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Opie JE, Vuong A, Welsh ET, Esler TB, Khan UR, Khalil H. Outcomes of Best-Practice Guided Digital Mental Health Interventions for Youth and Young Adults with Emerging Symptoms: Part II. A Systematic Review of User Experience Outcomes. Clin Child Fam Psychol Rev 2024; 27:476-508. [PMID: 38634939 PMCID: PMC11222193 DOI: 10.1007/s10567-024-00468-5] [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] [Accepted: 01/28/2024] [Indexed: 04/19/2024]
Abstract
Although many young people demonstrate resilience and strength, research and clinical evidence highlight an upward trend in mental health concerns among those aged 12 to 25 years. Youth-specific digital mental health interventions (DMHIs) aim to address this trend by providing timely access to mental health support for young people (12-25 years). However, there is a considerable gap in understanding young people user experiences with digital interventions. This review, co-designed with Australia's leading mental health organization Beyond Blue, utilizes a systematic methodology to synthesize evidence on user experience in youth-oriented digital mental health interventions that are fully or partially guided. Five relevant online databases were searched for articles published from 2018 to 2023, yielding 22,482 articles for screening and 22 studies were included in the present analysis. User experience outcomes relating to satisfaction and engagement were assessed for each included intervention, with experience indicators relating to usefulness, usability, value, credibility, and desirability being examined. Elements associated with positive/negative outcomes were extracted. Elements shown to positively influence user experience included peer engagement, modern app-based delivery, asynchronous support, and personalized content. In contrast, users disliked static content, homework/log-keeping, the requirement for multiple devices, and social media integration. Asynchronous interventions showed high satisfaction but faced engagement issues, with combined asynchronous/synchronous interventions reporting better completion rates. DMHIs offer a promising platform for youth mental health support and has the potential to dramatically increase the reach of interventions through the adoption of technological and user experience best practices. While young people respond positively to many aspects of intervention modernization, such as interactive, app-based design, other concepts, such as social media integration, they need to be adopted by the field more cautiously to ensure trust and engagement.Trial Registration CRD42023405812.
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Affiliation(s)
- Jessica E Opie
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia.
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia.
| | - An Vuong
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
| | - Ellen T Welsh
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia
| | - Timothy B Esler
- The Bouverie Centre, La Trobe University, Melbourne, 3056, Australia
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
| | - Urooj Raza Khan
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
| | - Hanan Khalil
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, 3000, Australia
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Opie JE, Vuong A, Welsh ET, Gray R, Pearce N, Marchionda S, Mutch R, Khalil H. Outcomes of Best-Practice Guided Digital Mental Health Interventions for Youth and Young Adults with Emerging Symptoms: Part I. A Systematic Review of Socioemotional Outcomes and Recommendations. Clin Child Fam Psychol Rev 2024; 27:424-475. [PMID: 38489101 PMCID: PMC11222273 DOI: 10.1007/s10567-024-00469-4] [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] [Accepted: 01/28/2024] [Indexed: 03/17/2024]
Abstract
Youth-specific digital mental health interventions (DMHI) represent an emerging field of study, and aim to increase access, improve socioemotional outcomes, and, where required, support triage to targeted interventions. However, prior reviews have reported inconsistent findings on the clinical effectiveness of such interventions in young adults (12-25 years). Further, shortfalls remain for the impact of guided interventions based on the mode of delivery and the type of human support personnel (e.g., professional or peer) guiding the intervention. In response, this systematic review, co-designed with Australia's leading mental health organization, aims to assess the effectiveness of guided digital programs in improving youth socioemotional outcomes. Included studies involve young people experiencing mental ill-health, receiving brief (i.e., 1-12 sessions), digitally delivered (at least partially) psychological interventions that were guided or partially guided, tested in a type of experimental study, with a socioemotional outcome. Specific socioemotional outcomes examined were depression, anxiety, stress, wellbeing, mindfulness, and quality of life. A systematic search of the contemporary published and grey literature identified 22,482 records with 32 relevant records published between 2018 and 2023. A narrative synthesis guided integration of findings. Results demonstrated strong evidence for the effectiveness of guided interventions on socioemotional outcomes (i.e., depression, anxiety, stress) yet these effects were short-lived. When factoring in the use of different control groups (i.e., active vs. inactive), inconsistent effects were observed for the socioemotional outcomes of depression, anxiety, and stress. The mode of delivery (i.e., asynchronous, synchronous, combined) and the type of human support personnel did not appear to impact socioemotional outcomes. Results indicate efficacious brief digital interventions for depression and anxiety include refresher/follow-up content, goal setting content, and relapse prevention content. In contrast, poor efficacy is associated with interventions that include homework tasks, self-monitoring, and log-keeping content.PROSPERO, ID CRD42023405812.
