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Ao L, Cheng X, An D, An Y, Yuan G. Relationship between Perceived Family Resilience, Emotional Flexibility, and Anxiety Symptoms: a Parent-Adolescent Dyadic Perspective. J Youth Adolesc 2024:10.1007/s10964-024-02083-7. [PMID: 39289211 DOI: 10.1007/s10964-024-02083-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 09/04/2024] [Indexed: 09/19/2024]
Abstract
Family resilience is crucial for individual's psychological health. Previous studies explored the protective factors of anxiety at the individual level, with less attention paid to the impact of family interaction from a dyadic perspective. This study utilized the Actor-Partner Interdependence Mediation Model to investigate the relationship between family resilience, emotional flexibility, and anxiety symptoms. A sample of 2144 Chinese parent-adolescent dyads (36% upper grades of primary school, 64% secondary school, 49.39% girls; 70.38% mothers) was recruited. Perceived family resilience was inversely related to anxiety symptoms, directly or indirectly, through the mediation of emotional flexibility at the individual level. At the dyadic level, adolescents' perceived family resilience was significantly associated with parents' anxiety symptoms through their own or parents' emotional flexibility. Parents' perceived family resilience was inversely link to adolescents' anxiety symptoms through parents' emotional flexibility. Parents emotional flexibility also mediated the association between adolescents' perceived family resilience and their anxiety symptoms. These findings contribute to understanding the intricate dynamics of family resilience and psychological outcomes in parent-child relationships under adversity, emphasizing the need for child-centered interventions to improve family members' mental health.
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Affiliation(s)
- Lu Ao
- School of Psychology, Nanjing Normal University, Nanjing, PR China
| | - Xuan Cheng
- School of Psychology, Nanjing Normal University, Nanjing, PR China
| | - Di An
- School of Psychology, Nanjing Normal University, Nanjing, PR China
| | - Yuanyuan An
- School of Psychology, Nanjing Normal University, Nanjing, PR China.
| | - Guangzhe Yuan
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- School of Education Science, Leshan Normal University, Leshan, PR China
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Ifrah K, Tsipper I. Does Interpersonal Vulnerability Mediate the Association Between Parental Bereavement and Mental Health? OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:649-666. [PMID: 35333676 DOI: 10.1177/00302228221080021] [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] [Indexed: 11/16/2022]
Abstract
The current study examined the role of interpersonal vulnerability, that is, self-perceived threats to one's interpersonal domain, in the mental health of bereaved parents. Israeli bereaved parents in older adulthood (N = 105, aged 48-88, M = 64.06, SD = 9.93) were pair-matched with equivalent 105 non-bereaved parents. Participants completed questionnaires assessing interpersonal vulnerability, satisfaction with life, and depressive symptoms. The results showed higher levels of interpersonal vulnerability among bereaved parents compared to their non-bereaved counterparts. Additionally, parental bereavement and interpersonal vulnerability were associated with worse mental health. Finally, interpersonal vulnerability mediated the association of parental bereavement with worse mental health. This study reveals interpersonal vulnerability as an important vulnerability factor among a significant minority in older adulthood.
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Affiliation(s)
- Kfir Ifrah
- Faculty of Social and Community Sciences, Ruppin Academic Center, Israel
- The Herczeg Institute on Aging, Tel Aviv University, Israel
| | - Itay Tsipper
- Faculty of Social and Community Sciences, Ruppin Academic Center, Israel
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Chen Y, Yang L. Social disabling: A qualitative study of interpersonal interaction patterns of shiduers in China. DEATH STUDIES 2024:1-14. [PMID: 38587081 DOI: 10.1080/07481187.2024.2336711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
The experience of shidu (i.e., losing one's only child) completely changes the lives and social interaction patterns of people. However, current research findings on interpersonal interactions of individuals who are experiencing shidu (referred to as "shiduers") are inconsistent, reducing the effectiveness of support programs. Therefore, a qualitative analysis was conducted on the interpersonal interaction process of shiduers using the classic grounded theory. The results showed that "shidu" as an interpersonal information has two contradictory attributes, "family shame" and "family routine," which create a social disabling dilemma for shiduers. Shiduers can reset their interpersonal relationships by establishing a clear inner and outer circle of relationships (centralizing) and by sequencing and typing relationships (differentiating). The interpersonal interactions of shiduers are complex and depend on the type of relationship. The current results can help community workers target individual support, family empowerment, and community building for people experiencing shidu.
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Affiliation(s)
- Yin Chen
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu Province, People's Republic of China
| | - Liping Yang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu Province, People's Republic of China
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Hu X, Luo Y, Qi R, Ge J, Wu L, Dai H, Lan Q, Liu B, Zhang L, Xu Q, Chen F, Cao Z, Lu G. Disorganized Functional Connectivity of Anterior Insular Subnetworks in Adults with Executive Dysfunction after Trauma Exposure. Neuroscience 2024; 538:40-45. [PMID: 38103859 DOI: 10.1016/j.neuroscience.2023.12.005] [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: 08/10/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
There is increasing evidence that major trauma can adversely affect the brain and cognition. In some cases, trauma may lead to deficits in executive function (EF). The anterior insula may be a causal outflow hub acting to coordinate EF-related brain networks. To clarify the neural underpinnings of EF deficits (EFD) after trauma, we performed a resting-state functional magnetic resonance imaging (rs-fMRI) study of anterior insular subnetworks in adults who have lost their only child. A total of 167 participants completed various psychological and cognitive assessments to assess EF-related deficits. Correlations were computed between abnormal connectivity and cognitive/post-traumatic stress symptoms. The results showed abnormal anterior insular subregion connectivity in the default mode network (DMN), prefrontal lobe, and cerebellum lobe in participants with EFD. No correlation was found between abnormal connectivity and cognitive/post-traumatic stress symptoms in participants with EFD. These results suggest that excessive connections between the insula and DMN could contribute to EFD after trauma. Overall, this study provides novel references into the neural mechanisms of EF status after trauma exposure.
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Affiliation(s)
- Xiao Hu
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing 210002, Jiangsu, China
| | - Yifeng Luo
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing 210002, Jiangsu, China
| | - Jiyuan Ge
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Huanhuan Dai
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Qingyue Lan
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Bo Liu
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Li Zhang
- Mental Health Institute, the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing 210002, Jiangsu, China
| | - Feng Chen
- Department of Radiology, People's Hospital of Hainan Province, Haikou 570311, China
| | - Zhihong Cao
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing 210002, Jiangsu, China.
