Persistence and remission of depressive symptoms and psycho-social correlates in Chinese early adolescents

The mediation and interaction effects of Internet addiction in the association between family functioning and depressive symptoms among adolescents: A four-way decomposition

INTRODUCTION

Previous studies have demonstrated that both family dysfunction and internet addiction (IA) are associated with a higher risk of adolescent depression. However, no study has yet investigated the mechanisms involved. This study aims to explore the mediation and interaction roles of internet addiction (IA) between family functioning and depressive symptoms among adolescents in rural China.

METHODS

A multi-stage, stratified cluster, and random sampling was conducted among 3343 adolescents in rural China from October 27 to November 6, 2020. Depressive symptoms, IA, and family functioning were assessed using the Epidemiologic Studies Depression Scale (CESD), the Internet Addiction Test (IAT), and the Family Adaptation Partnership Growth Affection and Resolve Index (APGAR), respectively. Correlation analysis was performed by binary logistic regression. The study employed a four-way decomposition method to explore the potential mechanisms of family functioning on depressive symptoms.

RESULTS

The results indicated that family functioning and IA were associated with adolescents' depressive symptoms. The interaction between family functioning and IA accounted for 74 % of the association between family functioning and depression symptoms, while direct effects accounted for 24 %. The "proportion eliminated" (76.11 %) was substantially larger than "proportion mediated" (7.36 %).

LIMITATIONS

The cross-sectional design limited to identify the causal relationship among the variables.

CONCLUSIONS

We found that family dysfunction synergizes with IA to contribute to the high risk of adolescent depression. Prioritizing at preventing IA in adolescence could be an effective way to mitigate the adverse effects of family dysfunction on depression.

Associations between the number of siblings, parent-child relationship and positive youth development of adolescents in mainland China: A cross-sectional study

BACKGROUND

Positive development plays an important role in youth when dealing with stressful circumstances. According to the resource dilution theory, adolescents with or without siblings may receive different levels of emotional and material resources from their parents. The purpose of this study is to examine the association between the positive development of adolescents in China today with their family characteristics such as the number of siblings.

METHODS

A total of 2072 junior high and senior high school students (13 to 18 years old) in Chengdu, Sichuan, China, were investigated by cluster sampling. The Chinese Positive Youth Development scales (CPYDs) were used to measure positive youth development. The generalized linear model was used to explore the relationships among the number of siblings, parent-child relationships and positive youth development.

RESULTS

Adolescents from only-child families had better performance on positive development (H = 21.87, P < 0.001) and better relationships with parents (H = 15.1, P < 0.05). The positive development of male and female adolescents does not significantly differ in families with different numbers of siblings. The generalized linear model showed that a positive parent-child relationship is positively correlated with adolescent positive development (P < 0.05).

CONCLUSION

Positive youth development is not only associated with the number of siblings but also other modifiable familial factors. The positive relationship between parents and adolescents is of great practical value in daily life to improve youth development, and this might be the real lesson the resource dilution theory tells.

Relationships between physical activity, sleep, and screen time with academic performance and psychological functioning among US children and adolescents with depression

OBJECTIVE

This cross-sectional study examined the relationships between adherence to 24-HMB guidelines (including physical activity [PA], screen time [ST], and sleep) with academic performance and psychological functioning among children and adolescents with depression.

METHODS

This study consists of 2165 participants aged 6-17 years with depression. Independent variables were components of 24-HMB guideline adherence, while outcomes of interest were academic performance (i.e., caring about school performance and completion of required homework) and psychological functioning (i.e., resilience and self-regulation). Logistic regression analysis was conducted while adjusting for confounding variables.

RESULTS

Only 1.03 % of the participants adhered to PA + ST + Sleep guidelines. Compared to non-adherence, adherence to PA + ST guidelines was significantly linked to a greater likelihood of caring about school performance (OR = 2.17), while ST + Sleep guidelines adherence was significantly linked to a greater likelihood of caring about school performance (OR = 2.02), completing homework (OR = 2.91), resilience (OR = 2.51), and self-regulation (OR = 2.51). Furthermore, adherence to PA + ST + Sleep guidelines was significantly linked to a higher likelihood of caring about school performance (OR = 5.01), resilience (OR = 2.49), and self-regulation (OR = 2.88) among these participants with depression.

CONCLUSION

Adhering to 24-HMB guidelines is positively linked to academic performance and psychological functioning among children and adolescents with depression. Thus, establishing healthy lifestyle behaviors should be promoted in school settings.

Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students

BACKGROUND

Depressive and anxiety symptoms affect about one-fourth of Chinese secondary school students. However, the prevalence and correlates of mental distress among secondary school students from Western China remain largely unexplored. This study aimed to examine the prevalence and associations of depressive and anxiety symptoms with demographic, family, school, life, and behavior factors in a large, representative sample of secondary school students in Zigong, a city in Western China.

METHODS

Secondary school students were recruited using cluster sampling. The 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire, Multidimensional Peer-Victimization Scale, the Pittsburgh Sleep Quality Index, and Nine-Item Internet Gaming Disorder Scale-Short Form were used. Descriptive statistic was used to describe the sociodemographic characteristics of participants. The clustering effect was adjusted by the "survey" package of R to calculate weighted prevalence. Univariate and multivariate logistic regression were used to explore associated factors of depression and anxiety, respectively.

