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Li D, Chan VF, Wang H, Zhang H, Virgili G, Whitestone N, Xiao B, Singh MK, She X, Mackenzie G, Boswell M, Mavi S, Rozelle S, Congdon N. Depression, anxiety, stress symptoms and their determinants among secondary students with vision impairment in rural Northwestern China during the COVID-19 pandemic. Front Public Health 2024; 11:1282826. [PMID: 38328549 PMCID: PMC10847594 DOI: 10.3389/fpubh.2023.1282826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/12/2023] [Indexed: 02/09/2024] Open
Abstract
Objective The measures implemented to control the spread of Coronavirus disease 2019 (COVID-19) could affect children's mental and vision health. Youth particularly from minority and socioeconomically disadvantaged backgrounds were more likely to be impacted by these measures. This study aimed to examine the mental health of children with vision impairment and associated factors in North-western China during the COVID-19 pandemic. Methods A cross-sectional study was conducted among 2,036 secondary school children living in Ningxia Hui Autonomous Region. Participants completed a survey on sociodemographic and lifestyle information and answered the Chinese version of the 21-item Depression Anxiety Stress Scales (DASS-21) questionnaire. Presenting visual acuity was measured by a trained enumerator. Multivariate logistic regression analysis was used to identify potential risk factors for mental health problems. Results Responses from 1,992 (97.8%) children were included in the analysis after excluding those with incomplete mental health outcome data. The prevalence of depression, anxiety and stress symptoms within the dataset were 28.9, 46.4, and 22.3%, respectively. The distribution of children with different stress levels differed significantly between those with and without vision impairment (p = 0.03). Multivariable logistic regression analyses revealed that depression symptoms decreased with higher parental education (OR, 0.76, 95% confidence intervals (CI):0.63-0.96), longer sleep duration (OR, 0.90, 95% CI: 0.81-0.97) and longer study time (OR, 0.82, 95% CI: 0.74-0.91), whereas they increased with higher recreational screen time (OR, 1.19, 95% CI: 1.08-1.32). Anxiety symptoms decreased with higher parental education (OR, 0.80, 95% CI: 0.66-0.96) and increased with higher recreational screen time (OR, 1.15, 95% CI: 1.04-1.27) and being a left-behind child (OR, 1.26, 95% CI: 1.04-1.54). In addition, stress symptoms decreased with longer sleep duration (OR, 0.92, 95%CI: 0.85-0.99) and increased with higher number of siblings (OR, 1.10, 95% CI: 1.01-1.19), higher recreational screen time (OR, 1.15, 95% CI: 1.04-1.28) and older age (OR,1.12, 95% CI: 1.004-1.24). Conclusion A considerable proportion of our sample experienced mental health problems during the pandemic. Healthcare planners in China should consider interventions such as reducing recreational screen time, ensuring sufficient sleep, and timely detection of mental health symptoms among socioeconomically disadvantaged groups.
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Affiliation(s)
- Dongfeng Li
- Department of Ophthalmology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Ving Fai Chan
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Huan Wang
- Stanford Centre on China’s Economy and Institutions, Stanford University, Stanford, CA, United States
| | - Huiping Zhang
- School of Financial and Management, Ningxia University, Yinchuan, China
| | - Gianni Virgili
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Department NEUROFARBA, University of Florence, Florence, Italy
| | | | - Baixiang Xiao
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Manpreet K. Singh
- Stanford University School of Medicine, Stanford University, Stanford, CA, United States
| | - Xinshu She
- Stanford University School of Medicine, Stanford University, Stanford, CA, United States
| | | | - Matthew Boswell
- Stanford Centre on China’s Economy and Institutions, Stanford University, Stanford, CA, United States
| | - Sonia Mavi
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Scott Rozelle
- Stanford Centre on China’s Economy and Institutions, Stanford University, Stanford, CA, United States
| | - Nathan Congdon
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Orbis International, New York, NY, United States
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
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Pan SW, Liang Y, Wu S, Wang W, Hu X, Wang J, Huang W. Health Effects of Religion, Spirituality, and Supernatural Beliefs in Mainland China: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2022; 61:2726-2742. [PMID: 35347576 DOI: 10.1007/s10943-022-01543-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
Effects of religion, spirituality and supernatural beliefs (RSS) upon health in mainland China remain poorly understood, despite strong RSS beliefs influencing Chinese society. We conducted a Chinese-English bilingual systematic review to summarize the state of RSS-health research in mainland China. Study quality was assessed using the Critical Appraisal Skills Program tool. We screened 1858 studies, 162 of which were included in the review. From 2000-2004 to 2015-2019, the number of RSS-health studies in China increased from five to 73. However, only 7% of studies were rated as higher quality. Cross-sectional and case-control studies represented the vast majority of study designs (94%) and religious affiliation was the only RSS measure for 58% of studies. Higher, moderate, and lower quality studies indicated that RSS has both beneficial and adverse health implications. RSS-health research in China has accelerated rapidly in the last 20 years, but fundamental gaps in knowledge remain. Longitudinal study designs and nuanced RSS measures are needed to advance understanding of RSS health effects in China.
