The Psychometric Properties of the Chinese Version of the Beck Depression Inventory-II With Middle School Teachers

Depression and Smartphone Addiction Among College Students: The Mediating Effect of Emotional Exhaustion

Objective

Multiple studies claim that depression was a triggering factor for smartphone addiction among college students. But we still know very little about the underlying mechanisms of smartphone addiction. The aim was to shed light on the underlying mechanisms of smartphone addiction from the perspective of depression and emotional exhaustion, to provide alternative paths for university administrators to address smartphone addiction among college students.

Methods

A total of 2764 Chinese college students participated in the survey. They independently filled out self-assessment questionnaires including the Cell Phone Addiction Scale, Beck Depression Inventory II, and Emotional Exhaustion Scale. Subsequently, mediation analysis was conducted using the PROCESS macro developed by Hayes (v 4.0; Model 4).

Results

Statistical analysis showed that depression was positively correlated with emotional exhaustion and smartphone addiction, emotional exhaustion was positively correlated with smartphone addiction, all of which were statistically significant. In addition, the effect of depression on smartphone addiction among college students was partially mediated by emotional exhaustion.

Conclusion

The impact of depression and emotional exhaustion on smartphone addiction had been preliminarily explored, which had certain value for further understanding of smartphone addiction among college students. This study could provide references for universities to develop intervention measures for smartphone addiction.

Psychological changes among women with recurrent pregnancy loss during the COVID-19 period in northeastern China: a cross-sectional study

Background

It aimed to investigate the prevalence of anxiety and depression in recurrent pregnancy loss (RPL) women and the related factors in Northeastern China during the Coronavirus disease 2019 (COVID-19) pandemic.

Methods

From March to June 2021, we conducted an electronic questionnaire survey of 267 RPL women who attended the recurrent pregnancy loss clinic at Shengjing Hospital of China Medical University. The State-Trait Anxiety Inventory (STAI), Beck Depression Inventory-II (BDI-II), Perceived Stress Scale (PSS), and Medical Outcomes Study Social Support Survey (MOS-SSS-C) were used to screen for anxiety, depression, stress, and social support. Logistic regression was used to explore the related factors of anxiety and depression.

Results

RPL women had severe psychological problems during the pandemic: 56.6% showed state anxiety or trait anxiety, 26.6% showed high levels of stress, and 13.1% showed depression. Economic pressure caused by COVID-19, and high stress were common related factors for anxiety and depression. The interval since last miscarriage <6 months, worse mood changes due to COVID-19, and concerns about COVID-19 were associated with anxiety. A history of pregnancy loss >14 weeks was associated with depression. While adequate social support and actively seeking health help were protective factors for trait anxiety. And identifying the etiology was a protective factor for depression.

Conclusion

The study revealed the prevalence of anxiety, depression, and the associated factors in RPL women during COVID-19. More attention should be paid to the psychology of RPL women and adequate social support should be provided.

Mediating effects of attention problems on the link between parenting style and internet gaming disorder in adolescents

Background

Positive and negative parenting styles as well as psychiatric comorbidities including attention deficit hyperactivity disorder (ADHD) have been associated with internet gaming disorder (IGD) in children and adolescents. We hypothesized that ADHD and parenting style would be associated with IGD in adolescents. In addition, psychological status could mediate the link between parenting style and the severity of IGD.

Methods

A total of 256 adolescents with IGD and 211 healthy internet game players and their mothers participated in the current study. Demographic data, gaming patterns, and psychological status including ADHD were recorded for all adolescents. The parenting style of each adolescent's mother was assessed using the Maternal Behavior Research Instrument (Korean version).

Results

There were significant differences in the internet game play patterns, psychological status, and parenting styles between the IGD group and healthy internet game players. In the hierarchical logistic regression analysis, higher ADHD scores, less affective parenting styles, and less autonomous parenting styles, were significant predictors of IGD. In the mediation test, the ADHD score was found to mediate the association between affective and autonomous parenting styles and the severity of IGD.

Conclusion

Attention problems could directly and indirectly mediate the relationship between positive parenting styles and the severity of IGD. Our findings have the potential to aid in the development of treatment plans for IGD and ADHD as well as to contribute to the development of educational resources regarding parenting styles.

Efficacy of an internet-based cognitive behavioral therapy for subthreshold depression among Chinese adults: a randomized controlled trial

BACKGROUND

Subthreshold depression (sD) negatively impacts well-being and psychosocial function and is more prevalent compared with major depressive disorder (MDD). However, as adults with sD are less likely to seek face-to-face intervention, internet-based cognitive-behavioral therapy (ICBT) may overcome barriers of accessibility to psychotherapy. Although several trials explored the efficacy of ICBT for sD, the results remain inconsistent. This study evaluated whether ICBT is effective in reducing depressive symptoms among Chinese adults with sD.

