Depression, Anxiety, and Stress as a Function of Psychological Strains: Towards an Etiological Theory of Mood Disorders and Psychopathologies

Does Bullying Victimization Accelerate Adolescents' Non-suicidal Self-injury? The Mediating Role of Negation Emotions and The Moderating Role of Submissive Behavior

Based on general strain theory, the current study examined whether bullying victimization was significantly related to adolescents' non-suicidal self-injury and whether negation emotions mediated this association and submissive behavior moderated this mediation process. A total of 1,984 adolescents completed a series of anonymous questionnaires regarding bullying victimization, negative emotions, non-suicidal self-injury, and submissive behavior. Results showed that bullying victimization was significantly and positively associated with non-suicidal self-injury and this relation was partially mediated by negative emotions. Submissive behavior moderated the relation between bullying victimization and non-suicidal self-injury as well as negation emotions and non-suicidal self-injury. Specifically, the victims of bullying with high submissive behavior were more likely to develop non-suicidal self-injury. Adolescents who had higher negative emotions were at greater risk of engaging in non-suicidal self-injury when they also had high submissive behavior. The positive association between negative emotions and non-suicidal self-injury was stronger in females than males.

Factor structure and measurement invariance of the Depression anxiety stress scale (DASS-21) in Chinese left-behind and non-left-behind children: an exploratory structural equation modeling approach

BACKGROUND

Comprehensive data has shown that adolescents often suffer from depression, anxiety, and low self-esteem, and are in a particularly fragile stage of psychological, physiological, and social development. Left-behind children in particular tend to have significantly higher, state anxiety and depression compared to non-left-behind children. The Depression, Anxiety, and Stress Scale (DASS-21) is an effective tool for evaluating depression, anxiety, and stress, and is used to measure levels of depression, anxiety, and stress in groups from a variety of backgrounds. The purpose of this study was to determine the effectiveness, reliability, and measurement invariance of the DASS-21 in Chinese left-behind children.

METHOD

The test and re-test method was used (N = 676), and the exploratory structural equation model (Mplus v.8.3) used to verify basic measurement models. For measurement invariance, the configural, weak, strong, and strict models were tested. The reliability of the DASS-21 was also tested using the collected data.

RESULTS

Analysis results showed that the DASS-21 had a stable three-factor structure in the sample of left-behind children in China. The measurement invariance test showed that gender and time not only had strong invariance, but also strict invariance. The results of cross left and non-left invariance indicated a lack of strict invariance. Finally, the McDonald's omega coefficient of the DASS-21 total scale was 0.864, and the internal consistency of each subscale was also good.

CONCLUSIONS

The DASS-21 is shown to be an effective and reliable tool for measuring depression, anxiety and stress in Chinese left-behind children.

Income dissatisfaction and migraine headache. Evidence from a nationwide population-based survey

Objective

We investigate whether and to what extent income dissatisfaction (ID) is an important determinant of migraine. Indeed, ID may play a more relevant role in migraines than realized income, and it may affect both low and high-income people.

Design

We exploit the Italian Statistical Institute (ISTAT) survey covering about 80,000 individuals for this study. On the methodological ground, an instrumental variable probit model has been implemented.

Main Outcome Measures

To measure income dissatisfaction we exploit a self-reported status ranging from 1 to 4, while the migraine variable captures whether the individual suffers from migraine.

Results

The results show that the higher the ID the greater the probability of having a migraine. This relationship is robust to the level of realized income, socioeconomic characteristics of the individual, and the existence of other illnesses.

Conclusions

The high relevance of ID among low-income as well as high-income people opens up a new perspective on the determinants of migraines and provides an explanation of the contrasting evidence in the literature about the income-migraine nexus.

Evaluating depression anxiety and stress assessment before and during the COVID-19 pandemic using generalisability theory

The current study investigated the assessment of depression, anxiety, and stress during normal and COVID-19 pandemic conditions. Generalisability theory (G-theory) was applied to examine stable and dynamic aspects of psychological distress and the overall reliability of the Depression, Anxiety and Stress Scales (DASS-21), using data from two independent samples collected on three occasions with 2- to 4-week intervals. The US data (n = 115) was collected before the COVID-19 pandemic, and the New Zealand (NZ) data (n = 114) was obtained during the pandemic. The total DASS-21 demonstrated excellent reliability in measuring enduring symptoms of psychological distress (G = .94-.96) across both samples. While all DASS-21 subscales demonstrated good reliability with the pre-pandemic US sample, the subscales' reliability was below an acceptable level for the NZ sample. Findings from this study indicate that the overall psychological distress is enduring and can be reliably measured by the DASS-21 across different conditions and populations, while shifts across depression, anxiety and stress levels are likely during emergency and uncertainty, as seen in the COVID-19 pandemic.

