai-Min Yao
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Jing-Xiao Kuang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, People's Republic of China
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Ming-Zhi Xu
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510120, People's Republic of China.
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El-Ammari A, El Malki H, Moutawakkil SG, El Hilaly J, El Houari F, El Gnaoui S, Ragala MEA, El Rhazi K, Zarrouq B. Validation of the Center for Epidemiologic Studies Depression Scale (CES-D) in a Moroccan sample with substance use disorder. BMC Psychiatry 2023; 23:723. [PMID: 37803359 PMCID: PMC10557308 DOI: 10.1186/s12888-023-05245-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Transcultural validation studies of depression scales are rare in Morocco. The Center for Epidemiologic Studies Depression Scale (CES-D) is commonly one of the most common and frequently used screening instruments for depressive symptoms, but the scale has not, up to date, been validated in dialect of Arabic in Moroccan contexts. Given the importance of assessing and preventing depressive symptoms in our Moroccan context, this study aims to validate the CES-D, translated, and adapted to the dialect of Arabic and Moroccan culture, in a sample with substance use disorder. METHODS The data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 140). Then, this structure was confirmed in the validation sample (N = 205) using confirmatory factor analysis (CFA). RESULTS Exploratory factor analysis extracted three factors different from the four factors in the original version. Confirmatory factor analysis confirmed the structure of three factors. The fit indices level showed acceptable to good performance of the measurement model. The instrument showed sufficient reliability and convergent validity, as demonstrated by acceptable values of composite reliability (CR = 0.89-0.93) and average variance extracted (AVE = 0.64-0.66), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio (HTMT) of correlations values was less than 0.85, indicating acceptable discriminant validity. CONCLUSIONS Overall reliability and both convergent and discriminant validity tests indicated that the Moroccan dialectal Arabic version of the CES-D had a good performance and may serve as a valid tool for measuring the severity of depression in people with substance use disorder.
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Affiliation(s)
- Abdelfettah El-Ammari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Hicham El Malki
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Salma Ghofrane Moutawakkil
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Jaouad El Hilaly
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRMEF) of Fez, Fez, Morocco
| | | | | | - Mohammed El Amine Ragala
- Department of Biology-Geology, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
- Department of Biology-Geology, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco.
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Chen YL, Jian CR, Chang YP, Chao SR, Yen CF. Association of loneliness with suicide risk and depression in individuals with schizophrenia: moderating effects of self-esteem and perceived support from families and friends. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:41. [PMID: 37402821 PMCID: PMC10319791 DOI: 10.1038/s41537-023-00368-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023]
Abstract
Loneliness is prevalent among individuals with mental illnesses. This cross-sectional survey study examined the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression in individuals with schizophrenia. In total, 300 participants (267 with schizophrenia and 33 with schizoaffective disorder) completed the University of California, Los Angeles, Loneliness Scale (Version 3); suicide module of the Mini International Neuropsychiatric Interview; Center for Epidemiologic Studies Depression Scale; Family and Friend Adaptability, Partnership, Growth, Affection, and Resolve Index; and Rosenberg Self-Esteem Scale. Moderation analysis was performed to examine the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression. The results found that self-esteem was significantly associated with a reduced magnitude of depression in participants with loneliness. In addition, perceived support from friends was significantly associated with a reduced magnitude of suicide risk in participants with loneliness. Our findings indicate the importance of intervention programs that strengthen support from friends and self-esteem in reducing suicide risk and depression among lonely individuals with schizophrenia.
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Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Cian-Ruei Jian
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY, USA
| | - Shu-Ru Chao
- Department of Social Work, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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Wang PW, Chang YP, Tsai CS, Yen CF. Sexual stigmas among lesbian, gay, and bisexual individuals with problematic internet use and depression. Front Psychiatry 2023; 14:1163032. [PMID: 37255683 PMCID: PMC10225597 DOI: 10.3389/fpsyt.2023.1163032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Sexual stigma causes psychological distress among lesbian, gay, and bisexual (LGB) individuals. LGB individuals are more likely to exhibit both problematic Internet use (PIU) and significant depression than are heterosexual individuals. Whether the severities of sexual stigma varied among LGB individuals with various statuses of comorbid PIU and depression warrants study. The present study aimed to investigate the differences in the experiences of familial sexual stigma (FSS), internalized sexual stigma (ISS), and sexual orientation microaggressions (SOMs) among LGB individuals with various statuses of comorbid PIU and depression. Methods In total, 1,000 self-identified LGB young adult individuals participated in the study. The level of PIU was assessed using the Chen Internet Addiction Scale, depression was assessed using the Center for Epidemiological Studies-Depression Scale, the experience of FSS was assessed using the Homosexuality-Related Stigma Scale, the experience of ISS was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and the experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. The differences in the levels of FSS, ISS, and SOMs among the four groups [i.e., the groups with both PIU and depression (comorbid group), only depression, only PIU, and neither PIU nor depression (neither group)] were investigated using multivariate analysis of covariance. Results The results indicated that LGB individuals with comorbid PIU and depression reported higher levels of ISS and SOMs than did those with depression only and PIU only, respectively. Moreover, LGB individuals with PIU or significant depression had higher levels of FSS and SOMs than did those with neither PIU nor depression. Discussion The results of this study supported that the experiences of FSS, ISS, and SOMs were significantly associated with various levels of PIU and depression in LGB individuals.
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Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY, United States
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
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Chen YL, Chang YP, Yen CF. Effects of gender nonconformity and biological sex on the relationship between sexual orientation microaggressions and anxiety and depressive symptoms among lesbian, gay, and bisexual Taiwanese young adults: A moderated-moderation study. J Affect Disord 2023; 334:129-136. [PMID: 37150223 DOI: 10.1016/j.jad.2023.04.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 03/11/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Sexual orientation microaggressions (SOMs) may negatively affect lesbian, gay, and bisexual (LGB) individuals' mental health. However, the moderating effects of gender nonconformity and biological sex on the relationship between SOMs and anxiety and depressive symptoms has never been examined. We evaluated the moderating effect of gender nonconformity on the association of SOMs with anxiety and depressive symptoms among LGB young male and female adults. We hypothesized that the associations of SOMs with anxiety and depressive symptoms weakened with increasing gender nonconformity among gay and bisexual men but strengthened with increasing gender nonconformity among lesbian and bisexual women. METHODS In total, 1000 self-identified LGB young adult individuals participated in the study. The experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory, anxiety was assessed using the State subscale on the State-Trait Anxiety Inventory, and depression was assessed using the Center for Epidemiological Studies-Depression Scale. The two-way moderation models stratified by sex examined the moderating effects of gender nonconformity on the association between SOMs and anxiety symptoms in the male and female participants. The three-way moderated moderation models were used to determine whether gender nonconformity and sex jointly moderated the associations between SOMs and anxiety and depressive symptoms. RESULTS In the two-way moderation models stratified by sex, gender nonconformity exerted opposite moderating effects on the association between SOMs and anxiety and depressive symptoms in the male and female participants. For the male participants, the association between SOMs and anxiety (β = -0.08) and depressive symptoms (β = -0.09) weakened with increasing gender nonconformity. For the female participants, the association between SOMs and anxiety (β = 0.08) and depressive symptoms (β = 0.13) strengthened with increasing gender nonconformity. The three-way moderated moderation models further confirmed that sex moderated the moderating effects of gender nonconformity on the associations between SOM and anxiety (β = -0.16, p = .047) and depressive symptoms (β = -0.22, p < .001). LIMITATION The cross-sectional study design limited the inferences that could be made concerning the temporal relationship between SOMs and mental health problems. CONCLUSIONS The association between SOMs and anxiety and depressive symptoms weakened with increasing gender nonconformity in gay and bisexual men, whereas the association between SOMs and anxiety and depressive symptoms strengthened with increasing gender nonconformity in lesbian and bisexual women.
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Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan; Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, NY, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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Chang R, Zhang L, Cao W, Zhang B. Factor structure of the Center for Epidemiological Studies Depression (CES-D) scale among Chinese coal miners. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04459-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Yang YH, Situmeang RFV, Ong PA, Liscic RM. Application of virtual reality for dementia management. BRAIN SCIENCE ADVANCES 2022. [DOI: 10.26599/bsa.2022.9050019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Age is recognized as the major factors of dementia, especially in for Alzheimer’s disease (AD). Given to the aged population, the increased number of demented population has been receiving a great impact in our society. Unfortunately, so far, no cured medicines have been demonstrated to provide effective treatment in AD. The combination of pharmacological and non-pharmacological interventions has been proposed to manage dementia with potential benefits especially in decreasing caregiver’s burden and behavior, as well as psychological problems of demented patients. Recently, giving to the glorious development in digital technologies, the virtual reality, one of the non-pharmacological interventions has been used extensively in dementia managements for its strengths which can be adapted in accordance with the heterogeneous needs from demented patients and their caregivers. However, various study designs and other reasons made these results difficult to be interpreted. In this review our goal is to provide a better understanding for these points.
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Affiliation(s)
- Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, China
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, China
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan, China
| | - Rocksy FV Situmeang
- Siloam Hospitals Lippo Village, Pelita Harapan University, Banten, Indonesia
| | - Paulus Anam Ong
- Department of Neurology, Hasan Sadikin Hospital, Bandung, Indonesia
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Huang LC, Yang YH. The Long-term Effects of Immersive Virtual Reality Reminiscence in People With Dementia: Longitudinal Observational Study. JMIR Serious Games 2022; 10:e36720. [PMID: 35877169 PMCID: PMC9361147 DOI: 10.2196/36720] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/14/2022] [Accepted: 07/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Novel nonpharmacological therapies are being developed to prevent cognitive decline and reduce behavioral and psychological symptoms in patients with dementia. Virtual reality (VR) reminiscence was reported to improve anxiety, apathy, and cognitive function immediately after intervention in individuals at residential aged care facilities. However, its effect on elderly patients with dementia and how long this effect could last remain unknown. Objective The aim of this paper is to investigate the effect of immersive VR reminiscence in people with dementia both immediately after and 3-6 months after intervention. Methods A pilot study was conducted in 2 dementia care units. VR reminiscence therapy sessions were conducted twice per week for a 3-month period. Cognitive function, global status, depressive symptoms, and caregiver burden were assessed before and immediately after VR intervention in 20 participants. Subsequently, 7 participants were reassessed 3-6 months after the VR intervention. Wilcoxon sign-rank test was used for statistical comparisons of the changes. Results There were no significant changes in cognitive function, global status, and caregiver burden immediately after the VR intervention, but there was a significant reduction in depressive symptoms (P=.008). Moreover, compared with the cognitive function immediately after VR, it kept declining 3-6 months after. Conclusions Immersive VR reminiscence can improve mood and preserve cognitive function in elderly patients with dementia during the period of the intervention. Studies using a control group and comparing the use of VR with traditional forms of reminiscence should be conducted in the future to confirm and expand on these findings.
