Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity

Relationship between trait mindfulness and physical activity among emerging adults: The mediating roles of exercise-related cognitive errors and trait self-control

OBJECTIVE

Exercise-related cognitive errors (ECEs) is a significant factor that can negatively influence physical activity (PA) engagement among emerging adults, whereas mindfulness interventions may be beneficial for promoting PA. Against this background, we investigated the potential association between trait mindfulness and PA levels among emerging adults and determined whether trait self-control and ECEs serve as mediators.

METHOD

328 Chinese participants (61.3 % female, mean age = 20.65, SD = 2.21) completed a series of questionnaires, including demographics, the Five Dimension Mindfulness Questionnaire short form (FFMQ-SF), the Exercise Cognitive Bias Questionnaire (E-CEQ), the Brief Self Control Scale (BSCS), and the short form of the International Physical Activity Questionnaire (IPAQ-SF). A structural equation model was used to investigate the potential relationships between trait mindfulness and PA levels, considering trait self-control and ECEs as mediators.

RESULTS

Trait self-control (Indirect 1; B = 0.09, 95%CI: 0.04, 0.16) and ECEs (Indirect 3; B = 0.02, 95%CI: 0.00, 0.04) mediates the relationship between trait mindfulness and PA levels, respectively, when considered as independent mediators. In addition, also in a dual-mediation model ECEs and trait self-control (Indirect 2; B = 0.02, 95%CI [0.00, 0.06]) mediate the relationship between trait mindfulness and PA.

CONCLUSIONS

This study provides evidence that trait self-control and ECEs are mediators of the relationship between trait mindfulness and PA levels, providing a new direction for further research aiming to reduce ECEs and improve PA levels among emerging adults.

Protective and risk factors of anxiety in children and adolescents during COVID-19: A systematic review and three level meta-analysis

BACKGROUND

In order to gain a deepened understanding of the impact of public health emergency and to develop effective interventions and preventions, this study aimed to evaluate risk and protective factors associated with anxiety in children and adolescents and to explore potential moderators in the background of COVID-19 within the framework of socio-ecological model.

METHODS

A literature search was conducted in Web of Science, MEDLINE, PubMed, Scopus, EBSCO, ScienceDirect, Emerald, and CNKI for studies published from early 2020 to early 2023 that examined factors associated with anxiety among children and adolescents with age range of 6 to 17 years old. Random effects models and a three-level meta-analytic approach were used.

RESULTS

In total, 141 articles and 1,018,171 subjects were included, with 1002 effect sizes extracted. 32 protective factors and 48 risk factors were examined, yielding significance for 14 protective factors and 29 risk factors, including individual factors (e.g., gender, logOR = -0.37, 95 % CI [-0.47, -0.27], p < 0.001; age, logOR = -0.12, 95 % CI [-0.22, -0.02], p = 0.02; emotional functioning, logOR = -1.45, 95 % CI [-1.84, -1.05], p < 0.001; pre-existing condition logOR = 0.94, 95 % CI [0.58, 1.30], p < 0.001; electronic device or internet addiction, logOR = 1.81, 95 % CI [0.74, 2.88], p < 0.001), family factors (e.g., family socioeconomic status, logOR = -0.25, 95 % CI [-0.39, -0.10], p < 0.001; family functioning, logOR = -1.31, 95 % CI [-1.60, -1.02], p < 0.001; anxiety level of caregiver, logOR = 1.06, 95 % CI [0.75, 1.37], p < 0.001), community factors (e.g., overall social support, logOR = -0.93, 95 % CI [-1.84, -1.05], p < 0.001; school burden, logOR = 0.56, 95 % CI [0.21, 0.90], p = 0.002), and COVID-19-related factors (e.g., higher exposure risk in local community or city, logOR = 0.48, 95 % CI [0.17, 0.78], p = 0.002; distant learning, logOR = 0.73, 95 % CI [0.19, 1.28], p = 0.008; COVID-19-related distress, logOR = 1.42, 95 % CI [0.55, 2.29], p = 0.001;). The majority of studies showed no publication bias. Age group moderated the relationship between gender and level of anxiety (F (1,96) = 4.42, p = 0.038), and no other moderator showed significance.

LIMITATIONS

This study does not reveal causality but correlation in nature, and our findings should be interpretated with caution.

CONCLUSIONS

Public health emergencies could bring challenges to the mental health of children and adolescents. Prevention and intervention strategies for children and adolescents with high risks, and family-based and community-based programs should be encouraged to buffer the adverse impact on children and adolescents. This study has been prospectively registered at PROSPERO (registration number: CRD42022316746).

Prevalence of cardiovascular risk factors according to Life's Essential 8 in children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis including 1 526 173 participants from 42 countries

INTRODUCTION

Cardiovascular health is a crucial aspect of overall health. The aim of this study was to estimate the prevalence of cardiovascular risk factors among children and adolescents during the COVID-19 pandemic based on the Life's Essential 8 domains.

METHODS

PubMed, Scopus and Web of Science were systematically searched until 24 February 2023. Studies had to meet the following criteria: (1) observational studies, (2) studies reporting proportion of selected risk factors, (3) studies involving children or adolescents, (4) studies that collected data during the COVID-19 pandemic and (5) studies with representative samples. The outcomes included were diet, physical activity, nicotine exposure, sleep health, obesity, dyslipidaemia, diabetes and elevated blood pressure.

RESULTS

Sixty-two studies with 1 526 173 participants from 42 countries were included. Of these, 41 studies were used in the meta-analyses. The overall pooled prevalence of risk factors in the behavioural domain was as follows: poor quality diet 26.69% (95% CI 0.00%-85.64%), inadequate physical activity 70.81% (95% CI 64.41%-76.83%), nicotine exposure 9.24% (95% CI 5.53%-13.77%) and sleep disorders 33.49% (95% CI 25.24%-42.28%). The overall pooled prevalence of risk factors in the health domain was as follows: obesity 16.21% (95% CI 12.71%-20.04%), dyslipidaemia 1.87% (95% CI 1.73%-2.01%), diabetes 1.17% (95% CI 0.83%-1.58%) and elevated blood pressure 11.87% (95% CI 0.26%-36.50%).

CONCLUSIONS

These results highlight the need for prevention strategies to maintain better cardiovascular health from an early age, particularly by increasing physical activity levels, sleep time and promoting the consumption of more fruits and vegetables.

Changes in insomnia symptoms among compulsory education students in China after the "Double Reduction" policy: a two-wave longitudinal study

OBJECTIVE

In July 2021, the "Double Reduction" policy was introduced in China, aiming to alleviate the burden of excessive homework and off-campus tutoring for students in the compulsory education stage. The purpose of this study is to explore the changes in students' insomnia symptoms and related factors after the policy implementation. Meanwhile, sex differences were further examined.

METHODS

The baseline survey (T1) began in April 2021 (pre-policy), with a follow-up (T2) conducted in December 2021 (post-policy). A total of 28,398 students completed both T1 and T2 surveys and were included in this study. Insomnia symptoms were measured at both T1 and T2 using three questions from the Youth Self-Report Insomnia Scale. Demographics and anxiety and depressive symptoms were collected at T1, and policy-related indicators were assessed at T2.

RESULTS

The prevalence of insomnia symptoms showed a slight decrease after the "Double Reduction" policy (9.9% vs. 9.2%). After controlling for demographics and anxiety and depressive symptoms, reduced homework (OR: 0.75 [0.65-0.86]), more family time (OR: 0.50 [0.44-0.57]), and reduced academic pressure (OR: 0.77 [0.71-0.83]) post-policy were related to a lower risk of new-onset insomnia symptoms. Additionally, more family time (OR: 0.59 [0.49-0.72]) and reduced academic pressure (OR:0.70 [0.56-0.86]) were factors against persistent insomnia symptoms. There were no significant sex differences in the associations between policy-related indicators and insomnia symptoms.

CONCLUSIONS

The "Double Reduction" policy has somewhat improved the students' insomnia symptoms. Extending family time, and alleviating homework and academic burden are considered measures for maintaining sleep health in students.

Association of types of on-screen content with mental health problems among Chinese adolescents

Excessive screen time was associated with mental health problems, yet whether the associations differ by screen content types remain unknown. Here, we conducted a cross-sectional study of adolescents from 156 junior and high school to investigate the association of types of on-screen content with mental health problems in China. The exposure variable was screen exposure, measured by the self-reported questionnaire. Symptoms of depression and anxiety were assessed by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7), respectively. Suicide-related behavior was adapted from the Centers for Disease Control's Youth Risk Behavior Surveillance. Generalized linear models and network analysis were performed. Of the 15,194 adolescents included in the final analysis, 8,019 were males and mean (SD) age was 14.50 (1.68) years. 34.6% of adolescents had an average screen time of ≥ 4 h/day on weekends. The most frequently used screen contents (≥ 4 h/d) were electronic games (9.1%), followed by short video (6.6%). Learning online had strong associations with depression (OR = 2.03, 95%CI: 1.29-3.11, P = 0.002) and anxiety (OR = 2.05, 95%CI: 1.24-3.27, P = 0.004) symptoms. The associations between on-screen content and mental health varied. The strongest edges linked to screen content types were edge between "Electronic games" and "Anhedonia" in the network model. "Control worry" was the most central nodes, followed by "Irritable" and "Worry A Lot". Findings suggested that both screen time and different types of screen content were associated with mental health problems among adolescents. Limiting screen exposure and developing effective interventions to improve mental health should be a priority.

