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Zeng Y, Song J, Zhang Y, Guo X, Xu X, Fan L, Zhao L, Song H, Jiang L. Life changes and symptoms of depression and anxiety among Chinese children and adolescents before, during, and after the COVID-19 pandemic lockdown: a combination of cross-sectional, longitudinal, and clustering studies. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02533-4. [PMID: 39060517 DOI: 10.1007/s00787-024-02533-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
The measures to prevent COVID-19 pandemic had caused significant life changes, which may have caused stress on the mental health of children and adolescents. We aimed to evaluate the short- and long-term effects of life changes on children's mental health in a large Chinese cohort. Survey-based life changes during COVID-19 lockdown were measured among 7,829 Chinese students at Grade 1-9, including social contacts, lifestyles and family financial status. Clustering analysis was applied to identify potential patterns of these changes. Depressive and anxiety symptoms were measured using the Center for Epidemiologic Studies Depression Scale and Screen for Child Anxiety Related Emotional Disorders. Logistic regression models were used to investigate the associations between these changes, their patterns and the presence of depression/anxiety symptoms using both cross-sectional and longitudinal designs. We found that the prevalence of depression and anxiety symptoms decreased during pandemic (34.6-32.6%). However, during and shortly after lockdown, students who reported negative impacts on their study, social and outside activities, and diet had increased risks of depressive/anxiety symptoms. Decreased electronic time and sugar-sweetened consumption, as well as family income decline and unemployment, were also associated with higher risks of these symptoms. Additionally, students with changed sleep time had increased depressive symptoms. These associations attenuated or disappeared one year later. Similar patterns were observed in clustering analysis, while only the group with severe impact on family financial status showed a sustained increase in depression symptoms. In summary, restrictive measures that changed children and adolescents' daily life during COVID-19 lockdown showed negative effects on their mental health, with some commonalities and distinctions patterns in the manifestation of depression and anxiety symptoms.
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Affiliation(s)
- Yu Zeng
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Jie Song
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Yanan Zhang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Xinyu Guo
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xinmao Xu
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Linlin Fan
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Huan Song
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Lihua Jiang
- Teaching & Research Section of General Practice, The General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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龙 宇, 徐 新, 张 换, 彭 银, 范 琳, 蒋 莉, 宋 戈, 赵 莉. [Relationship Between Empathy and Depression in Adolescents: The Mediating Role of Family Functioning]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:680-686. [PMID: 38948264 PMCID: PMC11211767 DOI: 10.12182/20240560602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Indexed: 07/02/2024]
Abstract
Objective To investigate the effect of empathy on depressive symptoms in adolescents and to explore the potential mediating role of family functioning in the effect of empathy on depressive symptoms. Methods The 2022 cross-sectional data from the Chengdu Positive Child Development (CPCD) cohort were analyzed in the study. A survey was conducted in Chengdu in June 2022, involving 3020 students in grades 5-8 from three randomly selected stratified schools. The Interpersonal Reactivity Index (IRI-C), the Chinese Family Assessment Instrument (C-FAI), and the Center for Epidemiologic Studies Depression Scale for Children (CES-DC) were used in the survey. Chi-square test or one-way analysis of variance was performed to examine the differences in various demographic characteristics (sex, grade, region, and total monthly household income) between groups of respondents, as well as the differences in family functioning, empathy, and depression. Pearson correlation coefficient was used to examine the correlation between family functioning, empathy, and depressive symptoms. Structural equation modeling and SPSS PROCESS component Model 4 were used to analyze whether family functioning played a mediating role in the effect of empathy on depressive symptoms in adolescents. Results The detection rate of depressive symptoms among survey respondents was 25.40%. The results of the difference analysis revealed significant differences in the detection rates of depressive symptoms among respondents of different grades, regions, and monthly household incomes (P<0.05). There was no significant difference in the detection rates of depressive symptoms between male and female students. There was a significant difference in the detection rate of depressive symptoms between respondents with different scores for family dysfunction and empathy ability (P<0.001). Correlation analysis results showed that empathy scores were negatively correlated with depression (r=-0.11, P<0.001), that family dysfunction was positively correlated with depression (r=0.29, P<0.001), and that empathy scores were negatively correlated with family functioning (r=-0.37, P<0.001). The mediating role of family dysfunction in the relationship between empathy and depressive symptoms was established, with the direct effect being 0.039 (95% confidence interval [CI]: 0.010-0.069, P<0.001) and the indirect effect value being -0.096 (95% CI: -0.115--0.079, P<0.001). The direct effect value accounted for 28.89% of the total effect value, while the mediation effect value accounted for 71.11% of the total effect value. Conclusion The empathy ability of adolescents is correlated to depressive symptoms, and family functioning plays a mediating role between empathy and depressive symptoms in adolescents. It is suggested that adolescents' empathy ability and family functioning should be enhanced through multiple channels to reduce the occurrence of depressive symptoms.