Influencing factors, prediction and prevention of depression in college students: A literature review

The high prevalence of depression among college students has a strong negative impact on individual physical and mental health, academic development, and interpersonal communication. This paper reviewed the extant literature by identifying nonpathological factors related to college students' depression, investigating the methods of predicting depression, and exploring nonpharmaceutical interventions for college students' depression. The influencing factors of college students' depression mainly fell into four categories: biological factors, personality and psychological state, college experience, and lifestyle. The outbreak of coronavirus disease 2019 has exacerbated the severity of depression among college students worldwide and poses grave challenges to the prevention and treatment of depression, given that the coronavirus has spread quickly with high infection rates, and the pandemic has changed the daily routines of college life. To predict and measure mental health, more advanced methods, such as machine algorithms and artificial intelligence, have emerged in recent years apart from the traditional commonly used psychological scales. Regarding nonpharmaceutical prevention measures, both general measures and professional measures for the prevention and treatment of college students' depression were examined in this study. Students who experience depressive disorders need family support and personalized interventions at college, which should also be supplemented by professional interventions such as cognitive behavioral therapy and online therapy. Through this literature review, we insist that the technology of identification, prediction, and prevention of depression among college students based on big data platforms will be extensively used in the future. Higher education institutions should understand the potential risk factors related to college students' depression and make more accurate screening and prevention available with the help of advanced technologies.

Time Spent on Social Media and Risk of Depression in Adolescents: A Dose-Response Meta-Analysis

Adolescent depression is a worldwide public health concern and has contributed to significant socioeconomic burden. Investigating the association between time spent on social media (TSSM) and depression may provide guidance toward the prevention and intervention of adolescent depression. However, related literature reported mixed findings in terms of the relationship between TSSM and depression in adolescents. Hence, we conducted a comprehensive dose−response meta-analysis to clarify this issue. We conducted a systematic title/abstract and topic search of the relative terms in Web of Science, PubMed, PsycINFO databases through 9 January 2022. Odd ratios (ORs) were used to examine the pooled effect size of the association between TSSM and risk of depression. Dose−response analysis was evaluated by a generalized least squares trend estimation. Twenty-one cross-sectional studies and five longitudinal studies including a total of 55,340 participants were included. Overall, more TSSM was significantly associated with a higher risk of depression symptoms (OR = 1.60, 95%CI: 1.45 to 1.75) with high heterogeneity (Q(29) = 105.9, p < 0.001; I2 = 72.6%). The association was stronger for adolescent girls (OR = 1.72, 95%CI: 1.41 to 2.09) than boys (OR = 1.20, 95%CI: 1.05 to 1.37). Five studies with seven reports were included in dose−response analysis. There was a linear dose−response association of TSSM and risk of depression. The risk of depression increased by 13% (OR = 1.13, 95%CI: 1.09 to 1.17, p < 0.001) for each hour increase in social media use in adolescents. TSSM is associated with depression in a linear dose−response and gender-specific manner, which suggests the need for better monitoring of adolescent social media use. However, motivation, content, and engagement on and exposure to social media use may also be important contributing factors, making it necessary to interpret the current findings with caution. Therefore, further research is required to clarify not only the causal link between TSSM and depression by randomized control studies but also the influence of other factors, such as active vs. passive social media use or different types of engagement or environments in which social media is used.

How can leaders alleviate employees' workplace anxiety caused by information overload on enterprise social media? Evidence from Chinese employees

Purpose

The purpose of this study is to explore the relationship between information overload and employees' workplace anxiety in the context of enterprise social media (ESM).

Design/methodology/approach

This study built a theoretical model to analyze the relationships among employees' perceptions of information overload on ESM, supervisor-subordinate instrumental and expressive ties on ESM and workplace anxiety. PLS-SEM was used to test the model through 219 questionnaires collected online.

Findings

The results revealed that information overload on ESM plays a positive role in employees' workplace anxiety. Supervisor-subordinate instrumental ties based on ESM can weaken the relationship between information overload and employees' workplace anxiety, but expressive ties can strengthen the positive relationship between information overload and workplace anxiety.

Originality/value

Little is known about whether information overload on ESM will affect employees' workplace anxiety and how leaders can mitigate this effect through ESM. Hence, this study developed a theoretical model and conducted an empirical study to open up a research opportunity to examine the relationships among information overload on ESM, supervisor-subordinate instrumental and expressive ties on ESM and employees' workplace anxiety. The study also has the potential to guide organizations in fine-tuning their social media usage strategies.

