Evaluating the validity and reliability of the Chinese entrapment scale and the relationship to depression among men who have sex with men in Shanghai, China

Understanding the influence of Social Determinants of Health (SDH) on suicidal behaviors among HIV-positive men who have sex with men (MSM) in China: A population-based study

BACKGROUND

HIV-positive men who have sex with men (MSM) are at high risk of suicide and experience intersectional inequalities. The Social Determinants of Health (SDH) framework provides valuable insights into how inequalities can lead to adverse outcomes. This study aimed to employ the SDH framework to identify factors that contribute to suicidal behaviors among this population.

METHODS

1410 HIV-positive MSM were recruited using a web-based questionnaire, whose mean age was 30.77 ± 6.92 years old. Participants completed questionnaires including baseline information and psychological measurements, such as Suicidal Behaviors Questionnaire-Revised (SBQ-R). Logistic regression analysis was conducted to screen for risk factors associated with suicidal behaviors.

RESULTS

More than half of the participants (53.3 %, 752/1410) had an SBQ score of 7 or higher. Binary logistic regression analysis of structural and intermediary determinants (Model 3) revealed that sexual orientation, stigma (ORs: 1.018, 95 % CI: 1.005-1.032), interpersonal needs (ORs: 1.021, 95 % CI: 1.010-1.031), depression (ORs: 1.037, 95 % CI: 1.001-1.074) and entrapment (ORs: 1.018, 95 % CI: 1.004-1.032) were positively correlated with suicidal behaviors. Individuals with other or unknown sexual orientation had significantly higher rates of suicidal behaviors compared to those with a heterosexual sexual orientation (ORs: 5.021, 95 % CI: 1.529-17.640).

LIMITATIONS

Sampling of HIV-positive MSM posed challenges in data collection. It may introduce selection bias and affect generalizability.

CONCLUSION

This study identified that sexual orientation, stigma, interpersonal needs, depression, and entrapment were significantly associated with suicidal behaviors among HIV-positive MSM. Additionally, these factors can be social determinants of health that contribute to suicidal behaviors.

Psychometric properties of an Arabic translation of the short entrapment scale in a non-clinical sample of young adults

BACKGROUND

Entrapment is the feeling of wanting to leave an unbearable situation but believing that there are no options to do so. An Arabic entrapment Scale will assist healthcare professionals in the region in the prevention of suicide as the tool is tailored to the specific sociocultural context, which would enhance entrapment detection.

OBJECTIVE

In the current study, we aim to evaluate the psychometric properties of a translated Arabic version of the Entrapment Scale Short Form (E-SF).

METHODS

Three hundred eighty-nine Lebanese citizens were enrolled in this cross-sectional study.

RESULTS

The mean age of participants was 23.03 years (SD = 2.93), 69.4% being women. To examine the factor structure of the entrapment scale, we used an exploratory-to-confirmatory factor analysis (EFA-to-CFA) strategy. EFA and CFA results indicated that the fit of the unidimensional model of the Arabic Entrapment Scale (A-ES) was generally acceptable. Composite reliability of scores was adequate in the total sample (ω = .87). All indices suggested that configural, metric, and scalar invariance was supported across genders. Entrapment was positively and significantly correlated with suicidal ideation, alcohol use disorder, psychological distress, and orthorexia nervosa, suggesting convergent and divergent validity.

CONCLUSION

The A-ES was found to be a valid and reliable tool to assess the degree of entrapment in Lebanese young adults. The A-ES will assist healthcare professionals in the region in the prevention of suicide as the tool is tailored to the specific sociocultural context, which would enhance entrapment detection.

Moderating effects of suicide resilience and meaning in life on the association between entrapment and suicidal ideation in Chinese patients with ovarian cancer: a cross-sectional study

BACKGROUND

Numerous studies have confirmed that patients with ovarian cancer have a relatively high risk of suicidality. Early identification of psychological factors related to suicidal ideation in patients with ovarian cancer may provide effective information for suicide prevention strategies. This study aimed to investigate whether and how suicide resilience and meaning in life moderate the relationship between entrapment and suicidal ideation in patients with ovarian cancer.

