Minor Forms of Parental Maltreatment and Educational Achievement of Immigrant Youths in Young Adulthood: A Longitudinal Study

Parental hostility and emotional rejection-or aggregated as general harsh family interactions with parents-have received little research attention due to such parent-child interactions being counted as minor forms of parental maltreatment and regarded as being less harmful. However, recent research showed that these minor forms of parental maltreatment on youth development are far from negligibility on account of their frequency, chronicity, and incessancy. In this longitudinal study, we investigated how parental hostility, emotional rejection, and harsh family interactions with parents of in early adolescence of immigrant youths (wave-1 M_age = 14) adversely impact successful college graduation of immigrant youths in young adulthood (wave-3 M_age = 24) through the mediation of their development of academic aspirations in late adolescence (wave-2 M_age = 17). Using data from a representative sample of the Children of Immigrants Longitudinal Study (N = 3344), the current study revealed that parental hostility, emotional rejection, and harsh family interactions with parents significantly impaired successful college graduation of immigrant youths in young adulthood, with the decreased odds of 20.1% to 30.22%. Furthermore, academic aspirations of immigrant youths in late adolescence not only significantly mediated the abovementioned relationships but also contributed to the higher odds of immigrant youths' college graduation by 2.226 to 2.257 times. Findings of this study related to educational innovations, family services, and policy implications are discussed herein.

Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol

Studies have consistently showed that informal caregivers have worse health, more medical consultations, anxiety and depression, and lower quality of life than those who do not provide such care. Positive outcomes of psychoeducation interventions have been found, but many of them are relatively long in duration, making them less cost-effective in implementation. The proposed study is a multi-site, three-arm randomized controlled trial of a mindfulness-based intervention for Chinese family caregivers. Effects of the intervention will be compared with those of an evidence-based psychoeducation program and treatment-as-usual. Two hundred forty cross-generational caregivers of frail older adults with moderate to severe levels of frailty will be recruited and randomly assigned to mindfulness-based intervention, psychoeducation, and treatment-as-usual experimental conditions. Program effectiveness will be analyzed on measures of caregiver burden, depression, anxiety, positive caregiving experience, spirituality, family conflict, and the biomarker of heart rate variability. Measures on coping styles, experiential avoidance, and self-efficacy will be explored to see if they mediate the changes to participant improvements in outcomes. Six-month follow-up will be included to investigate the maintenance effects. This study will provide evidence on mindfulness-based interventions on caregivers of frail older adults and expand the existing models of intergenerational caregiving in Chinese culture.

Intimate Partner Sexual Violence and Mental Health Indicators Among Chinese Emerging Adults

Intimate partner sexual violence (IPSV) among emerging adults, including heterosexuals and sexual minorities in the Chinese population, is poorly understood. Focusing on college students, the objectives of the present study were to estimate the prevalence of IPSV among Chinese emerging adults, examine the association between sexual orientation and IPSV, and evaluate the mental health and quality of life of survivors of IPSV. Data were collected from four university campuses in Hong Kong. A total of 1,015 participants were included in the data analysis. The prevalence of IPSV as identified by Conflict Tactics Scale (CTS)-2 was 12.1%. There was no gender difference in the prevalence of IPSV. Multiple logistic regression found that being older; having experienced childhood sexual abuse and having a smoking habit; and belonging to a sexual minority were factors associated with IPSV. Multiple linear regression found that IPSV survivors were more likely to have higher levels of anxiety and depression, more severe psychosomatic symptoms, and poorer quality of life in three domains: psychological, social relationships, and environment when compared with those without IPSV experience. The documented factors underscored the importance of awareness that men and sexual minorities might incur IPSV, which should receive more attention in IPSV prevention programs. Also, interventions for IPSV survivors should be targeted at improving their mental health and quality of life and sex education should place more emphasis on sexual consent and sexual health in dating relationships.

