Association between interpersonal relations and anxiety, depression symptoms, and suicidal ideation among middle school students

The bidirectional longitudinal associations between fear of negative evaluation and suicidal ideation among Chinese adolescents: The mediating role of interpersonal needs factors

Based on previous theories and studies, fear of negative evaluation (FNE) may be a key predictor of suicidal ideation in adolescents. However, few studies examined the longitudinal relationships between FNE and suicidal ideation. This study aimed to explore the bidirectional longitudinal relationships between FNE and suicidal ideation. Meanwhile, based on the Interpersonal Theory of Suicide, this study would examine the longitudinal mediating role of interpersonal needs factors (thwarted belongingness and perceived burdensomeness) on the relationship between FNE and suicidal ideation. A sample of 515 adolescents (Mage = 12.309, SD = 0.807; 49.3 % girls) completed questionnaires on 4 waves, 6 months apart. The Random Intercept Cross-Lagged Panel Models (RI-CLPMs) were utilized to estimate the associations among study variables. The results showed that: (1) there was a significant bidirectional longitudinal relationship between FNE and suicidal ideation; (2) thwarted belongingness and perceived burdensomeness independently and serially mediated the relationship between FNE and suicidal ideation. This study contributed to understanding the complex relationship between FNE and suicidal ideation, emphasizing the critical roles of thwarted belongingness and perceived burdensomeness. The findings underscore the bidirectional nature of these associations and provide insights into the potential pathways involved in the development of suicidal ideation among adolescents.

Associations between Adolescent Preoperative Mental Health, Psychosocial Factors, and Body Mass Index

BACKGROUND

There is little research on adolescent bariatric surgery and mental health (depression, anxiety, etc.) with racial/ethnic minority adolescents. The objective of this study is to determine associations between adolescents' preoperative reports of depression, anxiety, and self-esteem and caregiver's' reports of the caregiver-adolescent relationship and interpersonal relationships with adolescents' BMI and differences based on race/ethnicity.

METHOD

Adolescents (ages 12-21) who underwent metabolic and bariatric surgery from June 2020 to November 2022 had their responses to specific items on the BASC-3 (anxiety, depression, and self-esteem) analyzed for associations with their body mass index (BMI) and with caregiver responses to the BASC-3 for adolescents' interpersonal skills and relationship with caregiver. Demographic differences on the BASC-3 were assessed. Pearson's correlations, independent t-tests, and ANOVA were used.

RESULTS

Caregivers who had higher t-scores for relationship with their adolescents had adolescents who had lower depression t-scores, lower anxiety t-scores, and higher self-esteem t-scores. Parents who had higher t-scores for their adolescents' interpersonal relations had adolescents who had lower depression t-scores, lower anxiety t-scores, and higher self-esteem t-scores. White adolescents had higher depression t-scores than Black and Hispanic adolescents. Black and Hispanic adolescents had higher self-esteem t-scores compared to White adolescents.

DISCUSSION

Some of the findings within the study regarding adolescents' race and ethnicity and mental health are not consistent with prior research, affirming the need for additional research of these sub-populations.

School belonging mediates the association between negative school climate and depressive symptoms among Chinese adolescents: a national population-based longitudinal study

Background

A negative school climate is an important factor affecting students' mental health. However, few studies have focused on the mechanisms underlying the relationship. This study aimed to explore the mediating effect of school belonging on the association between negative school climate and depressive symptoms among Chinese adolescents, using a nationwide longitudinal survey.

Methods

We conducted a longitudinal study using data from the 2013 (T1) and 2014 (T2) waves of the China Education Panel Survey (CEPS). A negative school climate was assessed by school administrators' reports. School belonging and depressive symptoms were evaluated using adolescents' self-reports. We used a cross-lagged panel model to explore the mediating effect of school belonging on the association between negative school climate and depressive symptoms, adjusting for a set of covariates.

Results

In total, 7,049 Chinese adolescents with a mean age of 12.9 years were included in this study. The results of the cross-lagged model showed that negative school climate at T1 was significantly negatively associated with school belonging at T2 (β = -0.089, 95%CI = -0.111--0.067, p < 0.001), and was positively associated with depressive symptoms at T2 (β = 0.032, 95%CI = 0.012-0.054, p = 0.002). In addition, school belonging at T1 was significantly negatively associated with depressive symptoms at T2 (β = -0.025, 95%CI = -0.050--0.001, p = 0.045). Mediation analysis showed that school belonging played a mediating role in the association between negative school climate and depressive symptoms (β = 0.002, 95%CI = 0.001-0.005, p = 0.041).

