Association between social support and recovery from post-traumatic stress disorder after flood: a 13-14 year follow-up study in Hunan, China

Social networks and posttraumatic stress symptoms five to ten years after the Fukushima nuclear power plant disaster

Since the 2011 Fukushima nuclear power plant accident, multiple social network disruptions have been reported among the community in Fukushima, while posttraumatic stress symptoms among the residents have persisted. In this study, we aimed to explore the influence of time and social networks on the recovery of posttraumatic stress symptoms based on longitudinal data from community residents in Fukushima, following up five to ten years after the nuclear power plant accident. We conducted five questionnaire surveys quasi-annually, the targets of which were randomly sampled 4900 non-evacuee community residents. In this study, the data of 1809 respondents who participated in at least one survey were used (36.9% of the initial target). Setting posttraumatic stress symptoms as the outcome, we examined the interaction between time and social network size using a mixed model, adjusting for sociodemographic characteristics and disaster-related events. Their interaction was statistically significant, and the posttraumatic stress symptoms of those with small social networks persisted, while those with larger social networks recovered. Maintaining and promoting social networks may contribute to mental health recovery after a nuclear disaster.

Social support and the association between post-traumatic stress disorder and risk for long-term prescription opioid use

ABSTRACT

Post-traumatic stress disorder (PTSD) is common in patients with chronic pain, adversely affects chronic pain outcomes, and is associated with opioid use and adverse opioid outcomes. Social support is a robust predictor of PTSD incidence and course as well as chronic pain outcome. We determined whether the association between PTSD and persistent opioid use was modified by emotional support in a cohort of patients receiving opioids for noncancer pain. Eligible participants were ≥18 years and had completed a new period of prescription opioid use lasting 30 to 90 days. Bivariate associations between cohort characteristics and each key variable was assessed using χ2 tests for categorical variables and t-tests for continuous variables. Interaction between PTSD and emotional support was assessed by a priori stratification on low vs high emotional support. Participants (n = 808) were 53.6 (SD ± 11.6) years of age, 69.8% female, 69.6% White, and 26.4% African American. Overall, 17.2% had probable PTSD. High emotional support was significantly (P < 0.0001) more common among those without probable PTSD. Prescription opioid use at 6-month follow-up was significantly (P = 0.0368) more common among patients with vs without probable PTSD. In fully adjusted models, PTSD was no longer associated with opioid use at 6-month follow-up among participants with high emotional support. Among those with lower emotional support, PTSD was significantly associated with opioid use at 6-month follow-up in unadjusted (odds ratio = 2.40; 95% confidence interval: 1.24-4.64) and adjusted models (odds ratio = 2.39; 95% confidence interval: 1.14-4.99). Results point to the hypothesis that improvement of emotional support in vulnerable patients with chronic pain and PTSD may help reduce sustained opioid use.

Prevalence and predictors of prenatal depression during the COVID-19 pandemic: A multistage observational study in Beijing, China

OBJECTIVE

While growing psychological health issues among pregnant women during the COVID-19 pandemic have been clearly validated, most research was conducted in countries with relatively lax quarantine measures. This study aimed to compare the prevalence of prenatal depression among pre-, peak-, and post-COVID-19 in Beijing, the region with a stringent response policy in China. We also explore predictors of prenatal depression throughout the outbreak.

METHODS

We investigated prenatal depression among 742 pregnant women who received antenatal checkups in Beijing from March 28, 2019 to May 07, 2021 using the Edinburgh Postnatal Depression Scale and associative demographic, pregnancy-related, and psychosocial characteristics were measured. The phase was divided into pre-, peak-, and post-COVID-19 in light of the trajectory of COVID-19. Pearson's Chi-square test was used after the examination of confounders homogeneity. The bivariable and multivariable logistic regression was conducted to explore predictors.

RESULTS

The pooled prevalence of prenatal depression was 11.9% throughout the COVID-19 pandemic. Rates at different phases were 10.6%, 15.2%, and 11.1% respectively and no significant difference was observed. Multivariable logistic regression revealed that history of mental illness, number of boy-preference from both pregnant women and husband's family, social support, occupation, and living space were independent predictors of prenatal depression in Beijing.

CONCLUSION

Our data suggested that the impact of this pandemic on prenatal depression in Beijing appears to be not significant, which will strengthen confidence in adhering to current policy for decision-makers and provide important guidance for the development of major outbreak control and management policies in the future. Our findings may also provide a more efficient measure to identify high-risk pregnant women for professionals and help raise gender equity awareness of pregnant women and their husbands' families. Future studies should focus on the value of targeted care and family relations on the mental health of pregnant women.

Feasibility of a breath robot intervention to reduce sleep problems in posttraumatic stress disorder: protocol for a randomized controlled study

BACKGROUND

Many patients with posttraumatic stress disorder (PTSD) suffer from sleep problems. Robot-based interventions might be an innovative approach to reduce sleep problems and hyperarousal in PTSD. However, the feasibility and effectiveness of a breath robot in patients with PTSD have never been empirically tested. The aim of this study is to investigate the feasibility of a breath robot to reduce sleep problems and hyperarousal in patients with PTSD.

METHODS

This randomized controlled feasibility study will include N = 30 adult patients with at least subsyndromal PTSD (PTSD Symptom Scale - Interview-5 (PSSI-5)) according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and impaired sleep quality (Pittsburgh Sleep Quality Index (PSQI) > 5). Patients with organic sleep disorders or currently in psychotherapeutic treatment are excluded. Study participants are randomized to receive either a 4-week Somnox 2 robot intervention including simulation of human breath or a 4-week Somnox 2 robot intervention without human breath simulation. The primary outcome will be the proportion of randomized participants providing outcome data at post-treatment. We consider a proportion of > 50% to indicate feasibility. Additional feasibility outcomes include eligibility rate, recruitment speed, uptake, retention, treatment adherence, and dropout. Potential outcomes of effectiveness (sleep quality, PSQI; severity of PTSD symptoms, PSSI-5) will be assessed at two time points, before (T0) and after (T1) the intervention. Sleep characteristics (Consensus Sleep Diary (CSD)) are measured daily.

DISCUSSION

This study is the first to investigate the feasibility of a novel breath robot intervention for reducing sleep problems and hyperarousal in PTSD patients, with effectiveness considered as a secondary outcome. If feasible and effective, the use of a breath robot could be a nonintrusive and flexible intervention to supplement psychotherapy or to bridge treatment gaps.

TRIAL REGISTRATION

DRKS, DRKS00031063. Registered on 10/012023.

Trajectories of parental posttraumatic stress disorder and children's mental health following Super Typhoon Lekima: The mediating role of feeling of safety

INTRODUCTION

Several studies have examined the impact of parents' posttraumatic stress disorder (PTSD) on their children's mental health, but few have evaluated the role of parents' specific PTSD trajectories. The aim of this study was to assess the mechanisms underlying distinct trajectories of parental PTSD that affect children's PTSD and depression through the feeling of safety.

METHODS

The final sample comprised 242 dyads of parents and their children who experienced Super Typhoon Lekima in 2019. All participants were surveyed at three time points after the typhoon: 3 months (T1), 15 months (T2), and 27 months (T3). Parental PTSD symptoms at three time points and children's PTSD, depression, and feeling of safety at T3 were analyzed.

RESULTS

Four parental PTSD trajectories were identified: recovery, resilience, delayed, and coping. Compared with the resilient group, children of parents with delayed PTSD trajectories reported higher levels of depression at T3, while children of parents in the coping group were more likely to experience severe PTSD at T3. Children of parents in the recovery group, with a reduced feeling of safety, exhibited more severe depression and PTSD at T3, whereas children of parents in the delayed group were at an increased risk of PTSD at T3.

CONCLUSIONS

These findings highlight the heterogeneity of parental PTSD trajectories following natural disasters and their distinct effects on children's PTSD and depression. Furthermore, feeling of safety emerges as a crucial mechanism in this process.

Utility of the capability, opportunity, and motivation behaviour (COM-B) model in explaining the negative association between pre-pregnancy body mass index and exclusive breastfeeding at six weeks postpartum

The mechanisms underlying the negative associations between pre-pregnancy body mass index (BMI) and exclusive breastfeeding remain poorly understood. Thus, the study aimed to determine whether the negative associations between high pre-pregnancy BMI and exclusive breastfeeding at six weeks postpartum are mediated by components of the capability, opportunity, and motivation behaviour (COM-B) model. In this prospective observational study, we assigned 360 primiparous women to a pre-pregnancy overweight/obese group (n = 180) and a normal-BMI group (n = 180). A structural equation model was designed to study how capabilities (onset of lactogenesis II, perceived milk supply, breastfeeding knowledge, and postpartum depression), opportunities (pro-breastfeeding hospital practices, social influence, social support), and motivations (breastfeeding intention, breastfeeding self-efficacy, and attitudes towards breastfeeding) affected exclusive breastfeeding at six weeks postpartum in groups of women with different pre-pregnancy BMIs. In all, 342 participants (95.0%) possessed complete data. Women with high pre-pregnancy BMI were less likely to exclusively breastfeed at six weeks postpartum than women with a normal BMI were. We observed a significant negative direct effect of high pre-pregnancy BMI on exclusive breastfeeding at six weeks postpartum and a significantly negative indirect effect of high pre-pregnancy BMI via the explanatory mediating variables of capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy) on exclusive breastfeeding at six weeks postpartum. Our findings support certain capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy), partially explaining the negative association between high pre-pregnancy BMI and exclusive breastfeeding outcome. We suggest that interventions aimed at promoting exclusive breastfeeding among women with high pre-pregnancy BMI should address the capacity and motivation factors specific to this population.