Study Protocol of Brief Daily Body-Mind-Spirit Practice for Sustainable Emotional Capacity and Work Engagement for Community Mental Health Workers: A Multi-Site Randomized Controlled Trial

Background

Given the emotional demanding nature of social services, we developed a brief daily body-mind-spirit (BMS) program and successfully piloted it with workers at elderly services. The proposed study focuses on community mental health workers who are often under chronic stress and vulnerable to burnout.

Methods

The study aims to evaluate the program for fostering sustainable emotional capacity and work engagement for community mental health workers. A multi-site randomized controlled trial design is adopted. All the 24 the Integrated Community Centre for Mental Wellness (ICCMW of Hong Kong will be approached to join this program. Assuming conservatively, 60% ICCWM (14 centers) will respond and participate. At each site, a pair of intervention and control groups will be run. The targeted total sample size is 224. To investigate the course of changes in burnout and engagement, each group will last 6 months, including 3-month intervention and 3-month follow-up. Measures will be taken at monthly intervals.

Discussion

In light of literature and the pilot trial’s findings, participants in the Brief Daily BMS intervention group are expected to have a reduced burnout level and a narrowing of range in work engagement during the 3 months intervention. And within the 3 months post-intervention period, a rebound of burnout level and a widening of range in work engagement are expected to be observed in the same group of participants. Hopefully, this study will contribute to the deeper understanding of burnout and work engagement, and shed light on sustainable intervention for emotionally demanding workplaces.

Clinical Trial Registration

The trial has been registered in the Clinical Trials Centre of the University of Hong Kong. HKUCTR-2763 Registered 27 December 2019 – Retrospectively registered, http://www.hkuctr.com/Study/Show/eb930d24e2c647afb7a922055163f24b.

Effects of a Mindfulness-based Intervention on diurnal cortisol pattern in disadvantaged families: A randomized controlled trial

OBJECTIVE

The present study examined the psychophysiological effects of Family-based Mindfulness Intervention (FBMI) on children and parents from disadvantaged families.

METHODS

This randomized controlled trial recruited parents and their children from 51 disadvantaged families in Hong Kong and randomized them into FBMI (n = 26) and waitlist control (n = 25) groups. The parent intervention included 6 sessions and the child intervention included 8 sessions with 2 half-hour joint programs. Both interventions lasted 9 hours in total each. All participants completed four salivary cortisol measures after wakeup, before lunchtime, late-afternoon, and before sleep at baseline and end of the intervention. The diurnal cortisol pattern was summarized by the morning cortisol, evening cortisol, mean cortisol, and diurnal cortisol slope.

RESULTS

Compared to the control group, children in the FBMI group showed significant increases in morning cortisol (d = 0.50, p =  0.03) and significant decreases in diurnal cortisol slopes (d = 0.50, p =  0.04) at the end of intervention. Parents in the FBMI group displayed significant decreases in evening cortisol (d = 0.50, p =  0.04) compared to the control group at the end of intervention. No significant treatment effects were found on the mean cortisol.

DISCUSSION

The present findings suggest that FBMI could improve the diurnal cortisol slope and cortisol levels of the children and parents from disadvantaged families, respectively. Future studies should elucidate its potential benefits on neuroendocrine functioning.

The Effects of Family-Based Mindfulness Intervention on ADHD Symptomology in Young Children and Their Parents: A Randomized Control Trial

Objective: The aim of the study is to investigate the feasibility of a family-based mindfulness intervention in improving children with inattention and hyperactivity symptoms. Method: A total of 100 children aged 5 to 7 years with ADHD symptoms and their parents were randomly assigned to a family-based mindfulness intervention (n = 50) or a wait-list control group (n = 50). Results: Families from intervention group had greater improvements in children's ADHD symptoms, with medium effect sizes of -0.60 for inattention and -0.59 for hyperactivity; overall behaviors; and parenting stress and well-being than those in wait-list control group. Conclusion: The positive results on the child primary outcome measures have provided initial evidence of the family-based mindfulness intervention as a treatment option to ADHD. The reduction of parental stress and increase in psychological well-being has demonstrated the value of mindfulness in enhancing parent's self-management.