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Affiliation(s)
- 宇 龙
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 新茂 徐
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 换芳 张
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 银辉 彭
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 琳林 范
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 莉华 蒋
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医学院/四川大学华西医院 (成都 610041)West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, China
| | - 戈扬 宋
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 莉 赵
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Dai S, Qiu G, Li Y, Yang S, Yang S, Jia P. State of the Art of Lifecourse Cohort Establishment. China CDC Wkly 2024; 6:300-304. [PMID: 38634101 PMCID: PMC11018708 DOI: 10.46234/ccdcw2024.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Shaoqing Dai
- School of Resource and Environmental Sciences, Wuhan University, Wuhan City, Hubei Province, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan City, Hubei Province, China
| | - Ge Qiu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan City, Hubei Province, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan City, Hubei Province, China
| | - Yuchen Li
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan City, Hubei Province, China
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Geography, The Ohio State University, Columbus, OH, USA
| | - Shuhan Yang
- School of Resource and Environmental Sciences, Wuhan University, Wuhan City, Hubei Province, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan City, Hubei Province, China
| | - Shujuan Yang
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan City, Hubei Province, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan City, Hubei Province, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan City, Hubei Province, China
- Hubei Luojia Laboratory, Wuhan City, Hubei Province, China
- School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
- Renmin Hospital, Wuhan University, Wuhan City, Hubei Province, China
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Chen Y, Luo J, Jiang L, Shi W, Jia P, Zhang J, Zhao L. Association between positive youth development and non-suicidal self-injury: A longitudinal survey of children and adolescents in southwest China, 2019-21. J Affect Disord 2024; 350:755-760. [PMID: 38211752 DOI: 10.1016/j.jad.2024.01.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/26/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) could lead to serious problems (exp. suicidal attempts) among children and adolescents. Positive youth development (PYD) focuses on comprehensive development instead of a single problem. This study aims to explore the longitudinal relationship between NSSI and PYD among Chinese children and adolescents. METHODS The longitudinal study used the three-wave dataset from the Chengdu Positive Child Development (CPCD) in southwest China between 2019 and 2021, including 10,370 participants. The parallel process Latent Growth Curve Model (LGCM) was utilized to analyze the relationship between PYD and NSSI across time. RESULTS The study results demonstrated that the initial level of NSSI is negatively associated with the initial value (β = -0.730, p < 0.01) and the growth rate (β = -0.012, p < 0.01) of PYD, and the development rate of the two variables are negatively related to each other(β = -0.120, p < 0.01). LIMITATIONS The specific relationships between PYD attributes and NSSI should be explored in the future. And the cultural variation among countries deserves more research. Moreover, the dynamic cohort research leads to a relatively high loss of participants. CONCLUSIONS PYD and NSSI are closely associated among children and adolescents. Instead of playing a protective role, PYD tends to be predicted by NSSI behaviors over time.
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Affiliation(s)
- Yuxin Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Jingsong Luo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Lihua Jiang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wei Shi
- Institute for Disaster Management and Reconstruction(IDMR), Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Jinquan Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Guo X, Wang L, Li Z, Feng Z, Lu L, Jiang L, Zhao L. Factors and pathways of non-suicidal self-injury in children: insights from computational causal analysis. Front Public Health 2024; 12:1305746. [PMID: 38532971 PMCID: PMC10963487 DOI: 10.3389/fpubh.2024.1305746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
Background Non-suicidal self-injury (NSSI) has become a significant public health issue, especially prevalent among adolescents. The complexity and multifactorial nature of NSSI necessitate a comprehensive understanding of its underlying causal factors. This research leverages the causal discovery methodology to explore these causal associations in children. Methods An observational dataset was scrutinized using the causal discovery method, particularly employing the constraint-based approach. By integrating machine learning and causal inference techniques, the study aimed to determine direct causal relationships associated with NSSI. The robustness of the causal relationships was evaluated using three methods to construct and validate it: the PC (Peter and Clark) method, Fast Causal Inference (FCI) method, and the GAE (Graphical Autoencoder) method. Results Analysis identified nine nodes with direct causal relationships to NSSI, including life satisfaction, depression, family dysfunction, sugary beverage consumption, PYD (positive youth development), internet addiction, COVID-19 related PTSD, academic anxiety, and sleep duration. Four principal causal pathways were identified, highlighting the roles of lockdown-induced lifestyle changes, screen time, positive adolescent development, and family dynamics in influencing NSSI risk. Conclusions An in-depth analysis of the factors leading to Non-Suicidal Self-Injury (NSSI), highlighting the intricate connections among individual, family, and pandemic-related influences. The results, derived from computational causal analysis, underscore the critical need for targeted interventions that tackle these diverse causative factors.
