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Iovoli F, Hall M, Nenadic I, Straube B, Alexander N, Jamalabadi H, Jansen A, Stein F, Brosch K, Thomas-Odenthal F, Usemann P, Teutenberg L, Wroblewski A, Pfarr J, Thiel K, Flinkenflügel K, Meinert S, Grotegerd D, Hahn T, Goltermann J, Gruber M, Repple J, Enneking V, Winter A, Dannlowski U, Kircher T, Rubel JA. Exploring the complex interrelation between depressive symptoms, risk, and protective factors: A comprehensive network approach. J Affect Disord 2024; 355:12-21. [PMID: 38548192 DOI: 10.1016/j.jad.2024.03.119] [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: 09/28/2023] [Revised: 02/19/2024] [Accepted: 03/23/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Depressive symptoms seem to be interrelated in a complex and self-reinforcing way. To gain a better understanding of this complexity, the inclusion of theoretically relevant constructs (such as risk and protective factors) offers a comprehensive view into the complex mechanisms underlying depression. METHODS Cross-sectional data from individuals diagnosed with a major depressive disorder (N = 986) and healthy controls (N = 1049) were analyzed. Participants self-reported their depressive symptoms, as well as several risk factors and protective factors. Regularized partial correlation networks were estimated for each group and compared using a network comparison test. RESULTS Symptoms of depression were more strongly connected in the network of depressed patients than in healthy controls. Among the risk factors, perceived stress, the experience of negative life events, emotional neglect, and emotional abuse were the most centrally embedded in both networks. However, the centrality of risk factors did not significantly differ between the two groups. Among the protective factors, social support, personal competence, and acceptance were the most central in both networks, where the latter was significantly more strongly associated with the symptom of self-hate in depressed patients. CONCLUSION The network analysis revealed that key symptoms of depression were more strongly connected for depressed patients than for healthy controls, and that risk and protective factors play an important role, particularly perceived stress in both groups and an accepting attitude for depressed patients. However, the purpose of this study is hypothesis generating and assisting in the potential selection of non-symptom nodes for future research.
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Li W, Xiang M, Zhang EL, Liu Y, Ge X, Su Z, Cheung T, Jackson T, Xiang YT. Inter-relationships between suicidality and depressive symptoms among children and adolescents experiencing crisis: A network perspective. J Affect Disord 2024; 354:44-50. [PMID: 37827255 DOI: 10.1016/j.jad.2023.10.029] [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: 05/18/2023] [Revised: 09/13/2023] [Accepted: 10/08/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES Suicidality and depressive symptoms have emerged as major mental health issues reported among children and adolescents experiencing crises. In light of these concerns, this study was conducted to elucidate interrelationships between depressive symptoms and suicidality at an item level within this population during the COVID-19 pandemic, a worldwide public health crisis affecting children and adolescents. METHOD A cross-sectional study design was used. Primary and secondary school students completed the Children's Depression Inventory - Short Version (CDI-S) and two standard suicidality questions tapping suicidal ideation and suicide plans, respectively. A network analysis was performed to examine inter-connections between depressive symptoms and suicidality. RESULTS A total of 5380 students participated in the study. Prevalence of suicidal ideation and suicide plans were 12.8 % (95 % CI = 11.9 %-13.7 %) and 9.9 % (95 % CI = 9.2 %-10.8 %), respectively; the prevalence of depressive symptoms was 41.2 % (95%CI = 39.8 %-42.5 %). The network analysis identified CDI4 (self-hatred) as the most influential node with the highest centrality, followed by CDI8 (loneliness), CDI5 (crying), and CDI1 (sadness). Additionally, CDI5 (crying), CDI1 (sadness), CDI4 (self-hatred), and CDI10 (feeling unloved) were the most meaningful nodes linking depressive symptoms with suicidality. CONCLUSIONS Critical depressive symptoms linked with suicidality among children and adolescents living through the COVID-19 pandemic included self-hatred, loneliness, crying, and sadness. Interventions that target these depressive symptoms may have increased utility in reducing the risk of suicidality within this population.