METHODS

This was a cross-sectional investigation was conducted in 505 Chinese patients with ovarian cancer. Patients completed a battery of self-reported questionnaires that included the General Information Questionnaire, and Chinese versions of the Entrapment Scale, Scale for Suicidal Ideation, Suicide Resilience Inventory-25, and Meaning in Life Scale. Descriptive statistics, Pearson' s chi-square, Pearson' s correlation, and hierarchical multiple linear regression analysis were performed.

RESULTS

In this study, the prevalence of suicidal ideation reported by patients with ovarian cancer was 32.07%. Patients' suicidal ideation could be explained by the following three predictors: entrapment × suicide resilience × meaning in life (β = -0.169, p < 0.001), entrapment × suicide resilience (β = -0.148, p < 0.001), and entrapment × meaning in life (β = -0.107, p = 0.005).

CONCLUSION

These findings suggest that ovarian cancer patients are prone to suicidal ideation when they feel a sense of entrapment. Enhancing patients' suicide resilience and meaning in life may be two targeted interventions to reduce suicidal ideation in ovarian cancer patients. In particular, considering both the protective effects of suicide resilience and meaning in life may yield better suicide prevention outcomes than considering only one of these factors.

Mpox risk perception and associated factors among Chinese young men who have sex with men: Results from a large cross-sectional survey

The mpox outbreak since 2022 had attacked the community of men who have sex with men (MSM) heavily. This large cross-sectional study investigated the levels and associated factors of mpox risk perception among young MSM (YMSM) aged 18-29 years in six provincial regions of China in September 2022. The participants were recruited via facility-based sampling. Mpox risk perception was measured by perceived susceptibility and perceived severity of mpox. Geodetector was used to measure stratified heterogeneity of mpox risk perception. Univariate and multivariable linear regressions were used to examine the factors associated with mpox risk perception. A total of 2493 participants were included with a mean age of 24.6 years. The proportion of perceiving a susceptibility of mpox under different scenarios ranged 3.7%-17.0% and that of perceiving a severity of mpox ranged 81.6%-83.2%. Stratified heterogeneity of perceived susceptibility, perceived severity, and overall perceived risk of mpox were observed in several characteristics such as study sites, monthly income, risk behaviors, and psychosocial factors. Multivariable regression showed the level of mpox risk perception was positively associated with having in-person gathering activities (ba  = 0.457, 95% CI: 0.208, 0.705), history of HIV infection (ba  = 0.431, 95% CI: 0.028, 0.834), depressive symptoms (ba  = 0.069, 95% CI: 0.049, 0.090), and self-stigma to MSM identity (ba  = 0.047, 95% CI: 0.024, 0.071). The Chinese YMSM showed a high level of perceived severity of mpox but a low level of perceived susceptibility. It is warranted to strengthen targeted risk communication of mpox, develop comprehensive and unstigmatized health messages, and provide mental health support for YMSM.

Sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China: the mediating role of entrapment and defeat

BACKGROUND

The COVID-19 pandemic increases the risk of psychological problems, especially for the infected population. Sleep disturbance and feelings of defeat and entrapment are well-documented risk factors of anxiety symptoms. Exploring the psychological mechanism of the development of anxiety symptoms is essential for effective prevention. This study aimed to examine the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China.

METHODS

A cross-sectional study was conducted from March to April, 2022. Participants were 1,283 asymptomatic COVID-19 carriers enrolled from the Ruijin Jiahe Fangcang Shelter Hospital, Shanghai (59.6% male; mean age = 39.6 years). Questionnaire measures of sleep disturbance, entrapment, defeat, anxiety symptoms, and background characteristics were obtained. A mediation model was constructed to test the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms.

RESULTS

The prevalence rates of sleep disturbance and anxiety symptoms were 34.3% and 18.8%. Sleep disturbance was positively associated with anxiety symptoms (OR [95%CI] = 5.013 [3.721-6.753]). The relationship between sleep disturbance and anxiety symptoms (total effect: Std. Estimate = 0.509) was partially mediated by entrapment (indirect effect: Std. Estimate = 0.129) and defeat (indirect effect: Std. Estimate = 0.126). The mediating effect of entrapment and defeat accounted for 50.3% of the association between sleep disturbance and anxiety symptoms.