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Xia Z, Cao Z, Surento W, Zhang L, Qiu L, Xu Q, Zhang L, Li L, Cao Y, Luo Y, Lu G, Qi R. Relationship between SLC6A2 gene polymorphisms and brain volume in Han Chinese adults who lost their sole child. BMC Psychiatry 2024; 24:11. [PMID: 38166870 PMCID: PMC10763183 DOI: 10.1186/s12888-023-05467-4] [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: 02/13/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Norepinephrine transporter (NET) is encoded by the SLC6A2 gene and is a potential target for studying the pathogenesis of PTSD. To the best of our knowledge, no prior investigations have examined SLC6A2 polymorphism-related neuroimaging abnormalities in PTSD patients. METHODS In 218 Han Chinese adults who had lost their sole child, we investigated the association between the T-182 C SLC6A2 genotype and gray matter volume (GMV). Participants included 57 PTSD sufferers and 161 non-PTSD sufferers, and each group was further separated into three subgroups based on each participant's SLC6A2 genotype (TT, CT, and CC). All participants received magnetic resonance imaging (MRI) and clinical evaluation. To assess the effects of PTSD diagnosis, genotype, and genotype × diagnosis interaction on GMV, 2 × 3 full factorial designs were used. Pearson's correlations were used to examine the association between GMV and CAPS, HAMD, and HAMA. RESULTS The SLC6A2 genotype showed significant main effects on GMV of the left superior parietal gyrus (SPG) and the bilateral middle cingulate gyrus (MCG). Additionally, impacts of the SLC6A2 genotype-diagnosis interaction were discovered in the left superior frontal gyrus (SFG). The CAPS, HAMA, and HAMD scores, as well as the genotype main effect and diagnostic SLC6A2 interaction, did not significantly correlate with each other. CONCLUSION These findings indicate a modulatory effect that the SLC6A2 polymorphism exerts on the SPG and MCG, irrespective of PTSD diagnosis. We found evidence to suggest that the SLC6A2 genotype-diagnosis interaction on SFG may potentially contribute to PTSD pathogenesis in adults who lost their sole child.
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Affiliation(s)
- Zhuoman Xia
- Department of Medical Imaging, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Zhihong Cao
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, 75 Tongzhenguan Road, Wuxi, Wuxi, 214200, China
| | - Wesley Surento
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, Los Angeles, CA, 90292, USA
| | - Li Zhang
- Mental Health Institute, the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, National Technology Institute of Psychiatry, Central South University, Changsha, Hunan, 410011, China
| | - Lianli Qiu
- Department of Medical Imaging, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Longjiang Zhang
- Department of Medical Imaging, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, National Technology Institute of Psychiatry, Central South University, Changsha, Hunan, 410011, China
| | - Yang Cao
- College of Arts & Science, Vanderbilt University, Nashville, TN, 37235, USA
| | - Yifeng Luo
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, 75 Tongzhenguan Road, Wuxi, Wuxi, 214200, China.
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, China.
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, China.
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Xiong J, Ma H, Ma R, Xu T, Wang Y. The relationship between perceived stress and prolonged grief disorder among Chinese Shidu parents: effects of anxiety and social support. BMC Psychiatry 2023; 23:714. [PMID: 37784043 PMCID: PMC10546787 DOI: 10.1186/s12888-023-05206-9] [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: 01/26/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Shidu parents refer to the couple who have lost their only child and have not given birth or adopted another child in China. The number of Shidu parents is increasing annually. The aim of this research was to examine the mediating role of anxiety and the moderating role of social support between perceived stress and prolonged grief disorder (PGD) among Chinese Shidu parents. METHODS A cross-sectional study was carried out with 505 participants who completed a questionnaire including the Prolonged Grief Questionnair-3 (PG-13), the Perceived Stress Scale-10 (PSS-10), the Self-Rating Anxiety Scale (SAS) and the Duke-UNC Functional Social Support Questionnaire (FSSQ). SPSS PROCESS macro was employed to examine the mediating role of anxiety and the moderating role of social support. RESULTS The mediation analysis showed anxiety partially mediated the link between perceived stress and PGD, and the proportion of mediation of anxiety was 39.22%. The moderated mediation analysis revealed the second stage of mediating effects of anxiety on the link between perceived stress and PGD was moderated by social support. Specifically, compared with Shidu parents with higher social support, the association between anxiety and PGD was closer for those with lower social support. CONCLUSIONS The moderated mediation model can broaden our understanding of how and when perceived stress, anxiety and social support work together to affect PGD. The interventions aimed at improving mental health of Chinese Shidu parents need to work on reducing stress and enhancing social support.
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Affiliation(s)
- Jiexi Xiong
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Hongfei Ma
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Ruiyao Ma
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Tianhui Xu
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China
| | - Yang Wang
- Department of Social Medicine, College of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, P.R. China.
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Hu X, Luo Y, Qi R, Ge J, Wu L, Dai H, Lan Q, Liu B, Zhang L, Xu Q, Cao Z, Lu G. Altered brain degree centrality and functional connectivity in adults with executive dysfunction after trauma exposure. Psychiatry Res Neuroimaging 2023; 335:111713. [PMID: 37690162 DOI: 10.1016/j.pscychresns.2023.111713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 09/01/2023] [Accepted: 09/02/2023] [Indexed: 09/12/2023]
Abstract
Losing an only child is undoubtedly a huge blow that can adversely affect the prefrontal lobe, a highly sensitive brain region. Neuropsychological evidence emphasizes that executive function (EF) is closely related to the optimal functioning of the frontal cortex. However, the characteristics and potential mechanisms underlying changes in executive function following the huge shock of losing an only child remain insufficiently studied and understood. In this study, we performed degree centrality (DC) and functional connectivity (FC) analyses to explore the organization of the executive function deficits (EFD) network among adults who have lost their only child. In addition, we performed correlation analyses to establish an association between abnormal DC and FC values and post-traumatic stress symptoms. Finally, we used support vector machine analyses to assess the accuracy of abnormal DC and FC values in distinguishing adults with EFD who have lost their only child from those without EFD. Our findings revealed increased DC in the left superior frontal gyrus and right angular gyrus (ANG), whereas decreased DC in the left superior occipital gyrus among adults with EFD. Further FC analysis revealed that the altered FC primarily involved the prefrontal and temporal lobes and cerebellum. Notably, the altered FC between the right ANG and left inferior temporal gyrus exhibited a negative correlation with irritability symptoms (R = -0.047, p = 0.003) in the EFD group. A combined model incorporating altered DC and FC values enabled the classification of 96.69% of adults with EFD, with a sensitivity of 0.8837 and specificity of 0.9558. These findings provide valuable insights into the neural mechanisms underlying distinct EF statuses following trauma exposure, distinguishing adults with and without EFD.