The association between moderate-to-vigorous physical activity and health-related quality of life in Chinese adolescents: the mediating roles of emotional intelligence and perceived stress

Introduction

Chinese adolescents are facing tremendous academic pressure and challenges brought about by changes in the social environment, which pose a serious threat to their health-related quality of life (HRQOL). This cross-sectional survey uses convenience and snowball sampling to explore the relationship between adolescents' HRQOL and their participation in moderate-to-vigorous physical activity (MVPA).

Methods

This study subjects include 440 adolescents aged 12 to 18, from four youth training centers and three schools in the central regions of Hunan, Hubei, and Henan provinces, chosen as representative samples for this study. We used AMOS v.26 to construct a structural equation model for data analysis and hypothesis testing.

Results

The results indicated that active participation in MVPA helps reduce adolescents' perceived stress and enhances their emotional intelligence and HRQOL levels. Specifically, MVPA weakens adolescents' perceived stress through the mediating role of emotional intelligence (coefficient = -0.148, p < 0.001), and perceived stress also mediates the relationship between emotional intelligence and HRQOL (coefficient = 0.165, p < 0.001). Furthermore, the positive impact of MVPA on HRQOL is mediated by emotional intelligence and perceived stress (coefficient = 0.363, p < 0.001). The explanatory power of this study is R 2 = 0.50.

Conclusion

The study results indicate that MVPA has a positive impact on the HRQOL levels of Chinese adolescents. Physical activity, especially moderate-to-vigorous intensity exercise, should be considered a strategic approach to maintaining HRQOL among adolescents. Society, schools, and families should create an environment conducive to physical exercise to support adolescents in engaging in physical activities and developing a healthy lifestyle.

Children's Nutrition, Eating Behavior, and Mental Health During the COVID-19 Pandemic

PURPOSE OF REVIEW

The purpose of the current review was to detail changes in children's diet, eating behavior, and weight in the context of the COVID-19 pandemic.

RECENT FINDINGS

Global changes in children's diets and eating behavior occurred during the pandemic. Both undernutrition and obesity were prominent concerns. Obese children and those from low socioeconomic status families were particularly vulnerable. The COVID-19 pandemic increased longstanding global concern about child nutrition, both undernutrition and obesity. The pandemic and extended home confinement were associated with changes in children's food consumption, eating behavior, and ultimately weight. These changes were related to factors beyond food intake itself and included decreased physical activity, altered routines and schedules, sleep behaviors, and social concerns, among others. The findings have implications for both public health and clinical practice.

Fairness, Trust, and Well-Being Among Young Adults: Evidence from 2021 Chinese General Social Survey (CGSS)

Background. As China has undergone tremendous socioeconomic and demographic changes during and after the pandemic, it is crucial to enhance youth well-being and facilitate their transition into the workforce. This study aims to explore the multi-dimensional features of well-being and examine their relationships with fairness and trust. Methods. Using the nationally representative data from the 2021 Chinese General Social Survey (CGSS), this study analyzes the well-being of 1726 young adults aged 18 to 34 years old living in 19 provinces in China. Results. The research findings generate five latent factors of well-being and reveal the multi-faceted nature of subjective well-being, including physical and mental health challenges, positive outlook, sense of purpose, personal growth, and self-fulfillment. Physical and mental health is the cornerstone for well-being and happiness. Young people with poor physical and mental health conditions are less likely to perceive that society is fair or that people are trustworthy. Additionally, a positive outlook and future orientation are strongly associated with high fairness and/or trust. Discussion and Conclusions. By investigating the differential domains of well-being, this study contributes to the literature with the new conceptualization of well-being sub-measures and their application to youth. Furthermore, this study identifies that well-being is not only an individual-level characteristic but also a group-level attribute that can contribute to fairness and trust at the societal level. As China continues to expand its infrastructure on education, health, and technology, it is expected that sustainable economic growth and development should boost young people's career development and promote their upward mobility.

A friend in need is a friend indeed: Acute tandem rope skipping enhances inter-brain synchrony of socially avoidant individuals

Team-based physical activity (PA) can improve social cognition; however, few studies have investigated the neurobiological mechanism underlying this benefit. Accordingly, a hyper-scanning protocol aimed to determine whether the interbrain synchrony (IBS) is influenced by an acute bout of team-based PA (i.e., tandem rope skipping). Specifically, we had socially avoidant participants (SOA, N=15 dyads) and their age-matched controls (CO, N=16 dyads) performed a computer-based cooperative task while EEG was recorded before and after two different experimental conditions (i.e., 30-min of team-based PA versus sitting). Phase locking value (PLV) was used to measure IBS. Results showed improved frontal gamma band IBS after the team-based PA compared to sitting when participants received successful feedback in the task (Mskipping = 0.016, Msittting = -0.009, p = 0.082, ηp2 = 0.387). The CO group showed a larger change in frontal and central gamma band IBS when provided failure feedback in the task (Mskipping = 0.017, Msittting = -0.009, p = 0.075, ηp2 = 0.313). Thus, results suggest that socially avoidant individuals may benefit from team-based PA via improved interbrain synchrony. Moreover, our findings deepen our understanding of the neurobiological mechanism by which team-based PA may improve social cognition among individuals with or without social avoidance.

Bridging the relationship between physical exercise and mental health in adolescents based on network analysis

Although physical exercise has been recommended as a useful means of enhancing the mental health of adolescents, the exact mechanisms through which physical exercise plays a role are unclear. Both physical exercise and mental health are complex concepts with multiple facets, and traditional methods may constrain the manifestations of their mapping relationships. This research aimed to find the bridging connections between physical exercise and mental health. Mental health and physical exercise behaviors were assessed using the Symptom Checklist 90 (SCL-90) and the Adolescent Physical Activity Questionnaire (PAQ-A) in 9072 Chinese adolescents, respectively. Network analysis was utilized to construct the mental health-physical exercise network and to analyze the relationships between individual physical exercise behaviors and mental health symptoms. Core and bridging nodes were identified based on expected influence (EI) and bridge expected influence (BEI). Gender differences were also examined. The results revealed specific and distinct pathways between physical exercise and mental health (e.g., winter sports-obsessive-compulsive symptoms, winter sports-phobia). For both males and females, anxiety, depression, interpersonal sensitivity, ball sports, and evening activity were the most central symptoms/behaviors, reflecting their relative significance in their respective associations. The nodes with the highest BEI were obsessive-compulsive symptoms and physical education, showing negative associations with nodes in the other community. Furthermore, in the male group, somatization and winter sports stood out as the most positive bridge nodes. Conversely, in the female group, interpersonal sensitivity and sports games were the most positive bridge nodes. These findings illuminate the pathways linking physical exercise and mental health, supporting the implementation of physical exercise in a more elaborate way.

The mediating effect of resilience between physical activity and mental health: a meta-analytic structural equation modeling approach

Background

While the correlation between physical activity (PA) and mental health is well known, the mediating mechanism of resilience between the two variables remains unclear.

Objectives

To systematically evaluate the relationship between PA and mental health, and explore the mediating role of resilience between them.

Methods

A systematic search of electronic databases (PubMed, Web of Science, ProQuest, Ebsco, China Knowledge, and China Biomedical Database) was conducted to identify relevant studies, and meta-analytic procedures were used to assess the strength of the relationships between PA and mental health. Furthermore, a meta-analytic structural equation model (MASEM) was used to assess the mediating effects of resilience, ensuring the reliability of our findings.

Results

The findings of 15 studies (17,043 subjects) were subjected to meta-analysis and route analysis. The findings of the meta-analysis revealed a statistically significant positive correlation of 0.288 (95% CI, 0.166-0.402) between PA and positive indicators of mental health, as well as a statistically significant negative correlation (95% CI, -0.342 to -0.171) with negative indicators of mental health. Furthermore, the results of MASEM path analysis indicated that PA may indirectly impact both positive and negative indicators of mental health through the mediating factor of resilience. The indirect effect values were 0.108 (95% CI, 0.080-0.141) and -0.074 (95% CI, -0.100 to -0.051), respectively, accounting for 40.15% of the total effect value and 28.91%.

Conclusion

Physical activity is positively correlated with positive indicators of mental health and negatively correlated with negative indicators of mental health. Moreover, PA can positively influence mental health through the mediating role of resilience.

A cross-sectional study of the association between physical activity and depressive symptoms among adolescents in southwest China stratified by parental absence: the mediating role of insomnia and the moderating role of resilience

OBJECTIVES

This study explored the mechanisms by which physical activity was associated with depressive symptoms in multi-ethnic (Han, Yi and Tibetan) adolescents in southwest China. The mediating role of insomnia in the association of physical activity with depressive symptoms, the moderating role of resilience in this mediation model and the moderating role of parental absence in the moderated mediation model were also examined.

DESIGN

A cross-sectional survey.

SETTING

In southwest China (Sichuan Province and Tibet Autonomous Region).

PARTICIPANTS

3195 adolescents from a school-based survey conducted between April and October 2020.

METHODS

There were 3143 valid samples in this study (47.2% males with mean age=12.88±1.68 years). Structural equation models were developed to estimate the direct and mediating effect, and the moderating effect. Multigroup comparison was performed to examine the differences and similarities of the moderated mediation model across three parental absence subgroups: (1) both parents present, (2) one parent absent and (3) both parents absent.

RESULTS

As hypothesised, physical activity was significantly and positively associated with the reduction of depressive symptoms in adolescents. Insomnia partially mediated the effect of physical activity on depressive symptoms. In addition, resilience moderated the direct and indirect effects of physical activity (through insomnia) on depressive symptoms. Finally, the multigroup comparison indicated the moderating effect of parental absence on the moderated mediation model.