Prevalence of Sleep Problems Among Chinese Medical Students: A Systematic Review and Meta-Analysis

BACKGROUND

Sleep is a necessary physiological process, which is closely related to cognitive function, emotion, memory, endocrine balance, and immunity. The prevalence of sleep problems continues to rise in Chinese medical students, which has a potential influence on living and work.

OBJECTIVE

This study aimed to observe the prevalence of sleep problems among medical students in China.

METHOD

The included cross-sectional studies on the prevalence of sleep problems of medical students in China were retrieved from PubMed, Embase, the Cochrane Database of Systematic Reviews, CNKI, and Wanfang database. An 11-item checklist recommended by the Agency for Healthcare Research and Quality was adopted to evaluate the methodological quality of the included studies. Software Stata 12.0, SPSS 26.0, and R were used to analyze the data. Registration: PROSPERO, CRD 42021237303.

RESULT

The prevalence of sleep problems among Chinese medical students was 27.38%. The subgroup analysis showed significant differences in the prevalence of sleep problems among different regions, educational backgrounds, grades, and University types. The region, latitude, and gross domestic product (GDP) were significant heterogeneous sources of sleep problems. The prevalence is positively correlated with latitude and negatively correlated with GDP per capita. Regular screening and appropriate intervention are recommended for these mental health problems.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021237303, identifier: CRD42021237303.

To Help or Not to Help: Intervening in Cyberbullying Among Chinese Cyber-Bystanders

Cyberbullying has become a serious concern among Internet users worldwide. However, relatively little is known about individuals who witness cyberbullying and how they behave. A bystander is someone who sees bullying or other forms of aggressive or violent behavior that targets someone else and who may choose to respond by either being part of the problem (a hurtful bystander), or part of the solution (a helpful bystander). Few studies examined the phenomena of cyber-bystanders in Chinese populations. Guided by the five-step bystander theoretical model and the theory of planned behavior, this study, addressed this gap to understand how the characteristics of cyber-bystanders explained their intervention in cyberbullying in a Chinese population. This study tested two preregistered hypotheses: (1) controlling for age and gender, awareness of cyberbullying, attitudes, subjective norm and perceived behavioral control to intervene; plus past experience with cyberbullying (measured as past experience in cyberbullying perpetration and victimization), felt responsibility, and self-efficacy to intervene with regard to cyberbullying would explain the intention of cyber-bystanders to intervene in cyberbullying, and (2) the intention of cyber-bystanders to intervene cyberbullying would positively explain their intervening behavior. A total of 581 college students with experience of witnessing cyberbullying were included in the analysis. Applying structural equation modeling with observed variables, a path analysis model was built to test the hypotheses; this study also conducted exploratory analyses by including direct paths from the characteristics of cyber-bystanders to explain intervening behavior. Results found that only awareness of cyberbullying, a subjective norm, and self-efficacy to intervene positively explained intention to intervene cyberbullying; therefore, hypothesis 1 was partly supported. Also, intention to intervene cyberbullying positively explained intervening behavior; therefore, hypothesis 2 was supported. For the exploratory analysis, intention to intervene partially mediated the relation between a subjective norm to intervene and intervening behavior; and intention to intervene also partially mediated the relation between self-efficacy to intervene and intervening behavior. In addition, past experience in cyberbullying victimization also positively and directly predicted intervening behavior. Findings provided a foundation for designing future intervention programs to mobilize cyber-bystanders to become “upstanders.”

Prevalence of depression among Chinese medical students: A systematic review and meta-analysis

The prevalence of depression continues to increase among medical students in China, and higher than that of other majors, which is a potential risk for medical students and their patients. This study aimed to observe the prevalence of depression in Chinese medical students and also the correlation between them. All cross-sectional studies on the prevalence of depression in Chinese medical students were retrieved from PubMed, Embase, the Cochrane Database of Systematic Reviews, CNKI, and Wanfang. An 11-item checklist recommended by the Agency for Healthcare Research and Quality was adopted to evaluate the methodological quality of the included studies. Software Stata 12.0 was used to analyze the data. Registration: PROSPERO, CRD42020169681. The prevalence of depression among medical students in China was 27%. The subgroup analysis showed significant differences in the prevalence of depression in different regions. The sleep quality was a significant heterogeneous source of depression. Medical students with sleep disorders were more than three times as likely to report depression. The prevalence of depression in Chinese medical students is relatively high, and medical students with sleep disorders are more likely to have depression problems. Regular screening and appropriate intervention are recommended for these mental health problems.