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Affiliation(s)
- Xinyu Guo
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Linna Wang
- College of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Zhenchao Li
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ziliang Feng
- College of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Li Lu
- College of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Lihua Jiang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Teaching and Research Section of General Practice, The General Practice Medical Center, West China Hospital of Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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彭 银, 赵 莉, 李 祥, 龙 宇, 徐 新, 张 换, 蒋 莉. [Effect of Family Functioning on Adolescents' Internalizing and Externalizing Problem Behaviors: The Multiple Mediating Roles of Empathy and Emotional Competence]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:146-152. [PMID: 38322518 PMCID: PMC10839476 DOI: 10.12182/20240160507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Indexed: 02/08/2024]
Abstract
Objective To examine the mediating role of empathy and emotional competence in the association between family functioning and internalizing and externalizing problem behaviors among adolescents in China. Methods In this study, we used the data from the June-July 2022 survey of Chengdu Positive Child Development (CPCD) cohort. All respondents were 5th-9th graders from six primary or secondary schools in Chengdu. The Achenbach Child Behavior Checklist (CBCL), the Chinese Family Assessment Instrument (C-FAI), the empathy subscale of the Chinese version of the Interpersonal Reactivity Index (C-IRI), and the emotional competence (EC) subscale of the Chinese Positive Youth Development Scale (CPYD) were used to evaluate the respondents' internalizing and externalizing problem behaviors, family functioning, empathy, and emotional competence, respectively. The average score derived from the total score of a scale divided by the number of entries in each dimension was used as the final score of the scale. Independent samples t-tests or one-way analysis of variance (ANOVA) were performed to examine the differences in family functioning, empathy, emotional competence, and internalizing and externalizing problem behaviors across student groups with different demographic characteristics (sex, grade, and region). Pearson correlation analysis was conducted to examine the relationship between family functioning, empathy, emotional competence, and internalizing and externalizing problem behaviors. AMOS 24.0 was used to validate the hypothesized model and structural equation modeling was used to analyze the mediating effects of empathy and emotional competence between family functioning and internalizing and externalizing problem behaviors among adolescents. Results A total of 3026 eligible participants were included, including 1548 (51.16%) male students and 1478 (48.84%) female students. Among the respondents, 798 (26.37%) were 5th graders, 738 (24.39%) were 6th graders, 567 (18.74%) were 7th graders, 614 (20.29%) were 8th graders, and 309 (10.21%) were 9th graders. In addition, 2064 (68.21%) of all respondents were from urban areas and 962 (31.79%) were from rural areas. The results of the difference analysis showed that the differences in adolescents' internalizing and externalizing problem behaviors were statistically significant between students of different grades (P=0.004), and that the differences in family functioning and empathy scores were also statistically significant between students of different grades (all P<0.001), whereas the differences in adolescents' internalizing and externalizing problem behaviors were not statistically significant between sexes and regions (P=0.919, 0.959). The results of correlation analysis showed that family functioning scores (the higher the score, the worse the family functioning) were significantly negatively correlated with empathy and emotional competence (r=-0.482, -0.432, P<0.01), and significantly positively correlated with internalizing and externalizing problem behaviors (r=0.220, P<0.01). Empathy was significantly positively correlated with emotional competence (r=0.402, P<0.01). Empathy and emotional competence were significantly negatively correlated with all the dimensions of internalizing and externalizing problem behaviors (r=-0.115, -0.305, P<0.01). Emotional competence partially mediated the relationship between family functioning and adolescents' internalizing and externalizing problem behaviors, with a mediation effect value being 0.042 (95% [confidence interval] CI: 0.031-0.057). Empathy and emotional competence had chain mediation effect between family functioning and adolescents' internalizing and externalizing problem behaviors, with the value of the mediation effect being 0.010 (95% CI: 0.007-0.014). Conclusion Family functioning influences adolescents' internalizing and externalizing problem behaviors in a direct way and through the chain-mediating roles of empathy and emotional competence.
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Affiliation(s)
- 银辉 彭
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 莉 赵
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 祥 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 宇 龙
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 新茂 徐
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 换芳 张
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 莉华 蒋
- 四川大学华西公共卫生学院/四川大学华西第四医院 卫生政策与管理学系 (成都 610041)Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医学院/四川大学华西医院 全科医学中心/全科医学教研室 (成都 610041)Center for Family Medicine/Faculty of Family Medicine, West China Hospital and West China School of Medicine, Sichuan University, Chengdu 610041, China
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Xiong A, Liao S, Luo B, Luo S, Tong Y, Li Z. Associations between problematic internet use, life satisfaction, and deliberate self-harm among Chinese adolescents: A multi-centered longitudinal study. Addict Behav 2023; 147:107808. [PMID: 37536220 DOI: 10.1016/j.addbeh.2023.107808] [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: 03/14/2023] [Revised: 07/09/2023] [Accepted: 07/14/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Problematic Internet use (PIU), which is associated with deliberate self-harm (DSH), has become a common problem among adolescents. Life satisfaction (LS) may be able to mitigate the negative influences of PIU and DSH. But the longitudinal associations among them are yet to be well-researched. METHODS A longitudinal study with three-wave data collection involving 6092 adolescents was carried out in China. PIU, LS, and DSH were assessed using the Young Internet Addiction Test, the Satisfaction with Life Scale, and the Deliberate Self-Harm Inventory Nine-Item Version, respectively. A cross-lagged model was used to analyze the longitudinal interactions between them. Generalized Estimating Equations were adopted to identify their influential factors. RESULTS The prevalence of single DSH behaviors from wave 1 to wave 3 was 5.04%, 5.00%, and 4.67%, and the repeated DHS from wave 1 to wave 3 was 2.9%, 3.2%, and 3.4%, respectively. Bidirectional longitudinal predictive associations were revealed between PIU and LS (p<0.001), and LS and DSH (p<0.001). DSH could longitudinally predict PIU (p<0.001). Gender and age were associated with PIU, LS, and DSH (p<0.001), and PIU was influenced by ethnicity (p<0.001). CONCLUSION PIU and LS, LS and DSH were associated bidirectionally. Adolescents with more severe DSH behaviors were inclined to become addicted to the Internet, and adolescents with a history of DSH had a higher risk of recurring DSH. Parents, schools, and administrators need to improve the LS of adolescents, with a particular focus on older, female adolescents.
