Analysis of features of social anxiety and exploring the relationship between childhood major adverse experiences and social anxiety in early adulthood among Chinese college students

Adverse Childhood Experience, Parental Bonding, and Fatherhood as Parenting Vulnerabilities to Social Anxiety Severity

Background: The present study aims to elucidate the association between adverse childhood experiences, parental bonding, fatherhood, and social anxiety symptoms among emerging adults within an Iranian context. Methods: This prospective cross-sectional study utilized self-reported assessments to evaluate fatherhood, parental bonding, anxious thoughts, and childhood trauma. The study was administered to 242 university students exhibiting social anxiety symptoms. Among the participants, 181 (74.8%) were boys and 61 (25.2%) were girls between the ages of 18 and 29. In terms of educational background, 64.9% of them held a bachelor's degree, and 35.1% held a master's degree. A majority of them (84.3%) were of middle-class socio-economic status, 6.6% were of low income, and 9.1% were of high income. Results: Analysis via multiple linear regression revealed that individuals with adverse childhood experiences exhibited heightened levels of social anxiety symptoms (R2 = 0.32) compared to their counterparts without such experiences. Furthermore, fatherhood (R2 = 0.28), paternal bonding (R2 = 0.26), and maternal bonding (R2 = 0.26) were all significantly and equally associated with variance in social anxiety symptoms. The findings underscored the substantial correlation between ACEs, fatherhood, and both maternal and paternal bonding with social anxiety symptoms in adulthood. Conclusions: Accordingly, the study emphasizes the importance of thoroughly assessing the multifaceted contributors to social anxiety. Such insights are pivotal for the design and implementation of community-based preventive interventions aimed at reducing the societal burden of social anxiety disorders.

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

Background

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

Methods

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

Results

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

Conclusion

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

Interpersonal sensitivity as a mediator linking interpersonal stressors and social anxiety: Longitudinal mediation analysis using parallel process latent growth curve modeling

BACKGROUND

Little is known about the mechanism between interpersonal stressors and social anxiety in college students. This study was to investigate the mediating effect of interpersonal sensitivity between interpersonal stressors and social anxiety.

METHODS

The data was taken from a large-scale health-related cohort among Chinese college students. This study used data from the first four waves, including 4191 participants. The latent growth curve mediation model was used to examine the potential mediating role of interpersonal sensitivity in the relationship between interpersonal stressors and social anxiety over time.

RESULTS

Both levels and changes in interpersonal stressors were positively associated with subsequent levels and changes in social anxiety. Mediation analysis showed that interpersonal sensitivity mediated the relationship between interpersonal stressors and social anxiety.

LIMITATION

All variables were collected based on self-report.

CONCLUSIONS

Interpersonal stressor is a significant risk factor for social anxiety, and this association appears to be mediated by interpersonal sensitivity. It is necessary to evaluate and intervene against interpersonal sensitivity related to interpersonal stressors for the prevention of social anxiety.

Social media addiction and academic engagement as serial mediators between social anxiety and academic performance among college students

BACKGROUND

Social anxiety has been shown to affect college students' academic performance. However, the role of social media addiction and academic engagement in this association is unclear.

METHODS

A total 2661 college students completed a self-report questionnaire including Liebowitz Social Anxiety Scale, the Bergen Social Media Addiction Scale, the Utrecht Student Work Engagement Scale for Students, and the grade point average. Hayes' PROCESS macro for SPSS was employed to test the serial mediation effect.

RESULTS

Results indicated that social anxiety was negatively related to academic performance, only academic engagement played a single mediating role in the relationship between social anxiety and academic performance, meanwhile social media addiction and academic engagement acted as serial mediators between social anxiety on academic performance.

CONCLUSIONS

Social media addiction and academic engagement can explain the potential mechanisms of the association between social anxiety and academic performance, which have implications for devising intervention strategies to enhance the mental health and academic outcomes of college students.

The effect of virtual reality exposure therapy on focus of attention, self-criticism, and interpretation bias in university students with social anxiety

BACKGROUND

The present research aims to investigate the effectiveness of virtual reality exposure therapy on the focus of attention, self-criticism, and interpretation bias among university students with social anxiety.