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Affiliation(s)
- Ling-Chun Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Post-Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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Associations of intensity and emotional connection related to online social networking use on the risk of incident depression among Chinese adolescents: A prospective cohort study. J Affect Disord 2022; 308:116-122. [PMID: 35427714 DOI: 10.1016/j.jad.2022.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 03/21/2022] [Accepted: 04/09/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the longitudinal prediction of intensity and emotional connection (EC) related to online social networking use at baseline on the risk of incident depression at nine-month follow-up among adolescents. METHODS A total of 3196 secondary school students, who were online social networking users and free of depression at baseline, were included in this study. Multilevel logistic regression models were applied to investigate the longitudinal prediction of two dimensions of online social networking use intensity (social function use intensity (SFUI), entertainment function use intensity (EFUI)) and EC scores at baseline on incident depression at follow-up. RESULTS The incidence of depression was 23.37 per 100-person-years during a nine-month follow-up period. Baseline SFUI and EFUI scores were significantly associated with higher level of incident depression (adjusted OR = 1.017, 95% CI: 1.004-1.029 for SFUI, p = 0.010; adjusted OR = 1.046, 95% CI: 1.012-1.080 for EFUI, p = 0.007), after adjustment of significant background factors and baseline depressive symptom score. The associations of EC at baseline and its interaction with SFUI and EFUI on incident depression were statistically non-significant. CONCLUSION Online social networking use seems be a risk factor of depression among adolescents, regardless of its specific functions. Early intervention is recommended to reduce the level of online social networking use intensity as a means of preventing depression among adolescents.
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Lin HC, Chang CC, Chang YP, Chen YL, Yen CF. Associations among Perceived Sexual Stigma from Family and Peers, Internalized Homonegativity, Loneliness, Depression, and Anxiety among Gay and Bisexual Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106225. [PMID: 35627760 PMCID: PMC9141414 DOI: 10.3390/ijerph19106225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to examine the moderating factors of the association between perceived sexual stigma from family and peers and internalized homonegativity, as well as to compare the effects of perceived sexual stigma from family and peers and internalized homonegativity on loneliness, depression, and anxiety in gay and bisexual men. In total, 400 gay and bisexual men participated in this study. The experiences of perceived sexual stigma from family and peers on the Homosexuality subscale of the HIV and Homosexuality Related Stigma Scale, internalized homonegativity on the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, loneliness on the UCLA Loneliness Scale (Version 3), depression on the Center for Epidemiological Studies-Depression Scale, and anxiety on the State subscale of the State-Trait Anxiety Inventory were collected. The results indicated that perceived sexual stigma from family and peers was significantly associated with internalized homonegativity in both gay and bisexual men, and that sexual orientation moderated the association. Moreover, the association between internalized homonegativity and loneliness was significantly greater than that between perceived sexual stigma from family and peers and loneliness, although no significant differences were observed in their associations with depression and anxiety. Intervention programs that promote changes in the attitudes toward gay and bisexual men among the general population are needed to help prevent the development of internalized homonegativity and further loneliness, depression and anxiety.
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Affiliation(s)
- Huang-Chi Lin
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan;
- Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY 14214-3079, USA;
| | - Yi-Lung Chen
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
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Relationships of Homophobic Bullying Victimization during Childhood with Borderline Personality Disorder Symptoms in Early Adulthood among Gay and Bisexual Men: Mediating Effect of Depressive Symptoms and Moderating Effect of Family Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084789. [PMID: 35457655 PMCID: PMC9027503 DOI: 10.3390/ijerph19084789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
This study investigated (1) the associations of homophobic bullying victimization in childhood with borderline personality disorder (BPD) symptoms in early adulthood among gay and bisexual men; (2) the mediating effect of depressive symptoms on the association between homophobic bullying victimization and BPD symptoms, and (3) the moderating effects of perceived family support on the association between homophobic bullying victimization and BPD symptoms. A total of 500 gay or bisexual men aged between 20 and 25 years were recruited into this study. The experiences of physical, verbal and social relationship bullying victimization during childhood were evaluated using the Mandarin Chinese version of the School Bullying Experience Questionnaire. The experiences of cyberbullying victimization during childhood were evaluated using the Cyberbullying Experiences Questionnaire. BPD symptoms were assessed using the Borderline Symptom List. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale. Perceived family support was evaluated using the Family Adaptation, Partnership, Growth, Affection, and Resolve index. The results of mediation analyses demonstrated that all the types of homophobic bullying victimization in childhood were directly associated with BDP symptoms in young adulthood as well as indirectly associated with BPD symptoms through the mediation of depressive symptoms. The results of moderation analyses demonstrated that the association between homophobic bullying victimization and BPD symptoms decreased when the individuals had more family support. Intervention programs to reduce homophobic bullying victimization and enhance family support for gay and bisexual men and their families are necessary. Interventions to improve depressive and BPD symptoms among gay and bisexual men are also necessary, especially for those who experienced homophobic bullying victimization during childhood.
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Shi J, Dewaele A, Lai W, Lin Z, Chen X, Li Q, Wang H, Guo L, Lu C, Zhang W. Gender differences in the association of sexual orientation with depressive symptoms: A national cross-sectional study among Chinese college students. J Affect Disord 2022; 302:1-6. [PMID: 35065090 DOI: 10.1016/j.jad.2022.01.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depressive symptoms among the lesbian, gay, bisexual (LGB) in college students have generated worldwide concern in recent decades. This study aimed to estimate the associations between sexual orientation and depressive symptoms among Chinese college students, with a focus on gender differences. METHODS A total of 30,733 college students were recruited from 10 Chinese province-level regions with a multistage, stratified cluster, random sampling method between March and June 2019. The 20-item Center for Epidemiologic Studies Depression Scale (CESD-20) was used to measure the depressive symptoms. Sexual orientation was assessed by asking the question, "Which of the following options best describes you?" The responses were categorized as heterosexual, gay/lesbian, bisexual, and unsure. RESULTS In our sample (N = 30,733), the prevalence of depressive symptoms was 6.1%. Among the surveyed Chinese college students, 3.7% self-reported as LGB, and 7.2% were unsure. LGB (gay/lesbian: 14.9% for males and 6.8% for females; bisexual: 9.3% for males and 16.4% for females) had a higher risk of depressive symptoms than heterosexuals. After adjusting for control variables, LGB and unsure college students were more likely to have depressive symptoms than their heterosexual peers. For males, unsure college students reported the highest risk of depressive symptoms; for females, lesbian and bisexual college students reported the highest risk of depressive symptoms. LIMITATIONS The cross-sectional study design and self-reported depressive symptoms and sexual orientation. CONCLUSION LGB was associated with increased depressive symptoms among Chinese college students. Furthermore, the associations of LGB sexual orientation with depressive symptoms were more robust for females than males.
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Affiliation(s)
- Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Alexis Dewaele
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Ziyi Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Xiaoliang Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Qian Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Hongqiong Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Weihong Zhang
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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14
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Lee JI, Chang YP, Tsai CS, Yen CF. Internalized Sexual Stigma among Lesbian, Gay, and Bisexual Individuals in Taiwan: Its Related Factors and Association with Mental Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042427. [PMID: 35206614 PMCID: PMC8872568 DOI: 10.3390/ijerph19042427] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 02/04/2023]
Abstract
Internalized sexual stigma (ISS) is one of the major issues that can compromise the health of sexual minority populations. This quantitative study aimed to examine: (1) the relationships of individual factors (gender, age, education level, sexual orientation, and age of identification of sexual orientation) and perceived family support with ISS; and (2) the associations of ISS with mood problems and the moderating effects of gender on the associations among Taiwanese young adult lesbian, gay, and bisexual (LGB) individuals. In total, 500 male and 500 female young adult LGB individuals aged between 20 and 30 years participated in this study. The experience of ISS, individual (e.g., gender, age, education level, sexual orientation, and age of identification of sexual orientation) and environmental factors (perceived family), mood problems (e.g., anxiety and depression) were collected. The individual and environmental factors related to ISS and the associations of ISS with mood problems were examined using multivariate linear regression analysis. The results indicated that gender, sexual orientation, age of identification of sexual orientation, and perceived family support were significantly associated with all or some dimensions of ISS in LGB individuals. Various dimensions of ISS had different relationships with anxiety and depression. Gender had moderating effects on the association between the identity dimension of ISS and sexual orientation as well as between the social discomfort dimension of ISS and anxiety. Various dimensions of ISS among LGB individuals should be routinely assessed by mental health service units. Intervention programs should be provided for LGB individuals, especially those with factors related to ISS.
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Affiliation(s)
- Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, School of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY 14260, USA;
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-S.T.); (C.-F.Y.); Tel.: +886-7-7317-123 (ext. 8751) (C.-S.T.); +886-7-3124-941 (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, School of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-S.T.); (C.-F.Y.); Tel.: +886-7-7317-123 (ext. 8751) (C.-S.T.); +886-7-3124-941 (C.-F.Y.)
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15
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Relationships of Sexual Orientation Microaggression with Anxiety and Depression among Lesbian, Gay, and Bisexual Taiwanese Youth: Self-Identity Disturbance Mediates but Gender Does Not Moderate the Relationships. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412981. [PMID: 34948591 PMCID: PMC8701819 DOI: 10.3390/ijerph182412981] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
The aims of this cross-sectional survey study were to examine the association between sexual orientation microaggression and anxiety and depression among young adult lesbian, gay, and bisexual (LGB) individuals in Taiwan, as well as to examine the mediating effect of self-identity disturbance and the moderating effect of gender. In total, 1000 self-identified LGB individuals participated in the study. The experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory, self-identity disturbance was assessed using the Self-Concept and Identity Measure, anxiety was assessed using the State subscale on the Chinese version of the State-Trait Anxiety Inventory, and depression was assessed using the Center for Epidemiological Studies-Depression Scale. Structural equation modeling (SEM) was used to examine relationships between the variables. The SEM results demonstrated that sexual orientation microaggression was directly associated with increased anxiety and depression, as well as being indirectly associated with increased anxiety and depression via the mediation of self-identity disturbance among young adult LGB individuals. Gender did not moderate the relationships between any of the variables. Both sexual orientation microaggression and self-identity disturbance warrant program interventions for enhancing mental health among LGB individuals.
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16
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Zhu X, Shek DTL, Dou D. Factor structure of the Chinese CES-D and invariance analyses across gender and over time among Chinese adolescents. J Affect Disord 2021; 295:639-646. [PMID: 34509779 DOI: 10.1016/j.jad.2021.08.122] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 08/22/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Research findings on the factor structure and invariance of the Center for the Epidemiological Studies Depression Scale (CES-D) are inconclusive. Besides, very few studies have examined factorial invariance of the scale over time. Related studies based on Chinese adolescents are also sparse. This study attempted to examine the factor structure of the CES-D and its invariance across gender and time over a one-year period among adolescents in mainland China. METHOD A total of 3,010 adolescents (mean age = 13.16 years, 1,730 boys) completed a questionnaire including the CES-D at Wave 1 and 2,648 of them completed the same survey one year later. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure of the CES-D. Factorial invariance of the resultant factor structure was tested using cross-sectional multi-group CFA (girls vs. boys) at Wave 1 and Wave 2 and longitudinal CFA (Wave 1 vs. Wave 2). RESULTS EFA and CFA revealed a three-factor model of the CES-D, including "somatic complaints," "depressed affect," and "positive affect." Additionally, findings supported the factorial invariance across gender and over time for the three-factor model. LIMITATIONS Limitations of the present study included a lack of adolescents from different areas in mainland China (particularly rural areas) and only a one-year follow-up. CONCLUSIONS This pioneering study suggests that there are three stable dimensions of the CES-D in Chinese adolescents in mainland China which are invariant across gender and over time.