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Affiliation(s)
- Xiao Hu
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu 210002, China
| | - Yifeng Luo
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu 210002, China
| | - Jiyuan Ge
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Huanhuan Dai
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Qingyue Lan
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Bo Liu
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Li Zhang
- Mental Health Institute, the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu 210002, China
| | - Zhihong Cao
- Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, China.
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu 210002, China.
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Ge J, Luo Y, Qi R, Wu L, Dai H, Lan Q, Liu B, Zhang L, Lu G, Cao Z, Shen J. Persistence of post-traumatic stress disorder in Chinese Shidu parents is associated with combined gray and white matter abnormalities. Psychiatry Res Neuroimaging 2023; 335:111715. [PMID: 37716134 DOI: 10.1016/j.pscychresns.2023.111715] [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: 04/17/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Post-traumatic stress disorder (PTSD) is one of the most common mental health disorders among Shidu parents. Identification of gray and white matter differences between persistence of PTSD (P-PTSD) and remission of PTSD (R-PTSD) is crucial to determine their prognosis. A total of 37 Shidu parents with PTSD were followed for five years. Surface-based morphometry and diffusion tensor imaging were carried out to analyze the differences in gray and white matter between P-PTSD and R-PTSD. Finally, 30 patients with PTSD were enrolled, including 12 with P-PTSD and 18 with R-PTSD. Compared with patients with R-PTSD, patients with P-PTSD exhibited lower fractional anisotropy (FA) in Cluster 1 (including body of the corpus callosum, superior longitudinal fasciculus, corticospinal tract) and Cluster 2 (including inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, splenium of the corpus callosum) in the left cerebral hemisphere and higher cortical thickness in the right lateral occipital cortex (LOC). In patients with P-PTSD, FA values of Cluster 2 were negatively correlated with cortical thickness of the right LOC. These results suggest that among Shidu parents, differences were observed in gray and white matter between P-PTSD and R-PTSD. Moreover, some certain gray and white matter abnormalities were often present simultaneously in P-PTSD.
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Affiliation(s)
- Jiyuan Ge
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Huanhuan Dai
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Qingyue Lan
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Bo Liu
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China.
| | - Junkang Shen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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Eli B, Chen Y, Zhang J, Huang X, Wang Q, Ma Z, Yv Y, Liu Z. Time course of attentional bias and its relationship with PTSD symptoms in bereaved Chinese parents who have lost their only child. Eur J Psychotraumatol 2023; 14:2235980. [PMID: 37493173 PMCID: PMC10599259 DOI: 10.1080/20008066.2023.2235980] [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: 08/14/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 07/27/2023] Open
Abstract
Background: The death of a child is a highly traumatic event for parents and often leads to posttraumatic stress disorder (PTSD). Attentional bias has been demonstrated in the onset and maintenance of PTSD symptoms.Objective: This study aimed to investigate the time course of attentional bias among bereaved Chinese parents who have lost their only child (Shidu parents), and to examine its relationship with PTSD symptoms and symptom clusters.Methods: Shidu parents (n = 38; 50-72 years of age) completed a dot-probe task with negative (trauma-related), positive, and neutral images at four stimulus presentation times (250, 500, 750, and 1250 ms). PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5).Results: We observed difficulty in disengaging from both negative and positive stimuli at 750 ms and attentional bias away from negative stimuli at 1250 ms. At 1250 ms, attentional avoidance of trauma-related stimuli was positively correlated with PCL-5 total and intrusion scores. Difficulty in disengaging from positive stimuli was negatively correlated with PCL-5 total and intrusion scores as well as negative alterations in cogniti and mood scores.Conclusions: These findings enhance our understanding of attentional bias and cognitive-affective processing in PTSD. This study provides evidence that attentional bias (difficulty in disengaging from positive stimuli and bias away from negative stimuli) are correlated with PTSD symptoms and certain symptom clusters.
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Affiliation(s)
- Buzohre Eli
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Jing Zhang
- Gengdan Institute of Beijing University of Technology, Beijing, P.R. China
| | - Xin Huang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Qian Wang
- Beijing Key Laboratory of Behavior and Mental Health, Clinical and Health Psychology Department, School of Psychological and Cognitive Sciences, Peking University, Beijing, P.R. China
| | - Zhujiang Ma
- Beijing Wisdom Spirits Technology Co., Ltd, Beijing, P.R. China
| | - Yang Yv
- Yv Yang Psychological Service Center, Economic and Technological Development Zone, Huai'an, Jiangsu Province, P.R. China
| | - ZhengKui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
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Perceived Adequacy of Material Support Systems Available to the Childless Older Adults in Southeastern Nigeria: Implications for Social Workers. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09514-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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11
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Chan NPX, Chia JL, Ho CY, Ngiam LXL, Kuek JTY, Ahmad Kamal NHB, Hanifah Marican Abdurrahman AB, Ong YT, Chiam M, Lee ASI, Chin AMC, Mason S, Radha Krishna LK. Extending the Ring Theory of Personhood to the Care of Dying Patients in Intensive Care Units. Asian Bioeth Rev 2022; 14:71-86. [PMID: 34691261 PMCID: PMC8526529 DOI: 10.1007/s41649-021-00192-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022] Open
Abstract
It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician's concept of personhood, or "what makes you, 'you'", we adopt Radha Krishna's Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support.
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Affiliation(s)
- Natalie Pei Xin Chan
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Jeng Long Chia
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Chong Yao Ho
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Lisa Xin Ling Ngiam
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Joshua Tze Yin Kuek
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Nur Haidah Binte Ahmad Kamal
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Ahmad Bin Hanifah Marican Abdurrahman
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education , National Cancer Centre Singapore, Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education , National Cancer Centre Singapore, Singapore
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK
- Cancer Research Centre, University of Liverpool, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine , National University of Singapore, Singapore
- Division of Supportive and Palliative Care , National Cancer Centre Singapore, Singapore
- Division of Cancer Education , National Cancer Centre Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK
- Cancer Research Centre, University of Liverpool, Liverpool, UK
- Palliative Care Centre for Excellence in Research and Education (PalC), Singapore
- Centre for Biomedical Ethics, National University of Singapore , Singapore
- Duke-NUS Graduate Medical School, Singapore
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12
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Eli B, Liang Y, Chen Y, Huang X, Liu Z. Symptom structure of posttraumatic stress disorder after parental bereavement - a network analysis of Chinese parents who have lost their only child. J Affect Disord 2021; 295:673-680. [PMID: 34509783 DOI: 10.1016/j.jad.2021.08.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The death of a child is a highly traumatic event and often leads to mental health problems, including posttraumatic stress disorder (PTSD). Previous studies have focused on overall PTSD after the loss of an only child; however, little attention has been given to PTSD at the symptom level. This study aims to identify the network structure of PTSD symptoms in bereaved parents who have lost their only child, known as Shidu parents in Chinese society. METHODS A cross-sectional study enrolled 385 bereaved individuals who had lost an only child across 10 cities in China from November 2016 to July 2017. PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5). Network analysis was implemented by using the R packages qgraph and bootnet. RESULTS The PTSD network revealed that diminished interest, exaggerated startle, irritability/anger, and nightmares were the most central symptoms. The strongest connections emerged between the symptoms of recurrent thoughts and nightmares, irritability/anger and reckless/self-destructive behavior, and hypervigilance and exaggerated startle. LIMITATIONS We utilized cross-sectional data, and it is therefore not possible to infer the evolution of the symptom network over time. In addition, participants were limited to parents who had lost an only child, and the findings of this study must be interpreted with caution. CONCLUSIONS The current study provides further clarity regarding how PTSD symptoms relate to each other in bereaved parents who have lost an only child. Symptoms with high centrality and connectedness may be viable targets for intervention in bereaved parents who have lost an only child.