CONCLUSIONS

Physical activity was associated with alleviating insomnia symptoms among adolescents, thus correlating with the improvement of their depressive symptoms. Resilience was associated with enhancing the beneficial effects of physical activity, further improving depressive symptoms among adolescents, especially those with both absent parents. It is evident that physical activity interventions should be further incorporated into public health programmes to foster the physical and mental health of left-behind adolescents in southwest China.

Care Competencies Training Enhances Adolescents' Well-being: A Randomized Controlled Trial

Objective: This intervention study seeks to assess the impact of a care competencies training program on students' well-being. Method: This randomized controlled trial involved 191 Vietnamese adolescents (65.4% female, Mage = 16 years and 8 months) in a 7-week intervention study that used video vignettes to build their care competencies. Validated scales were used to determine their care competencies (Care Competencies Questionnaire for Adolescents) and well-being (Strengths and Difficulties Questionnaire, Perceived Stress Scale and Satisfaction with Life Scale) at three points in time: before, immediately after, and two months after the intervention. The full-information maximum likelihood approach was applied to latent growth curve modeling (LGM) in Mplus 8.5 to estimate the initial level (i.e., intercept) and the change (i.e., slope) in care competencies and well-being among adolescents over time. Factor scores of LGMs were saved for correlation and multiple linear regression analysis by using SPSS (version 26.0) to explore the relationships between the changes in care competencies/failures and the changes in well-being. Results: Results showed that, next to a significant increase in care competencies and a significant decrease in care failures, other well-being variables also significantly changed in the intervention group. In the intervention group, but not in the control group, changes in care competencies and failures consistently and significantly predicted changes in well-being. Conclusion: The results support the potential of the video vignette-based intervention to promote the development of adolescents' care competencies.

The long-term effects of perceived instructional leadership on teachers' psychological well-being during COVID-19

The COVID-19 outbreak led to widespread school closures and the shift to remote teaching, potentially resulting in lasting negative impacts on teachers' psychological well-being due to increased workloads and a perceived lack of administrative support. Despite the significance of these challenges, few studies have delved into the long-term effects of perceived instructional leadership on teachers' psychological health. To bridge this research gap, we utilized longitudinal data from 927 primary and secondary school teachers surveyed in two phases: Time 1 in mid-November 2021 and Time 2 in early January 2022. Using hierarchical linear modeling (HLM), our findings revealed that perceptions of instructional leadership, especially the "perceived school neglect of teaching autonomy" at Time 1 were positively correlated with burnout levels at Time 2. Additionally, burnout at Time 2 was positively associated with psychological distress and acted as a mediator between the "perceived school neglect of teaching autonomy" and psychological distress. In light of these findings, we recommend that schools prioritize teachers' teaching autonomy and take proactive measures to mitigate burnout and psychological distress, aiming for the sustainable well-being of both teachers and students in the post-pandemic era.

Self-Compassion as a Mediator Linking Sleep Disturbances with Non-Suicidal Self-Injury: A Four-Wave, Cross-Lagged Study

Objective

This longitudinal study examined the reciprocal relationship between sleep disturbances with non-suicidal self-injury and whether self-compassion mediates these associations.

Methods

A total of 5785 freshmen were sampled from a large-scale health-related cohort among Chinese college students at the baseline. This study spanned six waves with a six-month interval between each wave. Data from the last four waves were used because self-compassion or non-suicidal self-injury was not measured in the first two waves. The cross-lagged panel models were used to examine the longitudinal dynamic relationships between sleep disturbances, self-compassion, and non-suicidal self-injury.

Results

The results showed that all the auto-regressive paths were significant. For the cross-lagged paths, there was a reciprocal relation between sleep disturbances and self-compassion. Importantly, self-compassion played a longitudinal mediating role in the prediction from sleep disturbances to non-suicidal self-injury (indirect effect = 0.007 to 0.009, all p values < 0.001).

Conclusion

Psychological interventions targeting improved sleep quality and self-compassion may hold great promise for reducing the incidence of non-suicidal self-injury.

Associations of 24-hour movement guidelines adherence with fruit and vegetable intake in university students

Background

Unhealthy eating habits, such as low vegetable and fruit intake, are associated with many health problems. 24-h movement behaviors have been reported to be positively associated with numerous health-related outcomes. Despite the importance of these two modifiable lifestyle behaviors in building healthy habits in university students, there is a paucity of relevant research in this population. Therefore, this study aims to examine the correlation between compliance with 24-h movement guideline (24-h MG) and intake of fruits and vegetables (IFV) in Chinese university students.

Methods

This study investigated the relationship between the compliance with 24-h MG and IFV in 1,793 Chinese university students using a convenience sampling method online. Physical activity (PA) and sedentary behavior (SB) were assessed by the International Physical Activity Questionnaire-Short Form, while sleep was measured using the Pittsburgh Sleep Quality Index. The Chinese version of the Health Promoting Lifestyle Profile II was used to measure IFV. Generalized linear models were applied to examine the correlation between compliance with the 24-h MG and eating habits.

Results

The proportion of participants who routinely consumed vegetables and fruits was 24.6% and 43.1%, respectively, while the proportion of meeting the three 24-h MG and a combination of any two guidelines was 27.8% and 40.1%, respectively. Meeting all three guidelines was associated with a greater IFV intake compared to not meeting either guideline. Meeting all three guidelines (OR = 2.42 [1.63, 3.58]) and the combination of moderate to vigorous PA (MVPA) and sleep (OR = 2.06 [1.37, 3.10]) were positively associated with the frequency of vegetable consumption (p < 0.05). As well, meeting all three guidelines (OR = 2.06 [1.37, 3.10]), the combination of MVPA and sleep (OR = 1.72 [1.04, 2.84]), and sleep only (OR = 1.88 [1.21, 2.92]) were positively associated with fruits consumption (p < 0.05).

Conclusion

Almost a third of the university students met the three 24-h MG, and compliance with all three guidelines was associated with a higher frequency of IFV. Furthermore, meeting the sleep guideline alone or in conjunction with the PA, and meeting the entire 24-h MG was associated with greater consumption of fruits.

Improvements in stress among Latinas participating in a randomized controlled trial of technology-supported physical activity interventions

High levels of stress and inactivity likely contribute to chronic disease disparities among Latinas in the U.S. and call for intervention. To inform such efforts, the current study examined the relationships among changes (over time) in physical activity, stress, and related cardiometabolic biomarkers among sedentary (mostly) first generation Latinas. Data are taken from a randomized controlled trial (N = 199 Latinas) of two home-based physical activity interventions (Original vs. theory- and technology- Enhanced versions). Physical activity and perceived stress were assessed at baseline and 6 and 12 months. Blood draws occurred at baseline and 6 months in a random subsample (N = 153). The participants were underactive (<60/min week of moderate-to-vigorous physical activity) Mexican American (89%) women with moderate perceived stress scores (M = 21.49, SD = 8.55, range = 0-40) and excess weight (M BMI = 30.6) at baseline. Overall, participants reported decreases in stress after 6 months enroled in the physical activity programs. The odds of a reduction in perceived stress were 11% higher among Enhanced versus Original Intervention participants (OR = 1.11, 95% CI: 1.05-2.27). Those who met physical activity guidelines were significantly more likely to report reductions in perceived stress over 6 months (OR = 1.92, 95% CI: 1.08-4.16). Furthermore, those who reported reductions in perceived stress over 6 months reported significantly more moderate-to-vigorous physical activity at 12 months (+69 min/week, SE = 27.98, p = 0.01) compared to those who did not. Greater reductions in perceived stress over 6 months were associated with greater improvements in cardiometabolic biomarkers (HbA1c, triglycerides, p's < 0.05). These results support a bidirectional relationship between improvements in stress and physical activity among Latinas. Future implications include using physical activity to address stress management and health disparities in this community.

Longitudinal Associations between Healthy Eating Habits, Resilience, Insomnia, and Internet Addiction in Chinese College Students: A Cross-Lagged Panel Analysis

This study aimed to explore the longitudinal associations between healthy eating habits, resilience, insomnia, and Internet addiction by using a cross-lagged panel analysis of Chinese college students. Overall, 807 Chinese college students completed questionnaires on healthy eating habits, resilience, insomnia, and Internet addiction from August 2020 (time 1, T1) to November 2020 (time 2, T2), and were selected for the data analyses. Healthy eating habits (T1) had significant effects on resilience (T2; β = 0.064, p < 0.05) and insomnia (T2; β = -0.064, p < 0.05), but not Internet addiction (T2; β = -0.028, p > 0.05). Insomnia (T1) negatively predicted resilience (T2; β = -0.098, p < 0.01). Insomnia was bidirectionally associated with Internet addiction (Internet addiction at T1 to insomnia at T2: β = 0.085, p < 0.01; insomnia at T1 to Internet addiction at T2: β = 0.070, p < 0.05). Additionally, Internet addiction (T1) significantly predicted resilience (T2; β = -0.075, p < 0.05). This study further expanded the understanding of the longitudinal associations between healthy eating habits, resilience, insomnia, and Internet addiction, which provided higher-level evidence and important implications for the interventions for reducing college students' Internet addiction, developing healthy eating habits, and improving resilience and sleep health.