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Affiliation(s)
- Xiaoqin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
| | - Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China.
| | - Diya Dou
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
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17
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Dou D, Shek DTL, Zhu X, Zhao L. Dimensionality of the Chinese CES-D: Is It Stable across Gender, Time, and Samples? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211818. [PMID: 34831573 PMCID: PMC8625664 DOI: 10.3390/ijerph182211818] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 01/04/2023]
Abstract
Depression is a common mental illness among Chinese adolescents. Although the Epidemiological Studies Depression Scale (CES-D) has been widely used in diverse populations, the reported factor structures are inconsistent, and its longitudinal invariance is under-researched. This study examined the psychometric properties and factorial invariance across gender and time of the CES-D among Chinese adolescents. Adolescents aged above 11 years from five schools in Chengdu responded to a questionnaire at Wave 1 (n = 5690). Among them, 4981 participants completed the same questionnaire after six months (Wave 2). The matched sample was composed of 4922 students (51.5% were girls; mean age = 13.15 years) at Wave 1. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the factor structure and performed multi-group CFA to test the factorial invariance across gender and time. A three-factor solution was identified, including "positive affect", "somatic complaints", and "depressed affect". Results of multi-group CFA comparisons supported the factorial invariance of the resultant three-factor solution. Using a new sample of Chinese adolescents in Southwestern China, the present study reproduced earlier findings on adolescents in other areas in China. This study has implications for depression assessment and research in Chinese adolescents.
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Affiliation(s)
- Diya Dou
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China; (D.D.); (X.Z.)
| | - Daniel T. L. Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China; (D.D.); (X.Z.)
- Correspondence:
| | - Xiaoqin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China; (D.D.); (X.Z.)
| | - Li Zhao
- West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu 610041, China;
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18
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Tsai CS, Huang YT, Yen CF. Experience of Sexual Orientation Microaggression among Young Adult Lesbian, Gay, and Bisexual Individuals in Taiwan: Its Related Factors and Association with Mental Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11744. [PMID: 34831500 PMCID: PMC8624001 DOI: 10.3390/ijerph182211744] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/06/2021] [Accepted: 11/07/2021] [Indexed: 11/16/2022]
Abstract
Experiences of sexual orientation microaggression (SOM) are prevalent in lesbian, gay, and bisexual (LGB) individuals. The aims of this quantitative cross-sectional survey study were to examine the factors, including demographics, sexual orientation characteristics, and perceived social support related to SOM, as well as the relationships of SOM with anxiety, depression, and suicidality among young adult LGB individuals in Taiwan. In total, 1000 self-identified young adult LGB individuals (500 men and 500 women) participated in this study. The experience of SOM was assessed using the Sexual Orientation Microaggression Inventory. We also collected demographic and sexual orientation characteristics; perceived general family support, using the Family APGAR Index; anxiety on the State-Trait Anxiety Inventory; depression on the Center for Epidemiological Studies-Depression Scale; and suicidality on the suicidality module of the Kiddie-SADS. The factors related to SOM and the associations of SOM with anxiety, depression, and suicidality were examined using multivariate linear regression analysis. The results indicated that males experienced greater SOM than females, and that younger age of identification of sexual orientation and perceived lower general family support were significantly associated with greater SOM. Greater SOM was significantly associated with greater anxiety, depression, and suicidality. The experiences of SOM in LGB individuals with mental health problems warrant assessment and intervention that take the related factors into account.
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Affiliation(s)
- Ching-Shu Tsai
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
| | - Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong RM543, China;
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 80752, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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19
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Song C, Gadermann A, Zumbo B, Richardson C. Differential Item Functioning of the Center for Epidemiologic Studies Depression Scale Among Chinese Adolescents. J Immigr Minor Health 2021; 24:790-793. [PMID: 34536186 DOI: 10.1007/s10903-021-01275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/28/2022]
Abstract
This study examined differential item functioning (DIF) in the Center for Epidemiologic Studies Depression Scale (CES-D) between Chinese and White adolescents (aged 13 to 17 years) living in Canada. A series of ordinal logistic regressions were used to test for uniform and non-uniform DIF on items in the CES-D. The DIF analyses identified non-uniform DIF for Item 7 ("I felt that everything I did was an effort"). Controlling for gender and strength of ethnic identity in the DIF analyses did not alter the DIF results. The results of this study suggest that CES-D Item 7 does not appear to discriminate at higher levels of depression in Chinese adolescents. The results of this study hold notable implications for the use of the CES-D given that Chinese adolescents demonstrated a systematic difference in expression/experience of depression.
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Affiliation(s)
- Claire Song
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Bruno Zumbo
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
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20
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Self-Reported Depressive Symptoms and Suicidality in Adolescents with Attention-Deficit/Hyperactivity Disorder: Roles of Bullying Involvement, Frustration Intolerance, and Hostility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157829. [PMID: 34360120 PMCID: PMC8345765 DOI: 10.3390/ijerph18157829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022]
Abstract
This study examined the relationships of cyberbullying and traditional bullying victimization and perpetration, perceived family function, frustration discomfort, and hostility with self-reported depressive symptoms and suicidality in adolescents diagnosed as having attention-deficit/hyperactivity disorder (ADHD). Both the self-reported severity of depressive symptoms on the Center for Epidemiological Studies Depression Scale and the occurrence of suicidal ideation or a suicide attempt on the suicidality module of the Kiddie Schedule for Affective Disorders and Schizophrenia were assessed in 195 adolescents with ADHD. The adolescents completed the Cyberbullying Experiences Questionnaire, Chinese version of the School Bullying Experience Questionnaire, Frustration–Discomfort Scale, Buss–Durkee Hostility Inventory, and Family APGAR Index. Caregivers completed the ADHD problems component of the Child Behavior Checklist for Ages 6–18. Multiple regression analyses were used to examine the correlates for each of self-reported depressive symptoms and suicidality. The results showed that after the effects of gender, age, ADHD symptoms, and family function were controlled, greater frustration discomfort and bullying perpetration significantly predicted self-reported depressive symptoms. Being cyberbullying victims and displaying hostility significantly predicted the risk of suicidality. Various types of bullying involvement, frustration intolerance, and hostility significantly predicted self-reported depressive symptoms and suicidality in adolescents with ADHD. By monitoring and intervening in these factors, we can reduce the risk of depression-related problems and suicidality in adolescents with ADHD.
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21
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Weng YP, Hong RM, Chen VCH, Tsai CJ, Yeh DC, Fang YH. Sleep Quality and Related Factors in Patients with Breast Cancer: A Cross-Sectional Study in Taiwan. Cancer Manag Res 2021; 13:4725-4733. [PMID: 34163247 PMCID: PMC8213945 DOI: 10.2147/cmar.s302966] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/24/2021] [Indexed: 01/08/2023] Open
Abstract
Background Sleep disturbances are common and symptomatic burden in patients with breast cancer, but they are poorly documented and managed in routine clinical practice. This descriptive and cross-sectional study evaluated factors associated with post-treatment sleep disturbances in patients with breast cancer. Patients and Methods Patients with breast cancer who underwent standard treatment were enrolled and surveyed for their basic demographic data and precancerous and cancer treatment-related factors; they were also administered self-report questionnaires including the Family Adaptation, Partnership, Growth, Affection, Resolve questionnaire; Impact of Event Scale; Center for Epidemiologic Studies Depression Scale; and Maudsley Personality Inventory. Their sleep disturbances were evaluated using the Pittsburgh sleep quality index (PSQI). Independent sample t test and chi-square tests were used to compare the variables between patients with or without sleep disturbance, and multivariate logistic regression analyses were conducted to detect the independent factors. Results In total, 448 patients, including 145 with PSQI ≤ 5 and 303 with PSQI > 5, completed the investigation. Multiple logistic regression analysis revealed that significantly more patients with sleep disturbances demonstrated psychological distress, severe pain, depression, and impact of stress events than patients without sleep disturbances (adjusted odds ratios [95% confidence intervals]: 2.83 [1.135–7.067], P = 0.026; 1.14 [1.023–1.280], P = 0.018; 1.08 [1.036–1.133], P < 0.001; and 1.03 [1.002–1.051], P = 0.037, respectively). Conclusion Patients with breast cancer showed 67.6% prevalence of sleep disturbances after treatment. The patients with sleep disturbances were more likely to have previously experienced psychological disturbances, severe pain, depression within 5 years after diagnosis. After diagnosis for more than 5 years, higher distress caused by traumatic events still associated with sleep disturbances.
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Affiliation(s)
- Yi-Ping Weng
- Department of Nursing, Chia-Yi Chang Gung Memorial Hospital, Chiayi branch, Puzi City, Chiayi County, Taiwan, R.O.C.,Department of Nursing, Chia-Yi Chang Gung University of Science and Technology, Chiayi branch, Puzi City, Chiayi County, Taiwan, R.O.C
| | - Rei-Mei Hong
- Department of Nursing, Chia-Yi Chang Gung University of Science and Technology, Chiayi branch, Puzi City, Chiayi County, Taiwan, R.O.C
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Medical Foundation, Chang Gung Memorial Hospital, Chiayi branch, Puzi City, Chiayi County, Taiwan, R.O.C.,School of Medicine, Chang Gung University, Taoyuan City, Taiwan, R.O.C
| | - Chia-Jui Tsai
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C
| | - Dah-Cherng Yeh
- Breast Medical Center, Cheng Ching Hospital, Chung Kang Branch, Taichung City, Taiwan, R.O.C
| | - Yu-Hung Fang
- Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi branch, Puzi City, Chiayi County, 61363, Taiwan, R.O.C
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Blodgett JM, Lachance CC, Stubbs B, Co M, Wu YT, Prina M, Tsang VWL, Cosco TD. A systematic review of the latent structure of the Center for Epidemiologic Studies Depression Scale (CES-D) amongst adolescents. BMC Psychiatry 2021; 21:197. [PMID: 33874939 PMCID: PMC8054366 DOI: 10.1186/s12888-021-03206-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The Centre for Epidemiologic Studies Depression Scale (CES-D) is a commonly used psychometric scale of depression. A four-factor structure (depressed affect, positive affect, somatic symptoms, and interpersonal difficulties) was initially identified in an American sample aged 18 to 65. Despite emerging evidence, a latent structure has not been established in adolescents. This review aimed to investigate the factor structure of the CES-D in adolescents. METHODS We searched Web of Science, PsychINFO and Scopus and included peer-reviewed, original studies assessing the factor structure of the 20-item CES-D in adolescents aged ≤18. Two independent researchers screened results and extracted data. RESULTS Thirteen studies met the inclusion criteria and were primarily from school-based samples in the USA or Asia. Studies that conducted confirmatory factor analysis (CFA; n = 9) reported a four-factor structure consistent with the original factor structure; these studies were primarily USA-based. Conversely, studies that conducted exploratory factor analysis (EFA) reported distinct two or three factor structures (n = 4) and were primarily based in Asia. LIMITATIONS Studies in a non-English language and those that included individuals aged > 18 years were excluded. Ethnic or cultural differences as well as different analytical methods impacted generalisability of results. The use of CFA as the primary analysis may have biased towards a four-factor structure. CONCLUSIONS A four-factor CES-D structure was an appropriate fit for adolescents in Western countries; further research is required to determine the fit in in Asian countries. This has important implications for clinical use of the scale. Future research should consider how cultural differences shape the experience of depression in adolescents.