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Affiliation(s)
- Buzohre Eli
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yiming Liang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xin Huang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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Vig PS, Lim JY, Lee RWL, Huang H, Tan XH, Lim WQ, Lim MBXY, Lee ASI, Chiam M, Lim C, Baral VR, Krishna LKR. Parental bereavement - impact of death of neonates and children under 12 years on personhood of parents: a systematic scoping review. BMC Palliat Care 2021; 20:136. [PMID: 34481491 PMCID: PMC8418708 DOI: 10.1186/s12904-021-00831-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Losing a child tragically impacts the well-being and functioning of parents. With these effects extending beyond emotional, physical morbidity and compromising self-perceptions, appropriate, longitudinal, timely and personalised support is key to effective care of bereaved parents. However, in the absence of a comprehensive understanding of parental bereavement, effective support of bereaved parents remains suboptimal. To address this gap, we scrutinise prevailing data on the effects of a child's death, aged 0-12 years, through the lens of the Ring Theory of Personhood (RToP). METHODS To study prevailing accounts of bereaved parents following the death of a child, we adopt Krishna's Systematic Evidence Based Approach (SEBA) to structure our Systematic Scoping Review (SSR in SEBA). RESULTS Three thousand seventy-four abstracts were reviewed, 160 full text articles were evaluated, and 111 articles were included and analysed using thematic and content analysis. Four themes/categories were identified relating to the four rings of the RToP. Findings reveal that static concepts of protective and risk factors for grief are misplaced and that the support of healthcare professionals is key to assisting bereaved parents. CONCLUSION In the absence of consistent support of bereaved parents, this study highlights the need for effective training of healthcare professionals, beginning with an appreciation that every aspect of an individual parent's personhood is impacted by the loss of their child. Acknowledging grief as a complex, evolving and personalised process subjected to parental characteristics, settings, context and available support, this SSR in SEBA calls attention to effective nurturing of the relationship between parents and healthcare professionals, and suggests use of the RToP to assess and direct personalised, timely, specific support of parents in evolving conditions. We believe the findings of this review also call for further studies to support healthcare professionals as they journey with bereaved parents.
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Affiliation(s)
- Prachi Simran Vig
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Jia Yin Lim
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Randal Wei Liang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Huixin Huang
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Xiu Hui Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Wei Qiang Lim
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Marie Bernadette Xin Yi Lim
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Crystal Lim
- Medical Social Services, Singapore General Hospital, Outram Road, Block 3 Level 1, Singapore, 169608 Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
| | - Vijayendra Ranjan Baral
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
- Division of Neonatal and Developmental Medicine, Singapore General Hospital, Outram Road, Block 5 Level 4, Singapore, 169608 Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597 Singapore
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436 Singapore
- Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA UK
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Wang H, Frasco E, Shang J, Chen M, Xin T, Tang K. Maternal depression and loss of children under the one-child family planning policy in China: a cross-sectional study of 300 000 women. BMJ Open 2021; 11:e048554. [PMID: 34244273 PMCID: PMC8273468 DOI: 10.1136/bmjopen-2020-048554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study aims to explore the association between maternal depression and the loss of the only child under the family-planning (FP) policy. DESIGN Cross-sectional data from a Chinese population-based study were analysed. SETTING Population from 10 (5 rural and 5 urban) areas in China. PARTICIPANTS Around 300 000 females were included in the study. The FP group was defined as women with one or two live births. Those with no surviving child were classified into the loss-of-only-child group. The non-FP group included women who had more than two live births. Logistic regression was used to assess the relationship between major depressive disorder (MDD) and family types, after stratification and adjustment. OUTCOME MDD was assessed using the Composite International Diagnostic Inventory. RESULTS The odds of MDD are 1.42 times higher in the FP group in general (OR=1.42, 95% CI: 1.28 to 1.57), as opposed to the non-FP group. In particular, the odds of MDD are 1.36 times greater in the non-loss-of-only-child group (OR=1.36, 95% CI: 1.21 to 1.51) and 2.80 (OR=2.80, 95% CI: 0.88 to 8.94) times greater in the loss-of-only-child group, compared with the non-FP group. The associations between FP groups and MDD appeared to be stronger in the elderly population, in those who were married, less educated and those with a higher household income. The association was found progressively stronger in those who lost their only child. CONCLUSIONS People in the FP group, especially those who lost their only child, are more susceptible to MDD than their counterparts in the non-FP group. Mental health programmes should give special care to those who lost their only child and take existing social policies and norms, such as FP policies, into consideration.
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Affiliation(s)
- Hanyu Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Eric Frasco
- Institute for Global Health, University College London, London, UK
| | - Jie Shang
- Women's and Child Health Program, George Institute for Global Health, Beijing, China
| | - Minne Chen
- Marie Stopes International China, Beijing, China
| | - Tong Xin
- Department of Global Health, Peking University Health Science Centre, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Qi R, Luo Y, Zhang L, Weng Y, Surento W, Xu Q, Jahanshad N, Li L, Cao Z, Lu GM, Thompson PM. Decreased functional connectivity of hippocampal subregions and methylation of the NR3C1 gene in Han Chinese adults who lost their only child. Psychol Med 2021; 51:1310-1319. [PMID: 31983347 PMCID: PMC7938667 DOI: 10.1017/s0033291720000045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Losing one's only child is a major traumatic life event that may lead to post-traumatic stress disorder (PTSD); however, the underlying mechanisms of its psychological consequences remain poorly understood. Here, we investigated subregional hippocampal functional connectivity (FC) networks based on resting-state functional magnetic resonance imaging and the deoxyribonucleic acid methylation of the human glucocorticoid receptor gene (NR3C1) in adults who had lost their only child. METHODS A total of 144 Han Chinese adults who had lost their only child (51 adults with PTSD and 93 non-PTSD adults [trauma-exposed controls]) and 50 controls without trauma exposure were included in this fMRI study (age: 40-67 years). FCs between hippocampal subdivisions (four regions in each hemisphere: cornu ammonis1 [CA1], CA2, CA3, and dentate gyrus [DG]) and methylation levels of the NR3C1 gene were compared among the three groups. RESULTS Trauma-exposed adults, regardless of PTSD diagnosis, had weaker positive FC between the left hippocampal CA1, left DG, and the posterior cingulate cortex, and weaker negative FC between the right CA1, right DG, and several frontal gyri, relative to healthy controls. Compared to non-PTSD adults, PTSD adults showed decreased negative FC between the right CA1 region and the right middle/inferior frontal gyri (MFG/IFG), and decreased negative FC between the right DG and the right superior frontal gyrus and left MFG. Both trauma-exposed groups showed lower methylation levels of the NR3C1 gene. CONCLUSIONS Adults who had lost their only child may experience disrupted hippocampal network connectivity and NR3C1 methylation status, regardless of whether they have developed PTSD.