CONCLUSION

Sleep disturbance and anxiety symptoms were prevalent among asymptomatic COVID-19 carriers. Entrapment and defeat mediate the association between sleep disturbance and anxiety symptoms. More attention is needed to monitoring sleep conditions and feelings of defeat and entrapment to reduce the risk of anxiety.

A nomogram of suicidal ideation among men who have sex with men in China: Based on the integrated motivational-volitional model of suicidal behavior

Introduction

Men who have sex with men (MSM) are a high-risk group for suicide, with a much higher prevalence of suicidal ideation (SI) than the general population and male population. The aim of this study was to explore the risk factors influencing the development of SI and to develop and validate a nomogram among MSM.

Methods

A cross-sectional study was conducted in 915 MSM from Shanghai, Shenyang, Shenzhen and Kunming, China using the snowball sampling method. The integrated motivational-volitional (IMV) model of suicidal behavior was used as a theoretical framework to collect different potential influencing factors of SI including diathesis-environment-life events factors and psychosocial factors. The risk factors of SI were screened by logistic regression analysis, and a nomogram for predicting SI were developed. Model properties including discrimination, calibration and decision curves were evaluated to validate the prediction model.

Results

882 MSM were included in the statistical analysis, with a lifetime prevalence of SI of 34.4% (303/882). Logistic regression analysis showed that age group, sexual orientation disclosure, high-risk sexual behavior, entrapment, defeat and interpersonal needs were associated with SI. A nomogram was constructed based on the above six predictors. AUC values of ROC for prediction model were 0.761 (0.641-0.770) and 0.754 (0.565-0.822) in the training set (n = 662) and validation set (n = 220), respectively. And there was no statistical difference of the AUC values between the two sets (P > 0.05). The calibration plots of the prediction model in both sets fit well with the ideal model (P > 0.05). The decision curves demonstrated that the threshold probability of prediction model in training set was 1-85%, whereas in validation set was 1-63%.

Conclusions

The lifetime prevalence of SI among Chinese MSM is high. The nomogram can serve as a useful tool to predict the development of SI among MSM. Defeat, entrapment and interpersonal needs, as significant predictors of SI, can be measured to identify SI in advance. Early assessment of SI and the enhancement of psychosocial interventions are important to prevent suicide-related behaviors. Future studies could incorporate more variables of interest to refine the prediction model to better guide behavioral and psychological intervention strategies among MSM.

Predicting the risk of HIV infection among internal migrant MSM in China: An optimal model based on three variable selection methods

Introduction

Internal migrant Men who have sex with men (IMMSM), which has the dual identity of MSM and floating population, should be more concerned among the vulnerable groups for HIV in society. Establishing appropriate prediction models to assess the risk of HIV infection among IMMSM is of great significance to against HIV infection and transmission.

Methods

HIV and syphilis infection were detected using rapid test kits, and other 30 variables were collected among IMMSM through questionnaire. Taking HIV infection status as the dependent variable, three methods were used to screen predictors and three prediction models were developed respectively. The Hosmer-Lemeshow test was performed to verify the fit of the models, and the net classification improvement and integrated discrimination improvement were used to compare these models to determine the optimal model. Based on the optimal model, a prediction nomogram was developed as an instrument to assess the risk of HIV infection among IMMSM. To quantify the predictive ability of the nomogram, the C-index measurement was performed, and internal validation was performed using bootstrap method. The receiver operating characteristic (ROC) curve, calibration plot and dynamic component analysis (DCA) were respectively performed to assess the efficacy, accuracy and clinical utility of the prediction nomogram.

Results

In this study, 12.52% IMMSMs were tested HIV-positive and 8.0% IMMSMs were tested syphilis-positive. Model A, model B, and model C fitted well, and model B was the optimal model. A nomogram was developed based on the model B. The C-index of the nomogram was 0.757 (95% CI: 0.701-0.812), and the C-index of internal verification was 0.705.