Life changes and symptoms of depression and anxiety among Chinese children and adolescents before, during, and after the COVID-19 pandemic lockdown: a combination of cross-sectional, longitudinal, and clustering studies

The measures to prevent COVID-19 pandemic had caused significant life changes, which may have caused stress on the mental health of children and adolescents. We aimed to evaluate the short- and long-term effects of life changes on children's mental health in a large Chinese cohort. Survey-based life changes during COVID-19 lockdown were measured among 7,829 Chinese students at Grade 1-9, including social contacts, lifestyles and family financial status. Clustering analysis was applied to identify potential patterns of these changes. Depressive and anxiety symptoms were measured using the Center for Epidemiologic Studies Depression Scale and Screen for Child Anxiety Related Emotional Disorders. Logistic regression models were used to investigate the associations between these changes, their patterns and the presence of depression/anxiety symptoms using both cross-sectional and longitudinal designs. We found that the prevalence of depression and anxiety symptoms decreased during pandemic (34.6-32.6%). However, during and shortly after lockdown, students who reported negative impacts on their study, social and outside activities, and diet had increased risks of depressive/anxiety symptoms. Decreased electronic time and sugar-sweetened consumption, as well as family income decline and unemployment, were also associated with higher risks of these symptoms. Additionally, students with changed sleep time had increased depressive symptoms. These associations attenuated or disappeared one year later. Similar patterns were observed in clustering analysis, while only the group with severe impact on family financial status showed a sustained increase in depression symptoms. In summary, restrictive measures that changed children and adolescents' daily life during COVID-19 lockdown showed negative effects on their mental health, with some commonalities and distinctions patterns in the manifestation of depression and anxiety symptoms.

Association between Active Commuting and Lifestyle Parameters with Mental Health Problems in Chilean Children and Adolescent

BACKGROUND

Little is known about the association between active commuting (i.e., walking or cycling to school) with lifestyle parameters and mental health in youths. The objective of the present study was to investigate the association between mental health problems and symptoms of depression, anxiety, and stress with lifestyle (i.e., food habits, screen time, physical activity, and sleep quality), active commuting, and gender.

METHODS

A total of 511 children and adolescents (boys, n = 249; girls, n = 262) aged 10 to 17 years participated in the study. Lifestyle parameters and mental health were evaluated using the Depression Anxiety and Stress Scale (DASS-21).

RESULTS

Girls reported higher levels of anxiety (p = 0.001), depression (p = 0.001), and stress (p = 0.001). Mental health problems showed a positive association with gender (girls, β = 3.06, p < 0.001) and a negative association with food habits (β = -0.65, p = 0.019). Anxiety was positively associated with gender (β = 7.88, p < 0.001) and negatively associated with food habits (β = -0.23, p = 0.019). Gender (girls) and food habits were also associated with symptoms of depression (β = 2.29, p < 0.001 and β = -0.27, p = 0.005, respectively). Finally, active commuting was inversely associated with stress (β = -1.24, p = 0.008), and stress was positively linked to gender (β = 2.53, p < 0.001).

CONCLUSIONS

Active commuting, lifestyle parameters, and gender were associated with mental health in children and adolescents. Moreover, girls reported higher levels of anxiety, symptoms of depression, and stress.

The effects of occupational disruption during COVID-19 lockdowns on health: a cross-sectional study

The disruption in daily activity performance during COVID-19 lockdowns is widely understood to have impacted health, but a better understanding of how restricted performance of specific activities are associated with health is needed. This cross-sectional study answers the following question: How were changes in the performance of 16 daily activities associated with health during COVID-19 lockdowns? A total of 116 participants completed an online survey rating their health before and during COVID-19 lockdowns and comparing their recollection of the performance of 16 activities before COVID-19 with their performance during lockdowns. Multiple stepwise linear regression analysis was used to estimate the relationship between self-reported changes in activities during lockdowns and concurrent (during-lockdown) health status, while controlling for pre-COVID-19 health status. Only changes in activities that were uniquely and significantly associated with lockdown health status were retained in the final model. Health before COVID-19 accounted for 3.7% (P = 0.039) of the variance in health during COVID-19 lockdowns. After controlling for health before COVID-19, five types of activity were significantly and uniquely predictive of health during lockdowns, together accounting for 48.3% of the variance. These activities and the variances they accounted for were rest and sleep (29.5%, P < 0.001), play and recreational activities (8%, P < 0.001), work (4.8%, P = 0.002), personal hygiene (3.2%, P = 0.01), and healthy eating (2.8%, P = 0.013). The study suggests that these five types of activity should be prioritized in policy or interventions when participation in activity is constrained by lockdowns or comparable factors.

The relationship between physical activity and anxiety in college students: exploring the mediating role of lifestyle habits and dietary nutrition

Background

Physical activity has been shown to be effective in treating and improving anxiety in college students. However, no studies have been conducted to examine the relationship between physical activity and anxiety in college students through mediating factors such as dietary nutrition and lifestyle habits. Therefore, the aim of this study was to examine the mediating role of lifestyle and dietary nutrition in the relationship between physical activity and anxiety.

Methods

This study used a stratified random sampling method to survey 498 college students from three universities in Fujian, China. Data on participants' demographic characteristics, physical activity, lifestyle habits, and dietary nutrition were collected and analyzed using SPSS software. The proposed structural equation model was analyzed using Amos software.

Results

The results of the study showed that dietary nutrition and lifestyle habits had significant independent mediating effects and continuous multiple mediating effects (p < 0.01) in the effects of physical activity on college students' anxiety. Dietary nutrition and lifestyle habits played an independent mediating role, accounting for 24.9% of the total effect; there was also a continuous multiple mediating effect between dietary nutrition and lifestyle habits, accounting for 13.27% of the total effect value. In addition, physical activity had a direct effect value on anxiety in college students, accounting for 36.93% of the total effect value.

Conclusion

By increasing the behavior and awareness of college students to participate in physical activity, supplemented by guiding them to develop regular lifestyle habits and correct dietary nutritional patterns, the anxiety level of college students can be effectively improved and reduced. This type of regulation is an important reference for the self-management and rehabilitation of college students with anxiety disorders. Future studies can experimentally develop a combined intervention of physical activity, lifestyle habits, and dietary nutritional to help college students better cope with anxiety.

The effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the Covid-19 pandemic: A randomized controlled study

TOPIC

Adolescence is the period when people adopt healthy lifestyle behaviors and turn them into habits. Healthy lifestyle behaviors are a significant step toward a long and healthy life.

PURPOSE

This study investigated the effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the COVID-19 pandemic.

METHODS

This randomized controlled study was conducted between May and July 2021. The sample consisted of 100 adolescents living in a city in the south of Turkey. Participants were randomized into intervention and control groups using block randomization. The intervention group participated in an online (Zoom) training program consisting of two 45 min sessions once a week for 8 weeks. Data were collected using the adolescent stress questionnaire (ASQ) and the adolescent lifestyle profile (ALP).

RESULTS

The results showed that 73% (n: 73) of the participants had developed hygiene habits since the onset of the pandemic. However, the pandemic negatively affected participants' dietary habits (45%, n: 45), physical activity (70%, n: 70), coping mechanisms (68%, n: 68), sleep patterns (54%, n: 54), Internet/social media/video game addiction (64%, n: 64), and interpersonal relationships (57%, n: 57). The intervention group had a lower mean ASQ posttest score and a higher mean ALP posttest score than the control group. The intervention group had a lower mean ASQ posttest score than their pretest score. The intervention group also had a higher mean ALP posttest score than their pretest score.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The training program helped adolescents feel less stress and adopt more healthy lifestyle behaviors. Pediatric nurses should identify risk factors and design and implement appropriate plans to help adolescents go through future pandemics with as little damage as possible. Parents and educators should support adolescents against the adverse impacts of events such as the COVID 19 pandemic.

The relationship between health-promoting behaviors and negative emotions in college freshmen: a cross-lagged analysis

Background

The prevalence of mental health issues has been gradually increasing among college students in recent years. Improvements in mental health can be achieved through changes in daily behavior and the use of psychological counseling. This study aims to investigate the relationship between health-promoting behaviors and negative emotions among college freshmen as they enter the university. It also examines the impact of various sub-dimensions of health-promoting behaviors and other factors on the negative emotions (stress, anxiety, and depression) experienced by college freshmen.

Methods

Using the Negative Emotion and Health-Promoting Behavior scales, a 7-month longitudinal study was conducted on 4,252 college freshmen, with collection of data at two time points (T1: November 12, 2021; T2: June 17, 2022). Out of this longitudinal study, 3,632 valid samples were obtained. This research aimed to explore the association and impact between negative emotions and the level of health-promoting behaviors among college students during their time at the university.

Results

① There were significant differences in the levels of health-promoting behaviors and negative emotions over the course of 7 months (P < 0.05). Health-promoting behaviors were found to have a significant negative correlation with negative emotions (P < 0.05). ② Negative emotions at T1 significantly negatively predicted health-promoting behaviors at T2 (β = -0.11, P < 0.01), while health-promoting behaviors at T1 significantly negatively predicted negative emotions at T2 (β = -0.12, P < 0.001). ③ Stress management (β = -0.104, P < 0.05; β = -0.087, P < 0.05), self-actualization (β = -0.282, P < 0.01; β = -0.260, P < 0.05), health responsibility (β = -0.057, P < 0.05; β = -0.088, P < 0.05), and interpersonal relations (β = 0.068, P < 0.01; β = 0.138, P < 0.05) were important components in improving stress and anxiety. Self-actualization (β = -0.437, P < 0.001), exercise (β = 0.048, P < 0.001), nutrition (β = 0.044, P < 0.001), and interpersonal relations (β = 0.065, P < 0.001) were important components in improving depression. ④ Gender, place of household registration, and whether the individual is the only child were significant factors affecting negative emotions in college freshmen.