Conclusion

Among Chinese adolescents, a negative school climate is associated with a greater risk of depressive symptoms. Improving school belonging may be helpful in decreasing the impact of a negative school climate on depressive symptoms in adolescents.

Depression, Anxiety and Poor Sleep Quality are Associated with Chronotype and Financial Wellness in University Students

Background: Evidence suggests the importance of a person's chronotype in predicting various aspects of an individual's physical and mental health. While the effect of depression on sleep is well established, the impact of a person's specific sleep timing and chronotype on the prevalence of both depression and anxiety has yet to be fully understood, especially among university students, vulnerable to mental health problems. In addition, other factors also seem to influence the occurrence of depression and anxiety among students as well as their quality of sleep, one of which being the students' financial wellness. The objective was to evaluate the association between chronotype and the severity and prevalence of depression among Lebanese university students, while also taking into account the possible connection between chronotype and financial wellness and both anxiety and sleep quality. Methods: This cross-sectional study was conducted between December 2021 and February 2022; 330 Lebanese university students was included (mean age 21.75 ± 2.43; 67.3% females). Results: The majority of the Lebanese university students in our sample were found to have an intermediate typology (63.0%), followed by the evening typology, which appeared to constitute 28.2% of the sample, while only 8.8% possessed a morning typology. In this study, having an intermediate or evening typology compared to a morning one was significantly associated with higher depression and worse sleep quality. In addition, having an evening chronotype compared to a morningness propensity was significantly associated with more anxiety. Conclusion: This study found a positive association between an evening typology (chronotype) and higher depression and anxiety and poorer quality of sleep. Although preliminary and based on cross-sectional data, this research could help provide a better understanding of the different chronotypes among university students, and of the possible increased susceptibility of some of these typologies (i.e., evening-type) to mental health problems.

Stress events and stress symptoms in Chinese secondary school students: gender and academic year characteristics of the relationship

Objective

To explore the relationship between stress events and stress symptoms and their gender and academic year characteristics in Chinese secondary school students.

Methods

4,995 secondary school students were investigated by the Adolescent Self-rating Life Events Checklist (ASLEC) and the Calgary Symptoms of Stress Inventory (C-SOSI).

Results

First, there were significant differences in all dimensions and total scores of stress events and stress symptoms between boys and girls in secondary school and between junior high school students and senior high school students. Second, the dimensions and total scores of stress events in secondary school students are positively correlated with the dimensions and total scores of stress symptoms. Third, the influence of punishment on the stress symptoms of secondary school boys is the most obvious, and the influence of punishment, adaption, relationship stress, and learning stress on the stress symptoms of secondary school girls is the most obvious. The influence of punishment on the stress symptoms of junior high school students is the most obvious, and the influence of punishment and relationship on the stress symptoms of senior high school students is the most obvious.

Conclusion

Stress events and stress symptoms of Chinese secondary school students have significant differences in gender and academic year. The same stress event has different influence mechanisms on the stress symptoms of Chinese secondary school students of different genders and different academic years.

New factors affecting wound healing and recurrence after pilonidal sinus surgery in adolescents; seborrheic dermatitis and psychiatric co-occurring conditions

Postoperative wound healing problems and recurrence remain common for pilonidal sinus disease (PSD). Our study aimed to examine the effect of comorbidities in addition to the classic known factors that may affect wound complications and recurrence after PSD surgery. We retrospectively analysed 282 adolescent patients operated on in our clinic between 2014 and 2021. We gathered the postoperative wound healing patterns of the patients under four groups. With a mean age of 15.49 ± 1.45, 59.9% (n = 169) were male, 40.1% (n = 113) were female and 23.8% (n = 67) had recurrence. When examined according to the wound healing groups, 53.5% (n = 151) had an uneventful wound, 22.6% (n = 64) had prolonged wound care, 17.7% (n = 50) of the postoperative wounds did not close and had a recurrence and 6% (n = 17) had recurrence after the wound was healed. The number of sinuses, abscess presentation and the incidence of comorbid disease in group 1 were found to be statistically significantly lower than all other groups. Seborrheic dermatitis, obesity and psychiatric diagnoses showed high statistical association with group 3 and acne with group 4. In patients with seborrheic dermatitis or psychiatric diagnosis, a significant correlation was found between wound healing according to the type of surgery (p < 0.05). The wound healing patterns of these patients after total excision and primary closure surgeries were included in Group 3 with a statistically significant high rate. As two new factors, the significance of the presence of seborrheic dermatitis and psychiatric comorbidities should be evaluated in these patients whose wounds remain open postoperatively and do not respond to primary wound care and eventually relapse. Further histologic and pathologic investigations are needed for seborrheic dermatitis and PSD relation. Awareness of these diseases may change the decision of the type of surgery, and their treatment within the same time may support wound healing and ultimately reduce recurrence.

