Sleep problems and emotional dysregulation mediate the relationship between childhood emotional abuse and suicidal behaviors: A three-wave longitudinal study

Childhood adversity and suicidal ideation in older Korean adults: unraveling the mediating mechanisms of mental health, physical health, and social relationships

BACKGROUND

Suicide rates in older adults are much higher than those in younger age groups. Given the rapid increase in the proportion of older adults in Korea and the high suicide rate of this age group, it is worth investigating the mechanism of suicidal ideation for older adults. Generally, adverse childhood experiences are positively associated with suicidal ideation; however, it is not fully understood what mediating relationships are linked to the association between these experiences and current suicidal ideation.

METHODS

The data from 685 older Korean adults were analyzed utilizing logistic regression, path analyses, and structural equation modeling. Based on our theoretical background and the empirical findings of previous research, we examined three separate models with mental health, physical health, and social relationship mediators. After that, we tested a combined model including all mediators. We also tested another combined model with mediation via mental health moderated by physical health and social relationships.

RESULTS

The univariate logistic regression results indicated that childhood adversity was positively associated with suicidal ideation in older adults. However, multivariate logistic regression results demonstrated that the direct effect of childhood adversity became nonsignificant after accounting all variables. Three path models presented significant mediation by depression and social support in the association between childhood adversity and suicidal ideation. However, combined structural equation models demonstrated that only mediation by a latent variable of mental health problems was statistically significant. Social relationships moderated the path from mental health problems to suicidal ideation.

CONCLUSIONS

Despite several limitations, this study has clinical implications for the development of effective strategies to mitigate suicidal ideation. In particular, effectively screening the exposure to adverse childhood experiences, early identification and treatment of depressive symptoms can play a crucial role in weakening the association between childhood adversity and suicidal ideation in older adults.

Specific and cumulative effects of childhood maltreatment on nonsuicidal self-injury in Chinese adolescents: The moderating effect of sleep disturbance

BACKGROUND

Numerous studies have examined the relationship between childhood maltreatment (CM) and nonsuicidal self-injury (NSSI). However, few studies have explored both the specific and cumulative effects of CM on NSSI. Additionally, the impact of sleep disturbance on the association between CM and NSSI remains unclear.

OBJECTIVES

To comprehensively explore the effects of CM on NSSI, and to determine whether these effects are moderated by sleep disturbance.

PARTICIPANTS AND SETTING

A retrospective study was conducted in April 2021 among a representative sample of 21,340 students aged 11-20 years in China.

METHODS

All participants completed questionnaires assessing CM, sleep disturbance, and NSSI. Adjusted multivariate logistic regression models were utilized to evaluate the associations between CM and NSSI, as well as the impact of sleep disturbance.

RESULTS

The findings revealed that 13.0 % of adolescents reported occasional NSSI, while 25.2 % reported repetitive NSSI. Except for sexual abuse, all subtypes of CM were significantly associated with increased odds of both occasional and repetitive NSSI. A significant dose-response relationship was observed between cumulative CM and repetitive NSSI. Stratification analyses by sleep disturbance indicated that adolescents reporting sleep disturbance had a higher risk of developing repetitive NSSI, irrespective of the type of CM experienced. Furthermore, a dose-response relationship was identified between cumulative CM and repetitive NSSI among adolescents reporting sleep disturbance.

CONCLUSION

This study demonstrated that CM increases the risk of NSSI among Chinese adolescents, and sleep disturbance plays a moderating role. Interventions targeting sleep disturbance may hold significance in reducing NSSI.

The mediating role of sleep problems and depressed mood between psychological abuse/neglect and suicidal ideation in adolescent childhood: a multicentred, large sample survey in Western China

BACKGROUND

Adolescent suicidal ideation are associated with factors including psychological abuse/neglect, sleep problems, and depressed mood, but the systematic effects of these factors on suicidal ideation remain unclear, which is a research gap this work aims to fill.

METHODS

A multi-center, the cluster sampling method was employed to collect general demographic data, such as age, gender, the experience of being left behind, and parents' marital status, from 12,192 students across 17 secondary schools in China. The Child Psychological Abuse and Neglect Scale (CPANS), Pittsburgh Sleep Quality Index (PSQI), the Chinese version of the Depressed mood, Anxiety and Stress Scale - 21 Items (DASS-21) and Chinese version of Positive and Negative Suicide Ideation Inventory (PANSI) were utilized. Data were analyzed using t-tests, chi-square tests, correlation analyses, and structural equation modeling mediation analyses.

RESULTS

The prevalence of psychological abuse/neglect and adolescent suicidal ideation was 34.8% and 13%, respectively. This mediation analysis suggests that, in the relationship between psychological abuse/neglect and suicidal ideation, sleep problems and depressed mood play both parallel and sequential mediating roles.