Conclusion

The level of health-promoting behaviors is an important indicator for assessing the negative emotional states of college freshmen. Enhancing health-promoting behaviors across various dimensions can help alleviate different types of negative emotions. Gender, place of household registration, and being the only child are significant factors that influence negative emotions.

Mental health dynamics of adolescents: A one-year longitudinal study in Harari, eastern Ethiopia

AIMS

This study aims to assess the dynamics of in-school adolescents' mental health problems in Harari regional state, eastern Ethiopia for a year.

MATERIALS AND METHODS

Using multistage sampling technique, we conducted a year-long longitudinal study at three public high schools between March 2020 and 2021. Three hundred fifty-eight in-school adolescents were chosen by systematic random sampling for the baseline assessment, and 328 completed the follow-up assessment. We used self-administered, adolescent version of SDQ-25 Questionnaire to collect the data. Wilcoxon matched-pairs signed-rank test and McNemara's Chi-squared tests were used to examine the median difference and distribution of mental health problems between times one and two. Random-effects logistic regressions on panel data was used to identify factors associated with mental health problems. A p-value < 0.05 was considered as statistically significant.

RESULTS

The magnitude of overall mental health problems at baseline assessment was 20.11% (95% CI: 16-25), with internalizing problems accounting for 27.14% (95% CI: 23-32) and externalizing problems accounting for 7.01% (95% CI: 4.6-10.3). At the follow-up assessment, these proportions rose to 22.56% (95% CI, 18-27) for overall problems and 10.3% (95% CI, 7.7-14.45) for externalizing problems. On other hand, internalizing problems decreased unexpectedly to 22.86% (95% CI, 18.6-27.7) at follow-up assessment. Internalizing problem scores at time two were significantly lower than baseline among older adolescents, girls and those with average wealth index in our study cohort.

CONCLUSIONS

The prevalence of mental health problems were high among the study cohort. The proportion of overall problems and externalizing problems has increased over time, indicating a deterioration in the mental health of the study cohort. However, the decrease in internalizing problems among older adolescents, girls, and those with an average wealth index is a positive sign. The findings highlight that tailored interventions are required to reduce externalizing problems and maintain the decrease in internalizing problems. These interventions should target middle-aged and male adolescents from low-income families.

Strength and resilience of developing brain circuits predict adolescent emotional and stress responses during the COVID-19 pandemic

The COVID-19 pandemic has had profound but incompletely understood adverse effects on youth. To elucidate the role of brain circuits in how adolescents responded to the pandemic's stressors, we investigated their prepandemic organization as a predictor of mental/emotional health in the first ~15 months of the pandemic. We analyzed resting-state networks from n = 2,641 adolescents [median age (interquartile range) = 144.0 (13.0) months, 47.7% females] in the Adolescent Brain Cognitive Development study, and longitudinal assessments of mental health, stress, sadness, and positive affect, collected every 2 to 3 months from May 2020 to May 2021. Topological resilience and/or network strength predicted overall mental health, stress and sadness (but not positive affect), at multiple time points, but primarily in December 2020 and May 2021. Higher resilience of the salience network predicted better mental health in December 2020 (β = 0.19, 95% CI = [0.06, 0.31], P = 0.01). Lower connectivity of left salience, reward, limbic, and prefrontal cortex and its thalamic, striatal, amygdala connections, predicted higher stress (β = -0.46 to -0.20, CI = [-0.72, -0.07], P < 0.03). Lower bilateral robustness (higher fragility) and/or connectivity of these networks predicted higher sadness in December 2020 and May 2021 (β = -0.514 to -0.19, CI = [-0.81, -0.05], P < 0.04). These findings suggest that the organization of brain circuits may have played a critical role in adolescent stress and mental/emotional health during the pandemic.

Effectiveness of Mindfulness-Based Stress Reduction on Mental Health and Psychological Quality of Life among University Students: A GRADE-Assessed Systematic Review

Background

Psychological distress is a progressive health problem that has been linked to decreased quality of life among university students. This meta-analysis reviews existing randomized controlled trials (RCTs) that have examined the effects of mindfulness-based stress reduction (MBSR) on the relief of psychosomatic stress-related outcomes and quality of life among university students.

Methods

The PubMed, EMBASE, Web of Science, PsycINFO (formerly PsychLit), Ovid MEDLINE, ERIC, Scopus, Google Scholar, ProQuest, and Cochrane Library databases were searched in November 2023 to identify the RCTs for analysis. Data on pathology (anxiety, depression, and perceived stress), physical capacity (sleep quality and physical health), and well-being (mindfulness, self-kindness, social function, and subjective well-being) were analyzed.

Results

Of the 276 articles retrieved, 29 met the inclusion criteria. Compared with control therapies, the pooled results suggested that MBSR had significant effects, reducing anxiety (SMD = -0.29; 95% CI: -0.49 to -0.09), depression (SMD = -0.32; 95% CI: -0.62 to -0.02), and perceived stress (SMD = -0.41; 95% CI: -0.60 to -0.29) and improving mindfulness (SMD = 0.34; 95% CI: 0.08 to 0.59), self-kindness (SMD = 0.57; 95% CI: 0.30 to 1.12), and physical health (SMD = -0.59; 95% CI: -1.14 to -0.04). No significant differences were observed in sleep quality (SMD = -0.20; 95% CI: -0.06 to 0.20), social function (SMD = -0.71; 95% CI: -2.40 to 0.97), or subjective well-being (SMD = 0.07; 95% CI: -0.18 to 0.32). The quality of the evidence regarding sleep quality and physical health outcomes was low.

Conclusions

MBSR therapy appears to be potentially useful in relieving functional emotional disorders. However, additional evidence-based large-sample trials are required to definitively determine the forms of mindfulness-based therapy that may be effective in this context and ensure that the benefits obtained are ongoing. Future studies should investigate more personalized approaches involving interventions that are tailored to various barriers and students' clinical characteristics. To optimize the effects of such interventions, they should be developed and evaluated using various designs such as the multiphase optimization strategy, which allows for the identification and tailoring of the most valuable intervention components.

Physical activity, recreational screen time, and depressive symptoms among Chinese children and adolescents: a three-wave cross-lagged study during the COVID-19 pandemic

BACKGROUND

Longitudinal evidence is lacking on the interplay between lifestyle behaviors and depressive symptoms, especially in the context of the COVID-19 pandemic. This study investigated the changes in physical activity and recreational screen time during the pandemic, along with their reciprocal associations with depressive symptoms among children and adolescents.

METHODS

The public health emergency due to the pandemic started in January 2023 and lasted for two months in Shanghai, China. A three-wave longitudinal study was conducted among 1,666 children and adolescents (6-18 years) in January, March, and July 2023. Moderate-to-vigorous intensity physical activity (MVPA), recreational screen time, and depressive symptoms were measured using self-reported questionnaires. Random-intercept cross-lagged panel models were constructed to examine the bidirectional associations between physical activity and recreational screen time with depressive symptoms.

RESULTS

Children and adolescents experienced a significant decrease in MVPA and a substantial increase in recreational screen time during the pandemic, which failed to return to pre-pandemic levels post-pandemic. Pre-pandemic MVPA was negatively associated with subsequent depressive symptoms (β = -0.147). Conversely, pre-pandemic depressive symptoms were positively associated with subsequent recreational screen time (β = 0.085), which in turn predicted heightened post-pandemic depressive symptoms (β = 0.076). When stratified by age, significant associations were found in adolescents but not children.

CONCLUSIONS

Sustained unhealthy changes in physical activity and recreational screen time were observed during the COVID-19 pandemic among children and adolescents. This study elucidates a potential reciprocal relationship between lifestyle behaviors and mental well-being. Effective interventions are emphasized to counter the negative impacts of insufficient physical activity and excessive screen use on the mental health of children and adolescents.

Physical activity and mental health in school-aged children: a prospective two-wave study during the easing of the COVID-19 restrictions

BACKGROUND

Because physical activity (PA) has many benefits for children's and adolescents' mental health, it has been suggested that PA may be an effective strategy to physically and mentally recover from the COVID-19 pandemic. This study tested the reciprocal relationship between PA and mental health during the easing of COVID-19 restrictions. It was hypothesized that mental health during the pandemic would determine how much children and adolescents re-engage in PA after easing the restrictions. Furthermore, it was hypothesized that PA engagement would predict mental health improvement after the pandemic.

METHODS

This was a prospective study with two measurement occasions. Pretest data collection was undertaken in February 2022, shortly before German authorities eased and lifted the COVID-19 restrictions. The follow-up (posttest) occurred six weeks later (April 2022). Both times, a sample of elementary and grammar school students aged 6 to 18 years (N = 170) reported their mental health problems and health-related quality of life. Mental health problems were assessed with the Strengths and Difficulties Questionnaire and health-related quality of life was assessed with the KIDSCREEN-52 questionnaire. PA was measured continuously during the study period using smart electronic devices with a built-in pedometer.

RESULTS

PA gradually increased after the easing of COVID-19 restrictions (p < .001). This increase was unrelated to pretest mental health problems and health-related quality of life except for emotional symptoms (p = .041). Participants with higher emotional symptoms showed a sharper increase in PA towards the end of the study period. Furthermore, hyperactivity decreased (p = .004) and physical well-being (p = .004), perceived autonomy (p < .001), and perceived quality of school environment (p = .008) improved from before to after the easing of restrictions, yet participants' PA predicted none of these changes.

CONCLUSIONS

The adverse effects of COVID-19 containment on PA seem to alleviate after children and adolescents are allowed to return to schools. This is likely to be due to the school setting, which provides many different opportunities for formal and informal PA rather than students' mental health. School-related PA programs should be part of children's and adolescents' recovery from the pandemic .