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Affiliation(s)
- Joanna M. Blodgett
- grid.268922.50000 0004 0427 2580MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Brendon Stubbs
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK ,grid.37640.360000 0000 9439 0839Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Melissa Co
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Yu-Tzu Wu
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Matthew Prina
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Vivian W. L. Tsang
- grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Theodore D. Cosco
- grid.4991.50000 0004 1936 8948Oxford Institute of Population Ageing, University of Oxford, Oxford, UK ,grid.61971.380000 0004 1936 7494Gerontology Research Centre, Simon Fraser University, Vancouver, Canada
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Kuo JH, Albaladejo Carrera R, Cendra Mulyani L, Strong C, Lin YC, Hsieh YP, Tsai MC, Lin CY. Exploring the Interaction Effects of Gender Contentedness and Pubertal Timing on Adolescent Longitudinal Psychological and Behavioral Health Outcomes. Front Psychiatry 2021; 12:660746. [PMID: 34899405 PMCID: PMC8662518 DOI: 10.3389/fpsyt.2021.660746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Off-time pubertal timing (PT) and non-conforming gender identity have been reported to predict adverse health and well-being in adolescents. However, the joint effects of these two factors are less addressed. We aimed to investigate the main and interaction effects of gender identity, proxied by perceived gender contentedness (GC), and PT on longitudinal adolescent psychological and behavioral outcomes. Methods: Data (N = 1806, Mage = 13.3 ± 0.5 years) come from the Taiwan Youth Project, which prospectively followed a longitudinal cohort of Taiwanese junior high school students from 2000 (wave 1) to 2009 (wave 9). GC was self-reported at waves 1 and 9 in a binary response, and thus 4 GC trajectories were created. PT was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Multiple linear regression analyses with gender stratification were applied to examine the effects of the GC trajectory and its interaction with PT on the outcomes. Results: A total of 1,562 subjects (86.5%) remained consistently satisfied with their gender, while the GC of 226 subjects (12.6%) changed at some point. Regression analyses found that males with gender dissatisfaction at wave 9 were likely to engage in delinquent behavior, and females in this group were more likely to have lower self-esteem, as compared to those with consistent GC. The interaction effect between the GC trajectory and PT appeared to be associated with smoking and drinking only at wave 1. Conclusions: These findings indicate that healthcare professionals should concentrate on gender non-conforming individuals at early adolescence, navigating them toward a healthy adulthood.
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Affiliation(s)
- Jen-Hao Kuo
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | | | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Lin
- Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, Taipei, Taiwan
| | - Yi-Ping Hsieh
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, United States
| | - Meng-Che Tsai
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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24
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Wang W, Guo Y, Du X, Li W, Wu R, Guo L, Lu C. Associations Between Poor Sleep Quality, Anxiety Symptoms, and Depressive Symptoms Among Chinese Adolescents Before and During COVID-19: A Longitudinal Study. Front Psychiatry 2021; 12:786640. [PMID: 35095601 PMCID: PMC8795609 DOI: 10.3389/fpsyt.2021.786640] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/22/2021] [Indexed: 12/19/2022] Open
Abstract
Since the novel coronavirus disease 2019 (COVID-19) outbreak, adolescents' emerging mental health and behavior issues have been an international public health concern. This longitudinal study aimed to examine the situation of poor sleep quality, anxiety, and depressive symptoms among Chinese adolescents and to explore the associations between them before and during COVID-19. A total of 1,952 middle and high school students as eligible participants at baseline (pre-COVID-19, Wave 1; response rate: 98.79%), 1,831 eligible students were followed up at Wave 2 (October 2019 to December 2019, pre-COVID-19; retention rate: 93.80%), and 1,790 completed the follow-up at Wave 3 (during the COVID-19; retention rate: 97.80%). The mean age of the baseline students was 13.56 (SD: 1.46) years. The differences in anxiety and depressive symptoms between Wave 1, Wave 2, and Wave 3 were not statistically significant. The proportion of students with poor sleep quality increased over time, from Wave 1 (21.0%) to Wave 3 (26.0%, OR = 1.37, 95% CI = 1.17-1.60, P = 0.001) and from Wave 2 (21.9%) to Wave 3 (OR = 1.29, 95% CI = 1.11-1.51, P < 0.001). The cross-lagged generalized linear mixed models revealed that the concurrent and cross-lagged associations of poor sleep quality with anxiety symptoms across the three waves were significant (P < 0.05) and vice versa. Only a marginally significant positive cross-lagged association between poor sleep quality at Wave 2 and depressive symptoms at Wave 3 was found (standardized β estimate = 0.044, SE = 0.022, P = 0.045). Sleep quality was adversely affected during COVID-19, and the bidirectional associations of poor sleep quality with anxiety symptoms could not be neglected.
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Affiliation(s)
- Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Yangfeng Guo
- Department of Prevention and Treatment of Common Diseases Among Students, Health Promotion Center for Primary and Secondary Schools, Guangzhou, China
| | - Xueying Du
- Department of Prevention and Treatment of Common Diseases Among Students, Health Promotion Center for Primary and Secondary Schools, Guangzhou, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
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25
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Yen KT, Cherng S. Secondary Prevention of Depressive Prodrome in Adolescents: Before and After Attending a Jogging Program on Campus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7705. [PMID: 33105575 PMCID: PMC7659965 DOI: 10.3390/ijerph17217705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/27/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022]
Abstract
The adolescent depressive prodrome has been conceptualized as an early integrated sign of depressive symptoms, which may develop to a first episode of depression or return to normal for the adolescents. In this study, depressive prodrome presented the early self-rated depressive symptoms for the sample participants. By referring to the Kutcher Adolescent Depression Scale and the psychometric characteristics of the Adolescent Depression Scale (ADR), we proposed a self-rated questionnaire to assess the severity of the depressive symptoms in adolescents before and after attending the jogging program on a high school campus in Taiwan. With the parental co-signature and self-signed informed consent form, 284 high school students under the average age of 15 years, participated in this study in March 2019. Through the software of IBMSPSS 25, we used a binary logistic model, principal component analysis (PCA), multiple-dimensional analysis, and receiver operating characteristic curve (ROC) to analyze the severity of the depressive prodrome via the threshold severity score (SC) and false positive rate (FPR). Findings revealed that attending the 15-week jogging program (3 times a week, 45 min each) on campus can change the severity status and reduce the prevalence of moderate-severe depressive prodrome by 26%. The two-dimensional approach identified three symptoms, which were the crying spell, loss of pleasure doing daily activities, and feeling the decline in memory. They kept being invariant symptoms during the course of depressive prodrome assessment for sample participants. In this study, the campus jogging program appeared to be able to affect the FPR of the measure of depressive prodrome. Compared with the subthreshold depression, the depressive prodrome emphasized the assessment from the view of the secondary prevention by representing the change from a person's premorbid functioning up until the first onset of depression or returning to normal. However, the subthreshold depression is a form of minor depression according to DSM-5 criteria varying on the number of symptoms and duration required, highly prevalent in the concern of primary care.
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Affiliation(s)
- Ke Tien Yen
- Department of Leisure and Sports Management, Chengshiu University, Kaohsiung 83347, Taiwan;
- Center for Environmental Toxin and Emerging-Contaminant Research, Chengshiu University, Kaohsiung 83347, Taiwan
| | - Shen Cherng
- Department of Computer Science and Information Engineering, Chengshiu University, Kaohsiung 83347, Taiwan
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26
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Gong M, Zhang S, Li W, Wang W, Wu R, Guo L, Lu C. Association between Childhood Maltreatment and Suicidal Ideation and Suicide Attempts among Chinese Adolescents: The Moderating Role of Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176025. [PMID: 32824995 PMCID: PMC7503513 DOI: 10.3390/ijerph17176025] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/25/2022]
Abstract
Suicidal behavior is a major public health concern worldwide and has become the second-leading cause of death among adolescents. The purposes of this study were to investigate the associations between childhood maltreatment and suicidal behavior and to test whether depressive symptoms have moderating effects on these associations. A multistage stratified cluster randomized sampling method was adopted to collect data from 21,019 high school students in Guangdong Province, China. The prevalence of suicidal ideation and suicide attempts among Chinese adolescents were 18.2% and 3.6%, respectively. Physical abuse (adjusted odds ratios (AOR) = 1.35, 95% confidence intervals (CI) = 1.32–1.38), emotional abuse (AOR = 1.26, 95% CI = 1.25–1.28), sexual abuse (AOR = 1.25, 95% CI = 1.21–1.30), physical neglect (AOR = 1.09, 95% CI = 1.08–1.11), and emotional neglect (AOR = 1.08, 95% CI = 1.08–1.09) were all associated with an increased risk of suicidal ideation, and these associations were also found for suicide attempts. According to stratification analyses, physical abuse/emotional abuse/sexual abuse had a stronger effect on suicidal ideation and suicide attempts among students without depressive symptoms than among students with depressive symptoms. Childhood maltreatment was associated with an increased risk of suicidal ideation and suicide attempts in Chinese adolescents. Depressive symptoms play a moderating role in the association between childhood maltreatment and suicidal behaviors.
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Affiliation(s)
| | | | | | | | | | - Lan Guo
- Correspondence: (L.G.); (C.L.); Tel.: +86-20-87332477 (C.L.)
| | - Ciyong Lu
- Correspondence: (L.G.); (C.L.); Tel.: +86-20-87332477 (C.L.)