MIND-BASED AND MOVEMENT-BASED MIND-BODY INTERVENTION FOR CHINESE OLDER PEOPLE WITH DEPRESSION

Mind-body intervention has been well established as an alternative psychosocial intervention for managing depression. Mindfulness-based intervention (MBI) and health qigong (HQ) are two common forms of mind-body intervention which share the common focus on breathing. However, they may represent two distinct approaches with different mechanisms. MBI focuses more on mind-based practices whereas HQ may focus predominantly on body-based movement practices. Thus, a large research gap in comparing the unique therapeutic effects of mind-based and movement-based health practices on alleviating depression among older people is worthy of further investigation. A total of 45 community-dwelling Chinese older adults aged 60 or above with symptoms of clinical depression were recruited. They were randomly assigned to three different groups, including an MBI group, a HQ group, and a waitlist control (WLC) group. Comparisons were made before and after 8-week interventions. Regarding the primary outcome, the effect sizes between the MBI and WLC groups, as well as between the HQ and WLC groups, were reasonably large (Hedges’ g = 1.338 and 0.725, respectively), yet the effect size between the MBI and HQ groups was moderate (Hedges’ g = 0.325). Specifically, participants in the MBI group showed more improvements on perceived stress, self-efficacy, and mental health, whereas participants in the HQ group showed relatively better performance regarding interoception and physical mobility. Findings from this research demonstrate the unique therapeutic effects of mind-based and movement-based interventions on alleviating depression among older people. The application of two distinct forms of mind-body intervention in a Chinese context is discussed.

The effect of a brief mindfulness-based intervention on personal recovery in people with bipolar disorder: a randomized controlled trial (study protocol)

BACKGROUND

With the advent of the recovery movement in mental health, a humanistic paradigm shift has occurred, placing the focus on personal recovery (i.e., hope, identity, and life meaning) instead of functional or clinical recovery only (i.e., symptom reduction or increases in physical function). Along the journey of recovery, people with bipolar disorder (BD) struggle to cope with recurring mood fluctuations between depression and mania. Mindfulness-based interventions (MBIs) have the potential to result in improvements in personal recovery outcomes. Thus, this protocol will evaluate the efficacy and mechanisms of a brief MBI for helping individuals with BD with their personal recovery. It is hypothesized that adults with BD randomly assigned to a brief MBI intervention will report greater improvements in personal recovery than those in a waiting list control condition. In addition, it is hypothesized that such benefits will be mediated by improvements in emotion awareness, emotion regulation, and illness acceptance. Moreover, the specific stage of BD is hypothesized to moderate the beneficial effects of the brief MBI, such that those in the early stage of BD will report more benefits regarding emotion awareness and emotion regulation, whereas those in the late stage of BD will report more advantages concerning illness acceptance.

METHOD

One hundred and fifty-four adults with BD will be recruited from hospitals and community settings for this research project. This study will use a mixed methods design. A randomized-controlled trial will be conducted to compare a brief MBI (four sessions in total) group and a waiting list control group. Assessments will be made at baseline, after intervention, and at six-month follow-up. In addition, a qualitative and participatory research method called Photovoice will be employed to further understand the experiences of the participants who receive the brief MBI along their personal recovery journey.

DISCUSSION

If the study hypotheses are supported, the findings from this research project will provide empirical support for an alternative treatment. Moreover, by identifying the mechanisms of the beneficial effects of the brief MBI, the findings will highlight process variables that could be specifically targeted to make MBI treatment even more effective in this population.

TRIAL REGISTRATION

This study is registered with the Chinese Clinical Trial Registry ( ChiCTR- 1900024658 ). Registered 20th July 2019.

Corrigendum: A Multidimensional PERMA-H Positive Education Model, General Satisfaction of School Life, and Character Strengths Use in Hong Kong Senior Primary School Students: Confirmatory Factor Analysis and Path Analysis Using the APASO-II

[This corrects the article DOI: 10.3389/fpsyg.2018.01090.].