MATERIALS AND METHODS

The present research was conducted using quasi-experimental research with pre-test and post-test control group design. The participants were university students aged between 10 and 30 years old who had visited Isfahan counseling centers in 1399 HS. Among 53 patients referred to the counseling centers, 30 were randomly selected by convenience sampling and then assigned to an experimental group (15 individuals) and a control group (15 individuals). The experimental group received eight sessions of 30-minute and face-to-face virtual reality-based interventions. In contrast, the control group remained on the waiting list. A structured clinical interview and Social Phobia Inventory (SPIN) were used to select and screen students, and the Focus of Attention Questionnaire (FAQ), Levels of Self-Criticism Scale (LOSC), and revised interpretation bias inventory were applied for the pre-test and the post-test. Then, all the data were analyzed by a statistical analysis of covariance.

RESULTS

The results showed that virtual reality exposure therapy significantly reduces the symptoms of the focus of attention, self-criticism, and interpretation bias in the experimental group compared to the control group. (P < 0/01).

CONCLUSION

The research showed that virtual reality exposure therapy reduced the symptoms of social anxiety. Therefore, this method can be applied to reduce some symptoms of social anxiety in university students.

Measuring changes in adult health and well-being during the COVID-19 pandemic and their relationship with adverse childhood experiences and current social assets: a cross-sectional survey

BACKGROUND

Adverse childhood experiences (ACEs) can impact mental and physical health, leaving people with less resilience to health challenges across the life-course. This study examines whether individuals' levels and changes in levels of mental health, physical health and sleep quality reported across the first year of the COVID-19 pandemic are associated with ACEs and moderated by social assets such as having trusted family and friends.

METHODS

A cross-sectional household telephone survey in England (a North West local authority) and Wales (nationally) using landline and mobile numbers stratified by health areas, deprivation quintile and age group and supplemented by an online survey. Data were collected from 4,673 English and Welsh residents aged ≥ 18 years during national COVID-19 restrictions (December 2020 to March 2021). Measures included nine types of ACE; self-reported mental health, physical health and sleep quality at time of survey (in pandemic) and one-year earlier (pre-pandemic); numbers of trusted family members and friends, knowledge of community help; and COVID-19 infection.

RESULTS

ACEs were strongly related to moving into poorer mental health, physical health, and sleep categories during the pandemic, with likelihoods more than doubling in those with ≥ 4 ACEs (vs. 0). ACEs were also associated with increased likelihood of moving out of poorer health and sleep categories although this was for a much smaller proportion of individuals. Individuals with more trusted family members were less likely to move into poorer health categories regardless of ACE counts.

CONCLUSIONS

ACEs are experienced by large proportions of populations and are associated with poorer health even in non-pandemic situations. However, they also appear associated with greater vulnerability to developing poorer health and well-being in pandemic situations. There is a minority of those with ACEs who may have benefited from the changes in lifestyles associated with pandemic restrictions. Connectedness especially with family, appears an important factor in maintaining health during pandemic restrictions.

The relationship between emotional neglect and non-suicidal self-injury among middle school students in China: the mediating role of social anxiety symptoms and insomnia

 BACKGROUND: Non-suicidal self-injury (NSSI) is a vital public concern around the world, and it often starts in adolescence. Emotional neglect (EN) has been considered a distal risk factor for NSSI, but the effects of social anxiety symptoms (SA) and insomnia on this relationship have remained unclear. This study aimed to investigate the potential pathways from EN to NSSI, examining the role of SA and insomnia in this association.

METHODS

One thousand three hundred thirty seven Chinese middle school students (M_age = 13.040, SD = 0.981, 50.2% males) in China were enrolled in this cross-sectional study. Participants completed the Emotional Neglect sub-scale of Childhood Trauma Questionnaire (CTQ-SF), the Social Anxiety Scale for Adolescent (SAS-A), Athens Insomnia Scale (AIS) and non-suicidal self-injury assessment. Structural equation modelling (SEM) was used to test the possible mediation model among these variables.

