Sleep Reactivity and Depressive Symptoms Among Chinese Female Student Nurses: A Longitudinal Mediation Analysis

Sleep, mental health and physical health in new shift workers transitioning to shift work: Systematic review and meta-analysis

This systematic review and meta-analysis (PROSPERO registration CRD42022309827) aimed to describe how shift work impacts new workers' sleep, mental health, and physical health during the transition to shift work and to consolidate information regarding predictors of shift work tolerance (SWT) during this transition period. Inclusion criteria included: new shift workers; sleep, mental health, or physical health outcomes; prospective study design with the first timepoint assessing workers within three months of starting shift work; and written in English. Searches from six databases returned 12,172 articles as of August 2023. The final sample included 48 papers. Publication quality and risk of bias was assessed using the critical appraisal skills program. Forty-five studies investigated longitudinal changes in sleep, mental health, or physical health outcomes and 29 studies investigated predictors of SWT (i.e., better sleep, mental and physical health). Sleep and mental health outcomes worsened following the onset of shift work, while physical health did not significantly change. Pre-shift work mental health, sleep, and work characteristics predicted SWT later in workers' careers. Shift work adversely impacts new workers' sleep and mental health early in their career, and interventions before beginning shift work are needed to promote better SWT.

The sleep response to stress: how sleep reactivity can help us prevent insomnia and promote resilience to trauma

Sleep reactivity is a predisposition to sleep disturbance during environmental perturbations, pharmacological challenges, or stressful life events. Consequently, individuals with highly reactive sleep systems are prone to insomnia disorder after a stressor, engendering risk of psychopathology and potentially impeding recovery from traumatic stress. Thus, there is tremendous value in ameliorating sleep reactivity to foster a sleep system that is robust to stress exposure, ultimately preventing insomnia and its downstream consequences. We reviewed prospective evidence for sleep reactivity as a predisposition to insomnia since our last review on the topic in 2017. We also reviewed studies investigating pre-trauma sleep reactivity as a predictor of adverse post-traumatic sequelae, and clinical trials that reported the effect of behavioural treatments for insomnia on mitigating sleep reactivity. Most studies measured sleep reactivity via self-report using the Ford Insomnia Response to Stress Test (FIRST), demonstrating high scores on this scale reliably indicate a sleep system with a lower capacity to tolerate stress. Nascent evidence suggests elevated sleep reactivity prior to trauma increases the risk of negative posttraumatic outcomes, namely acute stress disorder, depression, and post-traumatic stress disorder. Lastly, sleep reactivity appears most responsive to behavioural insomnia interventions when delivered early during the acute phase of insomnia. Overall, the literature strongly supports sleep reactivity as a premorbid vulnerability to incident acute insomnia disorder when faced with an array of biopsychosocial stressors. The FIRST identifies individuals at risk of insomnia a priori, thereby guiding early interventions toward this vulnerable population to prevent insomnia and promote resilience to adversity.

Sleep and mental health in recruit paramedics: a 6-month longitudinal study

STUDY OBJECTIVES

To explore potential relationships and longitudinal changes in sleep and mental health in recruit paramedics over the first 6 months of work, and whether sleep disturbances pre-emergency work predict future mental health outcomes.

METHODS

Participants (N = 101, 52% female, Mage = 26 years) completed questionnaires prior to (baseline), and after 6 months of emergency work to assess for symptoms of insomnia, obstructive sleep apnea, post-traumatic stress disorder (PTSD), depression, anxiety, and trauma exposure. At each timepoint, participants also completed a sleep diary and wore an actigraph for 14 days to assess sleep patterns. Correlations between baseline sleep and mental health were conducted and changes in these variables across timepoints were examined using linear mixed models. Hierarchical regressions assessed whether sleep at baseline predicted mental health at follow-up.

RESULTS

Insomnia and depression symptoms, and total sleep time increased while sleep onset latency decreased across the first 6 months of emergency work. Participants experienced an average of 1 potentially traumatic event during the 6-month period. Baseline insomnia predicted increased depression symptoms at the 6-month follow-up, while baseline wake after sleep onset predicted follow-up PTSD symptoms.

CONCLUSION

Results highlight an increase in insomnia and depression across the initial months of emergency work, while sleep disturbances before emergency work were identified as potential risk factors for the development of depression and PTSD among paramedics in their early career. Screening and early interventions targeting poor sleep at the beginning of emergency employment may assist in reducing the risk of future mental health outcomes in this high-risk occupation.

Maternal adverse childhood experiences and behavioral problems in Chinese preschool children: The moderated mediating role of emotional dysregulation and self-compassion

BACKGROUND

The negative effects of maternal adverse childhood experiences (ACEs) may have a direct intergenerational effect on a child's behavior. This topic has been widely examined, but few studies have explored the underlying mechanism and protective factors influencing maternal ACEs and offspring's behavioral problems in the Chinese context.