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Affiliation(s)
- Anqi Xiong
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| | - Shujuan Liao
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| | - Biru Luo
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| | - Shiqi Luo
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| | - Yunxuan Tong
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| | - Zhao Li
- Department of Health Policy and Management, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
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Jiang X, Zhao X, Zhou J, Zhang X, Song Y, Zhao L. The relationship between family function and the incidence of overweight/obesity in children and adolescents in Chengdu city, Sichuan province of China: based on latent profile analysis. BMC Public Health 2023; 23:2272. [PMID: 37978361 PMCID: PMC10656920 DOI: 10.1186/s12889-023-17143-z] [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: 07/22/2022] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Overweight/obesity in children and adolescents has become a global health problem, and family function may be associated with its occurrence. Studies exploring the association between family function and overweight/obesity in children and adolescents were performed in Western and Taiwan, China. To date, related studies haven't been conducted in Mainland China. OBJECTIVES To investigate the current status of overweight, obesity, and family function among children and adolescents in Chengdu, China, and to explore their associations. METHODS Children and adolescents in five primary and middle schools were chosen by cluster sampling. Body Mass Index was used to measure the status of overweight and obesity, and the Chinese family assessment instrument was adopted to assess family function. Latent profile analysis and stepwise logistic regression were applied to identify family classification and explore the relationships between family function and overweight/obesity. RESULTS A total of 7616 (84.92%) children and adolescents out of 8968 completed the study with qualified-filled questionnaires. Nine hundred and sixty-six (12.68%)participants were overweight and 656 (8.61%) were obese. The family function was categorized into three profiles: mild (63.93%), moderate (12.32%), and severe (23.75%) dysfunction. The prevalence of overweight was 12.16%, 14.71%, and 13.05% for mild, moderate, and severe family dysfunction, respectively. And the prevalence of obesity was 8.19%, 10.77%, and 8.62% respectively. Participants in moderate and severe dysfunction families were more likely to be overweight (moderate: OR = 1.27, 95% CI:1.01 ~ 1.59, P = 0.04; severe: OR = 1.38, 95% CI:1.15 ~ 1.66, P = 0.001) and obese (moderate: OR = 1.35, 95% CI:1.02 ~ 1.79, P = 0.03; severe: OR = 1.55, 95% CI:1.23 ~ 1.96, P < 0.001). Sociodemographic data such as gender, residence, grade, pocket money per week, the number of siblings, and the education level of the mother were all associated with the risk of being overweight/obese in children and adolescents. CONCLUSIONS The problems of being overweight or obese exist among children and adolescents in Chengdu. And the risk of being overweight or obese increases along with the decrease in family function.
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Affiliation(s)
- Xixi Jiang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiufang Zhao
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Sichuan University, Chengdu, China
| | - Junxia Zhou
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Sichuan University, Chengdu, China
| | - Xiujuan Zhang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Sichuan University, Chengdu, China
| | - Yan Song
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China Fourth Hospital, West China School of Public Health, Sichuan University, 610041, Chengdu, Sichuan, China.
- West China Research Centre for Rural Health Development, Sichuan University, Chengdu, China.