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Affiliation(s)
- Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, 75 Tongzhenguan Road, 214200, Wuxi, China
| | - Li Zhang
- Mental Health Institute, the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China
| | - Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Wesley Surento
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, 75 Tongzhenguan Road, 214200, Wuxi, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
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Wang Q, Zhang S, Wang Y, Jing Z, Zhou Y, Qi K, Wang X, Zhou C. Prevalence and risk factors of posttraumatic stress disorder among Chinese shidu parents: A systemic review and meta-analysis. J Affect Disord 2021; 282:1180-1186. [PMID: 33601693 DOI: 10.1016/j.jad.2021.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Losing the only child is an extremely distressful life event for parents. Previous studies indicated that shidu parents were more vulnerable to develop posttraumatic stress disorder (PTSD). This study aims to calculate the pooled prevalence of PTSD and identify its risk factors. METHOD We conducted a systematic literature search in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang databases, Vip databases. We performed a meta-analysis using random effects models to calculate the pooled PTSD in shidu parents. Associated factors for PTSD was evaluated by determining standardized mean difference (SMD) with 95% CIs. All analyses were performed using the Stata 16.0. RESULTS Eight articles (covering 2,722 shidu parents) were included in this study. The pooled prevalence of PTSD was 46.8% (95%CI: 33.2%-60.3%) among Chinese shidu parents. Female (SMD[95%CI]: 0.41[0.20, 0.62]), higher education level (SMD[95%CI]: 0.15[0.03, 0.28]), lower income (SMD[95%CI]: 0.33[0.13, 0.53]), losing a daughter (SMD[95%CI]: 0.16[0.03, 0.28]) and shorter time since loss (SMD[95%CI]: 0.24[0.07, 0.40]) were significantly associated with a higher PTSD prevalence. Registered residence, cause of death, age of the child, and having a grandchild were not associated with PTSD. LIMITATIONS Some variables included in this meta-analysis were only measured twice, which limited the conclusions to some extent. CONCLUSION This meta-analysis indicated that nearly half of shidu parents experienced PTSD and provided evidence of risk factors for PTSD in shidu parents. Further research is suggested to determine how these factors interact. Effective interventions should be conducted to shidu parents with PTSD.
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Affiliation(s)
- Qiong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Shimin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Zhengyue Jing
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Yanxin Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Kaili Qi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Xiyuan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, China.
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17
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Wang N, Hu Q. Loneliness Trajectories: Evidence for Staged Intervention Among Chinese Bereaved Parents. J Appl Gerontol 2020; 41:134-141. [PMID: 33334219 DOI: 10.1177/0733464820978808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Losing an only child affects the mental health of many older adults in China, placing them at a higher risk of loneliness. However, few studies explore the long-term effects of losing an only child on loneliness trajectories among older Chinese bereaved parents. Adopting a qualitative, grounded theory approach, this study investigates how experiences of loneliness among bereaved parents evolve and the implications for staged intervention. Twenty-seven in-depth interviews were conducted with people who lost their only child in Shanghai and Wuhan. A multistep data analysis technique was used to analyze the data. The findings indicate that trajectories of perceived loneliness have three distinct stages and follow a U-shape in their frequency and intensity. Interventions of psychological consultation, social network restoration, and improved old-age support should be emphasized at each stage.
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Affiliation(s)
- Ning Wang
- East China University of Science and Technology, Shanghai, China
| | - Qian Hu
- Guangzhou University, Guangzhou, China
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18
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Sheng Q, Zhang X, Cai C, Shi Y. Parents' Experiences of Caring for Their Only Child With Mental Illness in China: A Qualitative Study. J Psychosoc Nurs Ment Health Serv 2020; 59:29-37. [PMID: 33095263 DOI: 10.3928/02793695-20201001-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022]
Abstract
The current study explored Chinese parents' experiences of caring for their only child with mental illness. Face-to-face interviews with semi-structured questions were conducted to learn about the care experiences of parents whose only child had mental illness. Purposeful sampling was used to recruit parents (n = 14) and thematic analysis was used. Five themes were identified: (1) Having Responsibility to Care for Children, (2) Feeling Guilt and Self-Blame, (3) Experiencing Loneliness and Helplessness, (4) Drained by Caregiving, and (5) Worrying About the Future. Parents who cared for their only child with mental illness experienced considerable emotional and physical challenges. Professionals and health care providers should recognize and understand the experiences of these parents to identity their needs and provide adequate support. Targeted support services and appropriate professional information should be developed and provided for parents to relieve them of negative caregiving experiences and improve their psychological and physical well-being. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 29-37.].
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19
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Xu X, Wen J, Zhou N, Shi G, Tang R, Wang J, Skritskaya NA. Grief and Posttraumatic Growth Among Chinese Bereaved Parents Who Lost Their Only Child: The Moderating Role of Interpersonal Loss. Front Psychol 2020; 11:558313. [PMID: 33162907 PMCID: PMC7581902 DOI: 10.3389/fpsyg.2020.558313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022] Open
Abstract
Objective: Losing the only child is considered as the most severe kind of bereavement. It can trigger intense grief symptoms along with loss of psychosocial resources, but meanwhile, it can also lead to posttraumatic growth (PTG). The current study aimed to examine (a) whether a curvilinear relationship exists between grief and PTG and (b) the moderating role of resources-loss among Chinese bereaved parents who lost their only child (shidu parents). Methods: One hundred and ninety-nine shidu parents from five provinces completed the assessment packet covering prolonged grief symptoms and PTG, as well as resource loss. Hierarchical regression analyses were computed to examine the curvilinear relationship and the moderating effect of interpersonal loss and socio-economic loss. Results: There was no significant curvilinear relationship between grief and PTG in shidu parents. Under the high levels of interpersonal loss, shidu parents' PTG scores decreased as the severity of grief increased. However, the socio-economic loss did not show a significant moderating effect. Conclusion: The results of the current study did not show a significant curvilinear relationship between grief and PTG in shidu parents. High levels of grief coupled with high levels of interpersonal loss may interfere with their ability to achieve PTG. Therefore, evaluating degrees of interpersonal loss seems to be an important part of the treatment process when working with shidu parents. To facilitate their adaptation from a positive perspective, helping them maintain existing or develop new interpersonal relationships may be helpful.