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27
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Wu RH, Jiang JH, Gu YF, Moonasar N, Lin Z. Pars plana vitrectomy relieves the depression in patients with symptomatic vitreous floaters. Int J Ophthalmol 2020; 13:412-416. [PMID: 32309177 DOI: 10.18240/ijo.2020.03.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/10/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the depressive state among the patients with symptomatic vitreous floaters (SVF), as well as its change after SVF removal via vitrectomy surgery. METHODS Twenty-eight eyes of 28 patients who underwent 27-gauge pars plana vitrectomy (PPV) for SVF were included. Thirty-nine eyes of 39 age- and gender-matched healthy volunteers without SVF were also recruited as a healthy control. Center for Epidemiologic Studies Depression (CES-D) was used to assess volunteers and patients' depression (before and 1wk after PPV). RESULTS The CES-D score was 18.3±8.6 for patients, and was 12.4±6.0 for healthy control (P=0.003). Patients were significantly more likely to be in a depressive state (53.6%, defined as CES-D score ≥16) than the healthy control (20.5%, P=0.005). For patients with SVF, the CES-D score was negatively correlated with their age (r s=-0.42, P=0.025). After PPV, both the CES-D score (11.9±5.4 vs 18.3±8.6, P<0.001) and proportion of depressive state (18.5% vs 53.6%, P=0.005) were significantly decreased. CONCLUSION This study suggests that symptoms of vitreous floaters have an apparently negative impact on patients' psychological state. The PPV can effectively relieve the depressive state for patients with SVF.
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Affiliation(s)
- Rong-Han Wu
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jun-Hong Jiang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yi-Fan Gu
- Minhang Hospital, Fudan University, Shanghai 201100, China
| | | | - Zhong Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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28
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Depressive Symptoms and the Link with Academic Performance among Rural Taiwanese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082778. [PMID: 32316516 PMCID: PMC7254188 DOI: 10.3390/ijerph17082778] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 11/21/2022]
Abstract
Previous studies reflect a high prevalence of depressive symptoms among Taiwanese adolescents (ages 13–18), but there is an absence of literature related to the risk of depression of children in Taiwan (ages 6–12), particularly among potentially vulnerable subgroups. To provide insight into the distribution of depressive symptoms among children in rural Taiwan and measure the correlation between academic performance, we conducted a survey of 1655 randomly selected fourth and fifth-grade students at 92 sample schools in four relatively low-income counties or municipalities. Using the Center for Epidemiological Studies-Depression Scale (CES-D) we assessed the prevalence of depressive symptoms in this sample, in addition to collecting other data, such as performance on a standardized math test as well as information on a number of individual and household characteristics. We demonstrate that the share of children with clinically significant symptoms is high: 38% of the students were at risk of general depression (depression score ≥ 16) and 8% of the students were at risk of major depression (depression score > 28). The results of the multivariate regression and heterogeneous analysis suggest that poor academic performance is closely associated with a high prevalence of depressive symptoms. Among low-performing students, certain groups were disproportionately affected, including girls and students whose parents have migrated away for work. Results also suggest that, overall, students who had a parent who was an immigrant from another country were at greater risk of depression. These findings highlight the need for greater resource allocation toward mental health services for elementary school students in rural Taiwan, particularly for at-risk groups.
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29
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Body Image Victimization Experiences and Disordered Eating Behaviors among Chinese Female Adolescents: The Role of Body Dissatisfaction and Depression. SEX ROLES 2020. [DOI: 10.1007/s11199-020-01122-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Luo J, Wang MC, Gao Y, Zeng H, Yang W, Chen W, Zhao S, Qi S. Refining the Parenting Stress Index-Short Form (PSI-SF) in Chinese Parents. Assessment 2019; 28:551-566. [PMID: 31072108 DOI: 10.1177/1073191119847757] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Parenting Stress Index-Short Form (PSI-SF) is a popular brief assessment of parenting stress. However, its latent structure and psychometric properties have not been extensively addressed, in particular in non-Western cultures. The present study is the first to examine the factor structure and psychometric properties of the PSI-SF in parents from Mainland China (683 mother-father dyads; mean age of mothers = 37.10 years, SD = 3.68; mean age of fathers = 39.81 years, SD = 4.13). Initial analyses revealed that previously proposed factor structure of the PSI-SF did not fit the data well. Exploratory and confirmatory factor analyses were then conducted to develop a psychometrically sound and efficient abbreviated version of the PSI-SF. In this new version of 15 items (PSI-SF-15), there are three factors (i.e., parental distress, parent-child dysfunctional interaction, and difficult child). This abbreviated scale showed strict measurement invariance across sex of parent and satisfactory internal consistency. The convergent validity of the PSI-SF-15 were supported by its expected relations with the original PSF-SF measures, the multitrait-multimethod procedure, and its expected relations with scores on parenting behavior, parental depressiveness, and children's conduct problems. In conclusion, these results suggest that the PSI-SF-15 is a valid measure of parenting stress in Chinese parents, and that it holds promise as an informative and reliable alternative to the original PSI-SF when administration time is limited.
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Affiliation(s)
- Jie Luo
- Inner Mongolia Normal University, Inner Mongolia, China.,Guizhou Normal University, Guiyang, China
| | | | - Yu Gao
- City University of New York, Brooklyn, NY, USA
| | - Hong Zeng
- Guangzhou University, Guangzhou, China
| | | | - Wei Chen
- Guizhou Normal University, Guiyang, China
| | | | - Shisan Qi
- Inner Mongolia Normal University, Inner Mongolia, China
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31
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Tseng WC, Liang YC, Su MH, Chen YL, Yang HJ, Kuo PH. Sleep apnea may be associated with suicidal ideation in adolescents. Eur Child Adolesc Psychiatry 2019; 28:635-643. [PMID: 30220076 DOI: 10.1007/s00787-018-1227-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 09/08/2018] [Indexed: 12/21/2022]
Abstract
Suicide is a major threat to adolescent health. Sleep problems increase the risk of adolescent suicidal behavior, but the role of sleep-disordered breathing (e.g., sleep apnea) is unclear. We investigated whether sleep apnea had an effect on suicidal ideation that was independent of depression and perceived stress. We examined a series of sleep variables with suicidal ideation in 746 fifth and seventh graders using self-reported questionnaires to assess time in bed, sleep quality, insomnia, and sleep apnea while controlling depression and perceived stress. Overall, 8.8% of students aged 10-14 years reported having recent suicidal ideation, and 33% or 3.8%, depending on the screening criteria, reported having suspected sleep apnea. The sleep variables were all associated with an increased risk of suicidal ideation, but the magnitude of effects was largely attenuated when depression and perceived stress were included in the models. Suspected sleep apnea using daytime sleepiness as a screening criterion was independently associated with suicidal ideation (odds ratio = 2.25, p < 0.05). Suspected sleep apnea was associated with suicidal ideation that was partly independent of depression and stress, which reveals the pertinence of screening for sleep apnea among school students and designing proper prevention strategies for reducing youth suicidal behavior.
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Affiliation(s)
- Wen-Che Tseng
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02215, USA.,National Taiwan University Hospital, 7, Zhongshan S. Rd., Taipei, Taiwan
| | - Yun-Chieh Liang
- Clinical Trial Center, National Taiwan University Hospital, 7, Zhongshan S. Rd., Taipei, Taiwan
| | - Mei-Hsin Su
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Taipei, Taiwan
| | - Yun-Ling Chen
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Taipei, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, 110, sec.1, Jianhuo N. Rd., Taichung, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Taipei, Taiwan. .,Research Center for Genes, Environment and Human Health, National Taiwan University, 2, Xuzhou Rd., Taipei, Taiwan.
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32
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Sun YC, Chen CL, Wen SH. Taiwanese depression questionnaire revisit: Factor structure and measurement invariance across genders. J Formos Med Assoc 2019; 118:1356-1361. [PMID: 30600133 DOI: 10.1016/j.jfma.2018.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/07/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND/PURPOSE Taiwanese Depression Questionnaire (TDQ) was widely used in Taiwan to measure individuals' proneness to depression. In light of well-established gender differences in the manifestation of depression, TDQ's structure invariance and measurement invariance across genders were examined in this study. METHODS Data from 2604 adults was analyzed. Exploratory factor analysis was first performed to explore the factor structure. Possible factor structures and the original 2-factor structure were then compared by confirmatory factor analysis (CFA). The best fitting model was tested for measurement invariance across genders using multi-group CFA. RESULTS EFA revealed 2 possible factor structures and suggested cross-loaded items deletion needed. This resulted in 4 models along with the original 2-factor structure to be tested in the follow-up CFA. Among the 5 models tested, the best-fitting model was the 3-factor solution with 3 cross-loaded items removed. The multi-group CFA performed on this 15-item TDQ revealed that the configural invariance, metrix invariance, and scalar invariance were all supported; partial strict invariance was supported when residual variances of items 1, 9, and 18 were set to vary. CONCLUSION The 15-item TDQ with a 3-factor structure reflects the manifestations of depression of Taiwanese general population well. Although the results of measurement invariance suggest no gender difference in factor structure, the partial strict invariance suggests that there is gender difference in the amount of variance captured by TDQ. Hence, examining gender differences in the predictive value of different factors regarding health behaviors or medical conditions may bring fruitful results.
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Affiliation(s)
- Yi-Chun Sun
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chien-Lin Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan
| | - Shu-Hui Wen
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan.
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33
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Testing of the factor structure of the Center for Epidemiologic Studies Depression Scale 10 in a sample of Korean "geese" mothers. Health Care Women Int 2018; 40:539-553. [PMID: 30570417 DOI: 10.1080/07399332.2018.1548017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The author's purpose in this study was to establish the factor structure of the Korean version of the Center for Epidemiologic Studies Depression Scale 10 (CES-D 10) by conducting confirmatory factor analysis based on preexisting models with a sample of Korean transnational mothers (referred to as "geese mothers"). Hundred and fifty-three Korean geese mothers in the USA and New Zealand completed the Korean version of the CES-D 10 questionnaire. The resulting data was subjected to confirmatory factor analysis, which tested three competing models. Our goodness-of-fit indices for the two-factor model indicated an acceptable fit with the current sample. Our results in the present study show that the CES-D 10 can be a useful tool for understanding the concept of depression in Korean geese mothers.
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34
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Li JB, Mo PKH, Lau JTF, Su XF, Zhang X, Wu AMS, Mai JC, Chen YX. Online social networking addiction and depression: The results from a large-scale prospective cohort study in Chinese adolescents. J Behav Addict 2018; 7:686-696. [PMID: 30203664 PMCID: PMC6426399 DOI: 10.1556/2006.7.2018.69] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS The aim of this study is to estimate the longitudinal associations between online social networking addiction (OSNA) and depression, whether OSNA predicts development of depression, and reversely, whether depression predicts development of OSNA. METHODS A total of 5,365 students from nine secondary schools in Guangzhou, Southern China were surveyed at baseline in March 2014, and followed up 9 months later. Level of OSNA and depression were measured using the validated OSNA scale and CES-D, respectively. Multilevel logistic regression models were applied to estimate the longitudinal associations between OSNA and depression. RESULTS Adolescents who were depressed but free of OSNA at baseline had 1.48 times more likely to develop OSNA at follow-up compared with those non-depressed at baseline [adjusted OR (AOR): 1.48, 95% confidence interval (CI): 1.14-1.93]. In addition, compared with those who were not depressed during the follow-up period, adolescents who were persistently depressed or emerging depressed during the follow-up period had increased risk of developing OSNA at follow-up (AOR: 3.45, 95% CI: 2.51-4.75 for persistent depression; AOR: 4.47, 95% CI: 3.33-5.99 for emerging depression). Reversely, among those without depression at baseline, adolescents who were classified as persistent OSNA or emerging OSNA had higher risk of developing depression compared with those who were no OSNA (AOR: 1.65, 95% CI: 1.01-2.69 for persistent OSNA; AOR: 4.29; 95% CI: 3.17-5.81 for emerging OSNA). CONCLUSION The findings indicate a bidirectional association between OSNA and depression, meaning that addictive online social networking use is accompanied by increased level of depressive symptoms.
