The reverse buffering effects of social support on the relationships between stresses and mental health: a survey of Chinese adults during the COVID-19 lockdown

Sex-specific modulating role of social support in the associations between oxidative stress, inflammation, and telomere length in older adults

Telomere length, a biomarker of human aging, is related to adverse health outcomes. Growing evidence indicates that oxidative stress and inflammation contributes to telomere shortening, whereas social support may protect from telomere shortening. Despite sex differences in telomere length and social support, little is known about whether there are sex differences in the relationship between oxidative stress/inflammation and telomere length, and sex-specific moderating roles of social support in older adults. Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, this study assessed whether the associations between oxidative stress/inflammation and telomere length vary with sex and explored social support as a moderator in these associations among 2289 older adults. Oxidative stress was measured based on serum Gamma-glutamyl transferase (GGT), and inflammation was measured based on C-reactive protein (CRP). After adjusting for the covariates, GGT was significantly associated with telomere length in females only (β =  - 0.037, 95% CI =  - 0.070, - 0.005), while CRP was associated with telomere length in males only (β =  - 0.019, 95% CI =  - 0.035, - 0.002). Moreover, high social support mitigated the negative association between GGT and telomere length, which was more evident in females. Furthermore, social support moderated the association between CRP and telomere length in males aged 70 and above. Our findings indicated that biological mechanisms related to telomere length may vary with sex, while social support plays a sex-specific moderating role.

Association between occupational burnout and psychological symptoms among Chinese medical staff: moderating role of social support

This study aimed to examine the association between occupational burnout and psychological symptoms among Chinese medical staff, assuming social support to play a moderating role in the aforementioned relationship. The survey was conducted online from May 1 to June 28, 2022, and the questionnaires were distributed and retrieved through a web-based platform. The final sample was comprised of 1461 Chinese medical staff in this cross-sectional study. Several multiple linear regressions were performed to analyze the data. After controlling for potential confounding factors, all three dimensions of occupational burnout were associated with poorer psychological symptoms. Emotional exhaustion (β = 0.33; 95% confidence interval [CI], 1.018, 1.479) had the strongest association with psychological symptoms, followed by depersonalization and diminished personal accomplishment. Moreover, medical staff with higher levels of friend support (β =  -0.11; 95% CI, -4.063, -0.573) and significant other support (β =  -0.10; 95% CI, -3.965, -0.168) were less likely to suffer from psychological symptoms when faced with occupational burnout. The results suggested that interventions aimed at lessening occupational burnout and boosting social support can be an effective way to promote the psychological health of medical staff.

Does the COVID-19 Pandemic Increase or Decrease the Global Cyberbullying Behaviors? A Systematic Review and Meta-Analysis

Although cyberbullying is an emerging public health problem, it is unclear how the COVID-19 pandemic affects cyberbullying. This systematic review and meta-analysis aimed to examine the effect of the COVID-19 pandemic on cyberbullying, to estimate the global cyberbullying prevalence and to explore factors related to cyberbullying during the COVID-19 pandemic. We searched the Medline, Embase, PubMed, Scopus, Eric, PsycINFO, Web of Science, Cochrane Library, Wanfang, Chinese CNKI, and EBSCO databases to identify relevant empirical studies published between 2019 and 2022. A total of 36 studies were included. Quality assessment, meta-analyses, and subgroup analyses were conducted. The pooled prevalences were 16% for overall cyberbullying, 18% for victimization and 11% for perpetration during the COVID-19 pandemic, which were lower than before the COVID-19 pandemic. The pooled prevalence of postpandemic cyberbullying perpetration is lower in children than in adults. In addition, both virus- and lockdown-related stressors were the main factors contributing to cyberbullying. The COVID-19 crisis may reduce cyberbullying, and the pooled prevalence of cyberbullying during the pandemic in adults is higher than in children and adolescents. In addition, the transient-enduring factor model of postpandemic cyberbullying built in this review could help identify people at high risk of cyberbullying during public health emergencies.

The interaction effects of social support and four types of bullying on sleep quality in Chinese adolescents

OBJECTIVES

The aims of this study were to examine the association of verbal, social, physical, and cyber bullying victimizations with sleep quality while taking social support as a moderator and to further examine gender and grade differences in the moderating effects of social support on bullying-associated sleep quality among Chinese adolescents.

METHODS

An online cross-sectional survey was conducted in a province of northwestern China. A total of 20,320 students were included in our analyses. Multivariable linear regression analyses were conducted to examine the association between bullying victimization and sleep quality as well as the moderating effects of social support on these relationships.