RESULTS

A total of 63,205 participants were involved, in which the weighted prevalence of depression in all subjects was 23.0% (95% CI: 19.6- 27.0%), and the weighted prevalence of anxiety was 13.9% (95% CI: 11.2- 17.0%). Logistic regression results showed girls, being single-child, non-nuclear family, peer bullying, sleep disturbance, and internet gaming disorder symptoms were positively associated with depressive and anxiety symptoms.

CONCLUSION

Depressive and anxiety symptoms were prevalent among secondary school students in Western China. Our results can guide policy strategies for the assessment, prevention, and intervention of psychological status among Chinese secondary school students.

The relationship between depressive and anxious symptoms and school attendance among adolescents seeking psychological services in a public general hospital in China: a cross-sectional study

BACKGROUND

School attendance problems (SAPs), whether absenteeism or dropout, are strongly associated with poor outcomes for adolescents. We examined multiple variables that influence SAPs to identify potential leverage points for improving school attendance.

METHODS

Self-reported SAPs and demographic information was collected from 392 adolescents in adolescents presenting to the general hospital for psychological services. PHQ-9 and GAD-7 were applied to assess the severity of depressive and anxious symptoms. We constructed logistic regression analysis and the Chi-Square Automatic Interaction Detection (CHAID) segmentation analysis via SPSS Decision Tree to identifying risk factors for the development of SAPs in adolescents.

RESULTS

SAPs were self-reported by 252 (64.3%) adolescents. The SAPs group and non-SAPs group showed a significant difference in age, PHQ9 total scores, GAD7 total scores, schools, siblings, residence, parental marital quality, general health, regular exercise, and regular diet. A post hoc comparison between the two groups showed that the frequency of SAPs was significantly higher in the moderately-severe and severe depressive groups compared with other three groups (none, mild, moderate). The frequency of SAPs in severe anxious groups was significantly different from the none-anxious group. According to the binary logistic regression analysis, the depressive severity, siblings, residence, marital quality of parents, general health, and regular diet were correlated with the SAPs among adolescents. The adjusted OR of SAPs according to moderately-severe depressive symptoms was 10.84 (95%CI: 1.967-59.742) and severe depressive symptoms was 6.659 (95%CI: 1.147-38.666). In the decision tree model, PHQ-9 severity was extracted as the first splitting variable, with regular exercise and residence as the second, and siblings as the third. The ROC curves for predicting SAPs showed a fair diagnostic accuracy of the model with AUCs of CHAID model (0.705,95%CI:0.652-0.759, P = 0.000) and logistic regression model (0.777,95%CI:0.729-0.824, P = 0.000).

CONCLUSION

Our study provides insights into the associations between depressive symptoms and poor school attendance and identifies a number of risk factors associated with SAPs. Effective intervention by mental health practitioners, more attention by policy makers, and further research in this area are urgently needed for adolescents.

Physical activity, sleep quality and life satisfaction in adolescents: A cross-sectional survey study

Background

Physical activity, sleep is an important component of adolescents' 24-h movement behavior, and life satisfaction predicts adolescent physical and mental health. However, few studies have explored the relationship between the two variables among Chinese high school students. Consequently, this study aimed to explore the relationship between sleep quality and life satisfaction among Chinese high school students.

Methods

This cross-sectional study was conducted in October 2020 in five high schools in Xuchang City, China. High school students from senior 1 to senior 3 were asked to fill up a questionnaire of demographic characteristics and validated screen instructions for sleep quality (Pittsburgh Sleep Quality Index) and life satisfaction (Satisfaction with Life Scale). The multivariate regression model was applied to explore the association between sleep quality and life satisfaction.

Results

A total of 1127 individuals (51.1% males) participated in this survey, and the prevalence of poor sleep quality was 42.3%. The mean score on the Satisfaction with Life Scale was 16.72 ± 5.67, according to the corresponding scoring criteria, with 15-19 being generally dissatisfied. After controlling for demographic variables, the contribution of subjective sleep quality (β = - 0.181, p < 0.01), sleep duration (β = - 0.080, p < 0.01) and daytime dysfunction (β = - 0.311, p < 0.01) to life satisfaction of high school students increased to 23.2%, indicating that subjective sleep quality, sleep duration, and daytime dysfunction were 22.9% predictive of life satisfaction among high school students. And also, physical activity on schooldays and weekend days were associated with better sleep quality and higher life satisfaction (p < 0.05).

Conclusions

Among Chinese high school students, the prevalence of sleep problems was high, and the majority of students held moderate life satisfaction. Sleep quality was positively correlated with life satisfaction among Chinese high school students, with better sleep quality resulting in higher life satisfaction among students.

The relationship between Internet addiction and childhood trauma in adolescents: The mediating role of social support

Background

Adolescents are at high risk of Internet addiction (IA). Previous studies have shown that the occurrence of IA may be associated with childhood trauma and social support to varying degrees. This study aimed to investigate the pathogenesis of IA in adolescents. Further, to explore the potential mediating role of social support in childhood trauma and IA. This study provides theoretical support for future interventions targeting IA in adolescents.