Psychometric properties of the Youth Self-rated Insomnia Scale (YSIS) in adolescent psychiatric patients

The 8-item Youth Self-rated Insomnia Scale (YSIS) was developed to assess insomnia severity in the past month among youths. The YSIS has satisfactory psychometric properties in the general adolescent population. This study examined psychometric properties of the YSIS in a large sample of adolescent psychiatric patients. A total of 536 patients aged 10-19 years were consecutively recruited from the outpatient department of Shandong Mental Health Center between December 2021 and March 2022. Patients completed a structured questionnaire consisting of the YSIS scale and questions about sleep duration, nightmares, psychiatric history, depression, psychiatric and sleep medications, and demographics. Patients were diagnosed following the ICD-10 criteria. Of the participants, the mean age was 15.30 years (SD = 1.95), 61.0% were female, 60.9% were diagnosed with mood disorders, 65.7% were on antidepressants, and 49.0% were on anxiolytics or hypnotics. The mean YSIS score was 22.6 (SD = 8.07). Coefficient omega was 0.84. Exploratory factor analysis revealed one factor and two correlated residuals. The YSIS scores were significantly correlated with depression scores (r = 0.68) and significantly increased with sleep onset latency, short sleep duration, nightmare frequency, and sleep medication use. The YSIS demonstrated satisfactory internal consistency reliability, construct validity, and criteria-related validity in adolescent psychiatric patients. The YSIS appears to be a reliable and valid scale for measuring insomnia severity in adolescent psychiatric patients.

Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students

BACKGROUND

The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic.

METHODS

A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro.

RESULTS

FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA.

CONCLUSIONS

The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.

Exploring symptom-level associations between anxiety and depression across developmental stages of adolescence: a network analysis approach

BACKGROUND

Anxiety and depression often co-occur during adolescence, but the associations between symptoms of these two disorders in this developmental period are not yet fully understood. Network analysis provides a valuable approach to uncover meaningful associations among symptoms and offers insights for prevention and intervention strategies. This study aimed to investigate symptom-level associations between anxiety and depression using network analysis and to identify core symptoms, bridge symptoms, and differences in network structure across different stages of adolescence.

METHODS

The cross-sectional study was conducted in March 2022 in Shenzhen, China. Participants completed the Generalized Anxiety Disorder Scale-7 and Patient Health Questionnaire Depression Scale, along with demographic questionnaires assessing age and gender. Chinese adolescents aged 10 to 17 who were in Grades 5 or 6 of elementary school, Grades 1 or 2 of middle school, or Grades 1 or 2 of high school, and who could comprehensively understand and read Chinese were recruited as participants. Students in Grade 3 of middle and high schools were excluded due to their upcoming high school or college entrance examinations. Based on age, participants were categorized into early, middle, and late developmental stages of adolescence.

RESULTS

"Loss of control" was among the most central symptoms in the comorbidity network throughout all three developmental stages; "excessive worry" and "anhedonia" emerged as the core symptoms in early adolescence, and "restlessness" as the core symptom in late adolescence. "Anhedonia," "sad mood," and "fatigue" were identified as bridge symptoms between anxiety and depression across all three developmental stages of adolescence. The global strength of the network in middle adolescence was significantly higher compared to the other two stages.

CONCLUSION

These findings highlight the core and bridge symptoms that require special attention and intervention at each stage of adolescence. Moreover, significantly higher network connectivity in middle adolescence suggests this is a critical period for intervention to prevent the development of comorbid mental disorders.

Unhealthy Eating Habits and Insomnia Symptoms are Associated with Internet Addiction in Chinese Left-Behind Children: The Gender Difference

Purpose

This study aimed to evaluate the associations between unhealthy eating habits and insomnia symptoms with Internet addiction (IA) among Chinese left-behind children (LBC) based on potential gender difference.

Methods

This cross-sectional study was conducted in junior high schools from an economically disadvantaged area of China in May 2020. Participants were asked to complete the information and scales of socio-demographic characteristics, eating habits (the frequency of eating carbohydrates, fruits, vegetables, protein, and breakfast), insomnia severity and IA. A total of 3156 LBCs (43.9% males and 56.1% females, aged 14.2 years in average) were used for final analyses. Associations between eating habits and insomnia symptoms with IA were analyzed by generalized linear model with binary logistic regression.

Results

The study found that left-behind children (LBCs) had unhealthy eating habits, particularly among females. Females reported more insomnia symptoms than males. The prevalence of IA was similar across genders. Consuming fewer fruits and vegetables and skipping breakfast were linked to increased IA risk, especially in females. Insomnia was significantly associated with higher IA risk in both genders.

Conclusion

In LBCs, unhealthy eating and sleep were notably linked to IA, especially in females. Addressing these factors might reduce the prevalence of IA among LBCs.

Changes in sleep disturbance among Chinese adolescents: A population-based online survey

OBJECTIVE

Sleep disturbance is prevalent among adolescents but little is known about the short-term changes among Chinese adolescents. The study aimed to explore the prevalence and change patterns of sleep disturbance and identify its risk and protective factors.

METHODS

Data were collected online from April 21st to May 12th, 2021 (Time 1, T1) and December 17th to 26th, 2021 (Time 2, T2). The final sample comprised 34,260 adolescents. Self-administrated questionnaires were used to assess socio-demographic variables, sleep disturbance, depression, anxiety, life events, family function, and resilience.

RESULTS

The prevalence of sleep disturbance was 12.0% at T1 and 11.8% at T2, with higher rates in females than males. Four groups of sleep disturbance change patterns were identified: non-sleep disturbance group (80.4%), persistent group (4.2%), new-onset group (7.6%), and remission group (7.8%). Risk factors for new-onset sleep disturbance included being in junior high school (AOR = 1.26, 95%CI = 1.15-1.38), family history of mental disorders (AOR = 1.49, 95%CI = 1.03-2.15), and moderate (AOR = 1.24, 95%CI = 1.13-1.36) and severe (AOR = 1.48, 95%CI = 1.27-1.72) family dysfunction. Risk factors for persistent sleep disturbance included being in junior (AOR = 1.25, 95%CI = 1.08-1.45) and senior (AOR = 1.53, 95%CI = 1.15-2.03) high school, parental currently unmarried status (AOR = 1.34, 95%CI = 1.05-1.73), moderate (AOR = 1.19, 95%CI = 1.02-1.39) and severe (AOR = 1.28, 95%CI = 1.06-1.55) family dysfunction. Medium (AOR = 0.48, 95%CI = 0.43-0.53) and high (AOR = 0.34, 95%CI = 0.29-0.40) levels of resilience were protective factors against new-onset sleep disturbance, as well as against persistent sleep disturbance (medium level: AOR = 0.51, 95%CI = 0.43-0.60; high level: AOR = 0.32, 95%CI = 0.25-0.43).

CONCLUSIONS

Interventions aimed at promoting family functions and enhancing resilience may improve sleep disturbance among adolescents.

Assessing the health, social, educational and economic impact of the COVID-19 pandemic on adolescents in low- and middle-income countries: a rapid review of the literature

COVID-19 has caused profound health, social, educational and economic devastation around the world, especially among the lives of adolescents in low- and middle-income countries. This paper looks at a wide array of outcomes impacting adolescents' daily lives including health (mental, physical, sexual and reproductive health, vaccine perceptions and overlap between these topics), social relationships (family and peer), education and socio-economic disparities. Both scientific and grey literature between December 2019 and February 2022 were sought from PubMed, Google Scholar and organisations conducting research among adolescents, and coded. A total of 89 articles were included, 73% of which were peer-reviewed; 37% of the articles were from WHO's Western Pacific region; 62% of the articles were cross-sectional; 75% were quantitative. Three major topics emerged in more than half the articles: mental health (72%), education (61%) and socio-economic ramifications (55%). However, there were regional differences in topics and many of them overlapped. The results indicate that, where there has been research, almost all findings have been linked to worse mental health during the pandemic. Overall, remote education was seen as a negative experience. The ramification of school closures on future aspirations, in particular early school leaving, highlights the importance of prioritising education during future pandemics based on the situation within the country. Gender and other disparities have made marginalised adolescents vulnerable to the economic ramifications of containment measures. Given the risks identified, there is a pressing need to put adolescents at the centre of establishing priorities for their health agenda for post-pandemic recovery.

Relationships between physical activity, sleep, and screen time with academic performance and psychological functioning among US children and adolescents with depression

OBJECTIVE

This cross-sectional study examined the relationships between adherence to 24-HMB guidelines (including physical activity [PA], screen time [ST], and sleep) with academic performance and psychological functioning among children and adolescents with depression.

METHODS

This study consists of 2165 participants aged 6-17 years with depression. Independent variables were components of 24-HMB guideline adherence, while outcomes of interest were academic performance (i.e., caring about school performance and completion of required homework) and psychological functioning (i.e., resilience and self-regulation). Logistic regression analysis was conducted while adjusting for confounding variables.

RESULTS

Only 1.03 % of the participants adhered to PA + ST + Sleep guidelines. Compared to non-adherence, adherence to PA + ST guidelines was significantly linked to a greater likelihood of caring about school performance (OR = 2.17), while ST + Sleep guidelines adherence was significantly linked to a greater likelihood of caring about school performance (OR = 2.02), completing homework (OR = 2.91), resilience (OR = 2.51), and self-regulation (OR = 2.51). Furthermore, adherence to PA + ST + Sleep guidelines was significantly linked to a higher likelihood of caring about school performance (OR = 5.01), resilience (OR = 2.49), and self-regulation (OR = 2.88) among these participants with depression.