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Chen Y, Hu R, Xu X, Hong B, Zhang J, Jia P, Zhao L. The Effect of Mental Health Status and Family Function on Nonsuicidal Self-Injury: A Longitudinal Analysis of Chinese Children and Adolescents. Psychol Res Behav Manag 2023; 16:4491-4500. [PMID: 37936973 PMCID: PMC10627038 DOI: 10.2147/prbm.s429748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023] Open
Abstract
Background Nonsuicidal self-injury (NSSI) is an overwhelming social problem in children and adolescents. Focusing on the change of NSSI behavior, including onset, cessation, and maintenance, is crucial to developing effective prevention and intervention strategies. This study explored the effect of mental health status (depressive and anxiety symptoms) and family function on NSSI. Methods The study sample comprised 7554 children and adolescents based on the first two rounds of the Chengdu Positive Child Development (CPCD) dataset in China. Depressive and anxiety symptoms measured mental health status. The self-reported questionnaires also assessed NSSI behaviors and family function. The interrelationship between NSSI behaviors, mental health status, and family function was evaluated. Logistic regression and linear regression were performed to examine the interrelationship between mental health status, family function and NSSI behaviors. Sensitivity analysis was performed. Results In this study, 2167 (28.69%) participants reported NSSI at baseline and 2101 (27.81%) at follow-up. Depression, anxiety, and family function were salient influential factors in the prevalence, onset, and cessation of NSSI. Parents' accompaniment showed a significant effect on the prevalence of NSSI. Conclusion Depression, anxiety, family function, and parents' accompaniment are all associated with NSSI behaviors. Strategies targeting mental health status and family function could effectively protect children and adolescents from NSSI behaviors.
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Affiliation(s)
- Yuxin Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
- China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, People’s Republic of China
| | - Rui Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xinmao Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Binxue Hong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jinquan Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, People’s Republic of China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, People’s Republic of China
| | - Li Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
- China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, People’s Republic of China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, People’s Republic of China
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10
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Peng L, Hu R, Feng Y, Shi W, Zhao L, Jiang L. The relationship between family diet consumption, family environment, parent anxiety and nutrition status children during the COVID-19 pandemic: a longitudinal study. Front Public Health 2023; 11:1228626. [PMID: 37637798 PMCID: PMC10447892 DOI: 10.3389/fpubh.2023.1228626] [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: 05/30/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Background The COVID-19 pandemic has exacerbated the trends of childhood overweight, obesity, and malnutrition, as well as increased psychological stress and family conflicts among family members. It is important to explore the relationship between changes in the family environment during the COVID-19 on child nutrition. Objective This study aims to analyze the nutritional status of Chinese children during the COVID-19 pandemic and its relationship with family diet, family environment, and parental anxiety, in order to provide evidence for further interventions in children's nutritional status. Method This study included 7,645 primary and secondary school students and their parents from five schools in Chengdu, China. Chi-square tests were used to analyze the categorical variables of children's malnutrition, overweight, obesity, and parental anxiety. T-tests were used to assess changes in the continuous variable of family environment between two rounds of follow-up surveys. Multiple logistic regression analysis was employed to examine the impact of changes in family diet during the COVID-19 pandemic on children's nutritional status. Generalized estimating equations were used to analyze the effects of family environment and parental anxiety on childhood obesity. Result The prevalence of malnutrition and obesity decreased from 11.64% and 11.60% in wave 1 to 4.96% and 10.50% in wave 2, and the rate of overweight increased from 13.11% in wave 1 to 13.73% in wave 2. Children whose families reduced consumption of staple foods during the COVID-19 were more likely to be frail, and families increased consumption of sugary drinks, take-out or meal delivery services, living in towns, family environmental barriers, and parental anxiety were risk factors for overweight obesity. Mother's education level in middle and high school and low age were protective factors for overweight obesity. Conclusion The physical environment of the family, the emotions of family members, and children's perceptions of the family's soft environment can influence children's eating behaviors, children's nutritional intake, and malnutrition and obesity in children under public health emergencies, and family-based dietary interventions may be effective. Parents can increase consumption of healthy foods and improve the family environment, which improve their growth.
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Affiliation(s)
- Lili Peng
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rui Hu
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yiwei Feng
- Department of Natural Science, Duke Kunshan University, Kunshan, China
| | - Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lihua Jiang
- Institute for Hospital Management, West China Hospital, Sichuan University, Chengdu, China
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11
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Zhao L, Li X, Yang Q, Peng Y, Jiang L, Jia P, Shi W. The longitudinal association between internet addiction and depressive and anxiety symptoms among Chinese adolescents before and during the COVID-19 pandemic. Front Public Health 2023; 10:1096660. [PMID: 36743184 PMCID: PMC9889652 DOI: 10.3389/fpubh.2022.1096660] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
Background The COVID-19 pandemic and related prevention policies, such as home quarantine or online courses, could increase the risks of experiencing internet addiction and mental health problems among Chinese adolescents. There is a lack of longitudinal evidence to show the association between internet addiction symptoms and psychological consequences (e.g., depressive and anxiety symptoms). Objective This study aimed to explore the association between internet addiction and depressive and anxiety symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods An effective sample of 7,958 Chinese adolescents was recruited for this two-wave longitudinal survey conducted over a six-month interval. All participants completed two-wave surveys before and during the COVID-19 pandemic. A longitudinal cross-lagged path model was used to analyze the associations between internet addiction and depressive and anxiety symptoms after controlling for four covariates (i.e., age, sex, minority, and COVID-19 influence). Results Higher depressive and anxiety symptoms before COVID-19 significantly predicted severe internet addiction during COVID-19. Results showed a significant bidirectional relationship between internet addiction and depressive symptoms. Furthermore, the prevalence of internet addiction displayed an increasing trend over the two waves. Conversely, a reduced prevalence of anxiety and depressive symptoms was observed over the two waves. Conclusion This current study provided valuable evidence that psychological problems and internet addiction significantly influenced each other before and during the COVID-19 outbreak. Consequently, the presence of psychological problems before and during the COVID-19 outbreak could indicate internet addiction. Thus, depression- and anxiety-related psychotherapies should be developed to prevent internet addiction among Chinese adolescents.