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Affiliation(s)
- Wen Li
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, China; Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Mi Xiang
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Hainan, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | - Er Liang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
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Grygiel P, Dolata R, Humenny G, Muszyński M. Depressive symptoms and loneliness among early adolescents: a psychometric network analysis approach. J Child Psychol Psychiatry 2024; 65:199-214. [PMID: 37550521 DOI: 10.1111/jcpp.13876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Previous studies demonstrate a high prevalence of depression and loneliness among adolescents. Although they often co-occur, the relationship between symptoms of depression and loneliness remains poorly understood. This study investigates: (a) the symptoms of depression that are connected to loneliness; (b) the role played by loneliness in the network of depression symptoms; and (c) whether the method used to measure loneliness (single-item direct or multi-item indirect) affects the relationship of loneliness with depressive symptoms. METHODS Participants were 496 Polish adolescents (50.8% girls) aged 11 to 13, who completed: (a) the 10-item Major Depressive Disorder subscale of the Revised Child Anxiety and Depression Scale; (b) the 11-item De Jong Gierveld Loneliness Scale (indirect loneliness), and (c) a single direct question evaluating loneliness: 'I'm lonely'. Networks were estimated using a Gaussian Graphical Model. RESULTS Loneliness shows a direct relationship with three affective symptoms of depression: sadness, worthlessness, and anhedonia, which mediate relationships with somatic symptoms. In contrast to previous studies, loneliness has the lowest level of centrality among all elements of the network. The method used to assess loneliness did not significantly affect the connections between loneliness and depressive symptoms. CONCLUSIONS Loneliness and depression overlap since they are formed by the same cognitive biases and deficits in emotion regulation but differ in the level of generality. In loneliness, they have an interpersonal context, while symptoms of depression can be intrapersonal. This helps us to understand why cognitive interventions, as compared to those which are social, are more effective in reducing loneliness.
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Affiliation(s)
| | | | | | - Marek Muszyński
- Institute of Philosophy and Sociology Polish Academy of Sciences, Warsaw, Poland
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Li K, Ren X, Ren L, Tan X, Zhao M, Liu C, Luo X, Feng Z, Dai Q. The Ripple Effect: Unveiling the Bidirectional Relationship Between Negative Life Events and Depressive Symptoms in Medical Cadets. Psychol Res Behav Manag 2023; 16:3399-3412. [PMID: 37664139 PMCID: PMC10473435 DOI: 10.2147/prbm.s419991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Background Previous studies have explored the relationship between negative life events and depression, but little is known about the bidirectional relationship between negative life events and depression, particularly in specific groups of medical cadets. Purpose This study aimed to explore the relationship between negative life events and depressive symptoms among medical cadets during their four years of college. Methods An analysis of 4-wave longitudinal data collected from 2015-2018 was conducted using a cross-lagged panel network (CLPN) model to explore the complex causal relationship between negative life events and depressive symptoms in medical cadets (N=433). Results We found differences in negative life events and depressive symptoms among medical cadets across four network models over four years of university. Nodes A-21, A-20, A-23 and A-24, and depressive symptoms D-6 showed greater lagged effect values. Conclusion Our findings suggest that there is a lagged and mutually causal interaction between negative life events and depressive symptoms in medical cadets over 4 years of college, but that the predictability of negative life events is more important. However, more attention needs to be paid to the predictive role of depressive symptoms, especially those in early life which are often overlooked. Our study provides new insights into the relationship between negative life events and depressive symptoms in university students and helps to refine strategies for prevention and intervention of depression.
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Affiliation(s)
- Kuiliang Li
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, People’s Republic of China
| | - Xiaomei Ren
- Department of Medical Psychology, Army Medical University, Chongqing, People's Republic of China
| | - Lei Ren
- Department of Clinical Psychology, Air Force Medical University, Xi’an, People’s Republic of China
| | - Xuejiao Tan
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, People’s Republic of China
| | - Mengxue Zhao
- Department of Medical Psychology, Army Medical University, Chongqing, People's Republic of China
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Xi Luo
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, People’s Republic of China
| | - Zhengzhi Feng
- Department of Medical Psychology, Army Medical University, Chongqing, People's Republic of China
| | - Qin Dai
- Department of Medical Psychology, Army Medical University, Chongqing, People's Republic of China
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Wang S, Zhao S, Guo Y, Huang C, Zhang P, She L, Xiang B, Zeng J, Zhou F, Xie X, Yang M. A network analysis of subjective well-being in Chinese high school students. BMC Public Health 2023; 23:1249. [PMID: 37370106 DOI: 10.1186/s12889-023-16156-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The psychological situation of high school students during adolescence is not promising, and the most obvious manifestation is the lack of subjective well-being (SWB). This network analysis presents a model of the interaction and correlation between different items of SWB, identifying the most central items for high school students. METHODS Through offline and online surveys, 4,378 questionnaires were sent out and finally 4,282 Chinese high school students were available. The response rate was 97.807%. The study used the eLASSO method to estimate the network structure and centrality measures. This algorithm used the EBIC to select the best neighbor factor for each node. RESULTS The average age for high school students was 16.320 years old and the average SWB score was 76.680. The distribution of SWB between male and female students was significant different (P < 0.001). S8 (Have you been anxious, worried, or upset) was the node with the highest strength and expected influence. The network structure and centrality remained stable after discarding 75% of the sample at random. Except for S15 (How concerned or worried about your health have you been), all nodes were positively correlated with each other (P < 0.01). The network structure of SWB was similar for female and male students (network strength: 8.482 for male participants; 8.323 for female participants; P = 0.159), as well as for rural and urban students (network strength: 8.500 for rural students; 8.315 for urban students; P = 0.140). CONCLUSION Targeting S8 (Have you been anxious, worried, or upset) as a potential intervention target may increase high school students' SWB effectively.