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Affiliation(s)
- Xin Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jun Wen
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Ningning Zhou
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Guangyuan Shi
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Renzhihui Tang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Natalia A Skritskaya
- Center for Complicated Grief, Columbia School of Social Work, New York, NY, United States
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20
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Fang C. Dynamics of Chinese Shidu Parents’ Vulnerability in Old Age –A Qualitative Study. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09293-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractShidu is a Chinese word, referring to a group of bereaved parents who were subject to the One-Child Policy and whose only child has died. Living in a society where care for older people largely relies on adult children, Shidu parents can be highly vulnerable due to losing an only child who may be their primary resource for old age security. Despite the noticeable rise of Shidu families in China, these vulnerable parents have often been overlooked in society and neglected by government policies. This article adopts a qualitative approach to analyse interviews with 15 older Shidu parents and four support professionals, capturing dynamic experiences of these parents’ vulnerability in grief, elderly care and end-of-life care. Through a sociological lens, these Shidu parents are found to have adapted, revised and even rejected the status quo to cope with significant gaps in support and to negotiate for more meaningful support for their old age. This dynamic but distressing picture has also revealed a lack of ongoing structures that can effectively address these older Shidu parents’ multifaceted and changing needs. Based on the findings, recommendations are made aiming to inform future practice and policymaking for older Shidu parents.
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Eli B, Zhou Y, Liang Y, Fu L, Zheng H, Liu Z. A profile analysis of post-traumatic stress disorder and depressive symptoms among Chinese Shidu parents. Eur J Psychotraumatol 2020; 11:1766770. [PMID: 33029310 PMCID: PMC7472999 DOI: 10.1080/20008198.2020.1766770] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/21/2020] [Accepted: 05/01/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Due to the one-child policy implemented in China, most families have only one child. When parents experience the death of their only child, these parents receive the label 'Shidu parents'. Shidu is a major public health issue in China. However, the patterns of post-traumatic stress disorder (PTSD) and depressive symptoms that are present in this population remain unclear. OBJECTIVE This study aims to identify profiles of PTSD and depressive symptoms among Shidu parents and to explore the predictors of profile membership. METHODS A total of 363 participants (M age = 61.5 years, SD = 7.5) were asked to complete questionnaires assessing PTSD, depressive symptoms, perceived social support, and demographic information. Latent profile analyses and multivariate logistic regressions were used. RESULTS Three distinct profiles were identified: low (39.4%), moderate (32.8%), and high symptoms (27.8%). Parents who were younger and perceived lower levels of support from family and significant others were more likely to experience higher levels of PTSD and depressive symptoms. CONCLUSIONS These results indicate that the severity of PTSD and depressive symptoms tightly cohere, providing evidence for the co-occurrence of PTSD and depressive symptoms after bereavement. The findings provide valuable information for the development of tailored professional interventions for bereaved parents.
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Affiliation(s)
- Buzohre Eli
- 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
| | - Yueyue Zhou
- 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
| | - Yiming Liang
- 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
| | - Lin Fu
- 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
| | - Hao Zheng
- 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
| | - Zhengkui Liu
- 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
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22
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Qi R, Luo Y, Zhang L, Weng Y, Surento W, Jahanshad N, Xu Q, Yin Y, Li L, Cao Z, Thompson PM, Lu GM. Social support modulates the association between PTSD diagnosis and medial frontal volume in Chinese adults who lost their only child. Neurobiol Stress 2020; 13:100227. [PMID: 32490056 PMCID: PMC7256056 DOI: 10.1016/j.ynstr.2020.100227] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 04/03/2020] [Accepted: 05/02/2020] [Indexed: 11/30/2022] Open
Abstract
Losing an only child is a devastating life event that a parent can experience and may lead to post-traumatic stress disorder (PTSD). Social support could buffer against the negative influence of this trauma, but the neural mechanism underlying this alleviation effect remains poorly understood. In this study, voxel-based morphometry was conducted on brain MRI of 220 Han Chinese adults who had lost their only child. We performed multiple regression analysis to investigate the associations between social support scores – along with PTSD diagnosis, age, sex, body mass index (BMI) – and brain grey matter (GM) volumes in these bereaved parents. For all trauma-exposed adults, social support-by-diagnosis interaction was significantly associated with medial prefrontal volume (multiple comparisons corrected P ˂ 0.05), where positive correlation was found in adults with PTSD but not in those without PTSD. Besides, PTSD diagnosis was associated with decreased GM volume in medial and middle frontal gyri (P ˂ 0.001, uncorrected); older age was associated with widespread GM volume deficits; male sex was associated with lower GM volume in rolandic operculum, insular, postcentral gyrus (corrected P ˂ 0.05), and lower GM in thalamus but greater GM in parahippocampus (P ˂ 0.001, uncorrected); higher BMI was associated with GM deficits in occipital gyrus (corrected P ˂ 0.05) and precuneus (P ˂ 0.001, uncorrected). In conclusions, social support modulates the association between PTSD diagnosis and medial frontal volume, which may play an important role in the emotional disturbance in PTSD development in adults who lost their only child.
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Affiliation(s)
- Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, 75 Tongzhenguan Road, 214200, Wuxi, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China
| | - Yifei Weng
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Wesley Surento
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
| | - Yan Yin
- Hangzhou Seventh People's Hospital, Mental Health Center of Zhejiang University School of Medicine, 305 Tianmushan Road, Hangzhou, Zhejiang, 310013, China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, 75 Tongzhenguan Road, 214200, Wuxi, China
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
- Corresponding author.
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
- Corresponding author. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China.