OBJECTIVE

This study aims to investigate the mediating effect of emotional dysregulation on the relationship between maternal ACEs and offspring behavior and examine whether self-compassion can moderate this association.

PARTICIPANTS AND SETTING

The participants were 2282 preschoolers (52 % male) with a mean age of M = 62.63 months (SD = 9.28) and their mothers. They were from northern, central, and southern Anhui Province China, and data were collected in relation to the family's socioeconomic status by population density of children in the region.

METHODS

Data were collected from the mothers with respect to maternal ACEs, emotional dysregulation, and self-compassion. Mothers provided information regarding children's behavior and demographic characteristics. A moderated mediation model was analyzed through SPSS.

RESULTS

First, the presence of maternal ACEs was positively associated with offspring behavioral problems. Second, maternal emotional dysregulation mediated the relationship between ACEs and offspring behavioral problems. Third, mothers' self-compassion moderated the indirect relationship between ACEs and offspring behavioral problems via emotional dysregulation.

CONCLUSIONS

Our findings highlight the critical role of emotional dysregulation and self-compassion in the relationship between maternal ACEs and offspring behavioral problems. Interventions should target maternal emotional dysregulation and self-compassion to minimize the risk of intergeneration transmission of negative effects.

The association between fear of future workplace violence and depressive symptoms among nurses based on different experiences of workplace violence: a cross-sectional study

BACKGROUND

Fear of future workplace violence (FFWV) has a negative impact on individuals' health. However, no study has investigated the association between FFWV and depressive symptoms. Nurses with different experiences of workplace violence may have different levels of FFWV and differences in mental health. This study explored the association between FFWV and depressive symptoms among Chinese nurses with different experiences of workplace violence.

METHODS

A cross-sectional study was conducted involving 1888 Chinese nurses from 12 tertiary hospitals in Shandong Province. The Fear of Future Violence at Work scale was used to measure FFWV. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression scale. Multiple logistic regression analysis was used to examine the association between FFWV and depressive symptoms.

RESULTS

The prevalence of depressive symptoms was 45.9% (no aggression group: 24.3%; non-physical violence group: 46.1%; physical violence group: 63.7%), and 72.8% of nurses had high levels of fear of future workplace violence (no aggression group: 60.2%; non-physical violence group: 75.6%; physical violence group: 70.8%). Compared with low levels of FFWV, high levels of FFWV were associated with more depressive symptoms among nurses in the no aggression group (odds ratio [OR] = 3.269, 95% confidence interval [CI]: 1.102-9.695) and in the non-physical violence group (OR = 2.338, 95% CI: 1.385-3.945).

CONCLUSION

Nurses who had experienced physical violence had the most depressive symptoms and nurses with experience of non-physical violence had the greatest FFWV. Our findings suggested that there was a significant association between FFWV and depressive symptoms among Chinese nurses in the no aggression and non-physical violence groups. Hospital administrators need to address FFWV needs when developing strategies to reduce depressive symptoms among nurses.

Emotional Dysregulation and Time Structure Mediate the Link between Perceived Stress and Insomnia among Unemployed Young People in China: A Cross-Sectional Study

In recent years, the problem of youth unemployment in China has become a great concern. Unemployed young people often find themselves under tremendous stress and vulnerable to sleep problems. The link between perceived stress and insomnia has been widely documented, but the potential mechanisms underlying this relationship have not been thoroughly revealed. The objective of this study was to examine the underlying mechanisms linking perceived stress to insomnia through testing the mediating effects of emotional dysregulation and time structure. Through a multiple-stage convenience sampling, 511 unemployed young people (38.6% women; mean age = 21.51; SD = 2.22) were measured using the 10-item Perceived Stress Scale (PSS-10), Insomnia Severity Index (ISI), 16-item Difficulties in Emotion Regulation Scale (DERS-16), and Time Structure Questionnaire (TSQ). Based on the statistical description of the sample, chi-squared tests, bivariate correlation analyses, and mediation analyses were performed. The study indicated that 53.0% (95% CI: 48.7-57.4%) of the participants reported probable insomnia, and both insomnia and perceived stress demonstrated strong associations with emotional dysregulation and time structure, which served as partial mediators between perceived stress and insomnia symptoms according to mediation analyses. Path analysis further revealed that, after controlling for age and gender, emotional dysregulation and time structure accounted for 31.8 and 17.6% of the effect of perceived stress on insomnia, respectively. This study provides empirical support for the association among perceived stress, emotional dysregulation, time structure, and insomnia symptoms. To improve the sleep quality and general wellbeing of unemployed young people, emotional dysregulation and time structure must be taken into consideration.

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.