A Multidimensional PERMA-H Positive Education Model, General Satisfaction of School Life, and Character Strengths Use in Hong Kong Senior Primary School Students: Confirmatory Factor Analysis and Path Analysis Using the APASO-II

The multidimensional PERMA-H positive education model provided evaluation and education framework for the theoretical and practice development of positive psychology in schools. Character strengths use mediates the association of strength knowledge and well-being. Using the Assessment Program for Affective and Social Outcomes (2nd Version) (APASO-II), the Subjective Happiness Scale, and the Physical Health Subscale of the PERMA-profiler, a multidimensional measure of PERMA-H was validated using confirmatory factor analysis in the context of a positive education program evaluation in senior primary school students. The association of PERMA-H measurements with school well-being as measured by general satisfaction of school life, and levels of depression and anxiety, and the mediation mechanism of character strengths use in such association were studied using path analysis. A cross-sectional sample of 726 senior primary school students (i.e., grade 4–6) aged 8–13 from the two primary schools completed a baseline evaluation questionnaire of a positive education program. Satisfactory internal reliability of the scales was obtained with Cronbach's alpha coefficients < 0.70. The scales were generally positively and moderately inter-correlated, except for level of anxiety and depression symptoms which was negative. Good psychometric properties of APASO-II were evidenced from the factor structure of sub-scale scores conforming to six factors of the PERMA-H model by confirmatory factor analysis. Path analyses showed that the APASO-II factors together with measures of subject happiness and positive health as the multidimensional PERMA-H model of positive education differentially predicted general satisfaction of school life, level of anxiety and depression, and character strengths use. Character strengths use mediated the relationship of Positive Engagement with general satisfaction of school life. Positive education utilizes knowledge and research findings from positive psychology in schools to produce intended positive outcomes like enhanced well-being and reduced level of depression in students. This study provided a solid foundation for related scientific research and the understanding of the multidimensional framework of positive psychology concepts. Systematic promotion and longitudinal evaluation of positive education at the institutional level in Hong Kong can be achieved with the use of APASO-II and the positive education scales of subjective happiness and physical health.

Association Between Using Smartphone Dating Applications and Alcohol and Recreational Drug Use in Conjunction With Sexual Activities in College Students

BACKGROUND

The association between using smartphone dating applications (apps) and substance use in conjunction with sexual activities was only examined in homosexual men. This association was poorly understood in heterosexual samples.

OBJECTIVE

To explore the association between using dating apps and alcohol, and use of recreational drug in conjunction with sexual activities in college students.

DESIGN

666 students from four universities in Hong Kong were recruited in this cross-sectional study in the year 2015. Outcome measures included the use of dating apps, sexual history, and drug and alcohol use. Multivariable logistic regressions were employed.

RESULTS

The use of dating apps for more than 1 year was found to be associated with recreational drug use in conjunction with sexual activities (adjusted odds ratio: 7.23). Other risk factors of recreational drug use in conjunction with sexual activities included being bisexual/homosexual male, a smoker, and having one's first sexual intercourse at the age of less than 16 years. The use of dating apps was not a risk factor for alcohol consumption in conjunction with sexual activities. Risk factors for alcohol consumption in conjunction with sexual activities included being older, having monthly income more than HKD5,000, and a smoker. Furthermore, risk factors for alcohol consumption in conjunction with the last sexual activity included currently being in a dating relationship, a smoker, and having sex with a casual partner.

CONCLUSIONS

Using dating apps is an emerging risk factor of drug misuse. Interventions for practising safe sex and preventing drug use should be targeted at dating app users.

The association between smartphone dating applications and college students' casual sex encounters and condom use

OBJECTIVE

This study aims to explore the association between using smartphone dating applications (apps) and having unprotected sex with a casual sex partner.

STUDY DESIGN

This is a cross-sectional study. Students were recruited from four university campuses in Hong Kong by convenience sampling.

MAIN OUTCOME MEASURES

Subjects completed a structured questionnaire asking about the use of dating apps, sexual history and socio-demographic information. Multiple logistic regressions were used to explore the association between using dating apps and having unprotected sex with a casual sex partner.