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Affiliation(s)
- Jessica E Opie
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia.
- La Trobe University, Melbourne, VA, 3000, Australia.
| | - An Vuong
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Ellen T Welsh
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Richard Gray
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Natalie Pearce
- La Trobe University, Melbourne, VA, 3000, Australia
- Latrobe University, Bendigo, VIC, 3551, Australia
| | - Sonia Marchionda
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | | | - Hanan Khalil
- La Trobe University, Melbourne, VA, 3000, Australia
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Li G, Shi W, Gao X, Shi X, Feng X, Liang D, Li C, Phillips MR, Hall BJ. Mental health and psychosocial interventions to limit the adverse psychological effects of disasters and emergencies in China: a scoping review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 45:100580. [PMID: 38699294 PMCID: PMC11064723 DOI: 10.1016/j.lanwpc.2022.100580] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Exposure to disasters and public health emergencies negatively affects mental health. Research documenting the psychosocial responses to these calamities in China increased dramatically after the 2008 Wenchuan earthquake. However, there is no comprehensive assessment of the available literature on China's mental health and psychosocial support (MHPSS) responses to these events. This scoping review systematically maps existing published research and grey literature sources regarding MHPSS to disasters and emergencies in China. We examined relevant literature in English and Chinese from six databases and official websites from Jan 1, 2000, to Aug 13, 2021, and included 77 full-text records in this review. The main types of interventions reported included a) stepped care intervention models, b) individual structured psychotherapy and pharmacotherapy, c) mental health education, d) psychological counselling, and e) government-based policy interventions. Most interventions were evaluated using quantitative methods that assessed the treatment of common mental disorders. The review found that rapid national mobilization, emphasis on resilience-strengthening interventions, and the widespread use of step-care models were essential components of reducing the adverse psychosocial effects of disasters. The review also identified remaining gaps, including a) a lack of integration of disaster-related services with the pre-existing health care system, b) inadequate supervision of MHPSS providers, and c) limited monitoring and evaluation of the services provided. These results show where additional research is needed in China to improve mental health services. It also provides a framework that other countries can adapt when developing and evaluating MHPSS policies and plans in response to disasters.
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Affiliation(s)
- Gen Li
- Center for Global Health Equity, New York University Shanghai, 1555 Century Avenue, Shanghai, China
| | - Wei Shi
- The Institute for Disaster Management and Reconstruction, Sichuan University, No.24 South Section 1, Yihuan Road, Chengdu, China
| | - Xing Gao
- The Institute for Disaster Management and Reconstruction, Sichuan University, No.24 South Section 1, Yihuan Road, Chengdu, China
| | - Xinyi Shi
- The Institute for Disaster Management and Reconstruction, Sichuan University, No.24 South Section 1, Yihuan Road, Chengdu, China
| | - Xiaoyu Feng
- The Institute for Disaster Management and Reconstruction, Sichuan University, No.24 South Section 1, Yihuan Road, Chengdu, China
| | - Di Liang
- School of Public Health, Fudan University, 220 Handan Rd., Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wanping Nan Rd., Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, China
| | - Michael R. Phillips
- Suicide Research and Prevention Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wanping Nan Rd., Shanghai, China
- Departments of Psychiatry and Epidemiology, Columbia University, New York, NY, USA
| | - Brian J. Hall
- Center for Global Health Equity, New York University Shanghai, 1555 Century Avenue, Shanghai, China
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Li G, Sit HF, Chen W, Wu K, Sou EKL, Wong M, Chen Z, Burchert S, Hong IW, Sit HY, Lam AIF, Hall BJ. A WHO digital intervention to address depression among young Chinese adults: a type 1 effectiveness-implementation randomized controlled trial. Transl Psychiatry 2024; 14:102. [PMID: 38378687 PMCID: PMC10879210 DOI: 10.1038/s41398-024-02812-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/22/2024] Open
Abstract
