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Liu Y, Zhang E, Li H, Ge X, Hu F, Cai Y, Xiang M. Physical activity, recreational screen time, and depressive symptoms among Chinese children and adolescents: a three-wave cross-lagged study during the COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2024; 18:11. [PMID: 38243299 PMCID: PMC10799442 DOI: 10.1186/s13034-024-00705-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/05/2024] [Indexed: 01/21/2024] Open
Abstract
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.
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Affiliation(s)
- Yujie Liu
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Erliang Zhang
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Huilun Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yong Cai
- Public Health department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Mi Xiang
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China.
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
- Public Health department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Yang Y, Yuan M, Zeng Y, Xie Y, Xu Y, Liao D, Chen Y, Chen M, Qu Y, Hu Y, Zhang W, Song H. Cohort Profile: The China Severe Trauma Cohort (CSTC). J Epidemiol 2024; 34:41-50. [PMID: 36567130 PMCID: PMC10701251 DOI: 10.2188/jea.je20220290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We sought to establish a prospective hospital-based cohort, featuring detailed multidimensional data of trauma patients with active follow-ups, which can be a reliable data source for all studies focusing on the effects or underlying mechanistic pathways of environmental and biological factors on multiple interested trauma-related outcomes, particularly the incidence and trajectory of trauma-related psychopathology, in a Chinese population. METHODS The China Severe Trauma Cohort (CSTC) enrolled all traumatized individuals aged 12 to 80 years admitted to the Trauma Center of West China Hospital between March 1st, 2020 and July 8th, 2022. The bio-sample and detailed questionnaire data were collected at recruitment, and phone/internet follow-ups were scheduled at 1, 3, 6, and 12 months after the baseline. Long-term health outcomes are planned to be obtained from administrative databases through data linkage. RESULTS A total of 2,500 trauma patients were enrolled (response rate = 87.1%) with an average age of 46.01 years, and most of the participants were males (62.6%). The proportions of participants with blood and fecal sample collected at baseline were 93.8% and 66.3%, respectively. As of August 31st, 2022, the follow-up rate was 90.0%, 77.0%, 76.5%, and 89.0% for 1-, 3-, 6-, and 12-month follow-ups, respectively. Fall/wrench (47.6%) and traffic accident (26.2%) were the top causes of current trauma. The most common psychopathology at recruitment was sleep disturbance (39.4%), followed by depression (22.6%), anxiety (18.2%), and acute stress reaction (7.8%), all of which showed recovering trajectories during the follow-up period, particularly the first 3 months after baseline. CONCLUSION CSTC provides a platform with multidimensional data to study both short-term and long-term trauma-related health consequences, prompting early identification and intervention for individuals with high risk of health decline after trauma exposures.
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Affiliation(s)
- Yao Yang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Minlan Yuan
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yu Zeng
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanjing Xie
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Shaanxi University of Chinese Medicine, Xian, China
| | - Yueyao Xu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Dengbin Liao
- Department of Orthopaedics and Trauma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yongmei Chen
- Department of Orthopaedics and Trauma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Meiru Chen
- Department of Orthopaedics and Trauma Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Hu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
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Lei Q, He Z, Koenig HG, Hu X, Xiong M, Shi X, Liu J, Wang Z. Light Personality Style and Moral Injury Among Chinese Health Professionals. JOURNAL OF RELIGION AND HEALTH 2023; 62:3942-3956. [PMID: 37777659 DOI: 10.1007/s10943-023-01921-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 10/02/2023]
Abstract
Moral injury has attracted attention widely in various occupations, particularly health professionals. Personality traits involve the professional values in clinical decision-making associated with mental outcomes. The current study examines the relationship between "light personality" style and moral injury. Scores on three subscales of the Light Triad Scale were negatively correlated with the Moral Injury Symptoms Scale-Health Professional. Health professionals more likely to have light personality styles may be less likely to suffer from moral injury under high-stake situations. The findings provide evidence to better understand the inner core of the moral injury, suggesting a potential pathway to improve the moral well-being of health professionals by strengthening key elements of light personality.
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Affiliation(s)
- Qiuhui Lei
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, 560001, People's Republic of China
| | - Zhehao He
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, 560001, People's Republic of China
| | - Harold G Koenig
- Departments of Psychiatry and Medicine, Duke University Medical Center, Durham, NC, 27710, USA
- Division of Psychiatry, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Xue Hu
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, 560001, People's Republic of China
| | - Mengyun Xiong
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, 560001, People's Republic of China
| | - Xiuquan Shi
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi, 56006, People's Republic of China
| | - Jun Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, 56006, People's Republic of China
| | - Zhizhong Wang
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan, 560001, People's Republic of China.
- The First Dongguan Affiliated Hospital, Guangdong Medical University, #1 Xincheng Road, Songshanhu, Dongguan, 523808, People's Republic of China.
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Tam CC, Qiao S, Garrett C, Zhang R, Aghaei A, Aggarwal A, Litwin AH, Li X. Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model. PLoS One 2023; 18:e0289413. [PMID: 37535623 PMCID: PMC10399860 DOI: 10.1371/journal.pone.0289413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/10/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. METHODS In January-March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. RESULTS In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors (βs = 0.38 to .68, ps < 0.001), while psychosocial factors were negatively associated with substance use behaviors (βs = -0.61 to -0.43, ps < 0.001). CONCLUSION Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.