RESULTS

231(17.3%) students reported NSSI history during last year and 322 (24.1%) participants reported experiences of EN. Students who experienced EN have higher rates of NSSI compared to students without EN history (29.2% vs 13.5%). EN, SA, insomnia and NSSI were positively related to each other. Furthermore, both SA and insomnia played a mediating role in the relationship between EN and NSSI, the series mediating effect of SA and insomnia on this association was also significant after controlling for demographics. Indirect effects accounted for 58.26% of the total effects (EN → NSSI).

CONCLUSIONS

Our study revealed that EN was associated with NSSI, SA and insomnia play indirect roles in the association between EN and NSSI. The findings of our research may have implications for clinicians, families, and schools in their efforts to lower the risk of NSSI in adolescents.

Pathway of effects of adverse childhood experiences on the poly-drug use pattern among adults using drugs: A structural equation modeling

Introduction

Adverse childhood experiences (ACEs) are associated with an increased risk of poly-substance use among drug-using adults. However, there is a paucity of literature on a direct or indirect relationship between ACEs and drug use patterns. We thus aimed to identify the pathway of effects of ACEs on drug use patterns in adults by the structural equation model (SEM).

Methods

A cross-sectional study was conducted by respondent-driving sampling and consecutive sampling among adult drug users in Southwest China in 2021. Descriptive, univariate, and SEM analyses were performed by R software 4.2.1.

Results

Of 406 participants recruited from a drug abuse clinic, the average age was 34 years. The majority of the participants were male patients (98.3%) from ethnic minorities (79.6%), who were unmarried (71.6%) and employed (81.2%). Nearly 95.5% experienced ACEs with 46.6% of them reporting four or more ACEs. The median value of self-perception of drug abuse score, friend drug use score, and drug use score was 8.0 (3.0, 11.0), 1.0 (0.0, 1.0), and 1.0 (1.0, 2.0) respectively. In the confirmatory analysis part of SEM, the construct of latent variables fitted well with the data. Poly-drug use was significantly and directly affected by three predictors including monthly incomes (β = 0.09), friend drug use (β = 0.50), and ACEs (β = 0.11). The indirect effect of ACEs passing through self-perception of drugs (β = 0.09) was not significant.

Discussion

ACEs have an independent and direct effect on the drug user for poly-drug use apart from the effect of drug-using friends and family income.

Detecting individuals with severe mental illness using artificial intelligence applied to magnetic resonance imaging

BACKGROUND

Identifying individuals at risk for severe mental illness (SMI) is crucial for prevention and early intervention strategies. While MRI shows potential for case identification even before illness onset, no practical model for mental health risk monitoring has been developed. This study aims to develop an initial version of an efficient and practical model for mental health screening among at-risk populations.

METHODS

A deep learning model known as Multiple Instance Learning (MIL) was adopted to train and test a SMI detection model with clinical MRI scans of 14,915 patients with SMI (age 32.98 ± 12.01 years, 9102 women) and 4538 healthy controls (age 40.60 ± 10.95 years, 2424 women) in the primary dataset. Validation analysis was conducted in an independent dataset with 290 patients (age 28.08 ± 10.95 years, 169 women) and 310 healthy participants (age 33.55 ± 11.09 years, 165 women). Another three machine learning models of ResNet, DenseNet and EfficientNet were used for comparison. We also recruited 148 individuals receiving high-stress medical school education to characterize the potential real-world utility of the MIL model in detecting risk of mental illness.

FINDINGS

Similar performance of successful differentiation of individuals with SMI and healthy controls was observed for the MIL model (AUC: 0.82) and other models (ResNet, DenseNet, EfficientNet, 0.83, 0.81, and 0.80 respectively). MIL had better generalization in the validation test than other models (AUC: 0.82 vs 0.59, 0.66 and 0.59), and less drop-off in performance from 3.0T to 1.5T scanners. The MIL model did better in predicting clinician ratings of distress than self-ratings with questionnaires (84% vs 22%) in the medical student sample. Brain regions that contributed to SMI identification were mainly neocortical, including right precuneus, bilateral temporal regions, left precentral/postcentral gyrus, bilateral medial prefrontal cortex and right cerebellum.