CONCLUSION

Adhering to 24-HMB guidelines is positively linked to academic performance and psychological functioning among children and adolescents with depression. Thus, establishing healthy lifestyle behaviors should be promoted in school settings.

Burden of mental health disorders and synthesis of community-based mental health intervention measures among adolescents during COVID-19 pandemic in low middle-income countries: A systematic review and meta-analysis

BACKGROUND

COVID-19 pandemic and the resultant lockdown could have negatively impacted adolescent mental health. The synthesised burden of mental health illness among adolescents during or after the pandemic is unknown in Low Middle-Income Countries (LMICs). The objective was to ascertain the pooled prevalence of mental health disorders among adolescents aged 10 - 19 years and to systematically review & conduct a descriptive synthesis of community-based mental health intervention measures in addressing adolescent mental health disorders during the COVID-19 pandemic in LMICs.

METHODS

The literature was searched in Embase, PubMed, and Scopus and selected the relevant studies. The data was extracted from the selected studies, and its quality was assessed using adapted Newcastle-Ottawa Quality Assessment Scales. Meta-analysis was performed using random effects model to pool the prevalence of mental health disorders. Statistical heterogeneity was evaluated through Cochran's Q test & I2 statistic.

RESULTS

Thirty-five studies were selected out of 7955 identified studies. Most of the studies (n = 7, each) were from India and Iran. The majority of research works were community-based (n = 18), conducted in 2020 (23 articles), and participant interviews were conducted through online mode (n = 21). Varied instruments were used to measure the burden of mental health in different settings. Pooled prevalence (95% confidence intervals) of anxiety, depression and stress was found to be 43.69 (18.58-68.80)%, 47.02 (31.72-62.32)% and 39.97 (30.53-49.40)%, respectively, with high heterogeneity between the studies. No studies reported community-based mental health interventions.

CONCLUSION

There has been a higher prevalence of anxiety, depression, stress, and other mental health illnesses, among adolescents in LMICs during the COVID-19 pandemic. It is important to note that no existing literature directly addresses community-based interventions for these common mental health illnesses. It is imperative to prepare the health system for early identification and management of common mental health illness among the adolescent age group in the event of any future disaster.

Application of a Digital Mental Health Clinic in Secondary Schools: Functionality and Effectiveness Evaluation

BACKGROUND

Adolescents experience relatively more stress than other populations as they are facing rapid physical changes and adapting to complex social environments. However, access for this population to professional service providers is limited. Therefore, there is an increasing need for access to mental health services and new mental health care resources tailored to adolescents.

OBJECTIVE

The aim of this study was to evaluate the functionality and effectiveness of a school digital mental health clinic (DMHC) created by a Chinese psychiatric hospital and provided to secondary school students for a trial.

METHODS

The trial period of the DMHC was from January to July 2021 at three secondary schools in Taizhou City, China. Under a collaborative agreement between the local educational bureau and provider, use of the DMHC was free to all students, teachers, and staff of the schools. The functionality of the DMHC was compared with existing digital health interventions introduced in the literature and its effectiveness was quantitatively analyzed in terms of the volume of received counseling calls, number of calls per 100 students, length and time of calls, and reasons for the calls. The mini course video views were analyzed by topics and viewing time.

RESULTS

The design functions of the DMHC are well aligned with required factors defined in the literature. The first advantage of this DMHC is its high accessibility to students in the three schools. All functions of the DMHC are free to use by students, thereby eliminating the economic barriers to seeking and receiving care. Students can receive virtual counseling during or after regular working hours. Acceptability of the DHMC was further ensured by the full support from a national top-tier mental health facility. Any audio or video call from a student user would connect them to a live, qualified professional (ie, a psychiatrist or psychologist). Options are provided to view and listen to resources for stress relief or tips to help address mental health needs. The major reasons for the counseling calls included difficulties in learning, interpersonal relationships, and emotional distress. The three topics with the highest level of interest for the mini course videos were emotional assistance, personal growth, and family member relationships. The DMHC served as an effective tool for crisis prevention and intervention during nonworking hours as most of the live calls and mini video viewing occurred after school or over the weekend. Furthermore, the DMHC helped three students at high risk for suicide and self-injury through live-call intervention.

CONCLUSIONS

The DMHC is an effective complementary solution to improve access to professional mental health care facilities, especially during nonworking hours, thereby helping adolescents meet their mental health needs. Extension of the DMHC into more schools and other settings is recommended.

The influence of aggressive exercise on responses to self-perceived and others' pain

Previous studies have reported relationships between exercise and pain. However, little is known about how aggressive exercise modulates individuals' responses to their own and others' pain. This present study addresses this question by conducting 2 studies employing event-related potential (ERP). Study 1 included 38 participants whose self-perceived pain was assessed after intervention with aggressive or nonaggressive exercises. Study 2 recruited 36 participants whose responses to others' pain were assessed after intervention with aggressive or nonaggressive exercise. Study 1's results showed that P2 amplitudes were smaller, reaction times were longer, and participants' judgments were less accurate in response to self-perceived pain stimuli, especially to high-pain stimuli, after intervention with aggressive exercise compared to nonaggressive exercise. Results of study 2 showed that both P3 and LPP amplitudes to others' pain were larger after intervention with aggressive exercise than with nonaggressive exercise. These results suggest that aggressive exercise decreases individuals' self-perceived pain and increases their empathic responses to others' pain.

Internet addiction and suicidal ideation among Chinese college students: the mediating role of psychotic-like experiences

Background

Individuals with Internet addiction (IA) are at significant risk of suicide-related behaviors. This study aimed to investigate the relationships among IA, psychotic-like experiences (PLEs), and suicidal ideation (SI) among college students.

Methods

A total of 5,366 college students (34.4% male, mean age 20.02 years) were assessed using the self-compiled sociodemographic questionnaires, Revised Chinese Internet Addiction Scale (CIAS-R), 15-item Positive subscale of the Community Assessment of Psychic Experiences (CAPE-P15), Self-rating Idea of Suicide Scale (SIOSS), and 2-item Patient Health Questionnaire (PHQ-2).

Results

The prevalence of IA and SI were 9.3 and 12.1% among Chinese college students, respectively. There were direct effects of IA and PLEs on SI. The total effect of IA on SI was 0.18 (p < 0.001). PLEs mediated the relationship between IA and SI (Indirect effect = 0.07).

Conclusion

IA had both direct and indirect effects on SI. These findings enable us to elucidate the mechanism of how IA influences individual SI, which can provide vital information for developing and implementing targeted interventions and strategies to alleviate SI among Chinese college students.

The influences of dormitory exercise on negative emotions among quarantined Chinese college students during the COVID-19 pandemic

Objectives

This study explores the influences of different types of dormitory exercise on the negative emotions of quarantined Chinese college students during the COVID-19 pandemic.

Methods

In a 3-week intervention, participants self-selected into a rope skipping group (RSG), an aerobic exercise group (AEG), and a resistance exercise group (REG), while participants in the control group (CG) engaged, by choice, in no physical exercise. Exercise frequency was three times a week for 45 min, with an intensity of 60-80% of maximum heart rate. Before and after the intervention, all participants completed the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Student's t-test was used for intra-group comparisons, while ANOVA was used for inter-group comparisons.

Results

Within the three exercise groups, there were some differences in the decrease levels of anxiety and depression, statistically significant at (p < 0.05); by contrast, the levels of anxiety and depression slightly increased in the CG group, again with statistical significance (p < 0.05). Comparing each of the RSG, AEG, and REG with the CG, we found some statistically significant differences in decreasing levels of anxiety and depression (p < 0.05). A comparison of the RSG and REG with the AEG also revealed some significant differences in levels of anxiety and depression (p < 0.05). However, the RSG and REG did not significantly differ in levels of anxiety and depression (p < 0.05).

Conclusion

Long-term and strict dormitory quarantine led to different levels of anxiety and depression among quarantined college students. The three different types of medium-intensity dormitory exercise evidently decreased anxiety and depression levels of quarantined college students, but aerobic exercise had the greatest influence, while rope skipping and resistance exercise had equivalent effects.

The impact of the COVID-19 pandemic on adolescent sleep behavior

Restorative sleep is a fundamental component of adolescent wellbeing, and the COVID-19 pandemic presented both challenges and opportunities for adolescents' sleep. In this review, we synthesize emergent themes from the growing scientific evidence for the impact of the pandemic on adolescent sleep behavior across different stages of the pandemic and in different locations around the world. We also highlight the ways in which COVID-19 shaped sleep patterns among college students-a subgroup of adolescents transitioning to emerging adulthood that were particularly impacted by the shift to remote learning. Finally, we discuss variations in the impact according to several potential moderating factors in adolescents' lives and point to areas that require additional longitudinal research.

Physical activity and depression of Chinese college students: chain mediating role of rumination and anxiety

Objective

To explore the relationship between physical activity and depression among college students, as well as the mediating role of rumination and anxiety.

Methods

A total of 1,292 Chinese college students were investigated by physical activity questionnaire, rumination scale, self-rating anxiety scale (SAS), and depression scale.