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Affiliation(s)
- Cheuk Chi Tam
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Camryn Garrett
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Ran Zhang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Atefeh Aghaei
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Abhishek Aggarwal
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Alain H. Litwin
- School of Health Research, Clemson University, Greenville, SC, United States of America
- Department of Medicine, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States of America
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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Deng W, Yan S, Xu Y, Lu Z, Liu L, Zhou Y, Chen M. Effects of BPD tendencies and subjective well-being on NSSI in adolescents with PTSD. Front Psychiatry 2023; 14:1152352. [PMID: 37398590 PMCID: PMC10308082 DOI: 10.3389/fpsyt.2023.1152352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/04/2023] [Indexed: 07/04/2023] Open
Abstract
Background Severe posttraumatic stress disorder (PTSD) may lead to non-suicidal self-injury (NSSI), and borderline personality disorder (BPD) tendencies may play a role in this process. Secondary vocational students experience more social, familial and other pressures and are more vulnerable to psychological problems. Thus, we explored the effect of BPD tendencies and subjective well-being (SWB) on NSSI in secondary vocational students with PTSD. Methods A total of 2,160 Chinese secondary vocational students in Wuhan participated in our cross-sectional investigation. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), criteria for PTSD, NSSI Questionnaire, Personality Diagnostic Questionnaire-4+, subjective well-being scale, and family adaptation, partnership, growth, affection, and resolve (APGAR) Index were used. We conducted a binary logistic regression model and linear regression analysis. Results Sex (odds ratio [OR] = 0.354, 95% confidence interval [CI] = 0.171-0.733), BPD tendencies (OR = 1.192, 95% CI = 1.066-1.333) and SWB (OR = 0.652, 95% CI = 0.516-0.824) were independent factors that predicted NSSI in secondary vocational students with PTSD. Spearman's correlation analysis showed that BPD tendencies were positively correlated with NSSI frequency (r = 0.282, P < 0.01). SWB was negatively correlated with NSSI frequency (r = -0.301, P < 0.01). The linear regression showed that BPD tendencies (β = 0.137, P < 0.05 and β = -0.230, P < 0.001) were significantly correlated with NSSI frequency. Spearman's correlation analysis showed that family functioning was positively correlated with SWB (r = 0.486, P < 0.01) and negatively correlated with BPD tendencies (r = -0.296, P < 0.01). Conclusion In adolescents, PTSD in response to stressful events could lead to NSSI, and BPD tendencies promote the intensity of NSSI, while SWB diminishes its intensity. Improvement in family functioning may actively guide the development of mental health and improve SWB; such steps may constitute interventions to prevent or treat NSSI.
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Affiliation(s)
- Weixi Deng
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, China
| | - Shu Yan
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yongjun Xu
- Wuhan Dongfang Bode Psychiatric Hospital, Wuhan, China
| | - Zhaoyuan Lu
- School of Medicine, Jianghan University, Wuhan, China
| | - Lianzhong Liu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yang Zhou
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Mo Chen
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
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He Z, Lei Q, Hu X, Xiong M, Liu J, Wen J, Shi X, Wang Z. Moral injury and suicidal ideation among health professionals: The role of mental health. J Affect Disord 2023; 333:58-64. [PMID: 37080491 PMCID: PMC10111858 DOI: 10.1016/j.jad.2023.04.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/23/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND The prolonged COVID-19 pandemic has burdened health professionals mentally and physically. This study aims to explore the relationship between moral injury (MI) and suicidal ideation (SI), and the role of mental health conditions in this relationship. METHODS Three-wave repeated online cross-sectional study with a total of 10,388 health professionals were conducted in different stages (2020-2022) of the COVID-19 pandemic in mainland China. Participants completed the Chinese version of the Moral Injury Symptoms Scale-Health Professional, Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5 coupled with a blanket of scales. RESULTS The prevalence of SI and MI among health professionals was 9.8 % and 40.2 %, respectively. The prevalence risk of SI was lower in wave 2 (OR = 0.64, 95 % CI: 0.54-0.77) and wave 3 (OR = 0.71, 95 % CI: 0.60-0.84) when compared with wave 1. MI (OR = 4.66, 95 % CI: 3.99-5.43), medical error (OR = 1.15, 95 % CI: 1.00-1.32), workplace violence (OR = 1.13, 95 % CI: 0.97-1.32), depression (OR = 94.08, 95 % CI: 63.37-139.69), anxiety (OR = 25.54, 95 % CI: 21.22-30.74), PTSD (OR = 24.51, 95 % CI: 19.01-31.60) were associated with a higher risk of SI. The mediation model revealed that depressive, anxiety, and PTSD symptoms explained 90.6 % of the total variance in the relationship between MI and SI. CONCLUSIONS The risk of SI has reduced among health professionals since the first peak of the COVID-19 pandemic in China. MI may contribute to prevalent SI, and mental health conditions, especially depressive symptoms, play a significant role as mediators. LIMITATIONS Cross-sectional design precludes the investigation of casual relationships. The nonrandom sampling method limits the generalization.
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Affiliation(s)
- Zhehao He
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Qiuhui Lei
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Xue Hu
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Mengyun Xiong
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China
| | - Jun Liu
- Department of Preventive Medicine, School of Public Health at Zunyi Medical University, Zunyi 56006, China
| | - Jing Wen
- Department of Epidemiology and Health Statistics, School of Public Health and Management at Ningxia Medical University, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China.
| | - Zhizhong Wang
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, Dongguan 560001, China; The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808, China.
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Xiao P, Zhu K, Feng Y, Jiang Q, Xiang Z, Zhang Q, Wu X, Fan Y, Zou L, Xiao H, Song R. Associations between dyslexia and children's mental health: Findings from a follow-up study in China. Psychiatry Res 2023; 324:115188. [PMID: 37054554 DOI: 10.1016/j.psychres.2023.115188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/15/2023]
Abstract
Dyslexia is a common learning difficulty that can lead to adverse health outcomes and socioeconomic difficulties. Evidence from longitudinal studies on the association between dyslexia and psychological symptoms in children is limited. Moreover, the psychological trends of children with dyslexia are unclear. In this study, we enrolled 2,056 students in Grades 2 to 5, including 61 dyslexic children, who participated in three mental health surveys and dyslexia screening. All the children were surveyed for symptoms of stress, anxiety and depression. We used generalized estimating equation models to estimate changes in psychological symptoms of children with dyslexia over time and the association between dyslexia and psychological symptoms. The results showed that dyslexia was associated with stress and depressive symptoms in children in both crude (β = 3.27, 95% confidence interval [CI] [1.89∼4.65], β=1.20, 95%CI: [0.45∼1.94], respectively) and adjusted models (β = 3.32, 95%CI: [1.87∼4.77], β=1.31, 95%CI: [0.52∼2.10], respectively). In addition, we found no significant differences in the emotional status of dyslexic children in either survey. Dyslexic children are at risk for mental health issues, and persistent emotional symptoms. Therefore, interventions regarding not only reading ability but also psychological conditions should be pursued.
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Affiliation(s)
- Pei Xiao
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Jiang
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Xiang
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Quan Zhang
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xufang Wu
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yixi Fan
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Child Healthcare, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Han Xiao
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ranran Song
- Department of Maternal and Child Health and MOE Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Zhang Q. The Moderation Effect of Cognitive Tendencies on the Relationship Between Fear of COVID-19 and Post-Traumatic Stress Symptoms in Chinese Children. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1-9. [PMID: 36785698 PMCID: PMC9909653 DOI: 10.1007/s40653-023-00518-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 pandemic is a public health emergency with potential traumatizing effects on children. However, not many studies have been devoted to investigating the association between fear of COVID-19 and post-traumatic stress symptoms (PTSS) in children during the pandemic. Also, if the association is modulated by cognitive tendencies to focus on negative and positive information in children is unknown. The study recruited 122 native Chinese children from a primary school in mainland China. Self-reported psychological inventories were used to assess the above variables. The prevalence rate of PTSS in Chinese children was approximately 15.1%. Girls had higher post-traumatic stress levels than boys. Fear of COVID-19 was associated with higher level of post-traumatic stress in children. Only cognitive tendency to focus on negative information was significantly associated with the level of post-traumatic stress in children. Moreover, cognitive tendency to focus on negative information was a significant moderator of the relationship between fear of COVID-19 and PTSS. Generalization of the results to adults should be cautious. It was concluded that stronger fear of COVID-19 was related to more PTSS in children. The association of fear of COVID-19 with PTSS was significant only for children with strong tendency to focus on negative information. Cognitive interventions for PTSS may need to be delivered to children who have both strong fear of COVID-19 and strong tendency to focus on negative information.