Common mental disorders among young people are rising globally. Current university-based interventions are inadequate to address the need for evidence-based interventions. We investigated the effectiveness and implementation of Step-by-Step (SbS), a WHO digital intervention to address depression, among Chinese university students with depressive symptoms. In this paper, we report a type 1 hybrid effectiveness-implementation randomized controlled trial conducted between September 2021 and September 2022. The control condition was enhanced treatment as usual (ETAU, psychoeducation). The primary outcome was improvement in depression symptoms. Secondary outcomes were improvements in psychological well-being, anxiety symptoms, and self-identified psychosocial problems. Effectiveness of the intervention was evaluated using generalized linear mixed models. Implementation outcomes were evaluated by thematic analysis of participant interviews. A total of 371 participants were enrolled to two treatment conditions in a 1:1 ratio. SbS resulted in a greater reduction in depressive symptoms at posttreatment (p = 0.004, Hedges' g = 0.35), but no significant difference between SbS and ETAU was observed at three-month follow-up (p = 0.179, Hedges' g = 0.16). The treatment effect was larger among those who adhered to the treatment (Hedges' gs = 0.59 and 0.30). Subjective well-being also improved for SbS at both time points (Hedges' gs = 0.31 and 0.30). In addition, SbS resulted in more improvement in anxiety symptoms at posttreatment (p = 0.029, Hedges' g = 0.26), but not at three-month follow-up (p = 0.265, Hedges' g = 0.13). The qualitative results demonstrated that the intervention was well-implemented as a self-help mental health service, with minimal support from peer supporters. In conclusion, Step-by-Step, a digital intervention developed by WHO, was effective in reducing depressive symptoms in the short term and improving psychological well-being in a longer term. The sustained effect on depression needs further investigation. Improving uptake and engagement in the program is needed for its scale-up implementation as a university-based mental health service for Chinese young adults. Trial registration: ChiCTR2100050214.
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Affiliation(s)
- Gen Li
- Center for Global Health Equity, New York University Shanghai, Shanghai, China
| | - Hao Fong Sit
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Centre for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Kunpeng Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Centre for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | | | - Mek Wong
- Student Affairs Office, University of Macau, Macau SAR, China
| | - Ze Chen
- Centre for Macau Studies, University of Macau, Macau SAR, China
| | - Sebastian Burchert
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Ieng Wai Hong
- Moon Chun Memorial College, University of Macau, Macau SAR, China
| | - Ho Yi Sit
- Shiu Pong College, University of Macau, Macau SAR, China
| | | | - Brian J Hall
- Center for Global Health Equity, New York University Shanghai, Shanghai, China.
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Bandeira M, Graham MA, Ebersöhn L. The significance of feeling safe for resilience of adolescents in sub-Saharan Africa. Front Psychol 2023; 14:1183748. [PMID: 37663363 PMCID: PMC10469746 DOI: 10.3389/fpsyg.2023.1183748] [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: 03/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents. Methods Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health). Results This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique. Discussion The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.
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Affiliation(s)
- Monica Bandeira
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - Liesel Ebersöhn
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
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Factors influencing attitudes toward cyber-counseling among China's Generation Z: A structural equation model. Arch Psychiatr Nurs 2022; 40:124-131. [PMID: 36064235 DOI: 10.1016/j.apnu.2022.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 06/12/2022] [Accepted: 07/03/2022] [Indexed: 11/20/2022]
Abstract
Information technology developments have combined traditional face-to-face counseling with online- or cyber-counseling. As digital natives, Generation Z has easy access to cyber-counseling. However, their attitudes toward cyber-counseling remain unknown. This study explored these attitudes and relevant influencing factors among 1216 Chinese adolescents using self-report questionnaires. Descriptive analyses and structural equation modeling were used for data analysis. The model explained 27.7 % of the total variance, attitudes toward psychological help was the most influential, followed by attitudes toward the Internet and perceived behavioral control. The model was effective in explaining attitudes toward cyber-counseling, emphasizing the influence of attitudes toward psychological help.