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Affiliation(s)
- Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Li
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qin Yang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yinhui Peng
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lihua Jiang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China,International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China,*Correspondence: Wei Shi ✉
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12
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Influences of the COVID-19 Pandemic on Obesity and Weight-Related Behaviors among Chinese Children: A Multi-Center Longitudinal Study. Nutrients 2022; 14:nu14183744. [PMID: 36145119 PMCID: PMC9504407 DOI: 10.3390/nu14183744] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/03/2022] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
COVID-19-related lockdown measures have been affecting children’s weight status and weight-related behaviors, which are often associated with an increase in childhood obesity. However, large-scale longitudinal studies are lacking. Our study aimed to analyze changes in obesity and weight-related behaviors in Chinese children before and during the COVID-19 pandemic and provide references for addressing the high prevalence of childhood obesity. A prospective multi-center longitudinal survey was conducted among Chinese children (n = 5963), collecting data on weight status, COVID-19-related measures, and lifestyle behaviors. Changes were assessed using t-tests and χ2 tests for paired samples, or the Wilcoxon signed-rank test, according to the type and distribution of data. The Generalized Estimating Equations model was used to explore influential factors of obesity. The prevalence of overweight and obesity increased from 9.2% and 8.6% before the pandemic to 10.5% and 10.6% during the pandemic (p < 0.001), respectively. Daily physical activity, sleep duration, and sugar-sweetened beverage consumption decreased while screen time increased. The results of the generalized estimating equations showed that ethnic minority, older age, less daily physical activity, reduced sleep duration, and longer screen time were positively associated with obesity. There is an intensifying trend of obesity in children in the context of the COVID-19 pandemic, to which altered weight-related behaviors might have contributed largely. Maintaining a healthy lifestyle, especially in social crises, should be highlighted to ease the burden of childhood obesity.
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13
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Shi W, Yuan GF, Hall BJ, Zhao L, Jia P. Chinese adolescents' depression, anxiety, and family mutuality before and after COVID-19 lockdowns: Longitudinal cross-lagged relations. FAMILY RELATIONS 2022; 72:FARE12761. [PMID: 36246205 PMCID: PMC9538438 DOI: 10.1111/fare.12761] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 07/11/2022] [Accepted: 07/24/2022] [Indexed: 05/30/2023]
Abstract
Objective This study aimed to investigate the longitudinal cross-lagged association between family mutuality, depression, and anxiety among Chinese adolescents before and after the COVID-19 lockdown in 2020. Background Limited attention has been paid to the longitudinal links between family mutuality, depression, and anxiety in the context of the COVID-19 pandemic. Method We used self-administered questionnaires to collect data from three high schools and two middle schools in Chengdu City at two time points: Time 1 (T1), December 23, 2019-January 13, 2020; Time 2 (T2), June 16-July 8, 2020. The sample consisted of 7,958 participants who completed two wave surveys before and after the COVID-19 lockdown. We analyzed the data using cross-lagged structural equation modeling. Results The longitudinal cross-lagged model showed family mutuality at T1 significantly predicted depression, anxiety, and family mutuality at T2. We observed a decreasing prevalence of depression and anxiety after the COVID-19 lockdown. Conclusion Family mutuality plays an important role in mitigating long-term mental health disorders, such as depression and anxiety. More family-centered psychological interventions could be developed to alleviate mental health disorders during lockdowns. Implications Improving family mutuality (e.g., mutual support, interaction, and caring among family members) could be beneficial for reducing mental health disorders among Chinese adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR)Sichuan UniversityChengduSichuanChina
| | - Guangzhe Frank Yuan
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public HealthUniversity of South CarolinaColumbia, SC
| | | | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth HospitalSichuan UniversityChengduSichuanChina
| | - Peng Jia
- Institute for Disaster Management and Reconstruction (IDMR)Sichuan UniversityChengduSichuanChina
- School of Resource and Environmental SciencesWuhan UniversityWuhanChina
- International Institute of Spatial Lifecourse Health (ISLE)Wuhan UniversityWuhanChina
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14
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Liang K, Zhao L, Lei Y, Zou K, Ji S, Wang R, Huang X. Nonsuicidal self-injury behaviour in a city of China and its association with family environment, media use and psychopathology. Compr Psychiatry 2022; 115:152311. [PMID: 35395465 DOI: 10.1016/j.comppsych.2022.152311] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/01/2022] [Accepted: 03/22/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION It is not clear whether there are differences in the risk factors for nonsuicidal self-injury (NSSI) between children and early adolescents. Clarifying this question is crucial for identifying actionable prevention strategies for NSSI in these two age groups. METHOD The study, comprising 8611 children and early adolescents (4409 (51.2%) children, 4202 (48.8%) early adolescents), was based on the baseline data of the Chengdu Positive Child Development (CPCD) in China. NSSI behaviours, emotional and behavioural problems and family environment were assessed and obtained via self-reports and parent reports. RESULTS Overall, 2520 (29.26%) participants reported having ever engaged in NSSI. There was a higher lifetime NSSI rate in males than in females during childhood, contrasting with higher NSSI rates in females than in males during early adolescence. Furthermore, NSSI shared similar risk factors, including major family conflict and poor relationships with caregivers, in both age groups. Specifically, in children, the risk of NSSI increased along with thought and attention problems (OR, 95% CI: 1.194, 1.106-1.288 and 1.114, 1.028-1.207, respectively), whereas in early adolescents, it increased with anxiety and depressive problems (OR, 95% CI: 1.259, 1.116-1.422). CONCLUSIONS The findings suggested the need for difference in preventive strategies for NSSI in the two age groups. It may be more efficacious to screen for NSSI in children with thought and attention problems and in early adolescents with anxiety and depressive problems.