RESULTS

Six hundred and sixty-six subjects were included in the analysis. Users of dating apps were more likely to have had unprotected sex with a casual sex partner the last time they engaged in sexual intercourse (aOR: 10.06). Using dating apps for more than 12 months was associated with having a casual sex partner in the last sexual intercourse (aOR: 3.21), as well as having unprotected sex with that casual partner (aOR: 13.56).

CONCLUSION

We found a robust association between using dating apps and having unprotected sex with a casual sex partner, implying that using dating apps is an emerging sexual risk factor. We recommend that interventions promoting the safe use of dating apps should be implemented.

The effect of a family-based mindfulness intervention on children with attention deficit and hyperactivity symptoms and their parents: design and rationale for a randomized, controlled clinical trial (Study protocol)

BACKGROUND

About 4 % of children in Hong Kong have attention deficit hyperactivity disorder (ADHD). The parents of children with ADHD report higher levels of stress and show more negative parenting behavior. Medication and behavior training are evidence-based treatments, but both show significant limitations. In short, medical treatment is not suitable for preschool children and would suppress growth, whereas parents under stress may not be capable of consistently applying behavior management skills. Mindfulness training can improve attention and facilitate cognitive development and overall functioning. It has been widely adopted as a treatment option in health care, but its application in a family context is limited. In this context, a family-based mindfulness intervention (FBMI) has been developed to promote the attention and mental health of children with attention symptoms and to reduce the stress experienced by their parents. This article describes the design and conduct of the trial.

METHODS/DESIGN

A multicenter, 8-week, waitlist, randomized controlled trial of FBMI is currently being conducted in Hong Kong (from mid-2015 to mid-2016). Its effectiveness will be examined by comparing the participants who receive treatment to those in a waitlist control group. The study population consists of one hundred twenty children with ADHD, or with symptoms of inattention and hyperactivity, between 5 and 7 years of age and their parents. To be included in the study, the children are required to meet or exceed the borderline cutoff score of the Chinese version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviors Rating Scale (SWAN-C). The primary outcome measures are the children's ADHD symptoms and behavior and the parents' stress. The secondary outcome measures include the children's overall behavioral problems and performance on the Attention Network Test, the parents' ADHD symptoms, the parents' mindful parenting scores, and heart rate variability of parents.

DISCUSSION

This study is probably the first randomized controlled trial of FBMI for young children and their caregivers. A rigorous design and multiple outcome measures are used to examine the effectiveness of FBMI. If the hypotheses are confirmed, FBMI may serve as an additional treatment option for children with ADHD.

TRIAL REGISTRATION

This study is registered with the Chinese Clinical Trial Registry (reference number: ChiCTR-IOR-15007292 ). Registered 28 October 2015.

The roles of emotional competence and social problem-solving in the relationship between physical abuse and adolescent suicidal ideation in China

The study investigated the relationship among physical abuse, positive psychological factors including emotional competence and social problem-solving, and suicidal ideation among adolescents in China. The possible moderating effects of emotional competence and social problem-solving in the association between physical abuse and adolescent suicidal ideation were also studied. A cross-sectional survey employing convenience sampling was conducted and self-administered questionnaires were collected from 527 adolescents with mean age of 14 years from the schools in Shanghai. Results showed that physical abuse was significantly and positively related to suicidal ideation in both male and female adolescents. Emotional competence was not found to be significantly associated with adolescent suicidal ideation, but rational problem-solving, a sub-scale of social problem-solving, was shown to be significantly and negatively associated with suicidal ideation for males, but not for females. However, emotional competence and rational problem-solving were shown to be a significant and a marginally significant moderator in the relationship between physical abuse and suicidal ideation in females respectively, but not in males. High rational problem-solving buffered the negative impact of physical abuse on suicidal ideation for females. Interestingly, females with higher empathy and who reported being physically abused by their parents have higher suicidal ideation. Findings are discussed and implications are stated. It is suggested to change the attitudes of parents on the concept of physical abuse, guide them on appropriate attitudes, knowledge and skills in parenting, and enhance adolescents' skills in rational problem-solving.