METHODS

A randomized controlled trial was performed. The participants were randomly assigned to 5 weeks of ICBT, group-based face-to-face cognitive-behavioral therapy (CBT), or a waiting list (WL). Assessments were conducted at baseline, post-intervention and at a 6-month follow-up. The primary outcome measured depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Outcomes were analyzed using a mixed-effects model to assess the effects of ICBT.

RESULTS

ICBT participants reported greater reductions on all the outcomes compared to the WL group at post-intervention. The ICBT group showed larger improvement on the Patient Health Questionnaire-9 (PHQ-9) at post-intervention (d = 0.12) and at follow-up (d = 0.10), and with CES-D at post-intervention (d = 0.06), compared to the CBT group.

CONCLUSIONS

ICBT is effective in reducing depressive symptoms among Chinese adults with sD, and improvements in outcomes were sustained at a 6-month follow-up. Considering the low rates of face-to-face psychotherapy, our findings highlight the considerable potential and implications for the Chinese government to promote the use of ICBT for sD in China.

Validation of a Farsi version of the Eating Pathology Symptoms Inventory (F-EPSI) among Iranian adolescents

PURPOSE

Limited research has validated eating pathology assessments in Iranian adolescent boys and girls. In particular, the measures that have been validated do not capture both boys' and girls' eating behaviors in adolescence. The purpose of the current study was to validate a Farsi version of the Eating Pathology Symptoms Inventory (F-EPSI) for use in Iranian adolescents.

METHODS

Participants (N = 913; 85.3% girls) were adolescents who completed a battery of questionnaires including the F-EPSI. In addition, F-EPSI data for Iranian adolescents were compared with those of previously published data of adult Iranian college students.

RESULTS

Confirmatory Factor Analysis (CFA) indicated that the F-EPSI had an acceptable fit to the data and supported the eight-factor model. The scale was invariant by gender, weight status, eating disorder, and age groups. Boys reported higher scores than girls on the Excessive Exercise, Muscle Building, Body Dissatisfaction, and Binge Eating subscales. Adolescents with higher weight and eating disorder symptoms endorsed higher scores on the F-EPSI subscales. Older adolescents and adults reported higher scores than younger adolescents and adolescents, respectively. Adolescents had higher scores than adults on Restricting and Excessive Exercise subscales. The F-EPSI demonstrated good convergent validity through correlations with other eating pathology symptoms. The F-EPSI subscales were associated with depression and body mass index (zBMI) in expected directions that indicate criterion validity of the scale.

CONCLUSIONS

Findings suggest that the F-EPSI is a reliable and valid measure in Iranian non-clinical adolescents. The F-EPSI will enable researchers to examine a broad array of eating pathology symptoms in adolescents for whom Farsi is their official language.

LEVEL OF EVIDENCE

Level V; Cross-sectional descriptive study.

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Background

Non-suicidal self-injury (NSSI) is commonly seen in adolescents with depression and is a high-risk factor leading to suicide. The psychological mechanisms underlying depression with NSSI are still unclear. The purpose of this study was to explore the differences in personality traits, defensive styles, and borderline symptoms among first-episode youth patients with depression and self-injury compared with patients with depression without self-injury and healthy populations.

Methods

The current study recruited 188 participants, including 64 patients with depression and NSSI, 60 patients with depression without NSSI, and 64 healthy control subjects. Eysenck Personality Questionnaire, the Defense Style Questionnaire, the short version of the Borderline Symptom List, the Beck Depression Inventory, and the Ottawa Self-Injury Inventory were used to assess all participants.

Results

Patients with depression and NSSI showed more psychoticism than patients with depression without NSSI and healthy control subjects. Patients with depression and NSSI presented more intermediate defense styles than healthy control subjects. In the patients with depression and NSSI group, the frequency of self-injury in the last week was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. Further regression analysis showed that EPQ-psychoticism and depressive symptoms were independent risk factors for NSSI in patients with depression.

Conclusion

This study found that patients with depression and self-injury presented more neuroticism, introversion, EPQ-psychoticism, immature defenses, intermediate defenses, and borderline symptoms. Self-injury frequency was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. EPQ-Psychoticism and depressive symptoms are risk factors for predicting non-suicidal self-injury in patients with depression.