CONCLUSION

Sleep problems and depressed mood play a mediating role in the development of suicidal ideation in adolescents. Good sleep habits and depressed mood interventions help reduce the risk of suicidal ideation in adolescents who experience psychological neglect/abuse.

Sleep problems mediate the influence of childhood emotional maltreatment on adolescent non-suicidal self-injury: The moderating effect of rumination

BACKGROUND

Non-suicidal self-injury (NSSI) is a highly serious public health problem among adolescents in China, and childhood emotional maltreatment has been found to be a risk factor for NSSI.

OBJECTIVE

Little is known about the longitudinal association between childhood emotional maltreatment and NSSI as well as its underlying mediating and moderating mechanisms. Thus, we hypothesized whether sleep problems mediated the association between childhood emotional maltreatment and NSSI, and whether this indirect effect was moderated by rumination.

PARTICIPANTS AND SETTING

A total of 1987 Chinese adolescents (56.1 % males; ages 10 to 14, M = 12.32, SD = 0.53) completed self-report questionnaires regarding childhood emotional maltreatment, sleep problems, rumination non-suicidal self-injury (NSSI) in three waves.

METHODS

Structural equation model was used to test a moderated mediation model, with gender, age and socioeconomic status and baseline measures as covariates.

RESULTS

Childhood emotional maltreatment was significantly associated with NSSI, and this association was mediated by sleep problems. Moderated mediation analyses revealed that rumination intensified the relation between childhood emotional maltreatment and sleep problems as well as the relation between sleep problems and NSSI.

CONCLUSIONS

Findings of this study demonstrate a relationship among childhood emotional maltreatment, sleep problems, rumination and NSSI. Interventions that target sleep problems and rumination may be beneficial for reducing NSSI for at-risk adolescents.

Characterization of Parental Knowledge on Early Child Sleep and Association with Child Sleep Quality: A Cross-Sectional Pilot Study in Chongqing, China

Purpose

Parental knowledge of child sleep is typically poor, and profiling of knowledge patterns has not been performed. In recent years, the Chinese government has issued a series of administrative and legal documents to promote guidance on family education and parenting knowledge. The purpose of this study was to characterize the pattern of parental sleep knowledge for 0~3-year-old children in Chongqing, China, and to examine the associations among the knowledge pattern, guidance channel, and sleep quality.

Participants and Methods

This was a cross-sectional pilot study of 264 primary caregivers of children aged 1~36 months who completed a brief survey using the 9-item Parents' Knowledge of Child Sleep (PKCS) and a modified Chinese version of the Brief Infant Sleep Questionnaire (BISQ). Hierarchical clustering was performed to determine knowledge patterns. Logistic and multiple linear regressions were used to assess the associations.

Results

The average PKCS score was 50.2%. Parental knowledge showed a five-group pattern from I to V, with knowledge score increasing with the group number. Parents' access to sources for guidance and information on children's sleep was categorized into three categories from i to iii considering the authenticity of sources and richness of channels. Significant correlates of knowledge pattern were age (mo.) of the child (OR=0.97, p=0.019), low family income (vs high, OR=0.44, p=0.022; vs medium, OR=0.55, p=0.014), and information access patterns i and ii (vs iii with the lowest credibility and richness, OR=2.22/1.85, p=0.004/0.022). Knowledge pattern IV, with a few critical structural defects, showed a significant association with longer daytime napping (β=0.121, p<0.001).

Conclusion

The child sleep knowledge of parents in Chongqing, China, was at a low level but showed characteristic patterns. Considering the social need and policy directions, it is necessary to improve public services to provide authentic and extensive guidance to strengthen parental knowledge on child sleep in Chongqing.

The Prevalence and Psychosocial Factors of Problematic Smartphone Use Among Chinese College Students: A Three-Wave Longitudinal Study

Problematic smartphone use (PSU) in college students has been a major public health concern in modern society, which may also lead to adverse health outcomes. Using a three-wave longitudinal study design, the current study aimed to examine the prevalence and psychosocial factors of PSU in a large sample of Chinese college students. The data used in this study was obtained from an ongoing longitudinal study in Guangdong, China. In the current study, a total of 7,434 freshmen and sophomores who completed the first three surveys were included. Self-administered questionnaires were used to assess PSU, possible social anxiety disorders, depressive symptoms, loneliness, family conflicts, academic stress, and some demographic characteristics. Generalized estimating equation (GEE) models were performed to determine the risk factors associated with PSU. The results showed that 65.8, 58.1, and 52.8% of college students reported PSU at three waves, with an apparent downward trend. Female students reported higher prevalence rates of PSU than males. Depressive symptoms, possible social anxiety disorders, loneliness, family conflicts, and high academic pressure were important risk factors for PSU. Early intervention and identification of those who show signs of PSU may prevent the development of maladaptive coping responses and addictive behaviors, so as to prevent future negative psychosocial consequences.