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Affiliation(s)
- Qiaochu Zhang
- Department of Social and Behavioural Sciences, College of Humanities and Social Sciences, City University of Hong Kong, Floor 7, AC1, Tat Chee Avenue Kowloon, Hong Kong
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Li J, Li J, Zhang W, Wang G, Qu Z. Effectiveness of a school-based, lay counselor-delivered cognitive behavioral therapy for Chinese children with posttraumatic stress symptoms: a randomized controlled trial. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 33:100699. [PMID: 36785644 PMCID: PMC9918421 DOI: 10.1016/j.lanwpc.2023.100699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023]
Abstract
Background Improving children's access to mental health services need more innovative solutions, especially in low- and middle-income countries. School-based psychosocial interventions delivered by lay counselors may be an efficient way to improve children's access to mental health services. But few studies were conducted to examine the effectiveness of these interventions. Therefore, this study is to evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) in a group format delivered by lay counselors to children with trauma-related symptoms in China. Methods A total of 234 children (aged 9-12 years) with full or subthreshold posttraumatic stress disorder (PTSD) were randomly assigned to group-based TF-CBT or treatment as usual (TAU). In the intervention group, 118 children received 10-12 sessions of group-based TF-CBT delivered by lay counselors for 9 consecutive weeks. In the TAU group, 116 children received the usual school services provided by psychology teachers. The primary outcome was the reduction in PTSD severity, which was assessed with the UCLA PTSD reaction index for DSM-5 (PTSD-RI-5). The secondary outcomes included the reduction in PTSD severity and the remission of PTSD, both of which were measured with the PTSD checklist-5 (PCL-5). Secondary outcomes also included the reduction in depression severity and the reduction in generalized anxiety severity. Blinded assessments were collected at baseline, posttreatment (primary endpoint), and 3-month follow-up. This trial is registered with Chinese Clinical Trial Registry, ChiCTR1900027131. Findings At posttreatment, the intervention group scored significantly lower than the TAU group on PTSD-RI-5 PTSD (30.98 vs. 39.22; adjusted mean difference [AMD], -7.35; 95% CI, -11.66 to -3.04), PCL-5 PTSD (28.78 vs. 38.04; AMD, -8.49; 95% CI, -13.23 to -3.75), depression (5.52 vs. 7.96; AMD, -1.63; 95% CI, -2.50 to -0.76), and generalized anxiety (7.23 vs. 8.64; AMD, -1.21; 95% CI, -2.20 to -0.23). The remission of PCL-5 PTSD was also significantly higher in the intervention group (42.86% vs. 13.54%, χ 2 = 13.10, P < 0.001). These two groups showed a similar level of symptoms at the 3-month follow-up. Interpretation The group-based TF-CBT can significantly alleviate PTSD, depression, and generalized anxiety right after treatment in Chinese children who suffer from different types of trauma. But the long-term effects of this intervention need to be further tested. This intervention can be delivered by trained lay counselors in low- and middle-income countries. Funding None.
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Affiliation(s)
- Jina Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Jia Li
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, China
| | - Weijun Zhang
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, China
| | - Gengchao Wang
- State Key Laboratory of Liver Research, University of Hong Kong, Hong Kong, 999077, China
| | - Zhiyong Qu
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, China,Corresponding author. Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
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10
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Tong J, Zhang J, Zhu N, Pei Y, Liu W, Yu W, Hu C, Sun X. Effects of COVID-19 pandemic on mental health among frontline healthcare workers: A systematic review and meta-analysis. Front Psychol 2023; 13:1096857. [PMID: 36778177 PMCID: PMC9912473 DOI: 10.3389/fpsyg.2022.1096857] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/23/2022] [Indexed: 02/14/2023] Open
Abstract
Background As some countries announced to remove Coronavirus Disease 2019 (COVID-19) border, it indicates that the COVID-19 may have entered its terminal stage. In this COVID-19 pandemic, the mental health of frontline healthcare workers (HCWs) experienced unprecedented challenges. However, the impact of the COVID-19 pandemic on mental health among frontline HCWs lacks a high-quality and long-term systematic review and meta-analysis. Methods We conducted a systematic review and meta-analysis according to PRISMA guidelines. The system searches EMBASE, MEDLINE, PsycINFO, Cochrane Library, ScienceNet, and ERIC. Analyze the mental health problems of frontline HCWs in different regions and periods, including insomnia, stress, anxiety and depression. This study was registered in PROSPERO under the number CRD42021253821. Results A total of 19 studies on the effects of COVID-19 pandemic on mental health among frontline HCWs were included in this study. The overall prevalence of insomnia was 42.9% (95% CI, 33.9-51.9%, I 2 = 99.0%) extracted from data from 14 cross-sectional studies (n = 10 127), 1 cohort study (n = 4,804), and 1 randomized controlled trial (RCT; n = 482) in 10 countries. The overall prevalence of stress was 53.0% (95% CI, 41.1-64.9%, I 2 = 78.3%) extracted from data from nine cross-sectional studies (n = 5,494) and 1 RCT study (n = 482) from eight countries. The overall prevalence of anxiety and depression was 43.0% (95% CI, 33.8-52.3%, I 2 = 99.0%) and 44.6% (95% CI, 36.1-53.1%, I 2 = 99.0%) extracted from data from 17 cross-sectional studies (n = 11,727), one cohort study (n = 4,804), and one RCT study (n = 482) from 12 countries. The prevalence of stress and depression was higher in 2020, while the prevalence of insomnia and anxiety was higher in 2021. The prevalence of mental health problems among physicians was higher than that of other frontline HCWs. The prevalence of mental health problems among frontline HCWs is higher in South America and lower in North America. Conclusions This systematic review and meta-analysis showed that the COVID-19 pandemic have significant effects on mental health among frontline HCWs. The overall prevalence of insomnia, stress, anxiety and depression among frontline HCWs is high. Therefore, the health policy-makers should pay attention to and respond to the mental health problems of frontline HCWs in the context of public health emergencies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/.