Conclusions

The model established by stepwise selection methods incorporating 11 risk factors (age, education, marriage, monthly income, verbal violence, syphilis, score of CUSS, score of RSES, score of ULS, score of ES and score of DS) was the optimal model that achieved the best predictive power. The risk nomogram based on the optimal model had relatively good efficacy, accuracy and clinical utility in identifying internal migrant MSM at high-risk for HIV infection, which is helpful for developing targeted intervention for them.

The association between entrapment and depression among migrant workers in China: a social rank theory based study

BACKGROUND

Migrant workers are a group susceptible for depression evolution due to occupational maladaptive triggers. The social rank theory illustrates the pathology process from defensive adaptation to depression, pointing out the early prevention of depression by discovering entrapment. This study aims to reveal the relationship between migrant workers' entrapment and depressive symptoms.

METHODS

A total of 1805 migrant workers in Shenzhen were recruited by stratified multi-stage sampling. Sample's demographic, behavioral and psychosocial characteristics were described and analyzed to reveal the relationship between entrapment and depressive symptoms. The Receiver Operator Characteristic was performed to find the optimal cut-off point of Entrapment Scale for predicting depressive symptoms.

RESULTS

In the binary logistic regression of sociodemographic variables, migrant workers who were married (univariate odds ratio (ORu) = 0.69, 95% Confidence Interval (CI) = 0.56-0.84), owned 1 or 2 children (ORu = 0.71, 95% CI = 0.58-0.86), had been working over 10 years (ORu = 0.71, 95% CI = 0.54-0.95), earned > 4999 yuan per month (ORu = 0.68, 95% CI = 0.47-0.99; multivariate odds ratio (ORm) = 0.57, 95% CI = 0.38-0.87) or with low risks of alcohol use disorders (ORu = 0.51, 95% CI = 0.34-0.75) had lower risks of depressive symptoms. After adjusted the aforementioned significant sociodemographic variables, migrant workers with severer entrapment were more likely to have depressive symptoms (adjusted odds ratio (ORa) = 1.13, 95% CI = 1.12-1.15). Besides, the study proved the reliability and validity of the Chinese version Entrapment Scale, preferring a two-dimensional structure, and 11 was the optimal cut-off value of this scale for predicting depressive symptoms among migrant workers.

CONCLUSIONS

This result indicates the potential value of entrapment according to the social rank theory on facilitating early prevention of migrant works' depression and the application value of Entrapment Scale for effectively measuring mental status among migrant workers.

The Mental Health and Syndemic Effect on Suicidal Ideation among Migrant Workers in China: A Cross-Sectional Study

Background: Migrant workers are in a socially disadvantaged position and thus suffer from more stress and mental health disorders, resulting in a high risk of suicidal ideation. This study aimed to explore the association between psychosocial problems and suicidal ideation, and the syndemic effect of concurrent psychosocial problems on suicidal ideation among migrant workers. Methods: We conducted a cross-sectional study and recruited 1805 migrant workers in Shenzhen, China. Each participant completed a self-administered questionnaire to report sociodemographic information and mental health status. Univariate and multivariate logistic regression were used to explore the association between psychosocial variables and suicidal ideation, and their syndemic effect on suicidal ideation. Results: The prevalence of suicidal ideation among migrant workers was 7.5%. All selected psychosocial variables were independently associated with suicidal ideation. Multivariate logistic regression analysis showed that three psychosocial variables were associated with suicidal ideation: anxiety (ORm: 1783, 95% CI: 1.089–2.920), entrapment (ORm: 2.064, 95% CI: 1.257–3.388), and defeat (ORm: 2.572, 95% CI: 1.612–4.103). Various mental health issues can exist simultaneously to increase the risk of suicidal ideation (AOR: 5.762, 95% CI: 3.773–8.802). Workers with more psychosocial problems were more likely to have suicidal ideation. Conclusions: The association between poor mental health and suicidal ideation should not be overlooked among migrant workers. The co-occurring or syndemic effect of psychosocial problems may increase the risk of suicidal ideation.