Increased plasma asprosin levels are associated with overeating and loss of control in drug-free bulimia nervosa

PURPOSE

Abnormalities in appetite hormones have been implicated in bulimia nervosa (BN). Orexigenic hormone asprosin has been reported to be associated with food intake and weight gain, but no relevant studies have yet been reported in BN. This study investigated asprosin concentrations and their association with eating disorder symptoms in patients with BN.

METHODS

This study recruited a total of 26 BN patients and 23 healthy controls (HC). Symptom severity for eating disorders, depression, and anxiety was determined by the Eating Disorder Examination Questionnaire 6.0, Beck Depression Inventory, Version 2, and Beck Anxiety Inventory, respectively. In addition, the study employed sandwich enzyme-linked immunoassay technology to determine plasma asprosin and glucose concentrations in all participants.

RESULTS

The results revealed that plasma asprosin concentrations were significantly higher in BN patients than in HC (P = 0.037), but the difference disappeared after adjusting for the covariate BMI (F = 2.685, P = 0.108). Correlation analysis showed that asprosin concentration was positively correlated with overeating (r = 0.451, P = 0.021) and eating loss of control (r = 0.483, P = 0.012) in BN patients. Linear regression analysis indicated that an increase in asprosin concentration was associated with an increase in the times of overeating (F = 6.303, P = 0.019, R² = 0.208). Multiple linear regression showed that increases in asprosin concentration and BDI-II total score could explain the frequent eating loss of control (F = 5.766, P = 0.009, R² = 0.334).

CONCLUSIONS

The present study is the first report of plasma asprosin concentration in BN patients and found that overeating and eating loss of control increased with the increase of asprosin concentration. Additionally, asprosin level and degree of depression may explain the frequency of loss of control.

LEVEL OF EVIDENCE

Level III: Evidence obtained from case-control studies.

Relationship between serum 25 hydroxyvitamin D (25(OH)D) levels and mental health in shift female nurses

The nurses work long hours and in various shifts, and often accompanied by depression, fatigue, and sleep disorders. Many studies have found that 25 hydroxyvitamin D (25(OH)D) is related to mental health. We aimed to investigate the relationship between depression, sleep problems, fatigue, and serum 25(OH)D levels in shift nurses. We recruited 34 day-shift, 30 evening-shift and 31 night-shift nurses. The Beck Depression Inventory II (BDI-II), Numerical Rating Scale and General Sleep Disturbance Scale to evaluate the levels of depression, sleep problems, fatigue. Blood samples (20 ml) were collected under a fasting state to determine basic biochemistry and inflammatory parameters. In central of Taiwan, approximately 96.1% of shift nurses had deficient (< 20 ng/ml) (45 females and 1 male) and inadequate (20-29 ng/ml) (39 females and 2 male) 25(OH)D levels. Approximately 84.2% of shift nurses experienced fatigue. In sleep disturbance, night-shift nurses experienced significantly more severe sleep disturbance than day-shift and evening-shift nurses. However, no significant correlation was observed between 25(OH)D levels and mental health when the 25(OH)D level was categorized. 25(OH)D deficiency, sleep disturbance, depression, and fatigue were common in shift female nurses, but it was not possible to demonstrate the impact of 25(OH)D deficiency on the mental health of shift nurses in Taiwan.

The relationship between resilience, anxiety, and depression in Chinese collegiate athletes

Anxiety disorder is becoming increasingly prevalent across college campuses, particularly among collegiate athletes who face different stressors and challenges than their non-athlete peers. Anxiety and depression are well documented comorbidities. Furthermore, the number of Chinese collegiate athletes suffering from anxiety and depression is increasing. Psychologists have recently begun to take a more prophylactic approach to defend against these disorders through resilience education. Resilience education focuses on developing greater capacity to cope when mental and emotional challenges arise. The purpose of this study was to analyze the relationship between resilience, depression, and anxiety in Chinese collegiate athletes. This study provides additional evidence of the value of incorporating an effective resilience educational module amongst collegiate athletes.

Research design

The study employed a survey research design to explore the complex relationship between depression, anxiety, and resilience for collegiate student athletes.

Data analysis strategy

Structural Equation Modeling (SEM) was employed to account for any measurement error between the observed items (responses on the instruments) and the latent variables (anxiety, depression, and resilience). The theoretical hypothesized relationship for this study is an inverse relationship between anxiety and depression, on the one hand, and resilience on the other hand. The SEM statistical analysis from this study supported this theoretical model.

Effective sample size

599 collegiate athletes from six different universities in the province of Guangdong, China P.R. participated in this study.

Correlations Between Psychological Status and Perception of Facial Expression

OBJECTIVE

Facial affect recognition is associated with neuropsychological status and psychiatric diseases. We hypothesized that facial affect recognition is associated with psychological status and perception of other affects.