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Affiliation(s)
| | | | | | | | | | | | - Chengping Hu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xirong Sun
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
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11
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Tam CC, Qiao S, Garrett C, Zhang R, Aghaei A, Aggarwal A, Li X. Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.11.23.22282679. [PMID: 36451878 PMCID: PMC9709789 DOI: 10.1101/2022.11.23.22282679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. METHODS In January - March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. RESULTS In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors ( β s = .38 to .68, p s < .001), while psychosocial factors were negatively associated with substance use behaviors ( β s = -.61 to -.43, p s < .001). CONCLUSION Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.
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Affiliation(s)
- Cheuk Chi Tam
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Camryn Garrett
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Ran Zhang
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Atefeh Aghaei
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Abhishek Aggarwal
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
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12
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Zhang D, Guo Q, Xu L, Liu X, Zhang T, Liu X, Chen H, Li G, Wang J. The impact of COVID-19 pandemic on individuals at clinical high-risk for psychosis: Evidence from eye-tracking measures. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110578. [PMID: 35618148 PMCID: PMC9126616 DOI: 10.1016/j.pnpbp.2022.110578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/19/2022]
Abstract
Emerging evidence suggested that people with severe mental disorders were more vulnerable to the negative effects of the COVID-19 pandemic. However, few researches investigated the influence of global pandemics on people at clinical high risk (CHR) for psychosis. This study aimed to investigate the impact of the COVID-19 pandemic on clinical symptoms, psychological distress, and eye-tracking characteristics in CHR individuals and healthy participants. Forty-nine CHR individuals and 50 healthy controls (HC) were assessed by PTSD Checklist for DSM-5 (PCL-5), Perceived Stress Scale, 10-item version (PSS-10), and Coronavirus Impact Scale (CIS). Eye movement performances were measured by the tests of fixation stability, free-viewing, and anti-saccade. According to the mean score of CIS, participants were stratified into high-impact (n = 35) and low-impact (n = 64) subgroups. Compared with the HC group, CHR participants reported significantly higher levels of post-traumatic symptoms caused by the COVID-19 pandemic and showed abnormalities in most of the eye movement indexes. Among the altered indexes, the saccade amplitude of fixation stability test (far distractor), the scan path length of free-viewing test, and the accuracy of anti-saccade test were negatively affected by the severity of impact level in the CHR group. Moreover, the altered eye movement indexes were significantly associated with the total scores of CIS, PCL-5, and subscales of the Scale of Prodromal Syndromes (SOPS) among CHR individuals. Overall, our findings suggested the negative impact of the COVID-19 pandemic on the eye movement characteristics of CHR individuals. The present study provides valuable information on physiological distress related to the COVID-19 pandemic and sensitive neuropsychological biomarkers that interacted with social and environment stress in the CHR population.
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Affiliation(s)
- Dan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Qian Guo
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China; Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Xu Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - TianHong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Xiaohua Liu
- Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Haiying Chen
- Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Guanjun Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai 201203, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, PR China.
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13
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Gebremeskel TG, Berhe M, Tesfahunegn TB, Gesesew HA, Ward PR. Prevalence and Factors Associated With Suicidal Ideation Among Adult Eritrean Refugees in Northern Ethiopia. Front Public Health 2022; 10:841848. [PMID: 35602160 PMCID: PMC9114296 DOI: 10.3389/fpubh.2022.841848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background The present study assessed the prevalence of and factor associated with suicidal ideations among adult Eritrean refugees in Tigray, Ethiopia. Methods A community-based cross-sectional study was carried out among 400 adult refugees living in the Mai-Aini refugee camp in Tigray, Northern Ethiopia from September 2019 to May 2020. The response variable was suicidal ideation and was measured using World Mental Health (WMH) Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview. We applied bivariate and multivariate logistic regression to determine predictors for suicide ideations. Odds ratios and p-values were determined to check the associations between variables, and a p-value <0.05 was considered as a cut-off for statistical significance. Results The prevalence of suicidal ideations was 20.5% (95% CI: 16.4%, 24.5%). Having previous history of trauma [AOR = 2.3, 95% CI: 1.4, 4.5], a history of chronic illness [AOR = 2.9, 95% CI: 1.3, 6.5], a family history of mental disorder [AOR = 3.08, 95% CI: 1.3, 7.06], and history of post-traumatic stress disorder [AOR = 5.7, 95% CI: 2.8, 11.5] were significantly associated with suicidal ideations. Conclusions This study showed that during the stay in the refugee camp, there was a high prevalence of suicide ideations compared to the prevalence of suicide ideations among the general populations of Ethiopia, Europe, and China, and the lifetime pooled prevalence across 17 countries. Having previous history of trauma, a history of chronic illness, a family history of mental disorder, and history of post-traumatic stress disorder were the factors statistically associated with the suicidal ideation.
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Affiliation(s)
- Teferi Gebru Gebremeskel
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.,Discipline of Public Health, Flinders University, Adelaide, SA, Australia
| | - Mulaw Berhe
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | - Tadis Brhane Tesfahunegn
- Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | - Hailay Abrha Gesesew
- Centre for Research on Health Policy, Torrens University, Adelaide, SA, Australia.,Departments of Epidemiology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Paul R Ward
- Centre for Research on Health Policy, Torrens University, Adelaide, SA, Australia
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14
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Interparental conflict and depressive symptoms among Chinese adolescents: A longitudinal moderated mediation model. Dev Psychopathol 2022; 35:972-981. [PMID: 35249580 DOI: 10.1017/s0954579422000190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
While the detrimental effect of interparental conflict on adolescent depression is well-established, the underlying mechanisms linking the two continue to be inadequately understood. This study investigated the mediating role of family functioning and the moderating role of cultural beliefs about adversity in the association between interparental conflict and adolescent depression. The samples included 651 Chinese adolescents (mean age at Time 1 = 13.27 years; 56.5% girls) from a two-wave longitudinal study with data spanning 1 year. The findings from path modeling analyses provided evidence for the mediating role of family functioning; these findings indicated that interparental conflict can damage family functioning, which in turn exacerbates the risk of adolescent depression. The moderating role of cultural beliefs about adversity was also demonstrated by interactions between interparental conflict and cultural beliefs about adversity, as well as, family functioning and cultural beliefs about adversity. The results indicated a buffering role of cultural beliefs about adversity on the deleterious effect of interparental conflict on adolescent depression. They also suggested that lower levels of family functioning was associated with increased depression among adolescents were lower in cultural beliefs about adversity.