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Affiliation(s)
- Shiwei Wang
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Siqi Zhao
- Wuhan centers for disease control and prevention, Wuhan, 430022, Hubei Province, China
| | - Yan Guo
- Wuhan centers for disease control and prevention, Wuhan, 430022, Hubei Province, China
| | - Chengjing Huang
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Pei Zhang
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Lu She
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Bing Xiang
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Jing Zeng
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Feng Zhou
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Xinyan Xie
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China
| | - Mei Yang
- Research Center for Health Promotion in Women, Youth and Children, School of public health, Wuhan University of science and technology, Wuhan, 430065, Hubei Province, China.
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Yang SL, Tan CX, Li J, Zhang J, Chen YP, Li YF, Tao YX, Ye BY, Chen SH, Li HY, Zhang JP. Negative life events and aggression among Chinese rural left-behind adolescents: do self-esteem and resilience mediate the relationship? BMC Psychiatry 2023; 23:167. [PMID: 36922776 PMCID: PMC10015683 DOI: 10.1186/s12888-023-04587-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/03/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Left-behind adolescents (LBAs) are adolescents aged 11-18 years who are separated from their parents and left behind in local cities by one or both parents for a period of more than 6 months. LBAs in rural areas are likely to engage in aggressive behavior, which can affect interpersonal relationships, reduce academic performance, and even lead to anxiety and depression. To our knowledge, no studies have examined the mediating effect of resilience and self-esteem on the relationship between negative life events and aggression among Chinese rural LBAs. Therefore, this study aimed to explore the relationship between negative life events and aggression among Chinese rural LBAs and how self-esteem and resilience mediate the association. METHODS Using a stratified random sampling method, 1344 LBAs in Hunan Province of China were investigated. Information was collected by a self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale and Aggression Scales to assess the psychology of LBAs. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. RESULTS Negative life events were significantly related to self-esteem (r = - 0.338), resilience (r = - 0.359), and aggression (r = 0.441). Aggression was directly affected by self-esteem (β = - 0.44) and resilience (β = - 0.34). Negative life events were not only directly related to aggression (β = 0.34, 95% CI: 0.275 ~ 0.398) but also showed an indirect effect on aggression through self-esteem and resilience. The direct effect, total effect and indirect effect of negative life events on aggression through self-esteem and resilience were 0.3364, 0.4344 and 0.0980, respectively. The mediating effect of self-esteem and resilience accounted for 22.56% of the relationship between negative life events and aggression. CONCLUSIONS We found that self-esteem and resilience mediated most negative life events on aggression. It is imperative for educators and families to improve LBAs' self-esteem and resilience to reduce the occurrence of aggression. Future intervention studies should be designed to strengthen self-esteem and resilience.
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Affiliation(s)
- Si Lan Yang
- grid.411870.b0000 0001 0063 8301The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Zhejiang, China
| | - Chu Xia Tan
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Juan Li
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Jie Zhang
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Yi Ping Chen
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Yi Fei Li
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Ying Xiang Tao
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Bi Yun Ye
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Shi Hao Chen
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Hui Yuan Li
- grid.10784.3a0000 0004 1937 0482The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Jing Ping Zhang
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
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Liu N, Li X, Ding X, Liu H, Zhang X. Mediating roles of perceived social support and sense of security in the relationship between negative life events and life satisfaction among left-behind children: A cross-sectional study. Front Psychol 2023; 13:1100677. [PMID: 36710749 PMCID: PMC9880476 DOI: 10.3389/fpsyg.2022.1100677] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
Objective Life satisfaction is closely related to the quality of life. Previous studies showed that left-behind children have low life satisfaction levels due to their separation from their parents. Therefore, it is significant to explore the risk factors and protective factors of left-behind children's life satisfaction to improve their life quality. Therefore, the purpose of this study was to determine the mediating roles of perceived social support and sense of security in the relationship between negative life events and life satisfaction among left-behind children. Methods A survey was conducted on 281 left-behind children in rural Shandong, China using negative life events, perceived social support, a sense of security, and life satisfaction scales. Results Negative life events had a negative impact on life satisfaction (β = -0.34, p = 0.001). In addition, not only does social support mediate between negative life events and life satisfaction (β = -0.21, p = 0.001), but also in between, security (β = -0.05, p = 0.030). Moreover, social support and security act as a chain intermediary between negative life events and life satisfaction (β = -0.03, p = 0.010), with an indirect effect share of 4.76%. Conclusion Negative life events could directly or indirectly affect the life satisfaction of left-behind children through the chain-mediating effects of perceived social support or the sense of security alone. Perceived social support and the sense of security are two important targets for further improving the life satisfaction of LBC.