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23
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Effects of COMT rs4680 and BDNF rs6265 polymorphisms on brain degree centrality in Han Chinese adults who lost their only child. Transl Psychiatry 2020; 10:46. [PMID: 32066722 PMCID: PMC7026113 DOI: 10.1038/s41398-020-0728-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/25/2022] Open
Abstract
Losing one's only child is a major traumatic life event that may lead to posttraumatic stress disorder (PTSD); however, not all parents who experience this trauma develop PTSD. Genetic variants are associated with the risk of developing PTSD. Catechol-O-methyltransferase (COMT) rs4680 and brain-derived neurotrophic factor (BDNF) rs6265 are two most well-described single-nucleotide polymorphisms that relate to stress response; however, the neural mechanism underlying their effects on adults who lost an only child remains poorly understood. Two hundred and ten Han Chinese adults who had lost their only child (55 with PTSD and 155 without PTSD) were included in this imaging genetics study. Participants were divided into subgroups according to their COMT rs4680 and BDNF rs6265 genotypes. Degree Centrality (DC)-a resting-state fMRI index reflecting the brain network communication-was compared with a three-way (PTSD diagnosis, COMT, and BDNF polymorphisms) analysis of covariance. Diagnosis state had a significant effect on DC in bilateral inferior parietal lobules and right middle frontal gyrus (MFG), where PTSD adults showed weaker DC. BDNF × diagnosis interaction effect was found in the right MFG and hippocampus, and these two regions were reversely modulated. Also, there was a significant COMT × BDNF interaction effect in left cuneus, middle temporal gyrus, right inferior occipital gyrus, and bilateral putamen, independent of PTSD diagnosis. These findings suggest that the modulatory effect of BDNF polymorphism on the MFG and hippocampus may contribute to PTSD development in bereaved adults. Interactions of COMT × BDNF polymorphisms modulate some cortices and basal ganglia, irrespective of PTSD development.
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24
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Wang Q, Ren L, Wang W, Xu W, Wang Y. The relationship between post-traumatic stress disorder and suicidal ideation among shidu parents: the role of stigma and social support. BMC Psychiatry 2019; 19:352. [PMID: 31703652 PMCID: PMC6842260 DOI: 10.1186/s12888-019-2353-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Losing an only child is a particularly traumatic and heartbreaking event for parents, which can trigger a lot of emotional responses, including PTSD and suicidal ideation (SI). The objectives of this study were mainly to identify predictors of SI and examine the interactions of PTSD with stigma and social support on SI among shidu parents. METHODS A total of 507 shidu parents from Shenyang, China were included in this cross-sectional study. Bivariate logistic regression analyses were conducted to explore risk or protective factors associated with SI. Interactions of PTSD with stigma and social support on SI were also examined by bivariate logistic regression analyses. RESULTS The prevalence of SI among shidu parents was 11.24%. PTSD (OR = 2.23, p < 0.05) and stigma (OR = 4.66, p < 0.01) were positively associated with SI. Social support was negatively associated with SI (OR = 0.90, p < 0.01). For individuals with PTSD, the presence of stigma was more likely to lead to SI. For individuals with PTSD, an increased level of social support was less likely to lead to SI. CONCLUSIONS SI is a serious issue among shidu parents. Stigma aggravated the effect of PTSD on SI, while social support buffered the effect of PTSD on SI among shidu parents.
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Affiliation(s)
- Qiong Wang
- 0000 0000 9678 1884grid.412449.eDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122 People’s Republic of China
| | - Longfei Ren
- 0000 0000 9678 1884grid.412449.eDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122 People’s Republic of China
| | - Wenhao Wang
- 0000 0000 9678 1884grid.412449.eDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122 People’s Republic of China
| | - Weihua Xu
- Department of Medical Care and Maintenance, Health Commission of Shenyang, No. 13 Beiqi Road, Heping District, Shenyang, Liaoning 110003 People’s Republic of China
| | - Yang Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning, 110122, People's Republic of China.
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25
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Gietel-Basten S, Han X, Cheng Y. Assessing the impact of the "one-child policy" in China: A synthetic control approach. PLoS One 2019; 14:e0220170. [PMID: 31693666 PMCID: PMC6834373 DOI: 10.1371/journal.pone.0220170] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 07/02/2019] [Indexed: 11/18/2022] Open
Abstract
There is great debate surrounding the demographic impact of China's population control policies, especially the one-birth restrictions, which ended only recently. We apply an objective, data-driven method to construct the total fertility rates and population size of a 'synthetic China', which is assumed to be not subjected to the two major population control policies implemented in the 1970s. We find that while the earlier, less restrictive 'later-longer-fewer' policy introduced in 1973 played a critical role in driving down the fertility rate, the role of the 'one-child policy' introduced in 1979 and its descendants was much less significant. According to our model, had China continued with the less restrictive policies that were implemented in 1973 and followed a standard development trajectory, the path of fertility transition and total population growth would have been statistically very similar to the pattern observed over the past three decades.
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Affiliation(s)
- Stuart Gietel-Basten
- Division of Social Sciences, The Hong Kong University of Science and Technology, Hong Kong, PRC
| | - Xuehui Han
- Asian Infrastructure Investment Bank, Beijing, PRC
| | - Yuan Cheng
- Population Research Institute, LSE-Fudan Research Centre for Global Public Policy, Fudan University, Shanghai, PRC
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26
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Chen L, Song Y, You Y. Life Restoration and Future Care Preparation Among Older Parents in Shanghai Who Have Lost Their Only Adult Child. J Appl Gerontol 2019; 39:1097-1105. [PMID: 31387434 DOI: 10.1177/0733464819868051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The combination of aging and losing their only adult child challenges an increasing number of older adults in China. Current literature primarily focuses on older parents' bereavement but seldom examines their effort to cope with subsequent life changes brought about by only-child loss. This study explores how older parents in Shanghai who lost their only adult child restore their lives and prepare for future care. Twenty-four older adults were purposively sampled and participated in face-to-face, in-depth interviews. The findings suggest that participants tried to restore their lives by rationalizing grief and expanding their social networks. Despite their losses, participants remained in favor of family caregiving and reluctantly prepared for future care. Their ambivalent attitudes toward government support call for caution in approaches to service delivery.
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Affiliation(s)
- Lin Chen
- Fudan University, Shanghai, China
| | - Yajun Song
- East China University of Science and Technology, Shanghai, China
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27
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Wang Q, Xu W, Ren L, Wang W, Wang Y. The relationship between hope and post-traumatic stress disorder in Chinese shidu parents: The mediating role of perceived stress. J Affect Disord 2019; 251:23-30. [PMID: 30897529 DOI: 10.1016/j.jad.2019.03.049] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/02/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Parents who lost their only child and can not conceive another child, are known as shidu parents in China. This study aimed to estimate the prevalence of post-traumatic stress disorder (PTSD) and examine the mediating role of perceived stress between hope and PTSD symptoms in Chinese shidu parents. METHODS 295 shidu mothers and 197 shidu fathers were recruited in Shenyang city. Shidu parents were asked to complete a questionnaire including the PTSD Checklist for DSM-5 (PCL-5), the Herth hope index (HHI) and the Perceived Stress Scale-10 (PSS-10). Hierarchical linear regression was performed to assess the associations among hope, perceived stress and PTSD symptoms. Asymptotic and resampling strategies were used to explore the mediating role of perceived stress. RESULTS The prevalence of PTSD in Chinese shidu parents was 23.78%. Mothers were more likely to develop PTSD than fathers. For shidu fathers, the proportion of mediation of perceived stress was 39.48%. For shidu mothers, the proportion of mediation of perceived stress was 40.00%. LIMITATIONS Due to the cross-sectional design, the findings of the present study can not be used to establish formal causal relationships or to determine the direction of causality. Longitudinal studies are need to validate our findings. CONCLUSIONS Perceived stress partly mediated the relationship between hope and PTSD symptoms in Chinese shidu parents. The interventions of hope and perceived stress should be included in PTSD prevention. More assistance should be directed to improve the mental health of shidu mothers.