INTERPRETATION

Our digital model based on brief clinical MRI protocols identified individual SMI patients with good accuracy and high sensitivity, suggesting that with incremental improvements the approach may offer potentially useful aid for early identification and intervention to prevent illness onset in vulnerable at-risk populations.

FUNDING

This study was supported by the National Natural Science Foundation of China, National Key Technologies R&D Program of China, and Sichuan Science and Technology Program.

A study on the effects of perceived playfulness and emotional support in interactive learning environments for German language acquisition-A role-playing library system case

Introduction

This study examines the emotional support offered by the non-player characters (NPCs) in an interactive learning environment, as well as the effects of the perceived playfulness of the interactive system on German language learning.

Method

We developed a role-playing library system to serve this purpose. 2,377 Chinese Internet users were surveyed using online questionnaire.

Results

A theoretical model of emotion- driven learning (ELM) was proposed based on the analysis results of valid recovered data. Additionally, NPCs were found to be effective in improving learning outcomes through emotional support.

Discussion

An interactive education system may be able to enhance the perceived playfulness of learning in order to enhance the learning experience.

Examining Childhood Adversities in Chinese Health Science Students Using the Simplified Chinese Version of the Adverse Childhood Experiences-International Questionnaire (SC-ACE-IQ)

Adverse childhood experiences (ACEs) are prevalent, costly, and associated with poor health outcomes in adults. Little is known about ACE prevalence rates or strategies for measuring ACEs among young adults in Mainland China. The aims of this study were to (a) translate the ACE-International Questionnaire (ACE-IQ) into Simplified Chinese, (b) assess the psychometric strength of the Simplified Chinese version of the ACE-IQ (SC-ACE-IQ), and (c) compare SC-ACE-IQ scores calculated using binary and frequency scoring methods. The ACE-IQ was translated from English to Simplified Chinese and evaluated for content validity, criterion validity, and test–retest reliability. Chinese young adults (n = 566) aged 18–38 years who were health science students were recruited in Shanghai, China from May to August 2020. ACE exposures were compared using binary and frequency scoring methods, as proposed by the World Health Organization (WHO). The SC-ACE-IQ has good content validity (S-CVI = 0.89) and test–retest reliability (ICC = 0.88). SC-ACE-IQ scores were associated with depressive (binary: r = 0.26, frequency: r = 0.29; p < 0.001) and anxiety (binary: r = 0.22, frequency: r = 0.24; p < 0.001) symptoms. Higher proportion of participants reported exposure to at least one ACE and four or more ACEs when using the binary scoring method compared to the frequency scoring method. The SC-ACE-IQ is a valid and reliable ACE measure for Chinese health science students. Using frequency methods may underestimate exposure to ACEs among this population. Researchers should carefully select scoring methods for different study populations and purposes.

The Experience Among College Students with Social Anxiety Disorder in Social Situations: A Qualitative Study

BACKGROUND

Few individuals have focused on the experience of students during social events, especially among college students with social anxiety disorder. This study aimed to explore the anxiety experience among college students with social anxiety disorder in social situations.

METHODS

This qualitative interpretive study was conducted on college students who were diagnosed with social anxiety disorder (SAD) and recruited from two colleges in Heilongjiang Province, China. A total of 7 participants were selected by purposive sampling with maximum variability. Data were collected through semistructured individual interviews, and data analysis was performed by using Colaizzi's 7-step analysis method.

RESULTS

The findings from the analysis of the interviews were classified into 4 themes and several main categories, including distorted self-awareness (3 main categories), fear of negative reaction from others (2 main categories), adverse reaction of body and mind (4 main categories) and strong desire to seek treatment.

CONCLUSION

In our study, we sought to understand the anxiety experience among college students with social anxiety disorder in social situations. The study results provide a reference for psychologists and clinical medical staff and establish a scientific basis for the prevention and intervention of social anxiety disorder.