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Affiliation(s)
- Kaili Liang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Health Policy and Management, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Yalin Lei
- Department of Health-Related Social and Behavioural Sciences, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Kun Zou
- Department of Child, Adolescent and Maternal Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China Research Center for Rural Health Development, Sichuan University, Chengdu, Sichuan 610041, China; Institute for Healthy Cities, Sichuan University, Chengdu, Sichuan 610041, China
| | - Shuming Ji
- Department of Health Policy and Management, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Ruiou Wang
- West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
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15
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Wang Z, Hong B, Zhang Y, Su Y, Li M, Zhao L, Jia P. Children and adolescents' positive youth development qualities and internet addiction during the COVID-19 pandemic: A longitudinal study in China. Front Psychiatry 2022; 13:1068737. [PMID: 36713917 PMCID: PMC9875032 DOI: 10.3389/fpsyt.2022.1068737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUNDS Recent studies have shown that the qualities of children and adolescents' positive youth development (PYD) enable them to cope with developmental challenges in an adaptive manner and maintain healthy functioning. During the COVID-19 pandemic, there is still a lack of reporting on changes in children and adolescents' PYD qualities and Internet addiction and their relationship. This study investigated the association between PYD qualities and Internet addiction among the children and adolescents who have experienced the COVID-19 lockdown. METHODS A school-based cohort survey was launched in December 2019 (Wave 1, before COVID-19 lockdown) and followed up in June 2020 (Wave 2, after COVID-19 lockdown). The Chinese PYD scale (80 items, scoring 80-480) and Young's Internet addiction test (20 items, scoring 20-100) were used to evaluate the children and adolescents' PYD qualities and the degree of their Internet addiction, respectively. Cross-sectional regressions, longitudinal regressions, and cross-lagged panel model were used to examine the association between PYD qualities and Internet addiction. RESULTS 7,985 children and adolescents completed both waves of surveys. Compared with children and adolescents before lockdown (Wave 1), their total PYD quality dropped from 4.99 to 4.96 after COVID-19 lockdown (Wave 2), and the mean score for Internet addiction rose from 35.56 to 36.16. Cross-sectional analysis showed that after controlling for basic characteristics such as age and gender, the total PYD quality of children and adolescents in two waves was negatively correlated with the degree of Internet addiction during the same period, with β of -6.10 and -6.95, respectively. Longitudinal analysis showed that after controlling for basic characteristics, children and adolescents' total PYD quality in Wave 1 was negatively correlated with the Wave 2 of Internet addiction and the change between the two waves of Internet addiction, with β of -3.35 and -0.26, respectively. Cross-lagged panel models showed a negative bilateral relationship between total PYD quality and Internet addiction. CONCLUSION During the COVID-19 pandemic, the qualities of children and adolescents' PYD declined, which makes children and adolescents more vulnerable to Internet addiction. Therefore, it is necessary to widely implement programs in China that can comprehensively improve the qualities of children and adolescents' positive development to prevent Internet addiction, especially after the blockade due to public health emergencies.