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15
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Oakey-Frost DN, Harris JA, May AM, Bryan AO, Tucker RP, Bryan CJ. Internal entrapment and fearlessness about death as precipitants of suicidal thoughts and planning in the context of post-traumatic stress disorder. Suicide Life Threat Behav 2022; 52:147-158. [PMID: 34738655 DOI: 10.1111/sltb.12815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The relationship between post-traumatic stress disorder (PTSD) and suicidal thoughts and behaviors (STB) has been extensively studied but explanatory mechanisms remain inconclusive. Entrapment is one variable that evinces a mechanistic relationship with PTSD and STB. The current study examined the indirect effect of PTSD screen on suicide ideation (SI), planning, and likelihood of future suicide attempt through internal (IE) and external entrapment (EE), moderated by levels of fearlessness about death (FAD). METHOD The cross-sectional sample consisted of military service members and civilians recruited from primary care clinics across the United States (N = 2690). RESULTS Moderated mediation models indicated an indirect relationship between a positive PTSD screen, past-month SI, and past-month suicide planning through IE but not EE at low, moderate, and high levels of FAD. These relationships were replicated for the association between positive PTSD screen and concurrent self-rated likelihood of a future suicide attempt through both IE and EE at moderate and high levels of FAD. CONCLUSIONS Phenomenological implications are discussed, including IE as a mechanism of action in the PTSD/SI pathway and FAD as necessary to potentiate suicidal planning for those experiencing IE.
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Affiliation(s)
| | - Julia A Harris
- College of Social and Behavioral Sciences, The University of Utah, Salt Lake City, Utah, USA
| | - Alexis M May
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - AnnaBelle O Bryan
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | - Craig J Bryan
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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16
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Xiao P, Zhu K, Liu Q, Xie X, Jiang Q, Feng Y, Wu X, Tang J, Song R. Association between developmental dyslexia and anxiety/depressive symptoms among children in China: The chain mediating of time spent on homework and stress. J Affect Disord 2022; 297:495-501. [PMID: 34743962 DOI: 10.1016/j.jad.2021.10.120] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The relationship between dyslexia and anxiety/depressive symptoms among children in China is unclear. Besides, the pathways to explain the risks are also undefined. METHODS 3993 primary school students from grade 2 to 6 were recruited in this study. The Dyslexia Checklist for Chinese Children and the Pupil Rating Scale-Revised Screening for Learning Disabilities were used to filter the dyslexic children. The Chinese perceived stress scale, the Screen for Child Anxiety Related Emotional Disorders, and the Children's Depression Inventory-Short Form were used separately to assess stress, anxiety symptoms, and depressive symptoms of the children. Time spent on homework was obtained by asking their parents: "How long does it take the children to complete the homework every day?". The chain mediation models were examined using SPSS PROCESS macro 3.3 software. RESULTS Dyslexic children spend more time on homework (2.61±1.15), and have higher scores for depression (4.75±3.60) and stress (26.55±7.40) compared to normal children (1.87±0.77, 3.25±3.32, and 23.20±8.43, respectively). The differences are statistically significant (all P<0.01). There is no direct association between dyslexia and anxiety symptoms, while dyslexia has a direct link with depressive symptoms. Dyslexia could affect anxiety/depressive symptoms via the independent mediating effect of stress and the chain mediating effect of time spent on homework and stress. The total indirect effect is 0.21 and 0.25, respectively. LIMITATIONS The data used in our study is self-reported and this is a cross-sectional study. CONCLUSIONS Time spent on homework and stress could mediate the association between dyslexia and anxiety/depressive symptoms.
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Affiliation(s)
- Pei Xiao
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Liu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyan Xie
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Jiang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoqian Wu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Tang
- Department of Children's Rehabilitation, Wuhan Psychology Hospital, Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Brewerton TD, Gavidia I, Suro G, Perlman MM, Genet J, Bunnell DW. Provisional posttraumatic stress disorder is associated with greater severity of eating disorder and comorbid symptoms in adolescents treated in residential care. EUROPEAN EATING DISORDERS REVIEW 2021; 29:910-923. [PMID: 34523192 DOI: 10.1002/erv.2864] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/21/2021] [Accepted: 09/02/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Past traumatic events, subsequent posttraumatic stress disorder (PTSD) and related psychiatric comorbidities are commonly associated with eating disorders (EDs) in adults but remain understudied in adolescents. METHODS Adolescent participants (mean [SD] age = 15.1 ± 1.5 years, 96.5% female) with EDs entering residential treatment (n = 647) at six sites in the United States completed validated self-report assessments of ED, PTSD, major depression, anxiety disorders and quality of life. Provisional DSM-5 PTSD diagnoses (PTSD+) were made via the Childhood Trauma Questionnaire, admission interviews and the PTSD Symptom Checklist for DSM-5. RESULTS PTSD+ occurred in 35.4% of participants, and those with ED-PTSD+ had significantly higher scores on all assessments (p ≤ 0.001), including measures of ED psychopathology, major depression, anxiety disorders and quality of life, as well as significantly higher rates of all forms of childhood trauma. Those with PTSD+ also exhibited a significantly higher percent median body mass index for age and sex and a lower propensity toward anorexia nervosa, restricting type. CONCLUSIONS Results confirm that adolescent patients in residential treatment with ED-PTSD+ are more symptomatic and have worse quality of life than their ED counterparts without PTSD. Integrated treatment approaches that effectively address ED-PTSD+ are greatly needed in ED programs that treat adolescents.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.,LLC, Mt. Pleasant, South Carolina, USA.,Monte Nido and Affiliates, Miami, Florida, USA
| | | | - Giulia Suro
- Monte Nido and Affiliates, Miami, Florida, USA
| | - Molly M Perlman
- Monte Nido and Affiliates, Miami, Florida, USA.,Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA
| | | | - Douglas W Bunnell
- Monte Nido and Affiliates, Miami, Florida, USA.,Private Practice, Westport, Connecticut, USA
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18
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Huang RW, Shen T, Ge LM, Cao L, Luo JF, Wu SY. Psychometric Properties of the Chinese Version of the Primary Care Post-Traumatic Stress Disorder Screen-5 for Medical Staff Exposed to the COVID-19 Pandemic. Psychol Res Behav Manag 2021; 14:1371-1378. [PMID: 34512047 PMCID: PMC8421668 DOI: 10.2147/prbm.s329380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/20/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose The COVID-19 pandemic may increase the development of psychiatric disorders, such as posttraumatic stress disorder (PTSD) among medical staff. A brief validated screening tool is essential for the early diagnosis of PTSD. The purpose of the present study was to evaluate the validation of a Chinese version of the Primary Care-PTSD-5 (C-PC-PTSD-5) and determine an appropriate cutoff score with optimal sensitivity and specificity for medical staff in China during the COVID-19 pandemic. Participants and Methods An online cross-sectional survey was conducted on medical staff (n = 1104) from 17 medical institutions in Shanghai. Questionnaires comprising general information, medical-related traumatic event experiences, the PTSD Checklist (PCL-5), and C-PC-PTSD-5 were distributed to participants using the online Questionnaire Star electronic system. Internal consistency, convergent validity, and test–retest reliability were calculated. Receiver operating characteristic (ROC) analysis was performed to determine diagnostic accuracy and the optimal cutoff score of the C-PC-PTSD-5 for medical staff. Results We included 1062 valid questionnaires for the analysis. Data of 838 traumatic experiences were analyzed. Internal consistency of the C-PC-PTSD-5 was satisfied (Cronbach’s α = 0.756). The total score of the C-PC-PTSD-5 showed good test–retest reliability (r = 0.746). We found a strong correlation between the C-PC-PTSD-5 score and PCL-5 total score (r = 0.669, p < 0.001), which indicated good convergent validity. The ROC analysis showed an area under the curve of 0.81 ± 0.016. A cutoff score of 2 provided optimal sensitivity and specificity for the C-PC-PTSD-5 (sensitivity = 0.632, specificity = 0.871, Youden index = 0.503, and overall efficiency = 0.768). Conclusion Our results indicated that the C-PC-PTSD-5 can be employed as a brief and efficient screening instrument for medical staff exposed to the COVID-19 pandemic. A score of 2 was identified as the optimal threshold for probable clinical PTSD symptoms.