Social support and community embeddedness protect against post-disaster depression among immigrants: a Vietnamese American case study

Immigrants often face increased vulnerabilities to disaster-related poor health and recovery, compared to mainstream populations. Little is known about Hurricane Harvey's impacts among the storm affected area's large Vietnamese American population. Our study documented diverse psychological experiences and recovery challenges 1 year post-storm among a sample of 120 Vietnamese Americans residing in the Houston, Texas area. Using linear regression modeling, we examined the association between social support and depressive symptom development among these storm-affected Vietnamese Americans. Social support encapsulating both social embeddedness and perceived support was measured by the Louisville Social Support Scale and depressive symptom development was measured by 18 items that assessed emotional distress. These items included loss of appetite, loss of concentration, exposure to persistent pain, and the exhibition of hopelessness, tiredness, sadness, frustration, discouragement, desperation, exhaustion, disgraced, anger, and craziness. We found adverse post-disaster health outcomes, as well as potential avenues to mitigate them, that should be taken into consideration in the design and implementation of inclusive disaster programs. A high level of social support lowered depressive symptomology among Vietnamese Americans post-Hurricane Harvey, even when accounting for Hurricane Harvey-related home damages and injuries/illness. The negative association between social support and depressive symptom development remained after accounting for both post-storm self-rated mental and physical health. Our results suggested that public health practitioners and emergency management entities should prioritize social support resources to foster mental well-being after hurricanes among Vietnamese Americans as future hurricanes are expected to be stronger and more prevalent along the United States Gulf Coast.

Prevalence of depression and anxiety, and their relationship to social support among patients and family caregivers of rare bone diseases

BACKGROUND

Rare bone diseases (RBDs) are a set of inherited rare diseases that can cause disability and have a devastating impact on families affected, which may lead to a particular high prevalence of psychological disorders in patients and caregivers. Social support plays a role in the well-being of families with rare disease patients, but its effect on psychology of RBD families remains unclear. The purpose of the current cross-sectional quantitative study was to investigate the frequency of depression and anxiety, and their relationship with social support among RBD patients and family caregivers.

RESULTS

A total of 196 participants responded to the questionnaire, including 72 patients and 124 caregivers. Depression was detected among 33.8% of patients and 57% of caregivers, and anxiety disorder was presented in 28.6% of patients and 50% of caregivers. Higher depression scores and anxiety scores were found in both patients and caregivers with an education level of ≤ middle school and monthly income of ≤ ￥2000 (all P < 0.05). The mean (SD) scores of Social Support Rating Scales in patients and caregivers were 37.06 (8.05) and 38.31 (5.76), respectively. After adjusting for gender, age, monthly income, education, employment and marital status, the reverse associations between depression scores, anxiety scores and social support were found merely in caregivers (depression & social support: β = - 0. 46, P < 0.001, anxiety & social support: β = - 0. 44, P < 0.001), specifically for subjective support (depression & subjective support: β = - 0.94, P < 0.001, anxiety & subjective support: β = - 0.87, P < 0.001).

CONCLUSIONS

The study identified a high prevalence of depression and anxiety among RBD patients and caregivers, and pointed out the significance of social support in alleviating psychological distress. In order to provide RBD families with comprehensive assistance, the government should actively develop programs aimed at psychological aid, policy advocacy and tangible support.

Nonlinear effects of pandemic uncertainty on depression, pandemic preventive behavior intentions, and positive life attitudes: Moderating effects of high and low uncertainty grouping

Backgrounds

COVID-19 is difficult to end in a short time and people are still facing huge uncertainties. Since people's lives are gradually returning to normal, the sense of control and intolerance of uncertainty, which were mainly focused by past studies, are not specific to COVID-19 and will be more influenced by some factors unrelated to the pandemic. Therefore, they may be difficult to accurately reflect the individuals' perceptions of uncertainty. Besides, past research just after the outbreak mainly investigated people in high levels of uncertainty, we don't know the impact of uncertainties on individuals' psychological states when people gradually recovered their sense of control. To solve these problems, we proposed the concept of "pandemic uncertainty" and investigated its impact on people's daily lives.

Methods

During October 20, 2021 to October 22, 2021, this study obtained data about uncertainty, depression, positive attitude, pandemic preventive behavior intentions, personality, and social support from 530 subjects using convenient sampling. The subjects were all college students from the Dalian University of Technology and Dalian Vocational and Technical College. According to the distribution of uncertainty, we divided the dataset into high and low groups. Subsequently, by using uncertainty as the independent variable, the grouping variable as the moderating variable, and other variables as the control variables, the moderating effects were analyzed for depression, positive attitude, and pandemic preventive behavior intentions, respectively.

Results

The results showed that the grouping variable significantly moderate the influence of uncertainty on positive attitude and pandemic preventive behavior intentions but had no significant effect on depression. Simple slope analysis revealed that high grouping uncertainty significantly and positively predicted positive attitude and pandemic preventive behavior intentions, while low grouping effects were not significant.

Conclusion

These results reveal a nonlinear effect of pandemic uncertainty on the pandemic preventive behavior intentions and positive life attitudes and enlighten us about the nonlinear relationship of psychological characteristics during a pandemic.

Association between social support and depressive symptoms among Chinese nurses with formal employment versus contract-based employment

BACKGROUND

Inequalities may exist in social and health status among nurses with different employment types. Few studies have investigated the relationship between social support and depressive symptoms among formally employed nurses compared with those in contract-based employment. This study aimed to examine the associations between social support and depressive symptoms among Chinese nurses with different forms of employment.

METHODS

The present cross-sectional study was performed with 1,892 nurses from 12 tertiary hospitals in Shandong Province, China. The Social Support Rating Scale and the 10-item Center for Epidemiologic Studies Depression Scale were used to measure social support and depressive symptoms, respectively. The association between social support and depressive symptoms among participants was explored using multiple linear regression analysis.

RESULTS

The prevalence of depressive symptoms was 45.7%. The mean score for total social support was 40.16 (SD = 7.47), which was lower than the norms in the general Chinese population. Formally employed participants' total social support scores were statistically significantly higher than those of contract-based employees (p ≤ 0.05). After controlling for confounding factors, the multiple linear regression analysis showed that subjective support and support utilization scores were inversely associated with depressive symptoms. Objective support scores were negatively associated with depressive symptoms only among contract-employment nurses.

CONCLUSION

Chinese nurses have a higher prevalence of depressive symptoms and lower social support than the Chinese general population. Compared with contract-employment nurses, formally employed nurses had higher social support. Inverse associations exist between social support and depressive symptoms among nurses with different types of employment. It is suggested that improving Chinese nurses' social support levels and reducing their depressive symptoms, especially for nurses employed through contracts, are critical.

Worry about Radiation and Its Risk Factors Five to Ten Years after the Fukushima Nuclear Power Plant Disaster

Worry about radiation persists long after nuclear power plant accidents. Young age, low socioeconomic status, being married, and disaster-related experiences are known to be associated with greater worry about radiation. This study explored the duration of the effects of these risk factors on worry about radiation after the 2011 Fukushima nuclear power plant accident, using the longitudinal data of randomly sampled non-evacuee community residents who were followed five to ten years after the accident. Questionnaire surveys were conducted five times with 1825 respondents (37.2% of the 4900 initial targets). We examined the interaction of time and risk factors of worry about radiation using a mixed model. Fear or anxiety immediately after the accident had effects on worry about radiation that continued even after 10 years, though it slightly attenuated with time. Family problems stemming from the disaster retained their effects. While direct damage and evacuation experience were significantly associated with worry about radiation in the early phase, their effects diminished and became non-significant during the study period. Being under the age of 65, having low educational attainment, and being married were significantly associated with worry about radiation, although the association with age weakened over time. Individuals who experience intense fear or anxiety post-nuclear power plant accidents or disaster-related family problems may need continuous monitoring for their worry about radiation even 10 years after such accidents.