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Sit HF, Li G, Chen W, Sou EKL, Wong M, Burchert S, Hong IW, Sit HY, Lam AIF, Hall BJ. A protocol for a type 1 effectiveness-implementation randomized controlled trial of the WHO digital mental health intervention Step-by-Step to address depression among Chinese young adults in Macao (SAR), China. Internet Interv 2022; 30:100579. [PMID: 36217366 PMCID: PMC9547191 DOI: 10.1016/j.invent.2022.100579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/27/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Among Chinese college students, the burden of depression is considerably high, affecting up to 30 % of the population. Despite this burden, few Chinese students seek mental health treatment. In addition, depression is highly comorbid with other mental health disorders, such as anxiety. Scalable, transdiagnostic, evidence-based interventions are needed for this population. OBJECTIVE The study will evaluate the effectiveness of a World Health Organization transdiagnostic digital mental health intervention, Step-by-Step, to reduce depressive and anxiety symptoms and improve well-being compared with enhanced care as usual and its implementation in a Chinese university community. METHODS A type 1 effectiveness-implementation two-arm, parallel, randomized controlled trial will be conducted. The two conditions are 1) the 5-session Step-by-Step program with minimal guidance by trained peer-helpers and 2) psychoeducational information on depression and anxiety and referrals to local community services. A total of 334 Chinese university students will be randomized with a 1:1 ratio to either of the two groups. Depression, anxiety, wellbeing, and client defined problems will be assessed at pre-intervention, post-intervention, and 3-month follow-up. Endline qualitative interviews and focus group discussions will be conducted to explore SbS implementation among service users, university staff, and stakeholders. Data will be analysed based on the intent-to-treat principle. DISCUSSION Step-by-Step is an innovative approach to address common mental health problems in populations with sufficient digital literacy. It is a promising intervention that can be embedded to scale mental health services within a university setting. It is anticipated that after successful evaluation of the program and its implementation in the type 1 hybrid design RCT study, Step-by-Step can be scaled and maintained as a low-intensity treatment in universities, and potentially extended to other populations within the Chinese community. TRIAL REGISTRATION ChiCTR2100050214.
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Key Words
- AE, adverse event
- Behavioral activation
- CONSORT, Consolidated Standards of Reporting Trials
- CSQ, Client Satisfaction Questionnaire
- College students
- DASS-21, Depression, Anxiety, and Stress Scale – 21 items
- Depression
- Digital intervention
- ECAU, enhanced care as usual
- GAD-7, Generalized Anxiety Disorder
- ITT, intention-to-treat
- Implementation
- PCC, Psychological Counselling Center
- PCL, PTSD Checklist for DSM-5
- PHQ, Patient Health Questionnaire
- PSYCHLOPS, Psychological Outcomes Profile Instrument
- RCT, randomized controlled trial
- RE-AIM, Reach, Effectiveness, Adoption, Implementation, and Maintenance
- Randomized controlled trial
- SAE, serious adverse event
- SPIRIT, Standard Protocol Items: Recommendations for Interventional Trials
- SbS, Step-by-Step
- WHO, World Health Organization
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Affiliation(s)
- Hao Fong Sit
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong (SAR), People's Republic of China
| | - Gen Li
- Center for Global Health Equity, New York University (Shanghai), Shanghai, People's Republic of China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, People's Republic of China,Sun Yat-sen Centre for Migrant Health Policy, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, People's Republic of China
| | - Elvo Kuai Long Sou
- Student Affairs Office, University of Macau, Macao (SAR), People's Republic of China
| | - Mek Wong
- Student Affairs Office, University of Macau, Macao (SAR), People's Republic of China
| | - Sebastian Burchert
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin (FUB), Germany
| | - Ieng Wai Hong
- Moon Chun Memorial College, University of Macau, Macao (SAR), People's Republic of China
| | - Ho Yi Sit
- Shiu Pong College, University of Macau, Macao (SAR), People's Republic of China
| | - Agnes Iok Fong Lam
- Centre for Macau Studies, University of Macau, Macao (SAR), People's Republic of China
| | - Brian J. Hall
- Center for Global Health Equity, New York University (Shanghai), Shanghai, People's Republic of China,Corresponding author at: Center for Global Health Equity, New York University Shanghai, Shanghai, People's Republic of China.