Methods

This study used a descriptive cross-sectional design. The Childhood Trauma Questionnaire (CTQ), Social Support Rating Scale (SSRS), and Young’s Internet Addiction Test (IAT) were used to conduct an anonymous questionnaire survey among randomly selected adolescents aged less than 18 years old in two cities in southern Anhui Province. Descriptive statistics and correlation analysis were used to test the correlation between IA and other variables. A binary logistic regression model was used to explore the influencing factors of IA. Multiple regression models were examined with process macro and bootstrapping to confirm significant mediating effects.

Results

A total of 844 adolescents, equally divided between males and females, participated in this study, and the prevalence of IA in the region was 23.0%. Through the mediation test, the direct effect of childhood trauma on IA was 0.20 (95% CI [0.12, 0.27], p < 0.001), and the mediating effect of social support on childhood trauma and IA was 0.09 (95% CI [0.06, 0.14]).

Conclusion

The study showed that childhood trauma significantly affected the incidence of IA in adolescents. Social support had a significant mediating effect on childhood trauma and IA and attenuated its negative effects.

Developmental Trajectory of Depressive Symptoms in Chinese College Students: Latent Classes and Gender Effect

Depressive symptoms are prevalent in Chinese college students, but little is known about the heterogeneity in the developmental trajectory of depressive symptoms in China. This study examined heterogeneity in the development of depressive symptoms and examined the effect of gender on the developmental trajectories over a 14-month period among Chinese college students (N = 1163, mean age 20.18, 80.31% female). Three different trajectories, moderate-increasing, high-stable and low-stable, captured the heterogeneity in the development of depressive symptoms. Gender showed significant influence on class membership. Relative to the moderate-increasing class, males emerged as significantly more likely than females to be found in the low-stable class (odds ratio (OR) = 2.73, 95% CI = (1.21, 6.13), p = 0.015) and the high-stable class (OR = 5.10, 95% CI = (1.12, 23.18), p = 0.035). The results provide additional evidence for the conclusion that the trajectories of depressive symptoms are heterogeneous with Chinese samples. Moreover, cultural difference should be paid more attention to when examining the effect of gender and other predictors of the trajectories of depressive symptoms.

Prevalence and predictors of the persistence and incidence of adolescent internet addiction in Mainland China: A two-year longitudinal study

Internet addiction (IA), which can have different development patterns, is considered a serious problem among adolescents. Due to the increasing number of adolescent internet users in Mainland China, professionals are obligated to investigate the prevalence and predictors of IA persistence and incidence. This study investigated the prevalence of IA persistence and incidence among 1301 students in Mainland China across two years using a two-wave longitudinal design. Of the 187 students with IA in 7th grade, 40.64% had a persisting addiction by grade 9. Of the 1114 students without an IA in 7th grade, 10.32% had developed an IA by grade 9. Multilevel logistic regression analyses indicated that higher levels of depressive symptoms (odds ratio = 1.04; p = .04) and maternal education (odds ratio = 2.23; p = .01) could increase the likelihood of IA persistence. Significant predictors of IA incidence were being male (odds ratio = 0.59; p = .03), being an only child (odds ratio = 1.91; p = .01), having a low family income (odds ratio = 1.21; p < .001), and experiencing school maladjustment (odds ratio = 1.01; p < .01).

Correlates and Predictors of Chronicity among Adolescents Living in Puerto Rico With a History of Depressive Symptoms

Chronic depression (CD) among Hispanic/Latina(o) youths has been understudied, although chronicity is the biggest risk factor for treatment-resistant depression. We examined CD correlates and predictors among 291 youths (aged 12-18 years) living in Puerto Rico with a history of depressive symptoms. They completed the Children's Depression Inventory (CDI), the Depressive Symptoms Spectrum Assessment Inventory (DSSAI), and the Brief Structured Diagnostic Measure for Depression. We explored CD correlates using Odds Ratios adjusted for CDI-Total scores. With multiple logistic regression, we identified optimal predictors of a history of chronic depressive symptoms (HCDS) or any chronic depressive disorder (HACDD). Living zone (rural), history of depressive disorder, household size (< 4), age of onset of symptoms (< 13 years), death/suicidal thoughts at the first episode, antidepressants use, and scores ≥ 84^th percentile in the DSSAI-Anhedonia subscale, accounted for 37% of HCDS variance. The latter five variables and socioeconomic status (lower-middle/low) best distinguished HACDD and episodic disorders (R ² = .331). Identifying factors that distinguish chronic and episodic depression among Hispanic/Latina(o) youths may help to improve their diagnosis, access to and quality of care, as well as treatment selection, tailoring, and outcomes.

Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis

INTRODUCTION

The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic.

METHOD

We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression.

RESULTS

A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7-48.1, I 2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9-39.4, I 2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity, high publication bias confirmed by Egger's test, and varying prevalence rates across sub-groups.

CONCLUSION

South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.