Table for two: Perceptions of social support from participants in a weight management intervention for veterans with PTSD and overweight or obesity

Individuals with posttraumatic stress disorder (PTSD) are at an increased risk of being classified as overweight or with obesity in part due to PTSD symptoms (e.g., sleep disturbance and social isolation) interfering with activity and healthy eating. MOVE!+UP is a 16-week behavioral weight management program, tailored to address such barriers for people with PTSD, by combining evidence-based weight loss education and support with cognitive behavior therapy skills to reduce PTSD symptom-based weight management barriers. This qualitative study examined veterans' (n = 37) perceptions of social support relevant to weight management, health behaviors, and mental health while participating in an uncontrolled pilot of MOVE!+UP. Template analysis of transcripts from 1-hr semistructured qualitative interviews identified four main categories of participant responses. Participants described positive aspects, particularly cohesiveness around a shared veteran identity, feeling less alone, accountability, and having others eat healthier and exercise with them. Conversely, relationship-based barriers included other participants' poor MOVE!+UP group session attendance and engagement, and loved ones' encouragement of making unhealthy choices. Many described having limited relationships or trouble accessing available support. Finally, PTSD symptoms were a significant barrier to utilizing social support to facilitate weight loss. Findings suggest future behavioral weight management programs should recruit members with similar backgrounds to capitalize on shared experience, encourage consistent attendance and meaningful participation, deliver education about how to leverage social support from others outside the program, and address mental health symptoms that impede social support and healthy lifestyles. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The protective role of social support on prenatal depression among pregnant women of advanced maternal age: a Three-Trimester follow-up study in China

The aim of this study was to compare the depressive symptoms during pregnancy between pregnant women aged over 35 years and those aged less than 35 years and to evaluate the protective effect of social support in early pregnancy against prenatal depressive symptoms. One hundred and seventy one women aged over 35 years and 342 trimester-matched women aged less than 35 years were included from a level III hospital in Shenzhen, China. The self-report Edinburgh Postnatal Depression Scale (EPDS) and Social Support Rating Scale (SSRS) were used to evaluate prenatal depression and social support in early pregnancy. The proportions of women aged over 35 years who screened positive for prenatal depression were 22.8%, 23.4%, and 24.0% in the first, second and third trimesters, respectively. Advanced maternal age (≥35 years) was a positive predictor of prenatal depressive symptoms (β = 0.747, P = 0,008). Social support, especially objective support (β = -0.030, P = 0.002) and subjective support (β = -0.028, P = 0.006) in early pregnancy, had stronger protective effects against prenatal depressive symptoms for women aged over 35 years than younger women. Our findings support that older pregnant women experience more depressive symptoms than younger pregnant women, and social support could serve as a targeted intervention to decrease prenatal depressive symptoms.Impact statementWhat is already known on this subject? Depressive symptoms, which are strongly associated with adverse psychosocial and birth outcomes, appear to be prevalent and change in nature. Social support is an important protective factor against prenatal depression.What the results of this study add? Pregnant women of advanced maternal age experienced more depressive symptoms than younger women during the prenatal period. Social support, especially objective support and subjective support, had stronger protective effects against prenatal depression for women aged over 35 years than women aged less than 35 years.What the implications of these findings are for clinical practice? Screening of prenatal depression should be strengthened, especially for women aged over 35 years, and improving subjective support could improve their emotional experience.

Relationship between social support, anxiety, and depression among frontline healthcare workers in China during COVID-19 pandemic

Background

Social support is an important factor affecting individual mental health. However, the relationship between social support and mental health in frontline healthcare workers (FHW) during the coronavirus disease 2019 (COVID-19) pandemic has garnered less attention. In this study, we aimed to investigate the level of social support and the prevalence of depression and anxiety in FHW during the COVID-19 pandemic and determine the factors affecting the relationship between social support, depression, and anxiety.

Methods

A cross-sectional study using an online survey was conducted to collect data from FHW between 15 February and 31 March 2020 in China. The data included demographic factors, Self-rated Depression Scale (SDS), Self-rated Anxiety Scale (SAS), and Social Support Rate Scale (SSRS). Spearman correlation test was performed to determine the correlation among SAS, SDS, and SSRS scores. Multiple linear regression analysis was performed to determine the relationship among demographic factors, social support, depression, and anxiety in FHW.

Results

Of all 201 participants, 44 (21.9%) had depressive symptoms and 32 (15.9%) had anxiety symptoms. The average total SSRS scores among FHW were lower than that of the norms of the Chinese general population (37.17 ± 7.54 versus 44.38 ± 8.38, P < 0.001). Marital status positively affected the SSRS score (β = 7.395, P < 0.01). Age over 40 years old negatively affected the SSRS score (β = -5.349, P = 0.017). The total SSRS score, subjective social support score, objective social support score, and support utilization score among FHW negatively correlated with the SAS score and SDS score (P < 0.05). A lower support utilization score was significantly associated with high anxiety and depressive symptoms (β = -0.869, P = 0.024; β = -1.088, P = 0.035, respectively).

Conclusion

During the COVID-19 pandemic, FHW experienced depression, anxiety, and inadequate social support. The marital status and age had a major impact on social support. Social support was inversely associated with depression and anxiety. Improving the mental health of FHW by strengthening social support is crucial. Future studies are needed to investigate how to improve the level of social support and mental health condition of FHW facing public health emergencies in the future.

The association between social support and depression among patients with vitiligo in China

Vitiligo is a common depigmenting skin disease with profound psychosocial impacts. Depression is one of the most common mental distress. Social support has a significant impact on the psychological status of patients. The aim of this study is to investigate the depression and social support status of patients with vitiligo in China, and further explore the correlation between social support and depression. The outpatients with vitiligo were investigated face to face with SDS (Self-rating depression scale) and SSRS (Social support rate scale). The mean SDS score of the patients was 44.05 ± 6.76, which was significantly higher than Chinese norms (p = 0.000). Female patients, unmarried, disease at rapid progressive stage and skin lesions at the exposed site had higher SDS scores (all p < 0.05). The scores of total social support, subjective support, objective support and support availability were lower than Chinese norms (all p < 0.01), and all were negatively correlated with SDS scores (all p < 0.001). In conclusion, low social support is one of the risk factors for depression in patients with vitiligo in China. More support and acceptance should be given to the patients.

The Role of Mental Adjustment in Mediating Post-Traumatic Stress Disorder Symptoms and Social Support in Chinese Ovarian Cancer Patients: A Cross-Sectional Study

Background

Post-traumatic stress disorder (PTSD) can manifest in individuals following a traumatic event. There is a paucity of studies focusing on PTSD symptoms in ovarian cancer (OC) patients. This study aimed to investigate the association of social support, mental adjustment and PTSD symptoms in Chinese OC patients with a view to exploring whether mental adjustment could mediate the relationship.

Methods

A cross-sectional study was conducted from January 2015 to December 2016. A total of 171 OC subjects were recruited and the effective response rate was 81.3%. The PTSD Checklist-Civilian Version (PCL-C), Mini-Mental Adjustment to Cancer scale (Mini-MAC) and Duke-UNC Functional Social Support Questionnaire were disseminated to the patients. The Chinese Mini-MAC was used in this study focusing on three components, namely negative emotion, positive attitude, and cognitive avoidance. Hierarchical linear regression analyses were employed to investigate the association of social support and PTSD symptoms, and the role of mental adjustment in their mediation.

Results

The prevalence of PTSD symptoms was 17.3% in OC patients. PTSD symptoms were negatively related with both social support and positive attitude, and positively associated with negative emotion and cognitive avoidance. Social support was negatively associated with negative emotion and cognitive avoidance, and positively related with positive attitude. In addition, negative emotion and positive attitude mediated the association between social support and PTSD symptoms.

Conclusion

PTSD symptoms in OC patients should be paid attention to. Social support and mental adjustment were positive resources associated with PTSD symptoms. Moreover, mental adjustment could mediate the relation between social support and PTSD symptoms in OC patients. Therefore, intervention management that focusing on improving perceived social support as well as strengthening mental adjustment, especially negative emotion and positive attitude, may be useful for reducing PTSD symptoms in this context.

Prevalence of Post-traumatic Stress Disorder After Flood: A Systematic Review and Meta-Analysis

Introduction

Flood as the most common kind of the natural disasters has unpleased short, medium, and long-term consequences on the victims' welfare, relationships, and physical and mental health. One of the most common mental health disorders in these victims is Post-traumatic stress disorder (PTSD). The aim of this study is to investigate the prevalence of PTSD on the flood victims.

Methods

Data resources including PubMed, Scopus, Web of Science, Science Direct, Embase, Google Scholar, conference and congress papers, key journals, the reference list of selected articles as well as systematic reviews were searched to identify studies that reported the prevalence of PTSD in flood victims. Random Effect Model was used to perform meta-analysis of the studies. Cochran test and I2 indicator were used to explore heterogeneity between the studies. Publication bias of the study was evaluated using Begg'test. Data were analyzed by STATA (version 14) software.

Results

After a comprehensive search, 515 papers were extracted. After eliminating duplicates and final screening, 23 studies were selected and entered the meta-analysis phase after qualitative evaluation. The results showed that the prevalence of PTSD in flood victims is 29.48% (95% CI: 18.64-40.31, I2 = 99.3%, p-value < 0.001).

Conclusion

The results of the present study showed that the prevalence of PTSD is relatively high in the flood victims. So, it is necessary to take preventive, supportive, therapeutic and effective actions for them.

