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Okelo K, Murray A, King J, Hardie I, Hall HA, Luedecke E, Marryat L, Thompson L, Minnis H, Lombardo M, Wilson P, Auyeung B. Examining the Potential Mediating Role of Maternal Mental Health in the Association Between Socioeconomic Deprivation and Child Development Outcomes. Matern Child Health J 2025; 29:338-348. [PMID: 39918616 PMCID: PMC11925978 DOI: 10.1007/s10995-025-04050-5] [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: 01/02/2025] [Indexed: 03/21/2025]
Abstract
BACKGROUND Socioeconomic deprivation has been linked to negative child developmental outcomes including brain development, psychological well-being, educational attainment, and social-emotional well-being. Maternal mental health has also been linked to mothers' parenting practices and their children's developmental outcomes. However, limited evidence exists regarding the role of maternal mental health (prenatal and postnatal) in the association between socioeconomic deprivation and children's developmental outcomes. METHODS We examined the potential role of maternal mental health in the association between socioeconomic deprivation (SED) and child development outcomes. We used a large linked administrative health dataset covering children born between 2011 and 2015 in Greater Glasgow and Clyde, Scotland. Of the 76,483 participants, 55,856 mothers with matched children's developmental outcome data were included. A mediation analysis model, adjusted for confounders and covariates, was used. RESULTS Maternal mental health assessed by a history of hospital admissions mediated, but to a small extent, the relationship between SED and children's developmental outcomes. The average direct effect (ADE), of SED in the first model with a history of hospital admissions, was ADE: ES = - 0.0875 (95% CI = - 0.097, - 0.08; p < 0.001) and ACME: ES = - 0.0002 (95% CI = - 0.001, - 0.0001; p = 0.01). The proportion mediated by the history of mental health admission was 0.3%. CONCLUSION The association between SED and children's developmental outcomes appears to be partially mediated by maternal mental health, although the proportional-mediated effect was very small.
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Affiliation(s)
- Kenneth Okelo
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK.
| | - Aja Murray
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Josiah King
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Iain Hardie
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Hildigunnur Anna Hall
- Centre for Health Security and Communicable Disease Control, Directorate of Health, Reykjavík, Iceland
| | - Emily Luedecke
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Louise Marryat
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Lucy Thompson
- Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Helen Minnis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Michael Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Philip Wilson
- Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Centre for Research and Education in General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Bonnie Auyeung
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK
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Lesser TL, Matalon M, Clauss-Ehlers CS. Implications of Cash Transfer Programs for Mental Health Promotion among Families Facing Significant Stressors: Using Ecological Systems Theory to Explain Successes of Conditional and Unconditional Programs. Behav Sci (Basel) 2024; 14:770. [PMID: 39335984 PMCID: PMC11428543 DOI: 10.3390/bs14090770] [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: 02/18/2024] [Revised: 08/22/2024] [Accepted: 08/24/2024] [Indexed: 09/30/2024] Open
Abstract
The purpose of this paper is to apply Bronfenbrenner's ecological systems theory to explore the literature on how Conditional Cash Transfer (CCT) and Unconditional Cash Transfer (UCT) programs might support positive mental health outcomes. The paper begins with transnational considerations of stress, such as poverty and COVID-19, and their impact on mental health. Bronfenbrenner's theory is applied to better understand the mechanisms by which CCT and UCT programs can potentially lead to positive outcomes for children and families who face such stressors. The implications of cash transfer programs are subsequently discussed in terms of how they might promote positive mental health outcomes among families globally. This theoretical application paper concludes with a call for transnational research to explore connections between cash transfer programs and mental health outcomes for children/adolescents and their parents/caregivers.
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Affiliation(s)
- Tali L. Lesser
- Department of Psychology, School of Health Professions, Long Island University Brooklyn, Brooklyn, NY 11201, USA
| | - Maya Matalon
- Department of Psychology, School of Health Professions, Long Island University Brooklyn, Brooklyn, NY 11201, USA
| | - Caroline S. Clauss-Ehlers
- Department of Psychology, School of Health Professions, Long Island University Brooklyn, Brooklyn, NY 11201, USA
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Borairi S, Deneault AA, Madigan S, Fearon P, Devereux C, Geer M, Jeyanayagam B, Martini J, Jenkins J. A meta-analytic examination of sensitive responsiveness as a mediator between depression in mothers and psychopathology in children. Attach Hum Dev 2024; 26:273-300. [PMID: 38860779 DOI: 10.1080/14616734.2024.2359689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/21/2024] [Indexed: 06/12/2024]
Abstract
The current meta-analysis examined the mediating role of sensitive-responsive parenting in the relationship between depression in mothers and internalizing and externalizing behavior in children. A systematic review of the path of maternal sensitive responsiveness to child psychopathology identified eligible studies. Meta-analytic structural equation modelling (MASEM) allowed for the systematic examination of the magnitude of the indirect effect across 68 studies (N = 15,579) for internalizing and 92 studies (N = 26,218) for externalizing psychopathology. The synthesized sample included predominantly White, English-speaking children (age range = 1 to 205 months; Mage = 66 months; 47% female) from Western, industrialized countries. The indirect pathway was small in magnitude and similar for externalizing (b = .02) and internalizing psychopathology (b = .01). Moderator analyses found that the indirect pathway for externalizing problems was stronger when mother-child interactions were observed during naturalistic and free-play tasks rather than structured tasks. Other tested moderators were not significant.