METHODS

A total of 80 images depicting facial affect, including 20 Neutral, 20 Angry, 20 Fear, and 20 Sad, were screened for use in our research. A total of 100 healthy individuals were asked to rate these images using a 10-point Likert scale and complete psychological scales assessing the emotional statuses and cognitive functions.

RESULTS

The participants' emotional state of aggression, attention, and impulsivity may have been associated with their interpretation of the Angry facial expressions. The participants often rated the Angry facial expressions as Fear. The participants rated Fear images as Angry or Sad. In response to a Sad facial expression, the participants reported psychological statuses of attention and impulsivity which were associated with the facial expression rating. The participants rated the Sad expression as Angry or Fear.

CONCLUSION

The psychological statuses of the participants were significantly correlated with their interpretation of facial affects. In particular, a psychological state of attention was often correlated with incorrect affect ratings. Attention and impulsivity could affect the rating of the sad facial expressions.

Depression and Perceived Social Support among Unemployed Youths in China: Investigating the Roles of Emotion-Regulation Difficulties and Self-Efficacy

In recent years, the issue of youth unemployment has begun to emerge in China. Unemployed young people are at high risk of depression and other mental health problems. The present study investigates influential factors related to depression and examines the possible mediating effects of difficulties in emotion regulation and self-efficacy between perceived social support and depressive symptoms among unemployed youths in China. Through community recruitment, 511 unemployed young people from Shanghai participated in this cross-sectional survey. The results demonstrate that the prevalence of probable depression in the sample was 49.3% (95% CI: 45.0-53.7%). Moreover, we found that both the perceived social support and self-efficacy were significant negative predictors of depression, whereas difficulties in emotion regulation were positive predictors of depression. In addition, the analysis results indicate that difficulties in emotion regulation and self-efficacy partially mediate the relationship between perceived social support and depression. Overall, this cross-sectional study reveals that depression and mental health problems among China's unemployed youths are concerning while identifying emotion-regulation difficulties as a risk factor for these and social support and self-efficacy as protective factors, all of which warrant our attention in preventing and intervening with cases of youth depression.

Grounding the Body Improves Sleep Quality in Patients with Mild Alzheimer’s Disease: A Pilot Study

Background: Grounding refers to having direct contact with the Earth, such as by walking barefoot or lying on the ground. Research has found that grounding can improve inflammation, free radical damage, blood pressure, sleep quality, pain, stress, mood, and wound healing. However, there has been no research on the effect of utilizing grounding for patients with Alzheimer’s disease (AD). Thus, in this study, we investigated the effectiveness of grounding as a non-pharmacological therapy for treating sleep disturbances, anxiety, and depression in patients with mild AD. Methods: Patients with mild AD were enrolled in the study. The electrochemical analyzer CHI 1205b was employed to check the electrochemical signals at acupoints KI1 and GV16. We used the Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II) to evaluate sleep quality, anxiety, and depression, respectively, at weeks 0 and 12. Results: This 12-week placebo-controlled study enrolled 22 patients, but only 15 patients completed the 12-week intervention and survey. Grounding significantly improved PSQI scores compared to the sham-grounding group (mean ± SD: 0.3 ± 0.7 vs. 3.0 ± 1.9, p = 0.006). The scores on the BAI and BDI-II did not change significantly after grounding in comparison to the sham-grounding group. Conclusions: Grounding can improve sleep quality, but it does not significantly improve anxiety and depression among patients with mild AD.

The efficacy of Tai Chi for depression: A protocol for systematic review and meta-analysis

BACKGROUND

Depression is a commonly occurring and recurrent mental disorder cross the world. Tai Chi is a traditional Chinese mind-body exercise which could be used to treat mental disorders including depression. This study aimed to conduct a systematic review and meta-analysis to assess the efficiency of Tai Chi for patients with depression.

METHODS

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol statement. Literature will be searched at PubMed, EMBASE, Web of Science, Cochrane Library, China Biology Medicine Database, China National Knowledge Infrastructure, Technology Journal Database, and Wan Fang database from the start date to September 2021. The Review Manager 5.3 software will be used to manage literature. After literature screening, 2 reviewers will extract data from the respects of general information, methodology, and results. The data analysis will be conducted with Review Manager and Stata 16 software, and the publication bias and literature quality will be both evaluated.

RESULTS

The results will contain the evaluation of clinical efficacy of Tai Chi practice for depression, as well as the assessment of literature quality and publication bias.

CONCLUSION

The current review will provide new evidence on whether and to what extent patients with depression can benefit from Tai Chi practice.Registration number: DOI: 10.17605/OSF.IO/AUDNQ (https://osf.io/audnq).