Disaster Risks Management through Adaptive Actions from Human-Based Perspective: Case Study of 2014 Flood Disaster

In Malaysia, floods are often considered a normal phenomenon in the lives of some communities, which can sometimes cause disasters to occur beyond expectations, as shown during the flood of 2014. The issue of flood disasters, which particularly impacts SDG 13 of the integrated Sustainable Development Goals (SDGs), still lacks widespread attention from sociology researchers in Malaysia. Similarly, questions related to the welfare of victims, especially in regards to aspects of disaster management from a humanitarian perspective, are still neglected. This study aims to identify the adaptive actions through a solution from a humanitarian perspective in managing flood disaster risks. For the purpose of obtaining data, this study used a qualitative approach with a case study design. Data were collected using in-depth interviews and non-participant observation methods. A total of ten experts, consisting of the flood management teams involved in managing the 2014 flood disaster in Hulu Dungun, Terengganu, Malaysia, were selected through a purposive random sampling method. The results showed that adaptive actions in managing flood disaster risks from a humanitarian point of view include the provision of social support, collective cooperation from the flood management teams, and adaptation efforts after the floods.

Days with and without self-injurious thoughts and behaviors: Impact of childhood maltreatment on adolescent online social networking

INTRODUCTION

Among adolescents, an increasing rate of interpersonal interactions occurs online. Previous research has shown that interpersonal context exerts a robust impact on suicidal thoughts or behaviors, yet little attention has focused on examining the content of online interactions surrounding self-injurious thoughts or behaviors. As such, the present study sought to compare online social networking behaviors among adolescents on days with and without experiencing self-injurious thoughts or behaviors, as influenced by childhood maltreatment history.

METHOD

Adolescents aged 13-18 hospitalized for self-injurious thoughts or behaviors were recruited as part of an ongoing longitudinal study. A subsample (N = 22) of adolescents provided data from their online social networking platforms (i.e., text messages, Facebook, Instagram, and Twitter). Using a mixed-methods approach, online social networking data on days of experiencing self-injurious thoughts or behaviors and days of not experiencing self-injurious thoughts or behaviors were compared.

RESULTS

Results indicate the frequency and content of online social networking messaging do not change by day of self-injurious thoughts or behaviors or history of childhood maltreatment. However, childhood maltreatment predicts received conflictual messages as well as sent symptomatic messages on days of experiencing self-injurious thoughts or behaviors.

CONCLUSIONS

Childhood maltreatment may play a role in the content of adolescent online behaviors, particularly on days when they experience self-injurious thoughts or behaviors. Implications for intervention are discussed.

Post-traumatic stress in people from the interior drylands of the Maule region, Chile in the context of climate change

Progressive changes in local environmental scenarios, accelerated by global climate change, can negatively affect the mental health of people who inhabit these areas. The magnitude of these effects may vary depending on the socioeconomic conditions of people and the characteristics of the environment, so certain territories can be more vulnerable than others. In this context, the present study aimed to geographically analyse the levels of psychosocial impact and the types of disruptive responses related to the new territorial scenarios caused by climate change in the coastal drylands of the Maule region, Chile. For this purpose, 223 people from two communes (Curepto and Pencahue) were psychosocially evaluated for post-traumatic stress disorder (PTSD) together with a survey of the prevailing sociodemographic and socioeconomic conditions in relation to the environmental variables of the territory. All information was georeferenced, stored within an ArcGIS Desktop geographic information system (GIS) and then investigated by application of contingency tables, ANOVA and local clustering analysis using SSP statistical software. The results indicated a high level of PTSD in the population, with significant differences related to age and education as well as employment conditions and income. The spatial results showed high PTSD values in the communal capital of Curepto in the central agricultural valley near the estuary of the local river, while the existence of coldspots was observed in the central valley of the Pencahue commune. It was concluded that proximity to population centres and surface water sources played the greatest role for the development of PTSD.

MOSAIC (MOthers’ AdvocateS In the Community) for pregnant women and mothers of children under 5 with experience of intimate partner violence: A pilot randomized trial study protocol

Background

Pregnancy and motherhood increase the risk for long-term exposure to physical, psychological and sexual intimate partner violence (IPV; sexual or physical violence by current or former partners). Pregnant women and mothers with children under 5 who have experienced IPV exhibit poor physical and mental health and obstetric outcomes. Depression and posttraumatic stress disorder (PTSD) are the two most common mental health consequences of IPV. There is good evidence that women with good social support have better mental health and IPV outcomes.

Methods

This study will develop MOthers’ AdvocateS In the Community (MOSAIC) Plus intervention for pregnant women and mothers with children under the age of 5. MOSAIC uses trained mentor mothers and has been found to reduce subsequent IPV. This study will blend the original MOSAIC intervention with principles of interpersonal psychotherapy (IPT) to address symptoms of depression, PTSD, and prevent subsequent risk of IPV. We will conduct a pilot randomized trial of the MOSAIC Plus intervention compared to the traditional MOSAIC intervention to determine its feasibility and acceptability. Study samples include focus groups (n = 36), open trial (n = 15), and a randomized pilot trial including 40 pregnant women and mothers with children under 5 who report current/recent of IPV and elevated symptoms of maternal depression and/or PTSD. The study’s primary outcome will be changes in maternal depressive and PTSD symptoms. Secondary outcomes will include reduction in subsequent IPV, improvement in functioning, changes in social support and effectiveness in obtaining resources.

Discussion

This is a formative study evaluating the feasibility and acceptability of a mentor mother intervention for pregnant women and mothers with children under 5. Promising results of this study will be used for a larger, fully-powered randomized trial evaluating the effectiveness of a mentor mother intervention in preventing subsequent IPV and reducing depressive and PTSD symptoms in this population.

The Influential Factors of Adherence to Physical Activity and Exercise among Community-Dwelling Stroke Survivors: A Path Analysis

AIMS AND OBJECTIVES

To investigate the status of physical activity and exercise (PAE) adherence and identify its influential factors among community-dwelling stroke survivors.

BACKGROUND

Regular PAE after stroke is essential for recovery and secondary prevention, while adherence to PAE and its influential factors are rarely studied.

DESIGN

A cross-sectional descriptive study.

METHODS

In total, 208 stroke survivors (70.25 ± 9.08 years) were randomly selected from three communities. The influential factors of PAE adherence and associations between these variables were explored using multiple linear regression and path analyses. This study adhered to the EQUATOR checklist, STROBE.

RESULTS

The mean adherence rate was moderate (62.00%), and stroke survivors tended to be more adherent to PAE than monitoring and seeking advice (70.30%>53.50%>48.30%). The regression results revealed that seven factors were significantly associated with PAE adherence, including knowledge, attitude, self-efficacy, social support, self-care ability, community rehabilitation experience and times since stroke. Furthermore, the path analysis showed that knowledge had a significant indirect positive influence on adherence with self-efficacy as a mediator, while attitude and social support impacted both directly and indirectly with self-efficacy as the mediator. Moreover, self-efficacy had the most substantial direct effect on community-dwelling stroke survivors' PAE adherence. These four variables accounted for a total of 67.00% of the variance in PAE adherence among community-dwelling stroke survivors.

CONCLUSIONS

The PAE adherence of community stroke survivors needs to be improved. Healthcare professionals should develop more effective interventions to promote PAE adherence through enhancing self-efficacy among this population.

RELEVANCE TO CLINICAL PRACTICE

Adherence to the recommended regimen is the most challenging dimension of stroke physical activity and exercise. This study contributes to exploring status and influential factors of PAE adherence, and self-efficacy was found to be a significant determinant. The results could be used to inspire future community-based intervention programs for stroke survivors.

Climate change, climate-related disasters and mental disorder in low- and middle-income countries: a scoping review

INTRODUCTION

Climate change and climate-related disasters adversely affect mental health. Low- and middle-income countries (LMICs) are particularly vulnerable to the impacts of climate change and climate-related disasters and often lack adequate mental healthcare infrastructure. We used the scoping review methodology to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders among those living in LMICs. We also aimed to recognise existing gaps in this area of literature.

METHODS

This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. To identify relevant studies, we searched five electronic databases (MEDLINE, EMBASE, Global Health, APA PsycInfo and Sociological Abstracts) from 1 January 2007 to 31 December 2019. We also searched the grey literature. Included studies had an adult-focused LMIC population, a climate change or climate-related disaster exposure and a mental disorder outcome. Relevant study information was extracted and synthesised.

RESULTS

Fifty-eight studies were identified, most of which (n=48) employed a cross-sectional design. The most commonly studied exposure-outcome combinations were flood-related post-traumatic stress disorder (PTSD) (n=28), flood-related depression (n=15) and storm-related PTSD (n=13). The majority of studies identified a positive exposure-outcome association. However, few studies included a baseline or comparator (ie, unexposed) group, thereby limiting our understanding of the magnitude or nature of this association. There was also great heterogeneity in this literature, making studies difficult to pool or compare. Several research gaps were identified including the lack of longitudinal studies and non-uniformity of geographic coverage.

CONCLUSION

To our knowledge, this was the first scoping review to investigate the relationship between climate change and climate-related disaster exposures and mental disorder outcomes in LMICs. Our findings support the need for further research, but also highlight that mental health should be a priority within LMIC climate change policy considerations.