RESULTS

After adjusting for confounding variables, four types of bullying victimization were significantly associated with sleep quality. Social support only moderated the relationship of verbal, physical, and social bullying with sleep quality. Moreover, these positive moderating effects were found only for girls and, in terms of grade difference, only for primary students. Some reversed moderating effects of social support were also observed in the relationship of cyber, physical bullying with sleep quality.

LIMITATIONS

This was a cross-sectional study, limiting the causal inference.

CONCLUSIONS

This study revealed that bullying is a risk factor for poor sleep quality among adolescents in northwestern China. Furthermore, social support moderated the relationship between bullying and sleep quality in different ways depending on grade, gender, and type of bullying. More efforts are needed to prevent bullying and improve both school climate and students' sleep quality.

Effects of risk exposure on emotional distress among Chinese adults during the COVID-19 pandemic: The moderating role of disruption of life and perceived controllability

Background

COVID-19 affects not only the physical health of individuals but also their mental health and different types of risk exposures are believed to have different effects on individual emotional distress.

Objective

This study explores the relationships between risk exposure, disruption of life, perceived controllability, and emotional distress among Chinese adults during the COVID-19 outbreak.

Methods

This study is based on an online survey conducted during the COVID-19 pandemic, from 1 to 10 February 2020, with a total of 2,993 Chinese respondents recruited through convenience and snowball sampling. Multiple linear regression analysis were used to examine the relationships among risk exposure, disruption of life, perceived controllability, and emotional distress.

Results

This study found that all types of risk exposures were significantly associated with emotional distress. Individuals with neighborhood infection, family member infection/close contact, and self-infection/close contact had higher levels of emotional distress (B = 0.551, 95% CI: -0.019, 1.121; B = 2.161, 95% CI: 1.067, 3.255; B = 3.240, 95% CI: 2.351, 4.129) than those without exposure. The highest levels of emotional distress occurred among individuals experiencing self-infection/close contact, while the lowest levels of emotional distress occurred among individuals experiencing neighborhood infection and the moderate levels of emotional distress occurred among individuals experiencing family member infection (Beta = 0.137; Beta = 0.073; Beta = 0.036). Notably, the disruption of life aggravated the effect of self-infection/close contact on emotional distress and family member infection/close contact on emotional distress (B = 0.217, 95% CI: 0.036, 0.398; B = 0.205, 95% CI: 0.017, 0.393). More importantly, perceived controllability lowered the strength of the association between self-infection/close contact and emotional distress, as well as family member infection/close contact and emotional distress (B = -0.180, 95% CI: -0.362, 0.002; B = -0.187, 95% CI: -0.404, 0.030).

Conclusion

These findings shed light on mental health interventions for people exposed to or infected with COVID-19 near the beginning of the pandemic, particularly those who themselves had COVID or had family members with COVID-19 risk exposure, including being infected/having close contact with an infected person. We call for appropriate measures to screen out individuals or families whose lives were, or remain, more severely affected by COVID-19. We advocate providing individuals with material support and online mindfulness-based interventions to help them cope with the after-effects of COVID-19. It is also essential to enhance the public's perception of controllability with the help of online psychological intervention strategies, such as mindfulness-based stress reduction programs and mindfulness-oriented meditation training programs.

Levels and Determinants of Antenatal Breastfeeding Attitudes among Pregnant Women: A Cross-Sectional Study

Breastfeeding attitudes are strong predictors of breastfeeding behavior. Gaining a deeper understanding on the levels and determinants of antenatal breastfeeding attitudes is crucial. This cross-sectional study involved 124 pregnant women at a tertiary hospital in Hunan, China. A self-administered questionnaire, the Iowa Infant Feeding Attitude Scale, the Edinburgh Postnatal Depression Scale, the Pregnancy Stress Rating Scale, the Childbirth Attitude Questionnaire, the Perceived Social Support Scale, and the Breastfeeding Knowledge Questionnaire were assessed during their first-trimester, second-trimester, and third-trimester hospital visit. Multiple linear regression was conducted to identify the determinants of breastfeeding attitudes. The participants reported neutral (56.39 ± 5.69) levels of breastfeeding attitudes. The determinants of antenatal breastfeeding attitudes were other family members' support for exclusive breastfeeding: moderate (β = 0.278, p < 0.05), depressive symptoms (β = -0.191, p < 0.05), and breastfeeding knowledge (β = 0.434, p < 0.001). The variables explained 33.9% (adjusted R²) of the total variation in breastfeeding attitudes scores (F = 4.507, p < 0.001). Namely, other family members' support for EBF was a negative influence on positive breastfeeding attitudes. The women whose other family members were moderate of EBF had more positive attitudes toward breastfeeding compared to those whose other family members were very supportive of EBF. The depressive symptoms were negatively associated with positive breastfeeding attitudes, and lower levels of depressive symptoms were associated with higher levels of positive breastfeeding attitudes among pregnant women. Additionally, breastfeeding knowledge was positively associated with positive breastfeeding attitudes. The more knowledgeable about breastfeeding, the more positive the attitude towards breastfeeding. Health professionals should identify these modifiable factors that may contribute to poorer breastfeeding attitudes, which is useful in targeting promotions of breastfeeding.