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Affiliation(s)
- Na Liu
- School of Nursing, Binzhou Medical University, Yantai, China
| | - Xinzheng Li
- School of Public Health and Administration, Binzhou Medical University, Yantai, China
| | - Xuemei Ding
- School of Nursing, Binzhou Medical University, Yantai, China
| | - Haixia Liu
- School of Public Health and Administration, Binzhou Medical University, Yantai, China
| | - Xiaoli Zhang
- School of Nursing, Binzhou Medical University, Yantai, China,*Correspondence: Xiaoli Zhang, ✉
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Yang Y, Lu X. Social Anxiety and Subjective Quality of Life Among Chinese Left-Behind Children: The Mediating Role of Social Support. Front Psychol 2022; 13:836461. [PMID: 35360582 PMCID: PMC8962371 DOI: 10.3389/fpsyg.2022.836461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2022] Open
Abstract
The issue of left-behind children has become a key focus in China. In this study, we investigate the mediating role of social support between social anxiety and the subjective quality of life among left-behind children in China (N = 379, Mage = 13.65). A total of 710 junior high school students were recruited using clustering random sampling from five middle schools in China and investigated using the Social Anxiety Scale for Children, Social Support Rating Scale for Adolescents, and Inventory of Subjective Life Quality. The results show that social anxiety is negatively associated with social support and subjective quality of life, and social support is positively correlated with subjective quality of life. In addition, social support partially mediates the relationship between social anxiety and subjective quality of life. In conclusion, these findings provide new insights to improve the subjective quality of life of left-behind children. The focus should be on alleviating social anxiety and increasing social support in order to help left-behind children improve their subjective quality of life.
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Affiliation(s)
- Ying Yang
- School of Educational Sciences, Anshun University, Anshun, China
| | - Xiaozhou Lu
- School of Educational Sciences, Anshun University, Anshun, China
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Karaush I, Kupriyanova I, Dashieva B. Negative Events Related to School Functioning and Their Relationship with the Risk of Depression in Adolescents. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Negative experiences experienced by adolescents can cause the risk of developing mental health disorders, social maladaptation and academic problems. The aim of the study is to identify the risk of depression in adolescents in connection with experienced negative life events. The study involved 507 students of urban and rural secondary schools aged 12–17 years (median, quartiles 14 [14; 15]), 47.5% boys, 52.5% girls. The M. Kovacs Depression Scale (Children's Depression Inventory, CDI) and the Adolescent Mental Life Events Scale (ASLEC) were used. With adolescents who showed a high level of risk of depression on the CDI scale, an additional clinical interview was conducted. It is shown that adolescents perceive most of the negative events they have experienced as significant. A significant proportion of them account for life events related to school functioning, while no significant differences were found in the groups of boys and girls. It is suggested that the events experienced by students related to school functioning, in the absence of a statistically significant relationship with the risk of depression, may still increase the risk of depression in the presence of events in the life of adolescents related to family functioning (family conflicts, physical punishment in the family) and psychological factors (criticism or punishment). The data obtained concerning the frequency of experiencing negative life events related to the school sphere and noted by respondents as significant, make it necessary to work with teachers in the context of health-preserving psychological and pedagogical support.