Social Support and Family Functioning in Chinese Families of Children with Autism Spectrum Disorder

Families caring for children with autism spectrum disorder (ASD) have reported poorer family functioning. Social support might strengthen family functioning, but limited research to date has focused on this association in China. This study conducted a cross-sectional survey of Chinese families that have children with ASD to examine the relationship between social support and family functioning. Caregivers of children with ASD from Sichuan province in China (N = 167) were surveyed concerning their perceived social support and family functioning. The Social Support Rating Scale was used to investigate caregivers' perceived social support from three dimensions: subjective support, objective support, and the utilization of support. A Chinese version of the Family Adaptability and Cohesion Scale was used to investigate their perceptions of family cohesion and adaptability. The Pearson correlation coefficient and stepwise multiple regression were used for analyses. The results suggested that social support was positively related to family cohesion and adaptability. Of the three sub-domains of social support, both subjective support and the utilization of support were positively associated with family cohesion and adaptability. The study's findings evidenced the importance of different types of social support and could be used to develop a targeted support service for families that have children with ASD to improve their family functioning and sustain the family unit.

The impact of lockdown policy on depressive symptoms among pregnant women in China: mediating effects of internet use and family support

BACKGROUND

Although more and more attention has been paid to the psychological consequences of the lockdown policy amongst pregnant women, the underlying mechanism linking the lockdown policy to maternal depression has not been studied in the context of China. This study aimed to explore the association between the lockdown policy and maternal depressive symptoms, and whether such association was mediated by internet use and/or family support.

METHODS

This cross-sectional study used multi-stage sampling techniques in central and western China. Data were collected from 1266 pregnant women using a structtured questionnaire that measured internet use, family support, and depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Internet use was measured by length of usage and varierity of purpose for internet use. Family support was measureed by spousal support and parental support. The structural equation modelling was employed to conduct mediation analysis to test the specificity of the hypothetical paths.

RESULTS

Overall, 527 respondents (41.63%) presented depressive symptoms. The lockdown policy was negatively associated with depressive symptoms in pregnant women (β = - 0.925, 95% CI = -1.510, - 0.360). The impact of the lockdown policy on depressive symptoms was partially mediated by internet use (β = 1.589, 95% CI = 0.730, 2.807) and family support (β = - 0.162, 95% CI = - 0.341, - 0.017), accounting for 42.67% of the total effect.

CONCLUSIONS

The lockdown policy was generally associated with fewer depressive symptoms in pregnant women. The lockdown policy increased maternal depressive symptoms through increased internet use, but decreased maternal depressive symptoms through enhanced family support. The findings suggest that the psychological consequence of the lockdown policy may vary across different populations, and warrant the need to take into consideration the features of subgroups.

The impact of early social support on subsequent health recovery after a major disaster: A longitudinal analysis

Social support may facilitate disaster recovery. Prior analyses are hampered by the limits of cross-sectional approaches. We use longitudinal data from the KATIVA-NOLA survey to explore whether social support soon after Hurricane Katrina facilitated recovery of health status for a representative sample of 82 Vietnamese New Orleanians. Health and social support were assessed just before Hurricane Katrina (2005), soon afterwards (2006, 2007), and at longer durations post-disaster (2010, 2018). We use random effects regression to examine how social support measured in 2006 influences mental and physical health measured in 2006, 2007, 2010, and 2018. Social support soon after Katrina was positively associated with physical health and mental health years later in 2010, even after controlling for potential confounders such as Katrina-related housing damage and pre-Katrina health and support and modeling an interaction between year and social support in 2006. Other immigrants who are highly impacted by a major disaster could benefit from programs that seek to rapidly reconstruct systems of social support.

•

We use longitudinal data to explore if social support soon after Hurricane Katrina facilitated recovery for Vietnamese.

•

We use random effects regression to examine how social support measured in 2006 influences health in the following years.

•

Social support soon after Katrina was positively associated with health, even after controlling for potential confounders.

•

Immigrants could benefit from programs seeking to rapidly reconstruct social support systems after a major disaster.

•

Early social support may facilitate disaster recovery.

Symptoms of post-traumatic stress disorder and associated risk factors in type A aortic dissection

BACKGROUND

Surgery is the primary option of acute type A aortic dissection (AAAD) treatment. However, the unique traumatic stress of cardiovascular disease and surgery brings physical and psychological suffering to the patients and causes post-traumatic stress disorder (PTSD). The aim of this study was to investigate the rate of PTSD in AAAD patients after surgery and identify the risk factors of this complication.

METHODS

A prospective cohort design was used. All patients who underwent AAAD surgery from September 2017 to June 2019 were included. Resilience, anxiety, and depression level were assessed before patients discharged from the hospital. Additionally, the PTSD symptoms were assessed three months after discharge from hospital. The data were analyzed by SPSS 24.0 (IBM, Armonk, NY, USA) and P<0.05 was considered as statistically significant.

RESULTS

Two hundred and twenty-four patients were included in this study. The incidence of PTSD was 21.4%. Symptoms were highly prevalent with reexperience and increased alertness. "Primary or below" AAAD patients had a significantly higher score in "increased alertness" (P<0.05). Depressive symptoms (B=1.621, β=0.398, P<0.001), female gender (B=-7.539, β=-0.311, P<0.001) were the risk factors associated with PTSD, while optimism (B=-0.920, β=-0.169, P=0.012) was the protective factor in AAAD patients.

CONCLUSIONS

AAAD patients exhibited high prevalence of PTSD, which was highly prevalent with reexperience and increased alertness. Higher depressive level, female gender, and lower optimism were associated with higher risk of PTSD. The findings suggest that medical staff should assess the psychological health status of AAAD patients timely and identify high-risk patients early to improve the outcome.

Dissociative symptoms predict severe illness presentation in Canadian public safety personnel with presumptive post-traumatic stress disorder (PTSD)

BACKGROUND

Post-traumatic stress disorder affects 9% of individuals across their lifetime and increases nearly fourfold to 35% in Canadian public safety personnel (PSP). On-the-job experiences of PSP frequently meet criteria for traumatic events, making these individuals highly vulnerable to exposures of trauma and the negative consequences of PTSD. Few studies have reported on the clinical characteristics of Canadian samples of PSP and even fewer have examined the dissociative subtype of PTSD, which is associated with more severe, chronic traumatic experiences, and worse outcomes.

OBJECTIVE

This study aimed to characterize dissociative symptoms, PTSD symptom severity, and other clinical variables among Canadian PSP with presumptive PTSD.

METHODS

We sampled current and past PSP in Canada from both inpatient and outpatient populations (N = 50) that were enrolled in a psychological intervention. Only baseline testing data (prior to any intervention) were analysed in this study, such as PTSD symptom severity, dissociative symptoms, emotion dysregulation, and functional impairment.

RESULTS

In our sample, 24.4% self-reported elevated levels of dissociation, specifically symptoms of depersonalization and derealization. Depersonalization and derealization symptoms were associated with more severe PTSD symptoms, greater emotion dysregulation, and functional impairment.

CONCLUSIONS

Nearly a quarter of this sample of Canadian PSP reported experiencing elevated levels of PTSD-related dissociation (depersonalization and derealization). These high levels of depersonalization and derealization were consistently positively associated with greater illness severity across clinical measures. It is imperative that dissociative symptoms be better recognized in patient populations that are exposed to chronic traumatic events such as PSP, so that treatment interventions can be designed to target a more severe illness presentation.

Mental health outcomes among patients from Fangcang shelter hospitals exposed to coronavirus disease 2019: An observational cross-sectional study

Background

The coronavirus disease 2019 (COVID-19) is not only attacking physical health, but it is also increasing psychological suffering. This study aimed to observe the impact of the COVID-19 pandemic on mental health outcomes among patients with mild to moderate illness in Fangcang shelter hospitals.

Methods

We conducted an observational, cross-sectional study of 129 patients with mild to moderate illness from Jiangxia Fangcang shelter hospitals in Wuhan, China. The participants were assessed by quantifying their symptoms of depression, anxiety, insomnia, and stressful life events and analyzing potential risk factors associated with these symptoms. Using correlation analysis, we examined associations between exposure to COVID-19 and subsequent psychological distress in response to the outbreak.

Results

In total, 49.6% of participants had depressive or anxiety symptoms. The depressive and anxiety symptoms were highly related to sleep disturbances and hypochondriasis (all r > 0.50, P < 0.01). The impact of the event was positively related to depressive symptoms, anxiety symptoms, sleep disturbances, hypochondriasis and life events (all r > 0.35, P < 0.01) but was negatively related to psychological resilience (r = −0.41, P < 0.01). The presence of the COVID-19 infection in this setting was associated with increased anxiety, depression and stress levels, and decreased sleep quality, and seriously affected patients’ quality of life as well as adversely affecting the course and prognosis of physical diseases.

Conclusion

The sleep quality, anxiety, and depression of COVID-19 patients in Fangcang shelter hospitals were significantly related to the impact of the epidemic.

Perceived psychological stress and associated factors in the early stages of the coronavirus disease 2019 (COVID-19) epidemic: Evidence from the general Chinese population

INTRODUCTION

Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by novel coronavirus 2019. Many individuals suffered psychological symptoms in the early stage when the epidemic was uncertain. We explored the perceived psychological stress and associated factors in the early stage of COVID-19 epidemic.