Extraversion and Neuroticism on College Freshmen's Depressive Symptoms During the COVID-19 Pandemic: The Mediating Role of Social Support

OBJECTIVE

This study aims to explore the direct effects of extraversion and neuroticism on college freshmen's depressive symptoms and their indirect effects via social support under the background of COVID-19.

METHOD

A total of 3,563 college freshmen were surveyed using the extraversion and neuroticism scales of the Chinese version of the Eysenck Personality Questionnaire (EPQ), the Chinese version of the Beck Depression Inventory-II (BDI-II), and the Social Support Rating Scale (SSRS). Partial correlation analyses and regression analyses were used.

RESULTS

(1) Extraversion had a significant and negative predictive effect on depressive symptoms, while neuroticism positively predicted depressive symptoms. The interaction effect between extraversion and neuroticism on depressive symptoms was also significant. Neuroticism had a greater impact on depressive symptoms in college freshmen with low levels of extraversion. (2) Furthermore, social support partially mediated the relationships between extraversion and depressive symptoms, and neuroticism and depressive symptoms.

CONCLUSIONS

Extraversion and neuroticism can directly affect college freshmen' s depressive symptoms, and have indirect effects via the mediating role of social support. Additionally, extraversion interacts with neuroticism, and extraversion plays a protective role in the effect of neuroticism on depressive symptoms. These findings help identify college freshmen at high risk of depression and design effective prevention or intervention measures for them.

Remote and adjacent psychological predictors of early-adulthood resilience: Role of early-life trauma, extraversion, life-events, depression, and social-support

Resilience is important for people to maintain mental health after negative life-events. However, its longitudinal psychological and social predictors are poorly revealed. Based on the ecological system theory model, the current study aimed to determine the longitudinal temporal mechanism underlying the development of early-adulthood resilience using long-term (early-life trauma and personality), medium-term and short-term (life-events, social support, and depression) psychosocial predictors. A total of 505 university students were recruited at baseline (T1), 433 of whom took part in a three-year longitudinal investigation (T2). The results showed that at T1 and T2, the resilience scores of individuals were identically high (72.98 and 73.21, respectively). Pearson correlation analysis showed that early-adulthood resilience was negatively correlated with early-life trauma, psychoticism and neuroticism, depression, ad life-events, and positively correlated with extraversion, social-support, and resilience. Regression and structural equation models showed that extraversion had a direct positive effect on T1 resilience through the mediation of T1 life-events, depression, and social-support, while childhood emotional neglect (EN) had indirect negative effect and extraversion had direct positive effect on T2 resilience through the mediation of T1 resilience, and T2 depression and social-support. In conclusion, this study is among the first to reveal the longitudinal temporal process of the development of early-adulthood resilience using remote and adjacent psychosocial predictors. The findings confirm that childhood EN and extraversion have a remote impact on early-adulthood resilience through recent and current depression and social-support. Our results imply that early-life trauma does not hinder the development of early-adulthood resilience in a linear trend.

Using 24-h Heart Rate Variability to Investigate the Sleep Quality and Depression Symptoms of Medical Students

There have been numerous studies on the relationship between sleep and depression, as well as the relationship between sleep and depression, and heart rate variability (HRV), respectively. Even so, few studies have combined 24-h HRV analysis to study sleep quality and depressive symptoms. The purpose of this cross-sectional study was to investigate the relationship between depressed symptoms, sleep quality, and 24-h HRV in medical students. The particiants were all students at a medical university in Guangdong province, China. A total of 74 college students participated. They were asked to complete a questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory-II (BDI-II), the Positive and Negative Affect Scale (PANAS), and 24-h ECG monitoring. The results showed that 41.7% of the medical students had poor sleep quality, with higher levels of depressive symptoms and more negative emotions, and there was no difference in 24-h HRV indices between the low PSQI group and the high one. Correlation analysis showed that there was a significant relationship between sleep quality and depressive symptoms (r = 0.617), but the relationship between 24-h HRV indices and PSQI global scores, BDI scores were not significant. However, the correlation analysis of PSQI components and 24-h HRV showed that sleep disturbance was significantly negatively correlated with SDNN and LF in waking period (r = -0.285, -0.235), and with SDNN in sleeping period (r = -0.317). In general, the sleep disturbance in PSQI components can sensitively reflect the relationship between sleep quality and 24-h HRV of medical students. Individuals with higher sleep disturance may have lower SDNN during awake period and bedtime period, and lower LF in awake period. Twenty-four hour HRV has certain application value in clinical sleep quality monitoring, and its sensitivity and specificity in clinical application and daily life are still worth further investigation.