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Affiliation(s)
- I. Karaush
- V.P. Serbsky National Medical Research Center for Psychiatry and Narcology
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10
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Li K, Zhan X, Ren L, Liu N, Zhang L, Li L, Chen T, Feng Z, Luo X. The Association of Abuse and Depression With Suicidal Ideation in Chinese Adolescents: A Network Analysis. Front Psychiatry 2022; 13:853951. [PMID: 35418891 PMCID: PMC8995894 DOI: 10.3389/fpsyt.2022.853951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Abuse experiences in adolescents are associated with the risk of depression and suicide. Thus, there is an urgent need to develop prevention and intervention measures for clinicians, policymakers, and researchers. METHODS Network analysis method was used to analyze the cross-sectional data of Chinese adolescents in this study. The Patient Health Questionnaire for Adolescents (PHQ-A) was used for assessing depression, in which item 9 of the PHQ-A was used to assess suicide ideation, and International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-Children's Home Version (ICAST-CH) was used for assessing abuse. RESULTS The prevalence of suicidal ideation among Chinese adolescents was 21.46% (95% CI, 20.79-22.16%). The prevalence of moderate or severe depression was 16.76%, and the prevalence of violence exposure, psychological victimization, neglect, and physical victimization was 33.5%, 59.5%, 28.37%, and 31.51% in the past years, respectively. Network analysis results showed that the most central nodes in the network of abuse and depression were "unimportant," "not cared," and "pushed." The bridge nodes were "suicidal ideation" and "unimportant." The nodes "sadness," "failure," and "unimportant" explained the largest proportion of the variance of suicidal ideation in our network. Differences were found in the structure of both abuse and depression networks between adolescents with or without suicidal ideation. LIMITATIONS The self-reporting-based cross-sectional surveys and community sample groups limit the inference of causality and the generalization of the results. CONCLUSION This study shows that "unimportant" is the central and bridge nodes in the abuse and depression networks and also explains a part of variance of suicidal ideation. The effect of "unimportant" should be considered in the prevention and intervention of depression and suicide in adolescents with abuse experience. Future study is needed to confirm its role in clinical intervention.
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Affiliation(s)
- Kuiliang Li
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China.,School of Psychology, Army Medical University, Chongqing, China
| | - Xiaoqing Zhan
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Lei Ren
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Nan Liu
- Department of Health Examination, People's Hospital of Wansheng Economic Development Zone, Chongqing, China
| | - Lei Zhang
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Ling Li
- College of General Education, Chong Qing Water Resources and Electric Engineering College, Chongqing, China
| | - Ting Chen
- Department of Health Examination, People's Hospital of Wansheng Economic Development Zone, Chongqing, China
| | - Zhengzhi Feng
- School of Psychology, Army Medical University, Chongqing, China
| | - Xi Luo
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
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Feng T, Ren L, Liu C, Li K, Wu L, Wei X, Yuan S, Cui LB, Yang X, Li D, Yang W, Li Y, Wang B, Wang H, Liu X. The relations between different components of intolerance of uncertainty and symptoms of depression during the COVID-19 pandemic: A network analysis. Front Psychiatry 2022; 13:993814. [PMID: 36311506 PMCID: PMC9613443 DOI: 10.3389/fpsyt.2022.993814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/09/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The relations between depression and intolerance of uncertainty (IU) have been extensively investigated during the COVID-19 pandemic. However, there is a lack of understanding on how each component of IU may differentially affect depression symptoms and vice versa. The current study used a network approach to reveal the component-to-symptom interplay between IU and depression and identify intervention targets for depression during the COVID-19 pandemic. METHODS A total of 624 college students participated in the current study. An IU-Depression network was estimated using items from the 12-item Intolerance of Uncertainty Scale and the Patient Health Questionnaire-9. We examined the network structure, node centrality, and node bridge centrality to identify component-to-symptom pathways, central nodes, and bridge nodes within the IU-Depression network. RESULTS Several distinct pathways (e.g., "Frustration when facing uncertainty" and "Feelings of worthlessness") emerged between IU and Depression. "Fatigue" and "Frustration when facing uncertainty" were identified as the central nodes in the estimated network. "Frustration when facing uncertainty," "Psychomotor agitation/retardation," and "Depressed or sad mood" were identified as bridging nodes between the IU and Depression communities. CONCLUSION By delineating specific pathways between IU and depression and highlighting the influential role of "Frustration when facing uncertainty" in maintaining the IU-Depression co-occurrence, current findings may inform targeted prevention and interventions for depression during the COVID-19 pandemic.
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Affiliation(s)
- Tingwei Feng
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Lei Ren
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kuiliang Li
- School of Psychology, Army Medical University, Chongqing, China
| | - Lin Wu
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Xinyi Wei
- Department of Psychology, Renmin University of China, Beijing, China
| | - Shangqing Yuan
- School of Psychology, Capital Normal University, Beijing, China
| | - Long-Biao Cui
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Xi Yang
- Department of Health Economy Management, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Danyang Li
- College of Education Science, Changji University, Changji, China
| | - Wei Yang
- Psychological Counseling Center, Xijing University, Xi'an, China
| | - Ye Li
- Psychological Counseling Center, Xijing University, Xi'an, China
| | - Buyao Wang
- Clinical and Psychological Counseling, DongFang College, Beijing University of Chinese Medicine, Langfang, China
| | - Hui Wang
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Xufeng Liu
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
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