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Ho GWK, Chan KL, Karatzias T, Hyland P, Fung HW, Shevlin M. Prevalence and validity of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD: A population-based survey of Hong Kong adults. Asian J Psychiatr 2024; 96:104045. [PMID: 38643682 DOI: 10.1016/j.ajp.2024.104045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 03/29/2024] [Accepted: 04/06/2024] [Indexed: 04/23/2024]
Abstract
The present study aimed to report the prevalence of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in the general adult Hong Kong population, and examine the validity of the Chinese International Trauma Questionnaire (ITQ). This descriptive cross-sectional population-based telephone survey included a representative sample of 1070 non-institutionalized permanent Hong Kong residents ages 18-64 years. Participants provided responses to the Chinese version of the ITQ, and measures of adverse childhood experiences (ACEs), depression, anxiety, and stress. Based on the diagnostic algorithm of the ITQ, 5.9% of the sample screened positive for either CPTSD or PTSD, with CPTSD (4.2%) being more common that PTSD (1.7%). Results of the confirmatory factor analysis indicated the first-order correlated 6-factor model to be the best fitting solution. Symptom cluster summed scores were all positively and significantly correlated with all criterion variables. This investigation established the prevalence rates of ICD-11 PTSD and CPTSD using a general adult population sample in Hong Kong. The Chinese ITQ demonstrated sound factorial validity and concurrent validity. Future research can further characterize ICD-11 PTSD and CPTSD in subgroups using the Chinese ITQ.
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Affiliation(s)
- Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR China.
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR China
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, United Kingdom
| | - Philip Hyland
- Department of Psychology, Maynooth University, Ireland
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong, SAR China
| | - Mark Shevlin
- School of Psychology, Ulster University, United Kingdom
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Mak BSW, Zhang D, Powell CLYM, Leung MKW, Lo HHM, Yang X, Yip BHK, Lee EKP, Xu Z, Wong SYS. Effects of mindfulness-based cognitive therapy for Chinese adults with PTSD symptoms: protocol for a randomised controlled trial. BMC Psychiatry 2024; 24:400. [PMID: 38812001 PMCID: PMC11134912 DOI: 10.1186/s12888-024-05840-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/13/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Emerging evidence supports mindfulness as a potential psychotherapy for post-traumatic stress disorder (PTSD). Individuals with subthreshold PTSD experience significant impairment in their daily life and functioning due to PTSD symptoms, despite not meeting the full diagnostic criteria for PTSD in DSM-5. Mindfulness skills, including non-judgmental acceptance, attentional control and openness to experiences may help alleviate PTSD symptoms by targeting characteristics such as intensified memory processing, dysregulated hyperarousal, avoidance, and thought suppression. This trial aims to test the effects of mindfulness-based cognitive therapy (MBCT) when compared to an active control. METHOD AND ANALYSIS This 1:1 randomised controlled trial will enroll 160 participants with PTSD symptoms in 2 arms (MBCT vs. Seeking Safety), with both interventions consisting of 8 weekly sessions lasting 2 h each week and led by certified instructors. Assessments will be conducted at baseline (T0), post-intervention (T1), and 3 months post-intervention (T2), with the primary outcome being PTSD symptoms measured by the PTSD checklist for DSM-5 (PCL-5) at T1. Secondary outcomes include depression, anxiety, attention, experimental avoidance, rumination, mindfulness, and coping skills. Both intention-to-treat and per-protocol analyses will be performed. Mediation analysis will investigate whether attention, experimental avoidance, and rumination mediate the effect of mindfulness on PTSD symptoms. DISCUSSION The proposed study will assess the effectiveness of MBCT in improving PTSD symptoms. The findings are anticipated to have implications for various areas of healthcare and contribute to the enhancement of existing intervention guidelines for PTSD. TRIAL REGISTRATION NUMBER ChiCTR2200061863.