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Shan Y, Ji M, Xie W, Li R, Qian X, Zhang X, Hao T. Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review. Interact J Med Res 2022; 11:e38249. [PMID: 35704383 PMCID: PMC9244660 DOI: 10.2196/38249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/16/2022] [Accepted: 05/27/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being. OBJECTIVE The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers. METHODS We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis. RESULTS We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers. CONCLUSIONS This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.
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Affiliation(s)
- Yi Shan
- School of Foreign Studies, Nantong University, Nantong, China
| | - Meng Ji
- School of Languages and Cultures, University of Sydney, Sydney, Australia
| | - Wenxiu Xie
- Department of Computer Science, City University of Hong Kong, Hong Kong, China
| | - Rongying Li
- School of Artificial Intelligence, South China Normal University, Guangzhou, China
| | - Xiaobo Qian
- School of Computer Science, South China Normal University, Guangzhou, China
| | - Xiaomin Zhang
- Department of Linguistics, Macquarie University, Sydney, Australia
| | - Tianyong Hao
- School of Computer Science, South China Normal University, Guangzhou, China
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Chang CI, Fong Sit H, Chao T, Chen C, Shen J, Cao B, Montag C, Elhai JD, Hall BJ. Exploring subtypes and correlates of internet gaming disorder severity among adolescents during COVID-19 in China: A latent class analysis. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 35505828 PMCID: PMC9050178 DOI: 10.1007/s12144-022-03133-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 12/14/2022]
Abstract
The WHO recently included Gaming Disorder as a psychiatric diagnosis. Whether there are distinct groups of adolescents who differ based on severity of gaming disorder and their relationships with other mental health and addictive behavior outcomes, including problematic smartphone use (PSU), remains unclear. The current study explored and identified subtypes of Internet Gaming Disorder (IGD) severity and estimated the association between these subtypes and other disorders. Participants completed online questionnaires assessing the severity of IGD, PSU, depression, and anxiety during COVID-19. We conducted a latent class analysis of IGD symptoms among 1,305 Chinese adolescents (mean age = 15.2; male = 58.5%) from 11 secondary schools in Macao (SAR), China. Multinomial logistic regression estimated correlates of latent class membership and PSU. A 4-class model adequately described the sample subgroups. Classes were labeled as normative gamers (30.9%), occasional gamers (42.4%), problematic gamers (22.7%), and addictive gamers (4.1%). Relative to normative gamers, PSU severity, depression, and being male were significantly higher among problematic gamers, addictive gamers, and occasional gamers. Only problematic gamers showed significant positive associations with anxiety severity compared to the other groups. The study revealed the differences in severity of gaming disorder and its association with psychopathology outcomes. Application in screening for IGD and comorbidity is discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03133-8.
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Affiliation(s)
- Chi Ian Chang
- Department of Psychology, University of Macau, Macau, SAR People’s Republic of China
| | - Hao Fong Sit
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region People’s Republic of China
| | - Tong Chao
- Department of Psychology, University of Macau, Macau, SAR People’s Republic of China
| | - Chun Chen
- School of Humanities and Social Science, Chinese University of Hong Kong (Shenzhen), Shenzhen, People’s Republic of China
| | - Jie Shen
- Amsterdam School for Cultural Analysis, University of Amsterdam, Amsterdam, The Netherlands
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, People’s Republic of China
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
- neuSCAN Laboratory, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Jon D. Elhai
- Department of Psychology, and Department of Psychiatry, University of Toledo, Toledo, OH USA
| | - Brian J. Hall
- Center for Global Health Equity, New York University (Shanghai), Shanghai, 200122 People’s Republic of China
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