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Affiliation(s)
- Stephen W Pan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, 111 Ren'ai Road, Suzhou, 215123, Jiangsu, China.
- University of Liverpool, Liverpool, UK.
| | - Yuxin Liang
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Shiqiang Wu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, 111 Ren'ai Road, Suzhou, 215123, Jiangsu, China
| | - Wanqi Wang
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, 111 Ren'ai Road, Suzhou, 215123, Jiangsu, China
| | - Xinwen Hu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, 111 Ren'ai Road, Suzhou, 215123, Jiangsu, China
| | - Jing Wang
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, 111 Ren'ai Road, Suzhou, 215123, Jiangsu, China
| | - Wenting Huang
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Gearing RE, Brewer KB, Leung P, Cheung M, Chen W, Carr LC, Bjugstad A, He X. Mental health help-seeking in China. J Ment Health 2022:1-8. [PMID: 35532046 DOI: 10.1080/09638237.2022.2069703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 01/21/2022] [Accepted: 02/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND In China, mental health disorders are considered the leading causes of disability, yet treatment-seeking behaviors among individuals with mental health problems are deficient. AIMS This study sought to examine attitudes and participant characteristics associated with help-seeking among adults residing in China's Shanghai metropolitan area. METHODS This study employed a convenience cross-sectional sampling strategy and recruited 500 participants in public places in Shanghai. The survey administered in Mandarin was comprised of two sections: a series of demographic questions and standardized instruments measuring stigma and help-seeking attitudes. RESULTS Findings indicate that beliefs about seeking professional help for mental health are influenced by knowing someone with a mental health problem. In addition, men who were older, had a child, and were married endorsed more openness to help-seeking for mental health needs, underscoring the importance of life experience as an essential variable when considering attitudes toward help-seeking. CONCLUSIONS Findings support future research identifying the mechanisms by which these life experiences impact individuals' help-seeking attitudes.
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Affiliation(s)
- Robin Edward Gearing
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Kathryne B Brewer
- University of New Hampshire Institute for Policy and Social Science Research, Durham, NH, USA
| | - Patrick Leung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Monit Cheung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Wanzhen Chen
- East China University of Science and Technology, Shanghai, China
| | - L Christian Carr
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Arlene Bjugstad
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Xuesong He
- East China University of Science and Technology, Shanghai, China
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Choi SH, McClintock CHY, Lau E, Miller L. The impact of perceived relationship to ancestors on the association between self-transcendence and psychopathology: A cross-cultural examination. Transcult Psychiatry 2022:13634615211049072. [PMID: 34986065 DOI: 10.1177/13634615211049072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Self-transcendence has been associated with lower levels of psychopathology. Most studies of self-transcendence have focused on samples of Western participants, and used scales addressing such concepts as self-awareness and feelings of oneness with the larger universe. However, a common Eastern notion of transcendence-perception of ongoing relationships with ancestors-has not been studied. We conducted a cross-cultural investigation of the association between self-transcendence, perceived degree of relationship to ancestors and depression and anxiety in the United States (N = 1499), China (N = 3,150), and India (N = 863). Degrees of perceived relationship to ancestors differed across countries, with the highest rates in India and China, and lowest rates in the United States. Self-transcendence was negatively associated with risks for depression and anxiety in the United States. In India, self-transcendence was also negatively associated with risks for depression and anxiety, and a strong perceived relationship with ancestors had further protective benefit. In China, those with a high level of perceived relationship to ancestors and a high level of self-transcendence exhibited lower levels of psychopathology. Results suggest that measures of relationship to ancestors might be included in future cross-cultural studies of transcendence.