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Affiliation(s)
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Maria Kwan Wa Leung
- Department of Family Medicine & Primary Health Care, New Territories East Cluster, Hospital Authority, Hong Kong, China
| | - Herman Hay Ming Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xue Yang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Benjamin Hon Kei Yip
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Eric Kam Pui Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zijun Xu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Lei LKS, Suen YN, Hui CLM, Chan SKW, Lee EHM, Michael WTH, Chen EYH. Age-related differences in the impact of resilience on mental health outcomes during the COVID-19 pandemic in Hong Kong. Int J Geriatr Psychiatry 2024; 39:e6087. [PMID: 38613130 DOI: 10.1002/gps.6087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/01/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE This study investigated changes in mental health in Hong Kong over two years and examined the role of resilience and age in mitigating the negative effects of public health emergencies, particularly the COVID-19 pandemic. METHODS Complete data of interest from two telephone surveys conducted in 2020 (n = 1182) and 2021 (n = 1108) were analysed. Participants self-reported depressive and anxiety symptoms using the Patient Health Questionnaire 4-item version (PHQ), psychotic-like experiences (PLEs) using three items from the Prodromal Questionnaire Brief (PQB), and resilience using the Connor-Davidson Resilience Scale 2-item version (CD-RISC-2). RESULTS We observed an increase in the percentage of participants with high depressive and anxiety symptoms and PLEs from 1.6% to 6.5% between 2020 and 2021. The likelihood of having high depressive and anxiety symptoms or PLEs depended on resilience and age, with no significant between-year differences. Resilience and age interaction effects were significant when comparing the high PHQ-high PQB group to the low PHQ-low PQB group only in 2021 but not in 2020. CONCLUSIONS This study provides valuable insights into the impact of the COVID-19 pandemic on mental health in Hong Kong, emphasising the age-dependent nature of resilience in mitigating negative effects. Future research should explore the mechanisms by which resilience promotes mental health and well-being and identify ways to enhance resilience among older individuals during public health crises.
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Affiliation(s)
- Lauren Ka Shun Lei
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Yi Nam Suen
- School of Nursing, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Christy Lai Ming Hui
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Sherry Kit Wa Chan
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, Hong Kong SAR, China
| | - Edwin Ho Ming Lee
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Wong Tak Hing Michael
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
- Institute of Mental Health, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Qian Y, Fan W. Stressful life events and depressive symptoms during COVID-19: A gender comparison. THE BRITISH JOURNAL OF SOCIOLOGY 2024; 75:38-47. [PMID: 37974500 DOI: 10.1111/1468-4446.13067] [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] [Received: 09/03/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
The COVID-19 pandemic precipitated a wide range of public health, economic, social, and political shocks, setting in motion life events that reverberated to affect individuals' mental health. Moving beyond a checklist approach, this study drew on individuals' own words to identify both conventional and novel sources of stress during COVID-19 and examine the role of stressful life events in producing gender disparities in depressive symptoms. Drawing on a 2021 U.S. nationally representative survey, we coded text responses to an open-ended question on stressful life events and conducted descriptive and regression analyses (n = 1733). The analyses revealed three key findings. First, men were more likely to report having experienced no stressful life events or else mention politics as a source of stress. Women, by comparison, were more likely to report the following as stressful-inability to socialize, paid work, care work, health, or the death of loved ones. Second, for both women and men, respondents reporting no stressful life events had the lowest, and those reporting finances as the most stressful life event had the highest, depressive symptoms. Third, women had higher depressive symptoms than men, and mediation analysis showed that stressful life events explained approximately a third of the gender gap in depressive symptoms. The findings indicate that policies attending to people's financial stress are important for mitigating mental health risks in turbulent times. Interventions that reduce women's exposure to stressful life events are also crucial to bridging gender disparities in mental health.
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Affiliation(s)
- Yue Qian
- Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wen Fan
- Department of Sociology, Boston College, Chestnut Hill, Massachusetts, USA
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Tang C, Goldsamt LA, Yu S, Zhao T, Wang H. Psychological pathways to HIV-related posttraumatic stress disorder symptoms among people living with HIV in China: the mediating role of rumination. AIDS Care 2023; 35:165-169. [PMID: 35749306 DOI: 10.1080/09540121.2022.2092713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The occurrence of HIV-related posttraumatic stress disorder (PTSD) compromises the physical and mental health of people living with HIV (PLWH). This study examined the psychological pathways of HIV-related PTSD symptoms considering the influence of rumination in PLWH of China. A cross-sectional survey was conducted in Changsha, China. The data were collected using the PTSD Checklist-Civilian Version, the Ruminative Response Scale, the Multidimensional Scale of Perceived Social Support, and measures of sociodemographic and HIV-related clinic characteristics. A total of 602 PLWH were surveyed. The average score of HIV-related PTSD symptoms was (34.54 ± 13.58). The mediation model showed that perceived social stigma and physical health exhibited direct associations with PTSD symptoms (β = 0.093, -0.145, respectively), while the direct relations of family support, friend support and significant others support to PTSD symptoms were not significant. Rumination mediated the effect of perceived social stigma (β = 0.077), physical health (β = -0.150), family support (β = -0.144) and friend support (β = -0.105) on PTSD symptoms. The study findings underscore the importance of routinely assessing PTSD for PLWH, and developing trauma-focused interventions that alleviate HIV-related PTSD symptoms and reduce rumination while improving social support and physical health and reducing social stigma.
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Affiliation(s)
- Chulei Tang
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Lloyd A Goldsamt
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Simin Yu
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Ting Zhao
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China
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