The mediating effect of self-esteem on the relationship of living environment, anxiety, and depression of underprivileged children: A path analysis in Chinese context

Prevalence of antenatal depression and postpartum depression among Chinese fathers: A systematic review and meta-analysis

Background

Paternal antenatal depression and postpartum depression are associated with adverse health outcomes in mothers and infants; however, their prevalence among Chinese fathers remains controversial. This meta-analysis aimed to summarize the prevalence of antenatal depression and postpartum depression in Chinese fathers.

Methods

We conducted a systematic meta-analysis on the prevalence of antenatal depression and postpartum depression among Chinese fathers by searching 11 databases. Pooled estimates and 95 % confidence intervals were calculated. The choice between a random-effects model and a fixed-effects model was based on an assessment of heterogeneity among the studies as well as assumptions regarding the similarity of the studies in terms of clinical characteristics, quality, design, and conduct. Subgroup and meta-regression analyses were conducted based on the scale used to measure antenatal depression and postpartum depression, the region where the study was completed, the time of the study, the study design, the number of children, publication language, the study site, and quality assessment.

Results

This meta-analysis included 28 studies with 8795 participants. The prevalence of antenatal depression among Chinese fathers was 11 % (95 % CI: 5%-17 %, P < 0.01) using a random-effects model. Heterogeneity was I2 = 91 %. Publication language moderated the prevalence of paternal antenatal depression (the amount of heterogeneity accounted for was 92.13 %). The prevalence of postpartum depression among Chinese fathers was 16 % (95 % CI: 13%-18 %, P < 0.01), using a random-effects model. The heterogeneity was I2 = 94 %. The prevalence of paternal postpartum depression was moderated by the scale used to measure postpartum depression (39.17 % heterogeneity) and the region where the study was completed (33.15 % heterogeneity). Moreover, Egger's test (t = 4.542, P < 0.001) indicated publication bias in studies on postpartum depression among Chinese fathers. However, after applying the trimming correction, the pooled prevalence of postpartum depression had a P value of <0.05, indicating that despite the publication bias, the results remain reliable and unaffected in terms of effect size.

Conclusion

The prevalence of antenatal depression and postpartum depression among Chinese fathers was similar to those reported in low- and middle-income countries. Fathers should receive regular screening, effective prevention, and appropriate treatment. However, interpreting these results requires consideration of the limitations of the study.

Family Income and Child Depression: The Chain Mediating Effect of Parental Involvement, Children's Self-Esteem, and Group Differences

Family income is an important factor that affects depression in children and can indirectly be associated with children's development through family and individual factors. However, few studies have examined the mechanism of multiple risk factors. Therefore, this study focused on the relationship between family income and child depression, as well as the chain mediating the roles of parental involvement and children's self-esteem both in single-parent families and intact families. A total of 1355 primary school students completed questionnaires that assessed family income, parental involvement, children's self-esteem, and depression. The results showed that family income influenced child depression through both the mediating roles of parental involvement and children's self-esteem and the chain mediating role of parental involvement and children's self-esteem. Meanwhile, family income only influenced child depression through chain mediation in single-parent families. The group differences in the mechanism of depression provide a reference for empirical research on depression intervention in children from different family structures.

The role of self-esteem as moderator of the relationship between experienced stigma and anxiety and depression among tuberculosis patients

Anxiety and depression are very common in tuberculosis (TB) patients and can adversely affect TB treatment adherence, ultimately leading to higher morbidity, mortality and drug resistance. Therefore, the aim of this study was to identify the association among experienced stigma, self-esteem and anxiety and depression, and to further explore whether self-esteem could be a moderator in the association between experienced stigma and anxiety and depression in TB patients. A total of 473 TB patients from Dalian, Liaoning Province, Northeast China participated in a cross-sectional survey. A structured questionnaire was developed to collect data. Hierarchical multiple regression was used to analyze the association among experienced stigma, self-esteem and experienced stigma × self-esteem interaction with anxiety and depression. Simple slope analysis was applied to visualize the interaction. Experienced stigma was positively associated with anxiety (B = 0.307, P < 0.01) and depression (B = 0.277, P < 0.01), and self-esteem was negatively associated with anxiety (B = - 0.215, P < 0.01) and depression (B = - 0.351, P < 0.01) in TB patients. The association between experienced stigma and anxiety was different in the low (1 standard deviation (SD) below the mean, B = 0.376, standard error (SE) = 0.056, P < 0.01) and high (1 SD above the mean, B = 0.228, SE = 0.060, P < 0.01) groups of self-esteem. Additionally, the association between experienced stigma and depression was also different in the low (1 SD below the mean, B = 0.363, SE = 0.053, P < 0.01) and high (1 SD above the mean, B = 0.179, SE = 0.056, P < 0.01) groups of self-esteem. Self-esteem could moderate the association between experienced stigma and anxiety and depression. In addition to reducing experienced stigma, enhancing self-esteem as a way to reduce the impact of experienced stigma on anxiety and depression can also help improve the mental health of TB patients.

Post-traumatic growth among 5195 adolescents at 8.5 years after exposure to the Wenchuan earthquake: Roles of post-traumatic stress disorder and self-esteem

We evaluated the level of post-traumatic growth in a large sample of Chinese adolescent earthquake survivors (n = 5195) and relationships among self-esteem, post-traumatic stress disorder, and post-traumatic growth. This cross-sectional study indicated that the prevalence of post-traumatic growth among adolescent survivors was 14.8 percent. Post-traumatic growth was independently associated with self-esteem, severity of exposures, and avoidance facets of post-traumatic stress disorder. Post-traumatic stress disorder was found to be partially mediated by self-esteem on post-traumatic growth; and post-traumatic stress disorder was also a mediator between earthquake exposure and post-traumatic growth. This study suggests that future longitudinal research and clinical practice should test whether promoting self-esteem can enhance post-traumatic stress disorder treatment.

The longitudinal associations among grandparent-grandchild cohesion, cultural beliefs about adversity, and depression in Chinese rural left-behind children

This study examined the effects of grandparent-grandchild cohesion on the cross-lagged associations between depression and cultural beliefs about adversity in a sample of 625 rural left-behind children in China. Grandparent-grandchild cohesion was concurrently and longitudinally associated with children's depression and cultural beliefs about adversity. Cultural beliefs about adversity mediated the associations between grandparent-grandchild cohesion and children's depression, while depression mediated the associations between grandparent-grandchild cohesion and children's beliefs about adversity. Left-behind status differences were also found in mediation models. These findings suggest the important role of grandparent-grandchild cohesion in left-behind children's adjustment.