The prevalences, changes, and related factors of child maltreatment during the COVID-19 pandemic: A systematic review

BACKGROUND

The impact of the COVID-19 pandemic has been extensive and drastic during the twenty-first century. The increasing phenomenon of child maltreatment during the pandemic is a significant public health concern.

OBJECTIVE

This study is the first systematic review to analyze and summarize the prevalence rates, risk factors, and protective factors related to child maltreatment during the COVID-19 pandemic.

METHODS

Four electronic databases (PubMed, Web of Science, Scopus, Embase) were systematically searched. Some potential studies were also identified from the reference lists of previously included articles. The quality of the included studies was assessed by the National Institutes of Health (NIH) Quality Assessment Tool and Critical Appraisal Skills Program (CASP) Quality Assessment Tool.

RESULTS

A total of 35 articles were included in the analysis, with 16 having prevalence information and 22 having factor information. Sixteen studies were conducted in the US, the other 17 studies were from 12 countries, and only two studies contained mixed countries. The prevalences of child maltreatment during the pandemic varied widely in different types and measurements. The pandemic rates of physical abuse, psychological abuse, neglect, and sexual abuse were 0.1 %-71.2 %, and 4.9 %-61.8 %, 7.3 %-40 % and 1.4 %-19.5 %, respectively. There was a decline in allegations of child maltreatment and an increase in severe cases of child maltreatment during the COVID-19 pandemic. Lockdown measures and their side effects were the main risk factors contributing to child maltreatment.

CONCLUSIONS

This review calls for targeted measures to prevent child maltreatment during the COVID-19 pandemic and current and future lockdowns and more future replication studies conducted in countries other than the US.

Precarious Employment and Chronic Stress: Do Social Support Networks Matter?

Precarious employment has been identified as a potentially damaging stressor. Conversely, social support networks have a well-known protective effect on health and well-being. The ways in which precariousness and social support may interact have scarcely been studied with respect to either perceived stress or objective stress biomarkers. This research aims to fill this gap by means of a cross-sectional study based on a non-probability quota sample of 250 workers aged 25–60 in Barcelona, Spain. Fieldwork was carried out between May 2019 and January 2020. Employment precariousness, perceived social support and stress levels were measured by means of scales, while individual steroid profiles capturing the chronic stress suffered over a period of a month were obtained from hair samples using a liquid chromatography-tandem mass spectrometry methodology. As for perceived stress, analysis indicates that a reverse buffering effect exists (interaction B = 0.22, p = 0.014). Steroid biomarkers are unrelated to social support, while association with precariousness is weak and only reaches significance at p < 0.05 in the case of women and 20ß dihydrocortisone metabolites. These results suggest that social support can have negative effects on the relationship between perceived health and an emerging stressful condition like precariousness, while its association with physiological measures of stress remains uncertain.

Understanding the mental health impacts of COVID-19 through a trauma lens

This special issue of the European Journal of Psychotraumatology (EJPT) presents the first studies published by EJPT on COVID-19. We present 26 qualitative and quantitative studies assessing the prevalence of trauma-related symptoms and psychopathology within specific vulnerable populations such as health-care workers, students, children, and managers, or more broadly at a country level with a diverse set of outcomes including post-traumatic stress, moral injury, grief and post-traumatic growth. Intervention studies focus on whether telehealth delivery of mental health therapy in the pandemic environment was useful and effective. It is clear that the pandemic has brought with it a rise in trauma exposure and consequently impacted on trauma-related mental health. While for many individuals, COVID-19-related events met criteria for a DSM-5 Criterion A event, challenges remain in disentangling trauma exposure from stress, anxiety, and other phenomena. It is important to determine the contexts in which a trauma lens makes a useful contribution to understanding the mental health impacts of COVID-19 and the ways in which this may facilitate recovery. The papers included in this Special Issue provide an important and much-needed evidence-based foundation for developing trauma-informed understanding and responses to the pandemic.