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Affiliation(s)
- Zhuo Wang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center of Disease Control and Prevention, Chengdu, China
| | - Binxue Hong
- Department of Health Policy and Management, West China School of Public Health, Sichuan University, Chengdu, China
| | - Yanyan Zhang
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center of Disease Control and Prevention, Chengdu, China
| | - Ya Su
- Department of Sociology and Anthropology, Swarthmore College, Swarthmore, PA, United States
| | - Minghui Li
- Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center of Disease Control and Prevention, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health, Sichuan University, Chengdu, China.,Healthcare Evaluation and Organization Analysis (HEOA) Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.,School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
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16
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Shi W, Zhao L, Liu M, Hong B, Jiang L, Jia P. Resilience and mental health: A longitudinal cohort study of Chinese adolescents before and during COVID-19. Front Psychiatry 2022; 13:948036. [PMID: 36061276 PMCID: PMC9428694 DOI: 10.3389/fpsyt.2022.948036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/28/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak has resulted in mental health issues, mainly depression and anxiety, prompted by stressors such as the need to maintain social distance, adapting to quarantine, and lockdown policies. Resilience may be vital in protecting individuals from mental disorders. However, few studies have examined the longitudinal relationships between resilience and mental disorders (i.e., depression and anxiety) among adolescents before and during the COVID-19 pandemic. OBJECTIVE This study aimed to examine the association between resilience, depression, and anxiety among Chinese adolescents before and during COVID-19 using a longitudinal cross-lagged model. METHODS A total of 7,958 Chinese adolescents completed a baseline survey in the month before COVID-19 and were followed up after the COVID-19 lockdown. Structural equation modeling analyses were applied to evaluate the associations between resilience, depression, and anxiety after controlling for three covariates (i.e., gender, age, and COVID-19 effect). RESULTS A higher level of resilience before COVID-19 significantly predicted decreased severity of depression and anxiety after the lockdown. Moreover, the mean level of resilience and prevalence of mental disorders (i.e., depression and anxiety) among Chinese adolescents decreased after the lockdown. These findings suggest resilience is a vital protective factor against depression and anxiety among adolescents. Furthermore, younger participants and those less affected by the pandemic could be more resilient. No significant link was found between gender and resilience in the second wave. CONCLUSIONS Resilience is an essential protective factor for reducing mental disorders among Chinese adolescents exposed to COVID-19. Resilience-related interventions should be developed to efficiently promote mental health recovery among youth during pandemics.
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Affiliation(s)
- Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Min Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Binxue Hong
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lihua Jiang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China.,School of Resource and Environmental Sciences, Wuhan University, Wuhan, China.,International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
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Shi W, Yuan GF, Hall BJ, Liu X, Su Y, Zhao L, Jia P. Mental Disorders and Emotional Competence Among Chinese Adolescents Before and During COVID-19 Pandemic: A Longitudinal Mediation Model. Front Public Health 2021; 9:767004. [PMID: 34957019 PMCID: PMC8702639 DOI: 10.3389/fpubh.2021.767004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/18/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The outbreak of the COVID-19 pandemic has had a profound influence on the mental health and well-being of individuals across the globe. Emotional competence, defined as one's ability to recognize, understand, and manage their emotions, has been found linked with mental health problems (e.g., depression and anxiety) in previous studies. However, there is limited knowledge about the direction of the association between these factors among populations exposed to COVID-19. This study examined the possible mediation relationships between depression, anxiety, emotional competence, and COVID-19 exposure among Chinese adolescents. Methods: Responses from 7,958 Chinese adolescents who had previously taken part in a two-wave study before (December 23, 2019-January 13, 2020) and during COVID-19 (June 16, 2020-July 8, 2020) were analyzed (51.67% males, mean age = 11.74, SD = 2.15). Structural equation modeling with three covariates (i.e., age, gender, and ethnicity) was used to test the longitudinal mediation relationships between COVID-19 exposure and depression, anxiety via emotional competence. Results: Results indicated that the prevalence of depression (38.67 to 36.74%) and anxiety (13.02 to 12.77%) decreased from Time 1 to Time 2. The T2 emotional competence significantly mediated the relationship between T2 COVID-19 exposure and T2 anxiety (indirect effect [95% CI] = 0.011 [0.004-0.019], p < 0.05). T2 emotional competence also significantly mediated the relationship between T2 COVID-19 exposure and T2 depression (indirect effect [95% CI] = 0.013 [0.005-0.022], p < 0.05). The results indicated that T2 emotional competence had a significant and negative influence on T2 anxiety (β = -0.266, SE = 0.005, p < 0.001), and T2 depression (β = -0.326, SE = 0.029, p < 0.001). Conclusions: This longitudinal research study demonstrated the crucial role of emotional competence in influencing the severity of long-term mental health problems, and suggested that emotional competence interventions can be conducted to improve mental well-being among Chinese adolescents exposed to COVID-19.
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Affiliation(s)
- Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Guangzhe Frank Yuan
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau SAR, China
| | - Brian J. Hall
- Global and Community Mental Health Research Group, New York University, Shanghai, China
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Xiaoli Liu
- Office of Humanities and Social Sciences Administration, Sichuan University, Chengdu, China
| | - Ya Su
- Department of Sociology, Dickinson College, Carlisle, PA, United States
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Health Emergency Management Research Center. China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Peng Jia
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
- School of Resources and Environmental Science, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan University, Wuhan, China
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