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Affiliation(s)
- Ji-Bin Li
- Department of Clinical Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China,Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China,Corresponding authors: Ji-Bin Li, MD, PhD; Department of Clinical Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651, Dong Feng East Road, Guangzhou 510060, China; Phone: +86 20 8734 3553; Fax: +86 20 8734 3535; E-mail: ; Joseph T. F. Lau, PhD, Professor; Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, Hong Kong, China; Phone: +852 2637 6606; Fax: +852 2645 3098; E-mail:
| | - Phoenix K. H. Mo
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Joseph T. F. Lau
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Xue-Fen Su
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Xi Zhang
- Clinical Research Unit, Xin Hua Hospital – Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anise M. S. Wu
- Faculty of Social Sciences, Department of Psychology, University of Macau, Macao, China
| | - Jin-Cheng Mai
- Department of Psychological Health Research, Center for Health Promotion of Primary and Secondary School of Guangzhou, Guangzhou, China
| | - Yu-Xia Chen
- Department of Psychological Health Research, Center for Health Promotion of Primary and Secondary School of Guangzhou, Guangzhou, China
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Zhang M, Han J, Shi J, Ding H, Wang K, Kang C, Gong J. Personality traits as possible mediators in the relationship between childhood trauma and depressive symptoms in Chinese adolescents. J Psychiatr Res 2018; 103:150-155. [PMID: 29852422 DOI: 10.1016/j.jpsychires.2018.05.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 12/26/2022]
Abstract
Childhood trauma has been found to be a critical risk factor for depression in adolescents. Personality traits have been linked with mental health. However, the relationship between childhood trauma, personality traits, and depressive symptoms in adolescents is largely unclear. This study tried to examine the mediating effect of personality traits between childhood trauma and depressive symptoms among adolescents. Meanwhile, the possible bidirectional association between personality traits and depression was considered in the study. A group of community-based adolescents aged 10-17 years (N = 5793) were recruited from nine schools in Wuhan city, China. The participants completed self-report questionnaires, including the Center for Epidemiologic Studies Depression Scale (CES-D), the Childhood Trauma Questionnaire (CTQ) and the NEO-Five Factor Inventory (NEO-FFI). Results showed that childhood trauma experiences were positively related with depressive symptoms and neuroticism, and negatively related with extraversion and conscientiousness; depressive symptoms were related with high neuroticism, low extraversion, and conscientiousness. Neuroticism and extraversion partially mediated the relationship between childhood trauma and depressive symptoms. And 'childhood trauma-personality traits-depression' models showed better property than the alternative models of 'childhood trauma-depression-personality traits'. The current study provides preliminary evidence for mediation roles of neuroticism and extraversion in the effect of childhood trauma to depressive symptoms in adolescents. These findings may contribute to better prevention and interventions for depressive symptoms among adolescents with childhood trauma via personality traits improvement.
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Affiliation(s)
- Minli Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Junxin Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huisi Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaiqiao Wang
- Department of Education, Culture and Sports, East Lake New Technology Development Zone, Wuhan, China
| | - Chun Kang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiangling Gong
- Center for Mental Health, Institute of Education and Development, East Lake New Technology Development Zone, Wuhan, China
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Alexandrowicz RW, Jahn R, Wancata J. Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models. PLoS One 2018; 13:e0197908. [PMID: 29799866 PMCID: PMC5969764 DOI: 10.1371/journal.pone.0197908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/10/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives The CES-D is a widely used depression screening instrument. While numerous studies have analysed its psychometric properties using exploratory and various kinds of confirmatory factor analyses, only few studies used Rasch models and none a multidimensional one. Methods The present study applies a multidimensional Rasch model using a sample of 518 respondents representative for the Austrian general population aged 18 to 65. A one-dimensional model, a four-dimensional model reflecting the subscale structure suggested by [1], and a four-dimensional model with the background variables gender and age were applied. Results While the one-dimensional model showed relatively good fit, the four-dimensional model fitted much better. EAP reliability indices were generally satisfying and the latent correlations varied between 0.31 and 0.88. In the analysis involving background variables, we found a limited effect of the participants’ gender. DIF effects were found unveiling some peculiarities. The two-items subscale Interpersonal Difficulties showed severe weaknesses and the Positive Affect subscale with the reversed item wordings also showed unexpected results. Conclusions While a one-dimensional over-all score might still contain helpful information, the differentiation according to the latent dimension is strongly preferable. Altogether, the CES-D can be recommended as a screening instrument, however, some modifications seem indicated.
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Affiliation(s)
| | - Rebecca Jahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Johannes Wancata
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Guo L, Huang Y, Xu Y, Huang G, Gao X, Lei Y, Luo M, Xi C, Lu C. The mediating effects of depressive symptoms on the association of childhood maltreatment with non-medical use of prescription drugs. J Affect Disord 2018; 229:14-21. [PMID: 29294372 DOI: 10.1016/j.jad.2017.12.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/16/2017] [Accepted: 12/24/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Childhood maltreatment might increase the risk of subsequent drug use behavior, and depressive symptoms have been reported to be associated both childhood maltreatment and non-medical use of prescription drugs (NMUPD). This large-scale study aimed to test the mediating effects of depressive symptoms on the association of childhood maltreatment with NMUPD among Chinese adolescents. METHODS A secondary analysis of the cross-sectional data collected from 7th to 12th graders who were sampled using a multistage, stratified cluster, random sampling method in the 2015 School-based Chinese Adolescents Health Survey. There were 24,457 students who were invited to participate and 23,039 students' questionnaires were completed and qualified for our survey (response rate: 94.2%). RESULTS In the adjusted models without mediation, the results showed that students who reported that they had experienced emotional abuse were at a higher risk of past year use and past month use of opioids (past year: Adjusted OR [AOR] = 1.07, 95% CI = 1.05-1.10; past month: AOR = 1.08, 95% CI = 1.06-1.10) and sedatives (past year: AOR = 1.06, 95% CI = 1.03-1.08; past month: AOR = 1.15, 95% CI = 1.13-1.16). The results of mediation analyses demonstrated that there were significant standardized indirect effects of emotional abuse on opioids use and sedatives use through depressive symptoms, respectively (P < 0.001). LIMITATIONS Our study sample only included school students, and causal inference could not be examined due to the cross-sectional design. CONCLUSIONS Depressive symptoms play a significant mediator role on the association of childhood maltreatment with NMUPD. Interventions targeted at adolescents who are involved in NMUPD should pay attention to their histories of childhood maltreatment.
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Affiliation(s)
- Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Yeen Huang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Yan Xu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Xue Gao
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Yiling Lei
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Min Luo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Chuhao Xi
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
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Chang CC, Su JA, Chang KC, Lin CY, Koschorke M, Rüsch N, Thornicroft G. Development of the Family Stigma Stress Scale (FSSS) for Detecting Stigma Stress in Caregivers of People With Mental Illness. Eval Health Prof 2017; 42:148-168. [PMID: 29246085 DOI: 10.1177/0163278717745658] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
People with mental illness and their family caregivers often perceive public stigma, which may lead to stigma-related stress (or stigma stress). However, no instruments have been developed to measure this stress for family caregivers of people with mental illness. We modified an instrument that measures the stigma stress of people with mental illness (i.e., the cognitive appraisal of stigma as a stressor) and examined the psychometric properties of the scores of the newly developed instrument: the Family Stigma Stress Scale (FSSS). Primary family caregivers of people with mental illness in Southern Taiwan ( n = 300; mean age = 53.08 ± 13.80; 136 males) completed the FSSS. An exploratory factor analysis showed that the FSSS score had two factors; both factor scores had excellent internal consistency (α = .913 and .814) and adequate test-retest reliability ( r = .627 and .533; n = 197). Significant correlations between FSSS factor scores and other instruments supported its concurrent validity and the ability of the FSSS to differentiate between clinical characteristics, for example, having been previously hospitalized or not. The FSSS is a brief and effective measure of the stigma stress of family caregivers of people with mental illness.
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Affiliation(s)
- Chih-Cheng Chang
- 1 Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan.,2 Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,3 Department of Health Psychology, Chang Jung Christian University, Tainan, Taiwan
| | - Jian-An Su
- 4 Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,5 School of Medicine, Chang Gung University, Taoyuan, Taiwan.,6 Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan
| | - Kun-Chia Chang
- 7 Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.,8 Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- 9 Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Mirja Koschorke
- 2 Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nicolas Rüsch
- 10 Department of Psychiatry II, University of Ulm and BKH Günzburg, Germany
| | - Graham Thornicroft
- 2 Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Li JB, Lau JTF, Mo PKH, Su XF, Tang J, Qin ZG, Gross DL. Insomnia partially mediated the association between problematic Internet use and depression among secondary school students in China. J Behav Addict 2017; 6:554-563. [PMID: 29280394 PMCID: PMC6034947 DOI: 10.1556/2006.6.2017.085] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/06/2017] [Accepted: 12/03/2017] [Indexed: 01/02/2023] Open
Abstract
Background and aims This study aims to examine the mediating effects of insomnia on the associations between problematic Internet use, including Internet addiction (IA) and online social networking addiction (OSNA), and depression among adolescents. Methods A total of 1,015 secondary school students from Guangzhou in China participated in a cross-sectional survey. Levels of depression, insomnia, IA, and OSNA were assessed using the Center for Epidemiological Studies-Depression Scale, Pittsburgh Sleep Quality Index, Young's Diagnostic Questionnaire, and Online Social Networking Addiction Scale, respectively. Logistic regression models were fit to test the associations between IA, OSNA, insomnia, and depression. The mediation effects of insomnia were tested using Baron and Kenny's strategy. Results The prevalence of depression at moderate level or above (CES-D ≥ 21), insomnia, IA, and OSNA were 23.5%, 37.2%, 8.1%, and 25.5%, respectively. IA and OSNA were significantly associated with depression (IA: AOR = 2.79, 95% CI: 1.71, 4.55; OSNA: AOR = 3.27, 95% CI: 2.33, 4.59) and insomnia (IA: AOR = 2.83, 95% CI: 1.72, 4.65; OSNA: AOR = 2.19, 95% CI: 1.61, 2.96), after adjusting for significant background factors. Furthermore, insomnia partially mediated 60.6% of the effect of IA on depression (Sobel Z = 3.562, p < .002) and 44.8% of the effect of OSNA on depression (Sobel Z = 3.919, p < .001), respectively. Discussion The high prevalence of IA and OSNA may be associated with increased risk of developing depression among adolescents, both through direct and indirect effects (via insomnia). Findings from this study indicated that it may be effective to develop and implement interventions that jointly consider the problematic Internet use, insomnia, and depression.