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Affiliation(s)
- Rui-Wen Huang
- Department of Science and Education, RuiJin Hospital LuWan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Tao Shen
- Department of Psychiatry, Shanghai Huangpu District Mental Health Center, Shanghai, People's Republic of China
| | - Lei-Ming Ge
- Department of General practice, Changfeng Community Health Service Center of Putuo, Shanghai, People's Republic of China
| | - Lu Cao
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jian-Feng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, People's Republic of China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China.,Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, People's Republic of China
| | - Shi-Yu Wu
- Department of Science and Education, RuiJin Hospital LuWan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China
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Li J, Wang W, Hu W, Yuan Z, Zhou R, Zhang W, Qu Z. Validation of posttraumatic stress disorder (PTSD) and complex PTSD in Chinese children as per the ICD-11 proposals using the International trauma questionnaire. Eur J Psychotraumatol 2021; 12:1888525. [PMID: 33796232 PMCID: PMC7968872 DOI: 10.1080/20008198.2021.1888525] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Given that the validity of applying complex posttraumatic stress disorder (CPTSD) in nonclinical children remains unclear. Objectives: The current study aimed to explore the factor structure, discriminant validity, and risk factors of ICD-11 posttraumatic stress disorder (PTSD) and CPTSD using the International Trauma Questionnaire. Methods: A total of 3478 trauma-exposed Chinese children aged 9-12 years were included in this study. All participants were assessed for PTSD and CPTSD using the International Trauma Questionnaire (ITQ). Confirmatory factor analysis (CFA) was conducted to explore the factor structure of CPTSD in a sample of Chinese children. Latent class analysis (LCA) was employed to evaluate the discriminant validity of CPTSD symptoms. Multinomial logistic regression analyses determined associations between the different classes and traumatic events. Results: The CFA results showed that the first-order six-factor model was identified as the best-fitting model in Chinese children aged 9-12 years. Four different classes, CPTSD symptoms, PTSD symptoms, disturbances in self-organization (DSO) symptoms, and a low symptom class were found by LCA. Both prolonged interpersonal trauma and other types of trauma were risk factors for the CPTSD class and the PTSD class. Conclusions: The results of this study partially support the factorial validity and strongly support the discriminant validity of the ICD-11 proposals for PTSD and CPTSD in Chinese children, supporting the conceptualization of PTSD and CPTSD as sibling diagnoses based on the ICD-11. However, findings suggest the need for careful consideration of identified trauma types in the ICD-11 proposals.
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Affiliation(s)
- Jina Li
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R.China
| | - Weiwei Wang
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R.China
| | - Wei Hu
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R.China
| | - Ziyue Yuan
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R.China
| | - Ruifu Zhou
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R.China
| | - Weijun Zhang
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R.China
| | - Zhiyong Qu
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R.China
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20
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Anxiety, Depression, and Post-traumatic Stress a month after 2019 Cyclone Fani in Odisha, India. Disaster Med Public Health Prep 2021; 16:670-677. [PMID: 33583466 DOI: 10.1017/dmp.2020.368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Early Identification of disaster victims with mental health problems may be useful, but information within a short period after a disaster is scarce in developing countries. This study examined anxiety, depression, and post-traumatic stress symptoms at 1 month following 2019 Cyclone Fani in Odisha, India. METHOD Post-traumatic stress symptoms (PTSS) were assessed by the Primary care PTSD screen for DSM 5 (PC-PTSD-5), anxiety symptoms by the Generalised Anxiety Disorder (GAD-7), and depression by the Patient Health Questionnaire (PHQ-9). The survey included participants' disaster experience e.g., evacuation, fear of death, injury, death in family, damage to house, difficulty for food, displacement, and effect on livelihood. RESULTS Proportion of sample (n = 80) with probable PTSD was 42.9%, with severe anxiety was 36.7%, moderately severe depression was 16.5%, and severe depression was 3.8%. Suicidal cognitions were reported to increase by 14%. Comorbidity was common; with significant (P < 0.01) correlation between PTSS and anxiety (r = 0.69), depression (r = 0.596), and between anxiety and depression (r = 0.63). Damage of house and displacement were associated significantly with PTSD; evacuation and displacement with moderate and severe depression; and displacement with severe anxiety. No specific demographic factors were significantly linked to the psychiatric morbidities. CONCLUSION A considerable proportion of victims had psychiatric morbidities at 1 month. Associated risk factors included housing damages, evacuation, and displacement, suggesting the need to improve the disaster-management process.