METHOD

The Perceived Stress Scale, Simplified Coping Style Questionnaire, Social Support Rating Scale and a general information questionnaire were integrated in an on-line survey conducted from February 1, 2020 until February 4, 2020. Multiple linear regression analysis was performed to explore whether coping style, social support or other factors contributed to psychological stress.

RESULTS

A total of 1638 participants were included, of whom 44.3% showed moderate psychological stress. Individuals who were younger, female, unmarried, spent more time on the disease, felt more concern about it, reported lower social support (Subjective Social support; Objective social support; Utilization social support), or showed a negative coping style were more likely to suffer higher psychological stress in the early stages of the COVID-19 epidemic.

CONCLUSION

Psychological interventions may be targeted to individuals with the risk characteristics identified in this study. It may be helpful to promote social support and positive coping style in the early stage of infectious disease epidemics. This initial evidence from the general Chinese population may be relevant to interventions in other countries for dealing with the COVID-19 and other epidemics.

Posttraumatic stress disorder symptoms in healthcare workers after the peak of the COVID-19 outbreak: A survey of a large tertiary care hospital in Wuhan

This study examined the prevalence of posttraumatic stress disorder (PTSD) symptoms and assessed mental illness via an online survey among healthcare workers (HCWs) at the Central Hospital of Wuhan after the peak of the COVID-19 outbreak. PTSD symptoms were measured using the PTSD Checklist Civilian Version (PCL-C), with a cutoff score of 50. Among the 642 HCWs, the prevalence of probable PTSD was 20.87%. Additionally, 88.88%, 82.09%, 100%, and 95.52% of HCWs with probable PTSD reported varying degrees of anxiety, depression, somatic symptoms, and insomnia, respectively. HCWs with probable PTSD scored higher on the Hospital Anxiety and Depression Scale (HADS), Patient Health questionnaire-15 (PHQ-15), and Insomnia Severity Index (ISI) than non-PTSD HCWs (all p < 0.05). Multivariate regression analysis revealed that HCWs with negative COVID-19 tests (OR, 0.35; 95% CI, 0.21-0.58; p < 0.00), those with high Social Support Self-Rating Scale (SSRS) scores (OR, 0.30; 95% CI, 0.17-0.52; p < 0.00), and HCWs whose family members tested negative (OR, 0.64; 95% CI, 0.42-0.96; p = 0.03) were less likely to have probable PTSD. This study found a high prevalence of probable PTSD and severe mental illness among local HCWs. Our finding emphasizes the need to provide mental health support for HCWs.

The Effect of Social Support on Mental Health in Chinese Adolescents During the Outbreak of COVID-19

PURPOSE

The coronavirus disease 2019 (COVID-19) outbreak impacts physical and mental health. The purpose of this study was to explore the association between the levels of social support and mental health among Chinese adolescents during the outbreak.

METHODS

A total of 7,202 adolescents aged 14-18 years completed online survceys from March 8 to 15, 2020, in China. Researchers assessed the associations between depression symptoms (Patient Health Questionnaire-9), anxiety symptoms (Chinese version of the 7-item Generalized Anxiety Disorder scale), and social support (Social Support Rate Scale).

RESULTS

COVID-19 exposure was associated with a higher prevalence of depression symptoms (odds ratio [OR] = 1.38, 95% confidence interval [CI]: 1.14-1.66) and anxiety symptoms (OR = 1.26, 95% CI: 1.04-1.52). Only 24.6% of adolescents reported high levels of social support. Most adolescents (70%) reported medium levels of support, and 5.4% reported low support. Low support was associated with higher prevalence of depression (OR = 4.24, 95% CI: 3.38-5.33) and anxiety symptoms (OR = 3.18, 95% CI: 2.54-3.98), while controlling for gender, grade, living situation, and COVID-19 exposure; similarly, medium support was associated with higher prevalence of depression (OR = 2.79, 95% CI: 2.48-3.15) and anxiety (OR = 2.19, 95% CI: 1.94-2.48) symptoms.

CONCLUSIONS

This study indicates there is a higher prevalence of mental health problems among adolescents with medium and low levels of social support in China during the outbreak of COVID-19.

Examining the Influence of Early-Life and Recent Traumatic Events on Loneliness in Centenarians

Early-life traumatic experiences have lasting implications for late-life socio-emotional development, contributing to a greater prevalence of poor mental health in very old age. The purpose of this study was to examine the influence of early-life and recent traumatic life experiences on loneliness among centenarians. A total of 154 centenarians participated in a semistructured interview. The time of traumatic occurrence and type of trauma experienced influence loneliness in centenarians. Experiencing a natural disaster 70 or more years ago significantly predicted loneliness. Terror management theory proposes that coming to terms with one's mortality represents an underlying source of anxiety that can influence human behavior to create both immediate and future defenses. Evidence from this study can be used to improve how aging service practitioners integrate reminiscence or life-review therapy or counseling within clinical or educational settings.

Social support and clinical improvement in COVID-19 positive patients in China

•

Most COVID-19 positive inpatients had sleep, depressive, and anxiety symptoms.

•

Both physical and psychological symptoms significantly improved after clinical and psychosocial intervention.

•

Female, severe pneumonia, worse social support and more relatives infected were associated with the symptomatology.

•

Effective social support, improvement from COVID-19 and higher educational level predicted the psychological improvement.

Objectives

To explore the relationship between psychosocial support related factors and the mental health of COVID-19 positive patients.

Methods

This exploratory study of 35 COVID-19 positive patients were enrolled between February 1 to March 1, 2020. Sleep quality, depression, anxiety, and social support were measured and social support related data of participants were collected. Psychological intervention was administered and patients were followed two weeks post intervention. Linear regression was performed to explore the relationship between psychosocial risk factors and improvement of psychological symptoms.

Findings

Thirty-two individuals exhibited sleep, depressive and anxiety symptoms which improved post support intervention. At baseline, symptoms were associated with gender, severity of pneumonia, social support. Better social support at follow-up and improvement from COVID-19 predicted improvement in their psychological symptoms.

Discussion

This initial evidence from China may stress the importance of administering psychosocial intervention during the treatment of COVID-19 for better patient outcomes in other countries.

Social support and family quality of life in Chinese families of children with autism spectrum disorder: the mediating role of family cohesion and adaptability

BACKGROUND

The current study examined the interrelations among social support, family quality of life (FQOL), and family cohesion and adaptability in Chinese families of children with autism spectrum disorder (ASD).

METHODS

A sample of 163 caregivers of children with ASD in China were surveyed with the Social Support Rating Scale, Beach Center Family Quality of Life Scale, and Chinese version of Family Adaptability and Cohesion Scale II, respectively. We used structural equation modeling to examine the mediating role of family cohesion and adaptability on the relationship between social support and FQOL.

RESULTS

The results indicated that social support had a positive impact on FQOL and that family cohesion and adaptability completely mediated the relationship between social support and caregivers' satisfaction on FQOL.

CONCLUSIONS

Facilitating family cohesion and adaptability by providing social support may be beneficial to help families of children with ASD improve their FQOL. The findings identified the need for developing targeted interventions for this population.

The impact of social support and morally injurious events on PTSD symptoms in Veterans

Potentially morally injurious events (PMIEs), including committing transgressions (Transgressions-Self) and perceiving betrayals, have been positively associated with posttraumatic stress disorder (PTSD). A proposed mechanism for the association between PMIEs and PTSD symptoms is social disconnection. However, research on PMIEs and social disconnection is limited. Secondary data analysis from a larger study examined the moderating role of different sources of perceived social support (Family, Friends, and Significant Other) on the relation between PMIEs (Transgressions-Self and Betrayal) and PTSD. The interaction of Transgressions-Self and perceived social support subscales did not predict PTSD symptoms. However, the interaction of Betrayals and perceived social support (Significant Other and Family) predicted PTSD symptoms. Results suggest that perceived social support provides a protective effect for low to mean levels of perceived betrayals; however, for Veterans reporting high levels of betrayal, perceived social support did not attenuate PTSD symptom severity. Additional research on perceived betrayals and the association with PTSD is needed, especially for Veterans who experience high levels of perceived betrayals.

A profile analysis of post-traumatic stress disorder and depressive symptoms among Chinese Shidu parents

BACKGROUND

Due to the one-child policy implemented in China, most families have only one child. When parents experience the death of their only child, these parents receive the label 'Shidu parents'. Shidu is a major public health issue in China. However, the patterns of post-traumatic stress disorder (PTSD) and depressive symptoms that are present in this population remain unclear.

OBJECTIVE

This study aims to identify profiles of PTSD and depressive symptoms among Shidu parents and to explore the predictors of profile membership.

METHODS

A total of 363 participants (M age = 61.5 years, SD = 7.5) were asked to complete questionnaires assessing PTSD, depressive symptoms, perceived social support, and demographic information. Latent profile analyses and multivariate logistic regressions were used.

RESULTS

Three distinct profiles were identified: low (39.4%), moderate (32.8%), and high symptoms (27.8%). Parents who were younger and perceived lower levels of support from family and significant others were more likely to experience higher levels of PTSD and depressive symptoms.

CONCLUSIONS

These results indicate that the severity of PTSD and depressive symptoms tightly cohere, providing evidence for the co-occurrence of PTSD and depressive symptoms after bereavement. The findings provide valuable information for the development of tailored professional interventions for bereaved parents.