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Affiliation(s)
- Ji-Bin Li
- State Key Laboratory of Oncology in South China, Department of Clinical Research, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
- Faculty of Medicine, Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T. F. Lau
- Faculty of Medicine, Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Shenzhen Research Institute (SZRI), The Chinese University of Hong Kong, Shenzhen, China
| | - Phoenix K. H. Mo
- Faculty of Medicine, Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Shenzhen Research Institute (SZRI), The Chinese University of Hong Kong, Shenzhen, China
| | - Xue-Fen Su
- Faculty of Medicine, Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Shenzhen Research Institute (SZRI), The Chinese University of Hong Kong, Shenzhen, China
| | - Jie Tang
- Department of Social Health Education, Center for Health Education in Guangdong Province, Guangzhou, China
| | - Zu-Guo Qin
- Department of Social Health Education, Center for Health Education in Guangdong Province, Guangzhou, China
| | - Danielle L. Gross
- Faculty of Medicine, Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Guo L, Xu Y, Deng J, Gao X, Huang G, Huang J, Deng X, Zhang WH, Lu C. Associations between childhood maltreatment and non-medical use of prescription drugs among Chinese adolescents. Addiction 2017; 112:1600-1609. [PMID: 28430388 DOI: 10.1111/add.13850] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/12/2016] [Accepted: 04/18/2017] [Indexed: 11/28/2022]
Abstract
AIMS To test, among Chinese adolescents: (1) whether childhood maltreatment is associated with non-medical use of prescription drugs (NMUPD) and (2) whether there are interaction effects of childhood maltreatment and depressive symptoms on NMUPD. DESIGN A secondary analysis of the cross-sectional data collected from 7th- and 12th-graders who were sampled using a multi-stage, stratified-cluster, random-sampling method in the 2015 School-based Chinese Adolescents Health Survey (SCAHS). SETTING Surveys conducted in high schools in six cities of China in 2015. PARTICIPANTS There were 24 457 students who were invited to participate and 23 039 students' questionnaires were completed and qualified for our survey. MEASUREMENTS The outcomes comprised self-report of NMUPD (prior 30 days); a history of childhood maltreatment was our main predictor. Other covariates included depressive symptoms, smoking, drinking and demographics. Data were analysed using multi-level regression modelling. FINDINGS Our final multivariable logistic regression models demonstrated that after adjusting for other variables, physical abuse was associated positively with non-medical use of opioids [adjusted odds ratio (AOR) = 1.13, 95% confidence interval (CI) = 1.10-1.22], sedatives (AOR = 1.11, 95% CI = 1.10-1.21) and any prescription drugs (AOR = 1.13, 95% CI = 1.09-1.20); emotional abuse, sexual abuse and emotional neglect were also associated with an increased risk of opioids, sedatives and any prescription drugs misuse; students who reported that they had experienced childhood physical neglect were more likely to be involved in the non-medical use of sedatives (AOR = 1.08, 95% CI = 1.04-1.12) and any prescription drugs (AOR = 1.06, 95% CI = 1.03-1.10). Additionally, there was no evidence of interaction effects on NMUPD between depressive symptoms and each of physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect, respectively. CONCLUSIONS Maltreatment while a child is associated with an increased risk of non-medical use of prescription drugs (NMUPD) among Chinese adolescents. The interactions of maltreatment while a child and depressive symptoms do not appear to be associated significantly with NMUPD among Chinese adolescents.
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Affiliation(s)
- Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan Xu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jianxiong Deng
- Center for ADR monitoring of Guangdong, Guangzhou, China
| | - Xue Gao
- Center for ADR monitoring of Guangdong, Guangzhou, China
| | - Guoliang Huang
- Center for ADR monitoring of Guangdong, Guangzhou, China
| | - Jinghui Huang
- Center for ADR monitoring of Guangdong, Guangzhou, China
| | - Xueqing Deng
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wei-Hong Zhang
- Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Lee CT, Tsai MC, Lin CY, Strong C. Longitudinal Effects of Self-Report Pubertal Timing and Menarcheal Age on Adolescent Psychological and Behavioral Outcomes in Female Youths from Northern Taiwan. Pediatr Neonatol 2017; 58:313-320. [PMID: 27600751 DOI: 10.1016/j.pedneo.2016.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/29/2016] [Accepted: 04/22/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early puberty is linked to adverse developmental outcomes in adolescents in Western societies. However, little is known about this relationship in an East Asian context. In addition, whether the impact of subjective pubertal timing (PT) and menarcheal age (MA) on adolescent psychosocial development persists into early adulthood remains unclear and is worthy of investigation. METHODS A subset of data was retrieved from the Taiwan Youth Project, which recruited and followed a longitudinal cohort of 7th- and 9th-grade female Taiwanese students from 2000 to 2007. Subjective PT was defined using the Pubertal Developmental Scale (PDS), which mainly measures pubertal changes. MA was recalled by participants themselves. Various psychological and behavioral factors were recorded and measured until the age of 20, including the use of alcohol and cigarettes, psychological well-being, sexual activity, and socially problematic behaviors. A χ2 test for linear-by-linear association and one-way analysis of variance followed by multivariate regression models were used to dissect the differential effects of PT and MA in the association with the outcome variables. RESULTS In total, 1545 female participants with an average age of 14.5 (±1.1) years were deemed valid for analysis. Among them, 257 (16.6%) participants perceived themselves as having early PT, defined as more than 1 standard deviation above the mean PDS score, and 82 (5.3%) had early MA (occurring before the 4th grade). In univariate analysis, participants with early PT had higher rates of smoking and sexual activity, and MA was not related to their psychobehavioral outcomes. After multivariate adjustment, only late PT was significantly correlated with lower amounts of cigarette smoking and sexual activity before the age of 20. CONCLUSION Conceptual and actual pubertal developments may be differentially associated with psychobehavioral outcomes among young Taiwanese girls. Clinical attention should be given to adolescent self-perception of sexual maturation and developmental guidance provided accordingly.
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Affiliation(s)
- Chih-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract
Morningness/eveningness (M/E) preference is an important circadian rhythm indicator with strong individual variation. M/E chronotype has been found to be correlated with depression in adults, yet the relationship is less clear in children and adolescents. Additionally, poor sleep quality is another commonly studied risk factor for depression. The aims of the present study are to investigate the independent effects of M/E chronotype on youth depression using both self-report and parental-report questionnaires. We also evaluated how poor sleep quality may affect the relationship through a mediating or moderating effect. In total, 2,139 students attending grades 1 to 7 participated in this study. They completed questionnaires regarding M/E chronotype, depression, and sleep quality. A total of 1,708 parents also participated and filled out parental-reports of emotional and behavioral problems of their children. The prevalence of self- and parental-report depression was 16.8% and 12.8% among young students, respectively. Overall, 15.4% of the students were the eveningness type. Being an eveningness type was independently associated with self-report depression after adjustment for poor sleep quality (OR = 1.86, 95% CI = 1.07-3.24). We also observed that poor sleep quality mediated the influence of M/E chronotype on self-report depression among students aged 7-13 years (p < 0.001). On the other hand, being an eveningness type was associated with a number of parental-report emotional and behavioral problems in the students, in addition to depression, although these associations become non-significant after adjusted for poor sleep quality. Our results demonstrate the importance of M/E chronotype on youth depression and poor sleep quality partly mediates this effect.
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Affiliation(s)
- Wen-Hsuan Chiu
- a National Taiwan University, Department of Public Health & Institute of Epidemiology and Preventive Medicine , College of Public Health , Taipei , Taiwan
| | - Hao-Jan Yang
- b Department of Public Health , Chung Shan Medical University, College of Health Care and Management , Taichung , Taiwan.,c Chung Shan Medical University Hospital , Department of Family and Community Medicine , Taichung , Taiwan
| | - Po-Hsiu Kuo
- a National Taiwan University, Department of Public Health & Institute of Epidemiology and Preventive Medicine , College of Public Health , Taipei , Taiwan.,d National Taiwan University , Research Center for Genes, Environment and Human Health , Taipei , Taiwan
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Guo L, Xu Y, Deng J, Huang J, Huang G, Gao X, Li P, Wu H, Pan S, Zhang WH, Lu C. Association between sleep duration, suicidal ideation, and suicidal attempts among Chinese adolescents: The moderating role of depressive symptoms. J Affect Disord 2017; 208:355-362. [PMID: 27810718 DOI: 10.1016/j.jad.2016.10.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/28/2016] [Accepted: 10/16/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicidal ideation and attempts are still currently serious problems among adolescents worldwide, and there is evidence that sleep problem may be associated with increased rates of mental disorder. This study aimed to examine the associations between sleep duration and suicidal ideation and attempts among adolescents and to test whether depressive symptoms have moderating effects on the associations. METHODS A 3-stage, stratified cluster, random sampling method was used to collect data from 20,130 high school students in southeast China. RESULTS The weighted prevalence of short sleep among Chinese adolescents was 5.6% (95% CI, 5.3-6.0%), and the weighted prevalence of long sleep was 2.7% (95% CI, 2.5-3.0%). The final results demonstrated that short sleep was positively associated with suicidal ideation (AOR=2.28, 95% CI=1.96-2.66) and suicidal attempts (AOR=3.20, 95% CI=2.46-4.16), and long sleep was only significantly associated with suicidal attempts (AOR=2.47, 95% CI=1.70-3.58). Stratification analyses conducted separately for students with and without depressive symptoms demonstrated that depressive symptoms may have moderating effects on the associations between sleep duration and suicidality. LIMITATIONS Our study sample only included school students, and causal inference could not be examined due to the cross-sectional design. CONCLUSIONS Sleep duration was associated with suicidal ideation and attempts, and the association between sleep duration and suicidal attempts was U-shaped. These findings support that proper treatments services with the potential to restore adolescent normal sleep would be helpful in preventing suicidality among adolescents.