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Xue Q, Xie X, Liu Q, Zhou Y, Zhu K, Wu H, Wan Z, Feng Y, Meng H, Zhang J, Zuo P, Song R. Knowledge, attitudes, and practices towards COVID-19 among primary school students in Hubei Province, China. CHILDREN AND YOUTH SERVICES REVIEW 2021; 120:105735. [PMID: 33235402 PMCID: PMC7676362 DOI: 10.1016/j.childyouth.2020.105735] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 05/09/2023]
Abstract
This study was aimed to investigate the knowledge, attitudes, and practices (KAP) towards coronavirus disease 2019 (COVID-19) among school-aged children in the Hubei province when children were being confined to their homes. The questionnaire included questions of KAP about COVID-19, depressive and anxiety symptoms scales. Multivariable generalized linear regressions models were applied to estimate the unstandardized regression coefficients (β) of KAP. The awareness rates about COVID-19 were 70.1%-99.5% for all 1650 valid questionnaires. 37.2% of the participants quite worried about being infected with COVID-19. Approximately 96% of them washed hands in certain situations, while 85.6% of them washed hands after coughing or sneezing. Compared to the students without depressive symptoms, those who had depressive symptoms scored lower of total KAP, knowledge, attitudes, and practice. The findings suggest that primary students had a relatively good awareness of COVID-19 during the epidemic, as well as optimistic attitudes and appropriate practices. However, some items of appropriate practices still needed to be enhanced.
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Affiliation(s)
- Qi Xue
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyan Xie
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Liu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Zhou
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Wu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zihao Wan
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heng Meng
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Pengxiang Zuo
- Department of Nursing, Medical School, University of Shihezi, Shihezi, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nursing, Medical School, University of Shihezi, Shihezi, China
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22
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Cheng P, Jasinski N, Zheng W, Yadava A, Wang L, Li L, Xu L, Zhou Y, Zhang L, Li W. Psychometric Properties of the Primary Care PTSD Screen for DSM-5: Findings From Family Members of Chinese Healthcare Workers During the Outbreak of COVID-19. Front Psychiatry 2021; 12:695678. [PMID: 34594246 PMCID: PMC8477025 DOI: 10.3389/fpsyt.2021.695678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Minimal research has examined utility of PC-PTSD-5 in family members of frontline medical workers. The aims of our study were to develop and elucidate the psychometric properties of the Chinese version of the PC-PTSD-5 and to determine its usefulness in screening for possible PTSD in relatives of Chinese healthcare workers during the COVID-19. Methods: We conducted a cross-sectional research in the relatives of medical staffs working in a general hospital during the COVID-19. Descriptive analysis was used to characterize demographic information of family members to find factors associated with PTSD symptoms. For reliability test, the internal consistency of PC-PTSD-5 was accessed using Cronbach's alpha coefficient. A validity test was assessed by Pearson's correlation between scales. A receiver operating characteristic (ROC) curve was used to evaluate the optimal cutoff score with the maximum Youden Index in this study. Results: The result of demographic information indicated that gender and the type of work undertaken by medical staff in the family have a potential impact on the PTSD symptoms of medical staff's family members. Cronbach's alpha coefficient of PC-PTSD-5 was 0.83, indicating the high reliability. Good validity was also demonstrated by Pearson coefficient. By calculating the Youden index, a cutoff score of 2 was found to be optimal in our study, with sensitivity of 80.74% and specificity of 88.43%. Conclusions: Our study has demonstrated the robust psychometric strengths of the PC-PTSD-5, introducing a reliable tool for screening PTSD among vulnerable and neglected families of these medical workers.
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Affiliation(s)
- Peng Cheng
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Nicholas Jasinski
- Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, United States
| | - Wanhong Zheng
- Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, United States
| | - Aradhita Yadava
- Department of Biology and Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV, United States
| | - Lirong Wang
- XiangYa School of Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Lingjiang Li
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lizhi Xu
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ying Zhou
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Zhang
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - WeiHui Li
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
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23
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Li G, Wang L, Cao C, Fang R, Chen C, Qiao X, Yang H, Forbes D, Elhai JD. Test of the dynamic interplay between DSM-5 PTSD symptom clusters in children and adolescents. J Anxiety Disord 2020; 76:102319. [PMID: 33011555 DOI: 10.1016/j.janxdis.2020.102319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Revealing the dynamic interplay between posttraumatic stress disorder (PTSD) symptom clusters has always been an important topic in traumatic stress studies. Based on longitudinal studies, different hypotheses have been proposed to explain PTSD symptom dynamics. But currently, no study have been conducted to test these hypotheses in children and adolescents. METHODS Data were derived from a longitudinal study of child and adolescent traumatic event survivors of an explosion accident (N = 659). DSM-5 PTSD symptoms was measured by the PTSD Checklist-5 (PCL-5) at 4, 8, and 13 months after the disaster. Latent difference score (LDS) modeling was used to evaluate the dynamic interplay between clusters. RESULTS The results of LDS model indicated that intrusion level positively predicted subsequent rate of increase for hyperarousal (p = .008) and negative changes in cognitions and mood symptoms (p = .036). Also, intrusion level trended to positively predict subsequent increase rate of avoidance symptoms (p = .059). CONCLUSIONS This study expands previous knowledge of dynamic relations between symptom clusters during the maintenance and fluctuation of child and adolescent PTSD symptoms. By using new methodology, this study provided novel evidence for the hypothesis that intrusion symptom plays an important role in maintaining other PTSD symptoms.
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Affiliation(s)
- Gen Li
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Chengqi Cao
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ruojiao Fang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Chen
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xue Qiao
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Haibo Yang
- Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - David Forbes
- Department of Psychiatry, Phoenix Australia - Centre for Posttraumatic Mental Health, University of Melbourne, Carlton, Australia
| | - Jon D Elhai
- Department of Psychology, and Department of Psychiatry, University of Toledo, Toledo, USA
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Development and Preliminary Validation of the University of Minnesota's Traumatic Stress Screen for Children and Adolescents (TSSCA). J Behav Health Serv Res 2020; 48:50-62. [PMID: 32851563 DOI: 10.1007/s11414-020-09725-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Child and adolescent exposure to potential trauma experiences is pervasive. Given the prevalence, deleterious mental and physical effects, and economic cost of trauma exposure, child- and family-service systems are adopting trauma-informed approaches, including practices like trauma screening. Although a number of trauma-focused screening and assessment measures exist for youth, the majority are lengthy and inappropriate for universal administration. This study describes the development and preliminary validation of the Traumatic Stress Screen for Children and Adolescents (TSSCA), a six-item screening measure for trauma exposure and traumatic stress symptoms. Using two samples of youth presenting at community practice settings (n1 = 134, n2 = 137), reliability, discriminative validity, and criterion-related validity were calculated for the TSSCA. Results support the TSSCA as an empirically derived, reliable, and valid screening measure for exposure to trauma and symptoms of traumatic stress for youth ages 7 to 18.