What Explains the Association between Usage of Social Networking Sites (SNS) and Depression Symptoms? The Mediating Roles of Self-Esteem and Fear of Missing Out

The goal of the study was to understand the mechanisms of how social networking sites (SNS) usage is related to depression symptoms, as measured by the Center for Epidemiological Studies-Depression Scale (CESD). Three studies were conducted to examine the mediation roles of self-esteem and Fear of Missing Out (FoMO). In Study 1, among 347 Chinese college students, time spent on SNS was negatively associated with self-esteem; while self-esteem then negatively associated with depression symptoms. In Study 2, among 180 Chinese college students, time spent on SNS was positively related to FoMO; while FoMO then positively related to depression symptoms. In Study 3, among 233 Chinese university students, both self-esteem and FoMO were simultaneously included in the mediation model to test their respective roles in explaining depression symptoms. Results showed that more time spent on SNS was related to lower self-esteem, and higher FoMO, respectively; while self-esteem then negatively, and FoMO then positively, explained depression symptoms, respectively. In addition, when participants spent 3.5 h (Study 1), 2.5 h (Study 2), and 2.54 h (Study 3) on SNS, they reached the cutoff for subthreshold depression, as measured by CESD. Combining results from three studies, both self-esteem and FoMO mediated the relation between SNS usage and depression symptoms. This study provides implications to understand the mechanism of SNS-related depression.

Role of the Intestinal Microbiome, Intestinal Barrier and Psychobiotics in Depression

The intestinal microbiota plays an important role in the pathophysiology of depression. As determined, the microbiota influences the shaping and modulation of the functioning of the gut-brain axis. The intestinal microbiota has a significant impact on processes related to neurotransmitter synthesis, the myelination of neurons in the prefrontal cortex, and is also involved in the development of the amygdala and hippocampus. Intestinal bacteria are also a source of vitamins, the deficiency of which is believed to be related to the response to antidepressant therapy and may lead to exacerbation of depressive symptoms. Additionally, it is known that, in periods of excessive activation of stress reactions, the immune system also plays an important role, negatively affecting the tightness of the intestinal barrier and intestinal microflora. In this review, we have summarized the role of the gut microbiota, its metabolites, and diet in susceptibility to depression. We also describe abnormalities in the functioning of the intestinal barrier caused by increased activity of the immune system in response to stressors. Moreover, the presented study discusses the role of psychobiotics in the prevention and treatment of depression through their influence on the intestinal barrier, immune processes, and functioning of the nervous system.

Association between Mental Health Knowledge Level and Depressive Symptoms among Chinese College Students

This study aimed to explore the association between mental health knowledge level and the prevalence of depressive symptoms among Chinese college students. A cross-sectional study was conducted in six universities in Jinan, Shandong Province, China, and a total of 600 college students were recruited to self-complete a series of questionnaires. The Mental Health Knowledge Questionnaire (MHKQ) was used to investigate the level of mental health knowledge. Depressive symptoms were investigated with the depression subscale of the Depression Anxiety Stress Scale (DASS-21). The prevalence rate of depressive symptoms among college students was 31.2%. Compared with MHKQ scoring in the 1st quartile, college students with MHKQ scoring in the 3rd quartile and in the 4th quartile reported lower levels of depressive symptoms after adjusting for potential confounding factors. Since mental health knowledge level was related to depressive symptoms among college students, increased efforts to promote the level of mental health knowledge in Chinese college students are critical.

Psychological Strain and Suicidal Ideation in Athletes: The Multiple Mediating Effects of Hopelessness and Depression

The present study aims to examine the relationship between psychological strain, suicidal ideation, hopelessness, and depression among Chinese athletes. Participants were 774 Chinese athletes (454 men and 320 women), with a range of ages from 12 to 35 (M = 18.47, SD = 3.39). The structural equation modeling method was used to examine the multiple mediating effects of hopelessness and depression between psychological strain and suicidal ideation. As expected, a positive correlation between psychological strain, suicidal ideation, hopelessness, and depression was found. Additionally, results seem to indicate that psychological strain directly and positively influenced suicidal ideation, and that hopelessness and depression played a serial mediating role in the relationship between psychological strain and suicidal ideation. To conclude, the psychological strain theory is applicable for explaining suicidal ideation in athletes. In athletes, psychological strain is sequentially associated first with a sense of hopelessness and then depression, which is in turn related to suicidal ideation. The present study makes a significant contribution to the literature because we provide a new theoretical basis and new methods for preventing mental disorder and suicidality in athletes.