Forest Bathing Increases Adolescents' Mental Well-Being: A Mixed-Methods Study

Previous research has demonstrated that practicing forest bathing has significant positive effects on adult psychological well-being. Considering the ongoing adolescents' mental health crisis of increasing anxiety and depression, determining whether forest bathing has similar effects on adolescents is an important expansion of forest bathing research. This study investigated the possibility that forest bathing could improve adolescents' mental well-being and sought to determine participants' experiences of forest bathing. It used a convergent, parallel, mixed-methods design that was partially co-created with 24 participants aged 16-18 as part of a youth participatory action research (YPAR) project in which participants practiced forest bathing three times over 3 weeks. As measured using the Warwick-Edinburgh Mental Well-Being Survey, the mean participant mental well-being increased significantly after forest bathing, with moderate to large effect sizes. Participants described reduced stress and increased feelings of relaxation, peace, and happiness. These findings correlate with previous forest bathing research involving adult participants. It is recommended that educators and others who work with adolescents consider forest bathing as a simple, low-cost way to improve adolescents' mental well-being.

How loneliness linked to anxiety and depression: a network analysis based on Chinese university students

BACKGROUND

There is conclusive evidence of a multifaceted and bidirectional relationship between loneliness and depression and anxiety. Nonetheless, more extensive research is needed to examine their relationships at a more granular level. This study employed a network analysis approach to identify the pathological mechanisms underpinning those relationships and to identify important bridge nodes as potential targets for intervention.

METHODS

941 University students were included in this study. The ULS-6 (the short-form UCLA Loneliness Scale) was used to assess loneliness, the PHQ-9 (Patient Health questionnaire-9) and GAD-7 (Generalized anxiety disorder 7-item) scales were used to assess the symptoms of depression and anxiety. We constructed two network structures of loneliness-anxiety and loneliness-depression and computed bridge expected influence for each symptom. In addition, we showed a flow network of "Suicide" containing symptoms of depression and loneliness.

RESULTS

All edges were positive in both networks constructed and the strongest edges were present within disorder communities. The overall connection between loneliness and depression was stronger compared to anxiety. The results demonstrated that the loneliness item "People are around me but not with me" was identified as bridge symptom in both networks. Furthermore, "Suicide" was directly connected to five symptoms of depression and four items of loneliness, with the strongest connections being between it and "Feeling of worthlessness" and "Psychomotor agitation/retardation".

CONCLUSIONS

Our findings provide a more nuanced explanation of the link between loneliness and depression and anxiety. The results identified the bridge symptom "People are around me but not with me", which had the strongest effect on enhancing symptoms of depression and anxiety. Clinical improvements based on the findings of this study and the impact of the intervention are discussed.

Factors affecting sibling bullying and its association with self-esteem and depression in middle school students