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25
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Guo Q, Zheng Y, Shi J, Wang J, Li G, Li C, Fromson JA, Xu Y, Liu X, Xu H, Zhang T, Lu Y, Chen X, Hu H, Tang Y, Yang S, Zhou H, Wang X, Chen H, Wang Z, Yang Z. Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study. Brain Behav Immun 2020; 88:17-27. [PMID: 32416290 PMCID: PMC7235603 DOI: 10.1016/j.bbi.2020.05.038] [Citation(s) in RCA: 235] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 02/08/2023] Open
Abstract
Since the end of 2019, Corona Virus Disease 2019 (COVID-19) has been the cause of a worldwide pandemic. The mental status of patients with COVID-19 who have been quarantined and the interactions between their psychological distress and physiological levels of inflammation have yet to be analyzed. Using a mixed-method triangulation design (QUAN + QUAL), this study investigated and compared the mental status and inflammatory markers of 103 patients who, while hospitalized with mild symptoms, tested positive with COVID-19 and 103 matched controls that were COVID-19 negative. The severity of depression, anxiety, and post-traumatic stress symptoms (PTSS) was measured via an on-line survey. Using a convenience sampling technique, qualitative data were collected until the point of data saturation. In addition, a semi-structured interview was conducted among five patients with COVID-19. Peripheral inflammatory markers were also collected in patients, both at baseline and within ± three days of completing the on-line survey. Results revealed that COVID-19 patients, when compared to non-COVID controls, manifested higher levels of depression (P < 0.001), anxiety (P < 0.001), and post-traumatic stress symptoms (P < 0.001). A gender effect was observed in the score of "Perceived Helplessness", the subscale of PSS-10, with female patients showing higher scores compared to male patients (Z = 2.56, P = 0.010), female (Z = 2.37, P = 0.018) and male controls (Z = 2.87, P = 0.004). Levels of CRP, a peripheral inflammatory indicator, correlated positively with the PHQ-9 total score (R = 0.37, P = 0.003, Spearman's correlation) of patients who presented symptoms of depression. Moreover, the change of CRP level from baseline inversely correlated with the PHQ-9 total score (R = -0.31, P = 0.002), indicative of improvement of depression symptoms. Qualitative analysis revealed similar results with respect to patient reports of negative feelings, including fear, guilt, and helplessness. Stigma and uncertainty of viral disease progression were two main concerns expressed by COVID-19 patients. Our results indicate that significant psychological distress was experienced by hospitalized COVID-19 patients and that levels of depressive features may be related to the inflammation markers in these patients. Thus, we recommend that necessary measures should be provided to address depression and other psychiatric symptoms for COVID-19 patients and attention should be paid to patient perceived stigma and coping strategies when delivering psychological interventions.
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Affiliation(s)
- Qian Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yuchen Zheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jia Shi
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China; Graduate School, Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Guanjun Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chunbo Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - John A Fromson
- Department of Psychiatry, Brigham & Women's Hospital, and Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Yong Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaohua Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Hua Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Tianhong Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yunfei Lu
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Xiaorong Chen
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Hao Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yingying Tang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Shuwen Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Han Zhou
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaoliang Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haiying Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Zongguo Yang
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
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Song X, Fu W, Liu X, Luo Z, Wang R, Zhou N, Yan S, Lv C. Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China. Brain Behav Immun 2020; 88:60-65. [PMID: 32512134 PMCID: PMC7273140 DOI: 10.1016/j.bbi.2020.06.002] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The emergency department is considered to be a high-risk area, as it is often the first stop for febrile patients who are subsequently diagnosed with coronavirus disease 2019. This study, which employed a cross-sectional design, aimed to assess the mental health of emergency department medical staff during the epidemic in China. METHODS Demographic data and mental health measurements were collected by electronic questionnaires from February 28, 2020 to March 18, 2020. OUTCOMES A total of 14,825 doctors and nurses in 31 provinces of mainland China completed the survey. The prevalence rates of depressive symptoms and post-traumatic stress disorder (PTSD) were 25.2% and 9.1%, respectively. Men were more likely to have depressive symptoms and PTSD than women. Those who were middle aged, worked for fewer years, had longer daily work time, and had lower levels of social support were at a higher risk of developing depressive symptoms and PTSD. Working in the Hubei province was associated with a higher risk of depressive symptoms, while those working in the Hubei province but residing in another province had a lower risk of depressive symptoms and PTSD. Being a nurse was associated with a higher risk of PTSD. INTERPRETATION The findings suggest that targeted psychological interventions to promote the mental health of medical staff with psychological problems need to be immediately implemented. Special attention should be paid to local medical staff in Hubei.
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Affiliation(s)
- Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoran Liu
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China; Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Zhiqian Luo
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Rixing Wang
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Ning Zhou
- Central People's Hospital of Zhanjiang, Guangdong, China.
| | - Shijiao Yan
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China; School of Public Health, Hainan Medical University, Haikou, Hainan, China.
| | - Chuanzhu Lv
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China; Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China; Emergency and Trauma College, Hainan Medical University, Haikou, Hainan, China.
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He Q, Veldkamp BP, Glas CAW, van den Berg SM. Combining Text Mining of Long Constructed Responses and Item-Based Measures: A Hybrid Test Design to Screen for Posttraumatic Stress Disorder (PTSD). Front Psychol 2019; 10:2358. [PMID: 31695647 PMCID: PMC6817621 DOI: 10.3389/fpsyg.2019.02358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 10/03/2019] [Indexed: 11/13/2022] Open
Abstract
This article introduces a new hybrid intake procedure developed for posttraumatic stress disorder (PTSD) screening, which combines an automated textual assessment of respondents’ self-narratives and item-based measures that are administered consequently. Text mining technique and item response modeling were used to analyze long constructed response (i.e., self-narratives) and responses to standardized questionnaires (i.e., multiple choices), respectively. The whole procedure is combined in a Bayesian framework where the textual assessment functions as prior information for the estimation of the PTSD latent trait. The purpose of this study is twofold: first, to investigate whether the combination model of textual analysis and item-based scaling could enhance the classification accuracy of PTSD, and second, to examine whether the standard error of estimates could be reduced through the use of the narrative as a sort of routing test. With the sample at hand, the combination model resulted in a reduction in the misclassification rate, as well as a decrease of standard error of latent trait estimation. These findings highlight the benefits of combining textual assessment and item-based measures in a psychiatric screening process. We conclude that the hybrid test design is a promising approach to increase test efficiency and is expected to be applicable in a broader scope of educational and psychological measurement in the future.
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Affiliation(s)
- Qiwei He
- Educational Testing Service, Princeton, NJ, United States
| | - Bernard P Veldkamp
- Department of Research Methodology, Measurement and Data Analysis, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Cees A W Glas
- Department of Research Methodology, Measurement and Data Analysis, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Stéphanie M van den Berg
- Department of Research Methodology, Measurement and Data Analysis, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
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