Relationship Between Quality of Life and Social Support in Parents of Children with Congenital Anorectal Malformations in China

PURPOSE

This study aimed to explore the quality of life (QOL) and social support of parents of children with congenital anorectal malformation (ARM), and to examine the relationship between them.

DESIGN AND METHODS

A cross-sectional study was conducted at Anhui Provincial Children's Hospital of China from January to June of 2018. A total of 108 parents participated in this survey. QOL and social support were accessed using the short version of the World Health Organization's Quality of Life Instrument (WHOQOL-BREF) and the Social Support Rate Scale (SSRS), respectively. Analyses were performed with multivariate linear regression and canonical correlation.

RESULTS

The parents' scores in the physical, psychological, and environmental domains were lower than those in the general population in China. Gender, monthly income, combined malformation, objective support, subjective support and utilization of support were the major influencing factors of QOL. A canonical correlation analysis indicated social support was positively correlated with QOL, and subjective support, psychological domain had the largest standardized factor loading in social support and QOL.

CONCLUSIONS

The QOL of parents of ARM patients was not optimistic. More attention needs to be paid to increasing social support for the parents of ARM to enhance their QOL.

PRACTICE IMPLICATIONS

For government, increasing funds and resources to invest in the establishment and improvement of the social support network is necessary. For doctors and nurses, providing better medical and psychological services to patients and their parents is essential.

Social support modulates the association between PTSD diagnosis and medial frontal volume in Chinese adults who lost their only child

Losing an only child is a devastating life event that a parent can experience and may lead to post-traumatic stress disorder (PTSD). Social support could buffer against the negative influence of this trauma, but the neural mechanism underlying this alleviation effect remains poorly understood. In this study, voxel-based morphometry was conducted on brain MRI of 220 Han Chinese adults who had lost their only child. We performed multiple regression analysis to investigate the associations between social support scores – along with PTSD diagnosis, age, sex, body mass index (BMI) – and brain grey matter (GM) volumes in these bereaved parents. For all trauma-exposed adults, social support-by-diagnosis interaction was significantly associated with medial prefrontal volume (multiple comparisons corrected P ˂ 0.05), where positive correlation was found in adults with PTSD but not in those without PTSD. Besides, PTSD diagnosis was associated with decreased GM volume in medial and middle frontal gyri (P ˂ 0.001, uncorrected); older age was associated with widespread GM volume deficits; male sex was associated with lower GM volume in rolandic operculum, insular, postcentral gyrus (corrected P ˂ 0.05), and lower GM in thalamus but greater GM in parahippocampus (P ˂ 0.001, uncorrected); higher BMI was associated with GM deficits in occipital gyrus (corrected P ˂ 0.05) and precuneus (P ˂ 0.001, uncorrected). In conclusions, social support modulates the association between PTSD diagnosis and medial frontal volume, which may play an important role in the emotional disturbance in PTSD development in adults who lost their only child.

Which groups affected by Potentially Traumatic Events (PTEs) are most at risk for a lack of social support? A prospective population-based study on the 12-month prevalence of PTEs and risk factors for a lack of post-event social support

Objectives

Little is known about the 12-month prevalence of potentially traumatic events (PTEs) and to what extent the type of PTE is a risk factor for post-event lack of social support. In addition, it is largely unknown if pre-event mental health problems and loneliness, and demographics are risk factors for a lack of support. Aim of the present prospective study is to fill these gaps in evidence-based knowledge.

Methods

A survey was conducted among a large random sample of the Dutch adult population (i.e. the longitudinal LISS panel) in March-April 2018, and linked with pre-event mental health and loneliness data from surveys conducted in 2016 (n = 5,879). We distinguished four forms of perceived social support: emotional and esteem support, and social recognition and general disapproval.

Results

Loss of a significant other and/or colleague (28%) was the most prevalent 12-month PTE. The 12-month prevalence of violence, accidents and/or, and theft-related events was 13%. Multivariate logistic regression analyses revealed no differences in lack of emotional and esteem support, or in lack of recognition across non-death PTEs and death-related PTEs. However, victims of threat and physical (sexual) violence more often faced disapproval than those affected by burglary and accidents. Results furthermore showed that pre-event mental health problems, pre-event loneliness and stress during the PTE were important independent predictors of forms of support and acknowledgment. Affected individuals with a non-Western background more often lacked support and acknowledgment.

Conclusions

Many adults are confronted with a PTE during a year. In general, pre-event factors and stress during the event are better predictors of a perceived lack of support and acknowledgment than type of event. Early screening programs should especially assess pre-event mental health and loneliness, besides levels of stress during the event, to identify affected people who are at risk for a lack of social support and acknowledgment.

Psychological morbidities and fatigue in patients with confirmed COVID-19 during disease outbreak: prevalence and associated biopsychosocial risk factors

Objective

The coronavirus disease 2019 (COVID-19) - a novel and highly infectious pneumonia - has now spread across China and beyond for over four months. However, its psychological impact on patients is unclear. We aim to examine the prevalence and associated risk factors for psychological morbidities and fatigue in patients with confirmed COVID-19 infection.

Methods

Amidst the disease outbreak, 41 out of 105 COVID-19 patients in a local designated hospital in China were successfully assessed using a constellation of psychometric questionnaires to determine their psychological morbidities and fatigue. Several potential biopsychosocial risk factors (including pre-existing disabilities, CT severity score of pneumonia, social support, coping strategies) were assessed through multivariable logistic regression analyses to clarify their association with mental health in patients.

Results

43.9% of 41 patients presented with impaired general mental health, 12.2% had post-traumatic stress disorder (PTSD) symptoms, 26.8% had anxiety and/or depression symptoms, and 53.6% had fatigue. We did not find any association between pneumonia severity and psychological morbidities or fatigue in COVID-19 patients. However, high perceived stigmatization was associated with an increased risk of impaired general mental health and high perceived social support was associated with decreased risk. Besides, negative coping inclination was associated with an increased risk of PTSD symptoms; high perceived social support was associated with a decreased risk of anxiety and/or depression symptoms.

Conclusions

Psychological morbidities and chronic fatigue are common among COVID-19 patients. Negative coping inclination and being stigmatized are primary risk factors while perceived social support is the main protective factor.

Predictors of resilience among adolescent disaster survivors: A path analysis

AIMS

To investigate a theoretical model of risk and protective factors to predict resilience among adolescent disaster survivors.

DESIGN

A cross-sectional study.

METHODS

Parent's consent and student's informed consent forms were distributed at seven schools in a postdisaster setting (Yogyakarta, Indonesia) between July-October 2017; those who agreed to participate had to complete the self-reported questionnaires. Demographic data were evaluated using descriptive statistical analyses and relationships among study variables were determined using a path analysis.

RESULTS

Results of the model test analysis indicated that six of the seven the hypothesized paths were supported by data from our samples and demonstrated significance on the path coefficients (p < .01). One path coefficient on the association between posttraumatic stress disorder (PTSD) symptoms and resilience was found to be insignificant (β = -0.002, p > .05). However, overall, our hypothesized model was retained, indicating empirical support and adequate model's fit indices for the theoretical model.

CONCLUSIONS

Overall, the findings demonstrated the predictive roles of risk and protective factors in adolescent disaster survivors' resilience.

IMPACT

Resilience is known to be an important concept in recovering from long-term impacts following a disaster in adolescent populations, but its risk and protective factors have not been adequately explored. We found that PTSD symptoms influenced how adolescent disaster survivors developed defensive coping, social support had an indirect effect on resilience through courageous coping and defensive coping acted as a mediator between PTSD symptoms and courageous coping. These findings can help mental health professionals (i.e., community mental health nurses) promote intervention strategies to enhance resilience through improving coping skills in adolescent populations exposed to a disaster.

The English National Cohort Study of Flooding & Health: psychological morbidity at three years of follow up

BACKGROUND

Flooding is expected to increase due to climate change, population growth and urban development. The longer-term mental health impacts of flooding are not well understood. In 2015, the English National Study of Flooding and Health was established to improve understanding of the impact of flooding on health and inform future public health action.

METHODS

We used 3 years of data from the English National Study of Flooding and Health. Participants who had consented to follow up were sent a questionnaire. Participants were classified into either "unaffected", "disrupted" or "flooded" according to their exposure. Logistic regression models were used to calculate adjusted odds ratios for probable depression, anxiety and post-traumatic stress disorder (PTSD) in each exposure group. The Wald test was used to assess the difference in probable mental health outcomes for those who did and did not experience "persistent damage" to their home. Conditional logistic regression was conducted to assess change in prevalence over the 3 years and to identify possible determinants of recovery.

RESULTS

Eight hundred nineteen individuals were included in the final analysis - 119 were classified as unaffected, 421 disrupted and 279 flooded. Overall, 5.7% had probable depression, 8.1% had probable anxiety and 11.8% had probable PTSD, with higher prevalence in the flooded group compared with the unaffected group. After adjustment for potential confounders, probable mental health outcomes were higher in the flooded group compared to the unaffected group, significantly for probable depression (aOR 8.48, 95% CI 1.04-68.97) and PTSD (aOR 7.74, 95% CI 2.24-26.79). Seventy-seven (9.4%) participants reported experiencing persistent damage to their home, most commonly damp (n = 40) and visible mould (n = 26) in liveable rooms. Of the 569 participants who responded at all 3 years, a significant reduction in prevalence for all probable mental health outcomes was observed in the flooded group.