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Association between Religion and Health in China: Using Propensity Score Matching Method. RELIGIONS 2020. [DOI: 10.3390/rel11010037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The association between religion and health is well debated and receives continuous attention in research. Selection bias is often a major concern among the observatory data routinely used worldwide to examine this topic. Adopting the propensity score matching (PSM) method, the present study tries to assess the treatment effects of religion on self-reported health status. The final sample from the 2007 Spiritual Life Study of Chinese Residents (SLSC) contains 6194 valid responses. The average treatment effects (ATEs) estimated by the PSM method show that respondents with religious affiliations are on average significantly more likely to report being very healthy by 5.2 percentage points (by 3.6 and 9.6 percentage points among Buddhists and Protestants), especially, by 16.2 percentage points among those regarding religion as being very important in their lives. Meanwhile, ATEs of religion on reporting being very happy is 17.0 among Protestants and 13.4 among those regarding religion with high importance and 11.3 among those with “regular religious attendance”.
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Huang JX, Xu YM, Zhong BL. Relationship Between Buddhist Belief and Suicide Risk in Chinese Persons Undergoing Methadone Maintenance Therapy for Heroin Dependence. Front Psychiatry 2020; 11:414. [PMID: 32457671 PMCID: PMC7221180 DOI: 10.3389/fpsyt.2020.00414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/23/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In western countries, there is a negative association between religious belief and suicide risk, while in China this association is positive. Nevertheless, few data are available on the association between one specific type of religion and suicide risk, which might be different from the overall positive religion-suicide association in China. This study examined the association between Buddhist belief and suicide risk in Chinese persons receiving methadone maintenance therapy (MMT) for heroin dependence. METHODS In total, 61 Buddhist believers and 425 age, gender, and clinic frequency-matched non-religious believers were selected from a sample of patients with heroin dependence treated in three MMT clinics in Wuhan, China. The suicidality module of the Chinese version of the Mini-international Neuropsychiatric Interview 5.0 was used to assess current suicide risk. Patients' demographic and clinical characteristics were also collected. Multiple ordinary logistic regression was used to analyze the association between Buddhist belief and current suicide risk, controlling for the confounding effects of demographic and clinical factors. RESULTS In Chinese patients receiving MMT for heroin dependence, Buddhist believers had significantly higher levels of current suicide risk than non-religious believers (low: 45.9% vs. 24.7%, medium: 4.9% vs. 3.5%, high: 19.7% vs. 12.5%, P < 0.001). After adjusting for demographic and clinical covariates (including depressive symptoms), Buddhist belief was still significantly associated with an increase in the level of current suicide risk (OR: 2.98, P < 0.001). CONCLUSION Buddhist belief is significantly associated with elevated current suicide risk in Chinese patients receiving MMT for heroin independence. In Chinese MMT clinics, patients with Buddhist belief may have a high current suicide risk and a timely psychiatric assessment and crisis intervention (when necessary) should be provided to these patients.