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Affiliation(s)
- Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
| | - Yan Xu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Jianxiong Deng
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Jinghui Huang
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Xue Gao
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Pengsheng Li
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Hong Wu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Siyuan Pan
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Wei-Hong Zhang
- Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
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Guo L, Hong L, Gao X, Zhou J, Lu C, Zhang WH. Associations between depression risk, bullying and current smoking among Chinese adolescents: Modulated by gender. Psychiatry Res 2016; 237:282-9. [PMID: 26833280 DOI: 10.1016/j.psychres.2016.01.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 12/18/2015] [Accepted: 01/13/2016] [Indexed: 11/18/2022]
Abstract
This school-based study aimed to investigate the prevalence of being at risk for depression, bullying behavior, and current smoking among Chinese adolescents in order to explore gender differences in the vulnerability of adolescents with these behaviors to develop a smoking habit. A total of 35,893 high school students sampled from high schools in eighteen cities in China participated in the study from 2011 to 2012. Overall, the prevalence of current smoking was estimated at 6.4%. In total, 1.7% (618) of the participants admitted to bullying others, 5.8% (2071) reported being bullied, 3.5% (1269) were involved in both bullying others and being bullied, and 5.6% (2017) were at high risk for depression. Logistic regression analysis indicated that among girls, with high depression risk, bullying others, being bullied, and both bullying others and being bullied were independently and positively associated with current smoking habits, while the final results among boys showed that bullying others and both bullying others and being bullied were independently associated with an increased risk of current smoking. School-based prevention programs are highly recommended, and we should focus on high-risk students, particularly girls with high risk of depression or involved in school bullying and boys who are involved in school bullying.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
| | - Lingyao Hong
- Epidemiology Research Unit, Clinical trails Center, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu, Guangzhou 510000, People's Republic of China
| | - Xue Gao
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Jinhua Zhou
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
| | - Wei-Hong Zhang
- Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
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Lee YH, Salman A. Depression and AIDS Preventive Self-efficacy Among Taiwanese Adolescents. Arch Psychiatr Nurs 2016; 30:84-9. [PMID: 26804507 DOI: 10.1016/j.apnu.2015.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/29/2015] [Accepted: 09/06/2015] [Indexed: 11/15/2022]
Abstract
Effectively reducing adolescents' risky sexual behaviors has been an urgent need since the HIV/AIDS infections among young people has been acknowledged as a priority. Self-efficacy has been considered playing an essential role in behavioral changes, and depressed individuals may demonstrate lower self-efficacy. The purpose of this cross-sectional study was to gain insights into self-reported depression among 16-18 years-old Taiwanese adolescents as well as to explore psychosocial predictors of AIDS preventive self-efficacy. A convenience sample of 734 adolescents from southern Taiwan was recruited, and several reliable and valid questionnaires were used to collect data. Descriptive statistics, odds ratio, independent t-test, and hierarchical multiple regression analyses were utilized to analyze data. Results showed that the differences in self-reported depression and in the AIDS preventive self-efficacy varied by gender, substance use, and having sexual experience. Furthermore, depression was a significant predictor of AIDS preventive self-efficacy while controlling the covariates. This study suggests that gender and mental health status such as depression may play significant roles in AIDS preventive self-efficacy. Nurses and health care providers should take the influence of mental health into consideration when designing AIDS preventive interventions for male and female Taiwanese adolescents. The provided information may also enhance psychiatric nurses' capability to provide care and to enhance the prevention of HIV infection for adolescents.
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Affiliation(s)
- Yi-Hui Lee
- College of Nursing and Health, Wright State University-Miami Valley, Dayton, OH.
| | - Ali Salman
- Faculty of Health Studies, Brandon University, MB, Canada; Al-Andalus University for Medical Sciences, Tartus, Syria
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Hong L, Guo L, Wu H, Li P, Xu Y, Gao X, Deng J, Huang G, Huang J, Lu C. Bullying, Depression, and Suicidal Ideation Among Adolescents in the Fujian Province of China: A Cross-sectional Study. Medicine (Baltimore) 2016; 95:e2530. [PMID: 26844460 PMCID: PMC4748877 DOI: 10.1097/md.0000000000002530] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The relationship of bullying with suicidal ideation among adolescents is controversial. Although depression has been related to bullying and suicidal ideation, little is known about the combined impacts of depression and bullying on suicidal ideation.A sample of 20,509 high school students from Fujian Province were selected randomly by multistage stratified sampling. All participants completed an adolescent health status questionnaire. Three categories of bullying were assessed: perpetration, victimization, and both (victimization and perpetration). The associations of these 3 categories of bullying with depression and their interaction with suicidal ideation were examined in logistic models.After adjustment for potential confounders, all 3 categories of bullying (perpetration, victimization, and both) were related to increased risk of suicidal ideation with odds ratios (ORs) of 1.66 (95% confidence interval [CI] 1.20-2.30), 2.74 (95% CI 2.29-3.29), and 2.83 (95% CI 2.27-3.52), respectively. There was an interaction between depression and bullying (P = 0.001). Subgroup analyses showed a stronger association between perpetration and suicidal ideation in students with depression (odds ratio [OR] 2.97; 95% CI 1.44-6.09) than in those without depression (OR 1.65; 95% CI 1.19-2.28). The association between victimization and suicidal ideation was weaker in students with depression (OR 1.49; 95% CI 1.07-2.07) than in those without (OR 2.69; 95% CI 2.24-3.23). The association of both victimization and perpetration with suicidal ideation was weaker in students with depression (OR 2.22, 95% CI 1.43-3.47) than those without (OR 2.78; 95% CI 2.23-3.47).We observed an independent association of bullying with increased risk of suicidal ideation among adolescent students, and this association was affected by depression. Prospective studies should be conducted to confirm these findings.
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Affiliation(s)
- Lingyao Hong
- From the Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University (LH, LG, HW, PL, CL); Center for ADR monitoring of Guangdong (YX, XG, JD, GH, JH); and Epidemiology Research Unit, Clinical trials Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (LH)
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Yue Y, Hong L, Guo L, Gao X, Deng J, Huang J, Huang G, Lu C. Gender differences in the association between cigarette smoking, alcohol consumption and depressive symptoms: a cross-sectional study among Chinese adolescents. Sci Rep 2015; 5:17959. [PMID: 26639938 PMCID: PMC4671152 DOI: 10.1038/srep17959] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/09/2015] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to examine the association between cigarette smoking, alcohol consumption and depressive symptoms among adolescents, with a particular focus on gender differences. A total of 19,578 middle and high school students in Chongqing Province were surveyed. Self-reported cigarette smoking, alcohol consumption, depressive symptoms, and family- and school-related factors were assessed. A total of 8.8% adolescents reported smoking cigarettes. Tobacco use by boys (16.5%) was significantly higher than by girls (1.9%). Approximately 23.5% of adolescents reported alcohol consumption. Consumption in boys (31.5%) was significantly higher than in girls (16.2%). Depressive symptoms were prevalent in 9.1% of the sample. Girls reported significantly more symptoms (10.4%) than boys (7.7%). Multiple logistic regression analyses showed that the association between alcohol consumption and depressive symptoms was stronger among girls (AOR = 2.1, 95% CI = 1.8-2.5) than boys (AOR = 1.7, 95% CI = 1.4-2.1). A significant association (AOR = 2.3, 95% CI = 1.6-3.4) between cigarette smoking and depressive symptoms was revealed in girls only. The significant gender differences found above may provide a basis for the early identification of individuals at high risk for depression.
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Affiliation(s)
- Yue Yue
- School of Public Health, Sun Yat-sen University, Department of Medical Statistics and Epidemiology, Guangzhou, 510000, China
| | - Lingyao Hong
- School of Public Health, Sun Yat-sen University, Department of Medical Statistics and Epidemiology, Guangzhou, 510000, China
- The First Affiliated Hospital, Sun Yat-sen University, Epidemiology Research Unit, Clinical Trials Center, Guangzhou, 510000, China
| | - Lan Guo
- School of Public Health, Sun Yat-sen University, Department of Medical Statistics and Epidemiology, Guangzhou, 510000, China
| | - Xue Gao
- Centre for ADR Monitoring of Guangdong, Guangzhou, 510000, China
| | - Jianxiong Deng
- Centre for ADR Monitoring of Guangdong, Guangzhou, 510000, China
| | - Jinghui Huang
- Centre for ADR Monitoring of Guangdong, Guangzhou, 510000, China
| | - Guoliang Huang
- Centre for ADR Monitoring of Guangdong, Guangzhou, 510000, China
| | - Ciyong Lu
- School of Public Health, Sun Yat-sen University, Department of Medical Statistics and Epidemiology, Guangzhou, 510000, China
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Yang L, Jia CX, Qin P. Reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) among suicide attempters and comparison residents in rural China. BMC Psychiatry 2015; 15:76. [PMID: 25886490 PMCID: PMC4426543 DOI: 10.1186/s12888-015-0458-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is an important public health problem and is closely associated with suicidal behavior in the population. Although the Center for Epidemiologic Studies Depression Scale (CES-D) is widely used for assessment of depression, the psychometric characteristics of this scale have not been explored in studies of suicide attempters and local residents in rural areas. METHODS In this study, reliability and validity of CES-D were assessed in 409 suicide attempters and 409 comparison residents from rural China and through internal consistency analysis and confirmatory factor analysis (CFA). RESULTS Cronbach's alpha values of the CES-D were 0.940 and 0.895 in, respectively, suicide attempters and comparison residents. CES-D scores were significantly correlated with the scores of Trait Anxiety Inventory (TAI) and Beck Hopelessness Scale (BHS) in both the suicide attempters and the comparison residents. Confirmatory factor analyses indicated that 3-factor structure (positive affect, interpersonal problems, depressive mood and somatic symptoms combined) with 14 items (excluding items 9, 10, 13, 15, 17, and 19) had the best fit in these two populations. CONCLUSIONS The CES-D scale has satisfactory reliability and validity when used for assessing depression in suicide attempters and comparison residents in rural China.
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Affiliation(s)
- Li Yang
- Department of Epidemiology, Shandong University School of Public Health, Jinan, 250012, Shandong, China.
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan, 250012, Shandong, China. .,Shandong University Center for Suicide Prevention Research, Jinan, 250012, Shandong, China.
| | - Ping Qin
- Shandong University Center for Suicide Prevention Research, Jinan, 250012, Shandong, China. .,National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Tandoc EC, Ferrucci P, Duffy M. Facebook use, envy, and depression among college students: Is facebooking depressing? COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2014.10.053] [Citation(s) in RCA: 347] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Yen CF, Chou WJ, Liu TL, Yang P, Hu HF. The association of Internet addiction symptoms with anxiety, depression and self-esteem among adolescents with attention-deficit/hyperactivity disorder. Compr Psychiatry 2014; 55:1601-8. [PMID: 25015304 DOI: 10.1016/j.comppsych.2014.05.025] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 05/28/2014] [Accepted: 05/28/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The aims of this study were to examine the associations of the severity of Internet addiction symptoms with various dimensions of anxiety (physical anxiety symptoms, harm avoidance, social anxiety, and separation/panic) and depression symptoms (depressed affect, somatic symptoms, interpersonal problems, and positive affect) and self-esteem among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. METHOD A total of 287 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their severity of Internet addiction symptoms was assessed using the Chen Internet Addiction Scale. Anxiety and depression symptoms and self-esteem were assessed using the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T), the Center for Epidemiological Studies Depression Scale (CES-D), and the Rosenberg Self-Esteem Scale (RSES), respectively. The association between the severity of Internet addiction symptoms and anxiety and depression symptoms and self-esteem were examined using multiple regression analyses. RESULTS The results indicated that higher physical symptoms and lower harm avoidance scores on the MASC-T, higher somatic discomfort/retarded activity scores on the CES-D, and lower self-esteem scores on the RSES were significantly associated with more severe Internet addiction symptoms. CONCLUSIONS Prevention and intervention programs for Internet addiction in adolescents with ADHD should take anxiety, depression, and self-esteem into consideration.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center and College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pinchen Yang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huei-Fan Hu
- Department of Psychiatry, Tainan Municipal Hospital, Tainan, Taiwan.
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