CONCLUSIONS

Flooding can have severe long-lasting consequences on mental health in affected populations. If these problems are not identified and treated early, they may persist for years. Further research is necessary to develop and evaluate interventions to increase resilience in at risk populations and to ensure timely access to support services following flooding.

Effects of social support and depression on problematic drinking among trauma-exposed Chinese adults: A population-based study

Background

Alcohol consumption is prevalent and alcohol-related problems are a considerable social issue in China. Over 17% of Chinese consume alcohol regularly. Exposure to potentially traumatic events (PTE) is associated with increased alcohol-related problems. Social support often buffers this association. This study examined the relationship between exposure to PTE and alcohol misuse and explored the moderating effect of social support on this relationship in a Chinese context.

Methods

Data were collected through face-to-face computer assisted interviews in a stratified cluster sample of 753 Chinese adults living in Guangzhou, China. The Life Events Checklist-5 (LEC-5), World Health Organization Alcohol Use Disorders Identification Test (WHO-AUDIT), and Social Support Rating Scale (SSRS) were used to measure trauma exposure, problematic alcohol use, and social support.

Results

Univariable logistic regression analyses indicated that trauma exposure (OR = 3.18; compared to non-exposure), increased depression (OR = 1.06), and perceived friend support (OR = 1.21), were associated with higher odds of problematic drinking. Multivariable models adjusting for potential confounders demonstrated that PTE and depression were associated with problematic drinking, but this was not the case for perceived friend support. Perceived friend support modified the effect of trauma exposure and was associated with increased odds of problematic drinking among those who reported high levels of depressive symptoms.

Conclusion

Social support may not always be a beneficial resource among those who experienced PTEs in a Chinese context. Further research is needed to better understand the role and function of different types of support, and for whom these associations are beneficial.

Sex differences in factors associated with post-traumatic stress disorder in acute type A aortic dissection patients

BACKGROUND

Emergency surgery for acute type A aortic dissection (AAAD) is associated with a high risk for posttraumatic stress disorder (PTSD), and the risk factors for PTSD symptoms development in AAAD patients of different sexes remain unclear.

OBJECTIVE

To identify the risk factors for PTSD symptoms separately in the females and males following AAAD.

METHODS

A sample population of 214 patients who had AAAD surgery was recruited. Patients' sociodemographic and disease-specific data were collected during hospitalization.

RESULTS

In this study, PTSD symptoms was present in 22.1% of the male patients and 20.0% of the female patients (P = 0.739). For the male patients with AAAD, PTSD symptoms were significantly positively associated with HADS-D score (P = 0.029), while those with university education and above (P = 0.039), stronger subjective support (P = 0.010) and greater optimism (P = 0.001) had significantly lower possibility for the presence of PTSD symptoms. For the female patients with AAAD, support availability (P = 0.031) was significantly negatively associated with PTSD symptoms while HADS-D score (P = 0.033) was significantly positively associated with PTSD symptoms.

CONCLUSION

Risk factors for PTSD symptoms differ in male patients and female patients following AAAD.

The Role of Telemental Health, Tele-consultation, and Tele-supervision in Post-disaster and Low-resource Settings

PURPOSE OF REVIEW

The goal of this paper was to review recent literature and provide recommendations regarding the use of telemental health, with a focus on tele-consultation and tele-supervision in post-disaster and low-resource settings, including the impact of COVID-19.

RECENT FINDINGS

The latest research on mental health needs in low-resource settings has identified a high need for mental health services for difficult-to-reach and underserved populations. Research on tele-consultation and tele-supervision was reviewed and found that tele-consultation and tele-supervision to be an effective modality for insuring quality mental health care delivery in low-resource settings. Additionally, two case studies were included which illustrate the use of both tele-consultation and tele-supervision in low-resource low- and middle-income settings. The paper concludes that tele-consultation and tele-supervision hold the promise to narrow the gap in quality mental health services in low-resource settings so often impacted by disaster and conflict. The authors recommend that telemental health training be developed that specifically enhances consultants' and supervisors' skills in tele-consultation and tele-supervision.

Factors associated with subsequent diabetes-related self-care activities: The role of social support and optimism

Aim

This study aimed to explore how social support (external factor), optimism (internal factor) and their interaction associated with diabetes-related self-care activities (DRSCA) over 3 months among people with type 2 diabetes mellitus (T2DM).

Design

Both questionnaire-based and telephone-based survey were used. The data were collected face to face, the first time by questionnaire and the second time by telephone.

Methods

One hundred and fifty-five patients completed valid survey questionnaires (response rate was about 70% in the first and 62% in the second round). The association of social support and optimism with subsequent DRSCA was examined after adjusting for demographics and disease information.

Results

Based on results, optimism was significantly associated with subsequent DRSCA. In the dimensions of social support, objective social support and support use were significantly associated with subsequent DRSCA. The results showed that the mediation of optimism between the dimensions of social support and DRSCA was not significant after controlling for covariates. The results also indicated that social support and optimism played directly an important role in improving diabetes-related self-care activities.

Association between floods and hospital admissions for schizophrenia in Hefei, China: The lag effects of degrees of floods and time variation

BACKGROUND

Schizophrenia is a serious mental disorder, endangering 7.5 million patients in China. Floods, as the adverse consequence of temperature-rise, have a negative influence on mental health. However, the relationship between floods and schizophrenia is still insufficient. This study aimed to quantitative the relationship between floods and the admissions for schizophrenia in Hefei, China.

METHODS

A Poisson generalized linear model (GLM) combining a distributed lag non-linear model (DLNM) was used to quantify the lag effects of floods on schizophrenia and subgroups (male, female; ≤40 y, >40 y; the married, the unmarried) from 2005 to 2014, Hefei, China. We further explored the effects of different degrees (moderate and severe) of floods and their temporal changes on schizophrenia.

RESULTS

There was a significant association between floods and admissions risk for schizophrenia. And the lag effects for schizophrenia lasted ten days (lag 5-lag 14), with the greatest effect on lag 9 (RR = 1.036, 95% confidence interval (CI): 1.014-1.058). The married, ≤40 y were sensitive to floods. The significant difference wasn't found for genders. The effects of the severe flood were higher than moderate floods, with the largest RR of 1.073 (95%CI: 1.029-1.119). The adverse effects were found in the middle and late period with a decreasing trend in the later period.

CONCLUSIONS

This study suggests a significant association between floods and schizophrenia with ten days of lag effects in Hefei, China. Male, female, <40 y and the married are vulnerable to both moderate and severe floods. The findings might be used to allocate medical resources of mental health after floods.

The role of personality in posttraumatic stress disorder, trait resilience, and quality of life in people exposed to the Kiss nightclub fire

Objective

To evaluate the relationship among personality (according to Cloninger’s psychobiological model), posttraumatic stress disorder (PTSD) symptoms, trait resilience and quality of life (QoL) in people who were exposed to the Kiss nightclub fire.

Methods

188 participants were assessed with the Posttraumatic Checklist–civilian version (PCL-C), the Resilience Scale (RS), the Temperament and Character Inventory (TCI), the World Health Organization Quality of Life–Bref (WHOQOL-Bref), and the WHOQOL-100 Spirituality, religiousness, and personal beliefs (WHOQOL-100-SRPB). Data were analyzed in a dimensional approach, with correlation analysis, multiple linear regression and Structural Equation Modeling (SEM), with PCL-C, RS, and WHOQOL-Bref dimensions as dependent variables.

Results

Multiple linear regression showed that PTSD symptoms were predicted by harm avoidance (β = .34, p < .001), self-directedness (β = -.28, p < .01), and self-transcendence (β = .24, p < .01). Trait resilience was predicted by harm avoidance (β = -.38, p < .01), self-directedness (β = .20, p < .05), and self-transcendence (β = .18, p < .05). Also, PTSD symptoms had considerable negative effect on all dimensions of QoL. Self-transcendence was a positive predictor of subjective and spiritual QoL. SEM showed that QoL was predicted by PTSD symptoms (β = -.52, p < .001), trait resilience (β = .30, p < .001), cooperativeness (β = .135, p = 0.40), and self-directedness (β = .27, p < .01). The effect of self-directedness on QoL was mediated by PTSD symptoms and trait resilience. PTSD symptoms also mediated the relationship between trait resilience and QoL, and RS mediated the relationship of personality and PTSD symptoms.

Conclusion

The study gives insights on prediction of PTSD severity, trait resilience and QoL from temperament and character traits, in a sample of people exposed to the Kiss nightclub fire. Harm avoidance was the most influent trait on PTSD symptoms and trait resilience. Self-directedness was the most import trait related to QoL, still that it was more related to PTSD severity than personality traits. Self-transcendence had positive effects on both PTSD symptoms and trait resilience, indicating a coping style that may coexist with psychopathology.