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Affiliation(s)
- Qiong Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China
| | - Weihua Xu
- Department of Family Development, Health and Family Planning Commission of Shenyang Municipality, No. 13 Beiqi Road, Heping District, Shenyang, Liaoning 110001, PR China
| | - Longfei Ren
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China
| | - Wenhao Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China
| | - Yang Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China.
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28
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Gietel-Basten S, Verropoulou G. Maternity migration and the recent normalization of the sex ratio at birth in Hong Kong. Population Studies 2019; 73:423-438. [PMID: 30822230 DOI: 10.1080/00324728.2018.1559944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Hong Kong is characterized by very low fertility. However, over a period from 2000 to 2015, both the total number of births and the sex ratio at birth (SRB) increased and then declined dramatically. We analysed the increases in a 2013 paper in this journal, where we largely ascribed them to a rapid growth in the number of 'transient' mothers from Mainland China disproportionately giving birth to boys in the territory. In 2012, policies were implemented to halt this 'maternity migration'. Here, we explore the impact of these policies, both on births and the SRB in Hong Kong. We conclude that the rises and falls in births and SRBs in Hong Kong can, indeed, be broadly ascribed to the reproductive behaviour of transient Mainland mothers. However, the role of the Hong Kong government's policy interventions is much less clearly defined.
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29
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Liu J, Lummaa V. Whether to have a second child or not? An integrative approach to women's reproductive decision-making in current China. EVOL HUM BEHAV 2019. [DOI: 10.1016/j.evolhumbehav.2018.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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30
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Liang Y, Liang H, Wang J, Xu H, Wu B. End-of-Life Care Preference: Examination of Chinese Adults with Children and Those Who Lost Their Only Child. J Palliat Med 2018; 21:1596-1603. [PMID: 30016123 DOI: 10.1089/jpm.2018.0043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Little is known about the end-of-life (EOL) care preference and its associated factors among community-dwelling adults in Mainland China. This study investigated the EOL care preference and its associated factors among community-dwelling Chinese adults in Shanghai, China. METHODS A cross-sectional survey was conducted in Shanghai, China, from April to June in 2013. A total of 1200 older adults aged 60 years and older and another 200 middle-aged and older adults aged 45 years and older who lost their only child were included in the current study. In the current study, the EOL care preference included three categories: preferred family care, preferred care provided by visiting healthcare professionals, and preferred care in a specialized EOL care institute. Childlessness was coded as lost the only child, had children but not coresiding, and had coresiding children. Mor and Hiris's model of choices of setting at the EOL was used to explore the EOL care preference and its associated factors, including sociodemographic characteristics, support networks, functional characteristics, and healthcare system. Multinomial logistic regressions were used to estimate the factors associated with their EOL care preference. RESULTS In terms of EOL care preference, adults who lost their only child preferred care provided by a specialized EOL care institute (58.43%), while adults who had children preferred family care at home (46.72% for adults who did not coreside with children and 49.04% for those who did). Results from multinomial logistic regressions showed that adults with higher income, having properties, and having children tended to opt for family care at home. Participants with friends' support preferred EOL care provided by visiting healthcare professionals or specialized EOL care institutions over family care at home. CONCLUSIONS Income, wealth, having children, and having friends' support were significant factors that were associated with the EOL care preference among Chinese adults. Home-based EOL care, professional and individualized hospice, or palliative care provided by institutions need to be developed in China.
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Affiliation(s)
- Yan Liang
- 1 Fudan University School of Nursing , Shanghai, China
| | - Hong Liang
- 2 School of Social Development and Public Policy, Fudan University , Shanghai, China
| | - Jing Wang
- 3 Duke University School of Nursing , Durham, North Carolina.,4 Duke Global Health Institute, Duke University Medical Center , Durham, North Carolina
| | - Hanzhang Xu
- 3 Duke University School of Nursing , Durham, North Carolina.,4 Duke Global Health Institute, Duke University Medical Center , Durham, North Carolina
| | - Bei Wu
- 5 New York University Rory Meyers College of Nursing , New York, New York
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31
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Wang F, Cai Y, Shen K, Gietel-Basten S. Is Demography Just a Numerical Exercise? Numbers, Politics, and Legacies of China's One-Child Policy. Demography 2018; 55:693-719. [PMID: 29623606 DOI: 10.1007/s13524-018-0658-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Feng Wang
- Department of Sociology, University of California, Irvine, CA, USA.,School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Yong Cai
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Ke Shen
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Stuart Gietel-Basten
- Division of Social Science, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
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32
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Nie P, He X, Sousa-Poza A. Child loss and maternal wages in China. ASIAN POPULATION STUDIES 2017. [DOI: 10.1080/17441730.2017.1405552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Peng Nie
- School of Economics and Finance, Xi’an Jiaotong University, Xi’an, China
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany
| | - Xiaobo He
- School of Business, Institute for Regional and Industrial Development, Shanghai University of International Business and Economics, Shanghai, China
- Institute for Economic and Social Research, Jinan University, Guangzhou, China
- Centre for Global Food and Resources, Faculty of the Professions, University of Adelaide, Adelaide, Australia
| | - Alfonso Sousa-Poza
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany
- IZA, Bonn, Germany
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33
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Jiang Q, Yang S, Sánchez-Barricarte JJ. Can China afford rapid aging? SPRINGERPLUS 2016; 5:1107. [PMID: 27478724 PMCID: PMC4949193 DOI: 10.1186/s40064-016-2778-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/06/2016] [Indexed: 11/24/2022]
Abstract
China’s rapid aging has caused widespread concern, but it seems that the situations and consequences of rapid aging are not adequately acknowledged. This study analyzed the problem of ageing in China from the aspects of elderly people’s health status, income source, daily care, suicide, the weak social security system in terms of pension, health expenses, and long-term care costs as well as incoming accelerating ageing process in China. All these factors indicate that it is difficult for China to afford the issue of a rapidly aging population.
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Affiliation(s)
- Quanbao Jiang
- Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Shucai Yang
- Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
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