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Affiliation(s)
- Jian-Xing Huang
- College of Sociology and History, Fujian Normal University, Fuzhou, China
| | - Yan-Min Xu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Bao-Liang Zhong
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
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Sithey G, Li M, Wen LM, Kelly PJ, Clarke K. Socioeconomic, religious, spiritual and health factors associated with symptoms of common mental disorders: a cross-sectional secondary analysis of data from Bhutan's Gross National Happiness Study, 2015. BMJ Open 2018; 8:e018202. [PMID: 29453295 PMCID: PMC5857675 DOI: 10.1136/bmjopen-2017-018202] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Common mental disorders (CMDs) are a major cause of the global burden of disease. Bhutan was the first country in the world to focus on happiness as a state policy; however, little is known about the prevalence and risk factors of CMDs in this setting. We aim to identify socioeconomic, religious, spiritual and health factors associated with symptoms of CMDs. DESIGN AND SETTING We used data from Bhutan's 2015 Gross National Happiness (GNH) Survey, a multistage, cross-sectional nationwide household survey. Data were analysed using a hierarchical analytical framework and generalised estimating equations. PARTICIPANTS The GNH Survey included 7041 male and female respondents aged 15 years and above. MEASURES The 12-item General Health Questionnaire was used to measure symptoms of CMDs. We estimated the prevalence of CMDs using a threshold score of ≥12. RESULTS The prevalence of CMDs was 29.3% (95% CI 26.8% to 31.8%). Factors associated with symptoms of CMDs were: older age (65+) (β=1.29, 95% CI 0.57 to 2.00), being female (β=0.70, 95% CI 0.45 to 0.95), being divorced or widowed (β=1.55, 95% CI 1.08 to 2.02), illiteracy (β=0.48, 95% CI 0.21 to 0.74), low income (β=0.37, 95% CI 0.15 to 0.59), being moderately spiritual (β=0.61, 95% CI 0.34 to 0.88) or somewhat or not spiritual (β=0.76, 95% CI 0.28 to 1.23), occasionally considering karma in daily life (β=0.53, 95% CI 0.29 to 0.77) or never considering karma (β=0.80, 95% CI 0.26 to 1.34), having poor self-reported health (β=2.59, 95% CI 2.13 to 3.06) and having a disability (β=1.01, 95% CI 0.63 to 1.40). CONCLUSIONS CMDs affect a substantial proportion of the Bhutanese population. Our findings confirm the importance of established socioeconomic risk factors for CMDs, and suggest a potential link between spiritualism and mental health in this setting.
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Affiliation(s)
- Gyambo Sithey
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mu Li
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Li Ming Wen
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Health Promotion Unit, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Patrick J Kelly
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kelly Clarke
- Institute for Global Health, University College London, London, UK
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Distinct transcriptional and metabolic profiles associated with empathy in Buddhist priests: a pilot study. Hum Genomics 2017; 11:21. [PMID: 28865488 PMCID: PMC5581455 DOI: 10.1186/s40246-017-0117-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/20/2017] [Indexed: 02/08/2023] Open
Abstract
Background Growing evidence suggests that spiritual/religious involvement may have beneficial effects on both psychological and physical functions. However, the biological basis for this relationship remains unclear. This study explored the role of spiritual/religious involvement across a wide range of biological markers, including transcripts and metabolites, associated with the psychological aspects of empathy in Buddhist priests. Methods Ten professional Buddhist priests and 10 age-matched non-priest controls were recruited. The participants provided peripheral blood samples for the analysis of gene expression and metabolic profiles. The participants also completed validated questionnaires measuring empathy, the Health-Promoting Lifestyle Profile-II (HPLP-II), and a brief-type self-administered diet history questionnaire (BDHQ). Results The microarray analyses revealed that the distinct transcripts in the Buddhist priests included up-regulated genes related to type I interferon (IFN) innate anti-viral responses (i.e., MX1, RSAD2, IFIT1, IFIT3, IFI27, IFI44L, and HERC5), and the genes C17orf97 (ligand of arginyltranseferase 1; ATE1), hemoglobin γA (HBG1), keratin-associated protein (KRTAP10-12), and sialic acid Ig-like lectin 14 (SIGLEC14) were down-regulated at baseline. The metabolomics analysis revealed that the metabolites, including 3-aminoisobutylic acid (BAIBA), choline, several essential amino acids (e.g., methionine, phenylalanine), and amino acid derivatives (e.g., 2-aminoadipic acid, asymmetric dimethyl-arginine (ADMA), symmetric dimethyl-arginine (SMDA)), were elevated in the Buddhist priests. By contrast, there was no significant difference of healthy lifestyle behaviors and daily nutrient intakes between the priests and the controls in this study. With regard to the psychological aspects, the Buddhist priests showed significantly higher empathy compared with the control. Spearman’s rank correlation analysis showed that empathy aspects in the priests were significantly correlated with the certain transcripts and metabolites. Conclusions We performed in vivo phenotyping using transcriptomics, metabolomics, and psychological analyses and found an association between empathy and the phenotype of Buddhist priests in this pilot study. The up-regulation of the anti-viral type I IFN responsive genes and distinct metabolites in the plasma may represent systemic biological adaptations with a unique signature underlying spiritual/religious practices for Buddhists. Electronic supplementary material The online version of this article (10.1186/s40246-017-0117-3) contains supplementary material, which is available to authorized users.