Sibling bullying is an unwanted aggressive behavior of a sibling that is associated with peer bullying and emotional problems. However, the prevalence of sibling bullying, the factors that affect this condition, and its impact on depression and self-esteem are understudied, especially in Thailand. This study aims to examine the prevalence of sibling bullying, factors that affect sibling bullying, and its association with self-esteem and depression during the pandemic. From January to February 2022, a cross-sectional study was conducted in grades 7-9 (age 12-15 years) who had at least one sibling. Demographic characteristics, sibling bullying, self-esteem, and depression were collected using the revised Olweus bully/victim questionnaire, the Rosenberg self-esteem scale, and Patient Health Questionnaire-9, respectively. Binary logistic regression was analyzed to determine associations between sibling bullying and outcomes. Of 352 participants (30.4% female), 92 (26.1%) were victims and 49 (13.9%) were bullies of sibling bullying in the previous 6 months. Factors associated with an increased risk of being victims included female (OR = 2.46; 95%CI 1.34-4.53), peer victimization (OR = 12.99; 95%CI 5.27-32.04), domestic violence (OR = 4.48; 95%CI 1.68-11.95), and perpetrating sibling bullying (OR = 9.81; 95%CI 4.62-20.81). Factors associated with an increased risk of depression were female (OR = 2.59; 95%CI 1.57-4.26), sibling bullying victimization (OR = 2.08; 95%CI 1.22-3.56), physical abuse (OR = 9.50, 95%CI 1.13-79.71) and domestic violence (OR = 3.44; 95%CI 1.40-8.45).  Conclusion: Sibling bullying was not uncommon in Thai young adolescents and was associated with female, peer bullying, domestic violence, and depression. Such associations should be identified early so preventive measures and management could be properly implemented. What is Known: • Sibling bullying increases the risk for engaging in peer bullying, aggressive behaviors, violence, and emotional difficulties during life course trajectories. • Victims of sibling bullying are at increased risk of depression, anxiety, mental distress, self-harm, and decreased well-being. What is New: • The rate of sibling bullying in Thai middle school students, even during the pandemic, was comparable to previous studies of different cultural backgrounds without the pandemic. • Victims of sibling bullying were associated with female sex, peer victimization, domestic violence, perpetrating sibling bullying, and depression. Perpetrating sibling bullying was also associated with bullies in cyberbullying.

Suicidal Mortality and Motives Among Middle-School, High-School, and University Students

IMPORTANCE

The suicide mortality rate per 100 000 population (SMRP) consistently decreased before the COVID-19 pandemic outbreak in Japan and then unexpectedly increased during the pandemic. However, the underlying mechanisms remain poorly understood.

OBJECTIVE

To identify trends in and factors associated with suicidal mortality and motives among students in Japan from 2007 to 2022.

DESIGN, SETTING, AND PARTICIPANTS

In this cross-sectional study, data on SMRPs among Japanese middle-school, high-school, and university students were obtained from the government suicide database Suicide Statistics of the National Police Agency.

MAIN OUTCOMES AND MEASURES

Age-dependent and temporal fluctuations in annual SMRPs, disaggregated by suicidal motive (7 categories and 52 subcategories), sex, and school, were analyzed using linear mixed-effect and joinpoint regression models, respectively.

RESULTS

Total suicide numbers from 2007 to 2022 were as follows: 760 male middle-school students, 635 female middle-school students, 2376 male high-school students, 1566 female high-school students, 5179 male university students, and 1880 female university students. The mean (SD) student populations from 2007 to 2022 were as follows: 1 752 737 (81 334) male middle-school students, 1 675 572 (78 824) female middle-school students, 1 648 274 (67 520) male high-school students, 1 614 828 (60 032) female high-school students, 1 652 689 (32 724) male university students, and 1 229 142 (57 484) female university students. Among male students, the leading motives were school-related factors (underachievement and worrying about the future), followed by family-related and health-related motives. Among female students, school-related and family-related motives decreased, but health-related motives showed an age-dependent increase. The SMRPs of middle-school male students and female students were almost equal (mean [SD], 2.7 [1.0] vs 2.4 [1.4]), but the age-dependent increase in SMRPs among male students was pronounced (mean [SD], high-school vs university male students, 9.1 [2.4] vs 19.6 [3.0]; high-school vs university female students, 6.1 [2.4] vs 9.6 [1.8]). However, the incidence of suicide among high-school students associated with health-related motives was greater in female students. The majority of suicides associated with major impactable suicidal motives (school-related, health-related, and family-related motives) began increasing before the pandemic. Changes in SMRP associated with interpersonal relationships, such as conflict with classmates or parents, were not significant, but the rates increased greatly during the pandemic.

CONCLUSIONS AND RELEVANCE

School-related, health-related, and family-related problems were major motives, whereas the impacts of health-related and family-related motives increased and decreased with age, respectively. Notably, most SMRPs associated with major impactable motives (underachievement, conflict with a parent or classmate, and mental illnesses) had already begun increasing in the late 2010s, indicating that recent increasing SMRPs among school-aged individuals were associated with pandemic-related factors and other factors affecting this generation before the pandemic. It may be inappropriate to uniformly apply research findings based on school-aged individuals to school-based suicide prevention programs for students in middle school, high school, and university.