Results

(1) There was a significant negative correlation between physical activity and depression (r = -0.399, p < 0.01), and the direct path of physical activity on depression was significant (β = -0.399, t = -13.374, p < 0.01). (2) Physical activity negatively predicted rumination (β = -0.322, t = -10.440, p < 0.01) and anxiety (β = -0.222, t = -7.089, p < 0.01). Rumination positively predicted anxiety (β = 0.283, t = 9.017, p < 0.01) and depression (β = 0.267, t = 9.046, p < 0.01). Anxiety positively predicted depression (β = 0.262, t = 8.902, p < 0.01). (3) Rumination and anxiety play a significant mediating role between physical activity and depression. The mediating effect involves three paths: physical activity → rumination → depression (the mediating effect value: -0.076); physical activity → anxiety → depression (the mediating effect value: -0.052). Physical activity → rumination → anxiety → depression (the mediating effect value: -0.021).

Conclusion

(1) Physical activity can negatively predict the rumination, anxiety, and depression of college students, which means physical activity can reduce rumination, anxiety, and depression of college students. (2) Physical activity can not only directly affect the depression of college students, but also indirectly affect depression through the independent intermediary role of rumination and anxiety, and the chain mediation of rumination and anxiety.

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

BACKGROUND

The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic.

METHODS

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

RESULTS

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

CONCLUSIONS

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

Emotional dysregulation as a mediator linking sleep disturbance with aggressive behaviors: Disentangling between- and within-person associations

PURPOSE

Sleep problems and aggressive behaviors are two prevalent and highly related problems among adolescents and emerging adults worldwide. This longitudinal study examined the reciprocal relations between sleep disturbance with aggressive behaviors and whether emotional dysregulation functioned as mediator of the relations, after separating within-person effects from between-person effects.

METHODS

A total of 4352 freshman students participated in a five-wave longitudinal study across two and half years. Data from the second wave to the fourth wave was used in this study. Random intercept cross-lagged panel models (RI-CLPM) were utilized to separate between- and within-person effects.

RESULTS

Results from RI-CLPM showed: (a) Sleep disturbance and aggressive behaviors bidirectionally predicted each other at the within-person level; (b) Emotional dysregulation functioned as a mediator of the associations from sleep disturbance to aggressive behaviors at the within-person level.

CONCLUSION

These findings advanced the literature by elucidating longitudinal associations among sleep disturbance, emotional dysregulation, and aggressive behaviors at the within-person level, suggesting that prevention and intervention programs targeted at improving emotional regulation skills may be helpful to prevent the developmental pathway from sleep disturbance to aggressive behaviors among college students.

Physical, psychological, and behavioral problems among children and adolescents in countries with different economic statuses during the COVID-19 pandemic: a systematic review and meta-analysis

Introduction

The COVID-19 pandemic has impacted children and adolescents' physical activity (PA), sleeping patterns, and psychological and behavioral health. Yet, little is known about the differences between those in countries with various economic statuses.

Methods

Articles published from database inception through 16 March 2022 were retrieved using CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO. High-quality studies that reported the number of participants with parameters associated with PA, sleeping patterns, and psychological and behavioral problems in young people aged under 18 years during the pandemic were included. We referenced the Canadian 24-Hour Movement Guidelines for PA and sleep duration to provide the event rate for young people who were not compliant with the guidelines. The event rate of young people who had decreased sleep quality and experienced psychological and behavioral problems were also investigated. A subgroup analysis was conducted to identify the differences in those in countries with diverse economic statuses. Funnel plot analysis and Egger's test were also conducted to identify any risk of publication bias.

Result

A total of 66 studies with 1,371,168 participants aged between 0 and 18 years, involving 27 countries, were included. During the pandemic, we identified that 41% (95% CI: 39%, 43%; I2 = 96.62) and 43% (95% CI: 34%, 52%; I2 = 99.42) of young people did not meet the PA and sleep duration recommendation guidelines. In addition, 31% (95% CI: 28%, 35%; I2 = 99.66) of young people had decreased their sleep quality. Yet, no significant difference was found across countries with different economic statuses. However, the event rates of participants with psychological and behavioral problems were 32% (95% CI: 28%, 36%; I2 = 99.85) and 19% (95% CI: 14%, 25%; I2 = 99.72), respectively. In addition, the rate of psychological problems was more severe in those who live in lower middle-income countries (p < 0.001), while the rate of behavioral problems was more severe in those who live in high-income countries (p = 0.001).

Discussion

During the pandemic, the discouragement of PA, poor sleep quality, and high risk of psychological and behavioral problems are concerning. A large number of young people did not comply with the recommendation guidelines. Timely implementation of recovery plans is critical to address the adverse effects on young people.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309209, identifier CRD42022309209.

Lifestyle Pathways Affecting Children's Mental Health in Japan during the COVID-19 Pandemic

The recent prolonged COVID-19 pandemic has worsened the daily lives of preschoolers and elementary school children worldwide. Although these changes may have affected their mental health, the full picture still remains unknown. Since March 2020, Japan has intermittently experienced several COVID-19 waves. This survey was conducted between February and March 2022. In this study, we investigated the pathways by which specific lifestyle factors (such as exercise, sleep, diet, and life skills) affect physical/psychosocial health (PPH) in 1183 preschoolers (3-5 years old) and 3156 elementary school children (6-11 years old) in Toyama Prefecture, Japan. These pathways were examined using a path analysis. Consequently, "life skills" was found to be the factor most strongly associated with PPH in both preschoolers and elementary school children (p < 0.001). Furthermore, it was associated with the physical activity score and with PPH via physical activity. Moreover, both boys' and girls' mental health declined with age among elementary school children (p < 0.001). The results of the current study may be helpful for early interventions (around the start of elementary school) at home and at school to improve children's mental health during the COVID-19 pandemic.

Mindfulness group intervention improved self-compassion and resilience of children from single-parent families in Tibetan areas

OBJECTIVE

The current study aimed to examine the effects of a mindfulness group intervention on self-compassion, psychological resilience, and mental health of children from single-parent families in Tibetan areas.

METHODS

A total of 64 children from single-parent families in Tibetan areas were randomly allocated to a control group (n = 32) and an intervention group (n = 32). Participants in the control group received conventional education, while participants in the intervention group received 6-week mindfulness intervention in addition to the conventional education. Both groups completed the Five Facet Mindfulness Questionnaire (FFMQ), Self-compassion Scale (SCS), Resilience Scale for Chinese Adolescent (RSCA), and the Mental Health Test (MHT) before and after the intervention.

RESULTS

After the intervention, the levels of mindfulness and self-compassion in the intervention group were significantly improved in relative to the control group. The positive cognition in the RSCA was significantly increased in the intervention group, whereas no significant change was observed in the control group. There was a trend towards lower self-blame in the MHT, but no significant impact of the intervention on the overall level of mental health was found.

CONCLUSION

Results suggest that a 6-week mindfulness training effectively improve self-compassion and resilience of single-parent children. Thus, mindfulness training as a cost-effective approach can be arranged in the curriculum, which helps students develop high level of self-compassion and resilience. In addition, there may be a need to improve emotional control in order to improve mental health.

Impact of the Coronavirus Disease 2019 Pandemic on Leisure Screen Time and Eating Habits of Japanese High School Students: A Comparison between before and during the Pandemic

This study aimed to determine whether adolescents' leisure screen time differed during the coronavirus disease 2019 (COVID-19) pandemic compared to before the pandemic, and to identify factors that affect leisure screen time among Japanese high school students. The Health Behavior in School Children questionnaire was used to investigate differences in eating habits and physical and mental health. The results showed that the leisure screen time of Japanese high school students was 2.6 h (SD = 1.4) before the pandemic, and 3.2 h (SD = 1.5) during the pandemic. The factors that increased leisure screen time were found to differ between boys and girls. No significant deterioration in physical and mental health was observed. The impact of the pandemic on eating habits differed in boys and girls. Boys reported "not feeling great about life" as a factor that increased leisure screen time during the pandemic, suggesting that negative emotions influenced the increase in leisure screen time. The pandemic had a significant impact on girls' leisure screen time. Longer screen time should be carefully monitored because it can lead to sleep disturbances, worsening of mental health, and obesity. Compared with before the pandemic, the health status of boys and girls changed little. Eating habits tended to improve for both boys and girls.

The relationship between physical activity and depression among community-dwelling adults in Wuhan, China

Background

While the association between physical activity (PA) and depression has been established, there is limited research on the effect of PA on the risk of depression among Chinese individuals. Thus, this study aimed to investigate the relationship between PA and depression among Chinese individuals.

Methods

We used a stratified random sampling approach to recruit participants from five urban districts in Wuhan, China. A total of 5,583 permanent residents aged 18 years or older completed questionnaires, which included the International Physical Activity Questionnaire Short Form (IPAQ-SF) to measure PA, and the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. To control for potential confounders, multiple logistic regression was employed to assess the association of PA with depression.

Results

The depression group had significantly lower weekly PA levels, measured in metabolic equivalent of task-minutes per week (MET-min/w), compared to the non-depression group [1,770 (693-4,200) MET-min/w vs. 2,772 (1,324-4,893) MET-min/w, p < 0.001]. In the fully adjusted model, the moderate and high PA level groups had lower odds ratios (ORs) for depressive symptoms compared to the low PA level group [OR (95% confidence interval (CI)) = 0.670 (0.523-0.858), 0.618 (0.484-0.790), respectively]. Among males, moderate and high levels of PA were associated with lower risk of depression compared to low PA levels [OR (95% CI) = 0.417 (0.268-0.649), 0.381 (0.244-0.593), respectively]. However, this association was not observed in females [OR (95% CI) = 0.827 (0.610-1.121), 0.782 (0.579-1.056), respectively]. The study found a significant interaction between PA levels and gender in relation to depression (P for interaction = 0.019).

Conclusion

The findings suggest a negative association between PA and risk of depressive symptoms, indicating that moderate to high levels of PA may serve as a protective factor against depressive symptoms.