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Wang Z, Wang L, Jing J, Hu C. Prevalence of mental disorders in migrants compared with original residents and local residents in Ningxia, China. BMC Psychiatry 2016; 16:366. [PMID: 27793126 PMCID: PMC5084465 DOI: 10.1186/s12888-016-1088-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 10/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ecological migrants has a special background compared with other types of migrant. However, the mental health status of ecological migrants who were expected to benefit from a massive "ecological migration project" initiated by the Chinese government is unknown. This study aims to explore the influence of environmental change on individuals' mental health and to improve current understanding of the mechanisms that mental disorders occurred. METHODS The data were extracted from a cross-sectional study. Anxiety disorders, mood disorders and substance use disorders were assessed using the Chinese version WHO-CIDI. The prevalence of mental disorders was stratified by migration status into ecological migrant, local resident and original resident groups. Unconditional logistic regression models were used to calculate the risk of prevalence among these three groups. RESULTS After controlling for gender, ethnicity, age, marriage, and education, the migrants had lower risk of mental disorders than original residents [OR = 0.70 (95 % CI: 0.57-0.86)], p < 0.001), but had a higher risk of mental disorders than local residents [OR = 1.29 (95 % CI: 1.06-1.55)], p = 0.007). CONCLUSION The ecological migration project may be beneficial to people's mental health by improving their living environment and social economy.
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Affiliation(s)
- Zhizhong Wang
- Department of Epidemiology and Statistic, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China. .,, 1160#, Shengli Street, Yinchuan, 750004, China.
| | - Liqun Wang
- Department of Epidemiology and Statistic, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Jinyun Jing
- Department of Epidemiology and Statistic, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Chunping Hu
- Department of Psychiatry, Minkang Psychiatric Hospital of Civil Affairs, Ningxia, Yinchuan, 750010, China
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McClintock CH, Lau E, Miller L. Phenotypic Dimensions of Spirituality: Implications for Mental Health in China, India, and the United States. Front Psychol 2016; 7:1600. [PMID: 27833570 PMCID: PMC5082226 DOI: 10.3389/fpsyg.2016.01600] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 10/03/2016] [Indexed: 12/18/2022] Open
Abstract
While the field of empirical study on religion and spirituality in relation to mental health has rapidly expanded over the past decade, little is known about underlying dimensions of spirituality cross-culturally conceived. We aimed to bridge this gap by inductively deriving potential universal dimensions of spirituality through a large-scale, multi-national data collection, and examining the relationships of these dimensions with common psychiatric conditions. Five-thousand five-hundred and twelve participants from China, India, and the United States completed a two-hour online survey consisting of wide-ranging measures of the lived experience of spirituality, as well as clinical assessments. A series of inductive Exploratory Factor Analysis (EFA) and cross-validating Exploratory Structural Equation Modeling (ESEM) were conducted to derive common underlying dimensions of spirituality. Logistic regression analyses were then conducted with each dimension to predict depression, suicidal ideation, generalized anxiety, and substance-related disorders. Preliminary EFA results were consistently supported by ESEM findings. Analyses of 40 spirituality measures revealed five invariant factors across countries which were interpreted as five dimensions of universal spiritual experience, specifically: love, in the fabric of relationships and as a sacred reality; unifying interconnectedness, as a sense of energetic oneness with other beings in the universe; altruism, as a commitment beyond the self with care and service; contemplative practice, such as meditation, prayer, yoga, or qigong; and religious and spiritual reflection and commitment, as a life well-examined. Love, interconnectedness, and altruism were associated with less risk of psychopathology for all countries. Religious and spiritual reflection and commitment and contemplative practice were associated with less risk in India and the United States but associated with greater risk in China. Education was directly associated with dimensions of spiritual awareness in India and China but inversely associated with dimensions in the United States. Findings support the notion that spirituality is a universal phenomenon with potentially universal dimensions. These aspects of spirituality may each offer protective effects against psychiatric symptoms and disorders and suggest new directions for treatment.
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Affiliation(s)
- Clayton H McClintock
- Department of Clinical Psychology, Teachers College, Columbia University New York, NY, USA
| | - Elsa Lau
- Department of Clinical Psychology, Teachers College, Columbia University New York, NY, USA
| | - Lisa Miller
- Department of Clinical Psychology, Teachers College, Columbia University New York, NY, USA
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