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Affiliation(s)
- Sahar Borairi
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Chloe Devereux
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Melissa Geer
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Julia Martini
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | - Jennifer Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
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Jo Driscoll D, Kiely E, O'Keeffe LM, Khashan AS. Poverty trajectories and child and mother well-being outcomes in Ireland: findings from an Irish prospective cohort. J Epidemiol Community Health 2024; 78:409-416. [PMID: 38688701 PMCID: PMC11187358 DOI: 10.1136/jech-2023-221794] [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] [Received: 12/08/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Poverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood. OBJECTIVE To understand the prevalence of different trajectories of household poverty and their association with mid-childhood and mother indicators of physical health and psychopathology in Ireland. METHODS We used a nationally representative, prospective cohort (Growing Up in Ireland-Infant Cohort). Household poverty included lowest third income decile, subjective poverty and material deprivation when children were aged 9 months, and 3, 5, 9 years. We used group-based multitrajectory cluster modelling to classify trajectories of poverty. Using multivariable logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9 months to 9 years with child outcomes (overweight, any longstanding illness and psychopathology) at age 9 years and the same poverty trajectories over the same 9-year period with mother outcomes (overweight, any longstanding illness and depression). RESULTS Of 11 134 participants, 4 trajectories were identified: never in poverty (43.1%), material/subjective>monetary poverty (16.1%), monetary>material poverty (25.6%) and persistent poverty (15.2%). Children in persistent poverty compared with those in never in poverty experienced higher odds of being overweight at 9 years (adjusted OR (aOR) 1.70, 95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51, 95% CI 1.20, 1.91), and psychopathology (aOR 2.06, 95% CI 1.42, 2.99). The outcomes for primary parents (99.7% were mothers) were as follows: having higher odds of being overweight (aOR 1.49, 95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13, 95% CI 1.63, 2.79), and depression (aOR 3.54, 95% CI 2.54, 4.94). CONCLUSIONS Any poverty trajectory was associated with poorer psychopathology and physical well-being in late childhood for children and their mothers in Ireland.
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Affiliation(s)
- David Jo Driscoll
- School of Public Health, University College Cork, Cork, Ireland
- Specialist Neurodevelopmental ADHD Pathway (SNAP), Cork and Kerry Child and Adolescent Mental Health Services, Cork, Ireland
| | - Elizabeth Kiely
- School of Applied Social Studies, University College Cork, Cork, Ireland
| | - Linda M O'Keeffe
- School of Public Health, University College Cork, Cork, Ireland
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
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Evans RW, Maguet ZP, Stratford GM, Biggs AM, Goates MC, Novilla MLB, Frost ME, Barnes MD. Investigating the Poverty-Reducing Effects of SNAP on Non-nutritional Family Outcomes: A Scoping Review. Matern Child Health J 2024; 28:438-469. [PMID: 38372834 PMCID: PMC10914930 DOI: 10.1007/s10995-024-03898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION/PURPOSE Poverty-reduction efforts that seek to support households with children and enable healthy family functioning are vital to produce positive economic, health, developmental, and upward mobility outcomes. The Supplemental Nutrition Assistance Program (SNAP) is an effective poverty-reduction policy for individuals and families. This study investigated the non-nutritional effects that families experience when receiving SNAP benefits. METHODS We conducted a scoping review using the PRISMA Guidelines and strategic search terms across seven databases from 01 January 2008 to 01 February 2023 (n=2456). Data extraction involved two researchers performing title-abstract reviews. Full-text articles were assessed for eligibility (n=103). Forty articles were included for data retrieval. RESULTS SNAP positively impacts family health across the five categories of the Family Stress Model (Healthcare utilization for children and parents, Familial allocation of resources, Impact on child development and behavior, Mental health, and Abuse or neglect). DISCUSSION/CONCLUSION SNAP is a highly effective program with growing evidence that it positively impacts family health and alleviates poverty. Four priority policy actions are discussed to overcome the unintentional barriers for SNAP: distributing benefits more than once a month; increasing SNAP benefits for recipients; softening the abrupt end of benefits when wages increase; and coordinating SNAP eligibility and enrollment with other programs.
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Affiliation(s)
- R William Evans
- Department of Public Health, Brigham Young University, Provo, USA.
| | - Zane P Maguet
- Department of Public Health, Brigham Young University, Provo, USA
| | - Gray M Stratford
- Department of Public Health, Brigham Young University, Provo, USA
| | - Allison M Biggs
- Department of Public Health, Brigham Young University, Provo, USA
| | | | | | - Megan E Frost
- Science Librarians, Harold B. Lee Library, Provo, USA
| | - Michael D Barnes
- Department of Public Health, Brigham Young University, Provo, USA
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Dickson CA, Ergun-Longmire B, Greydanus DE, Eke R, Giedeman B, Nickson NM, Hoang LN, Adabanya U, Payares DVP, Chahin S, McCrary J, White K, Moon JH, Haitova N, Deleon J, Apple RW. Health equity in pediatrics: Current concepts for the care of children in the 21st century (Dis Mon). Dis Mon 2024; 70:101631. [PMID: 37739834 DOI: 10.1016/j.disamonth.2023.101631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
This is an analysis of important aspects of health equity in caring for children and adolescents written by a multidisciplinary team from different medical centers. In this discussion for clinicians, we look at definitions of pediatric health equity and the enormous impact of social determinants of health in this area. Factors involved with pediatric healthcare disparities that are considered include race, ethnicity, gender, age, poverty, socioeconomic status, LGBT status, living in rural communities, housing instability, food insecurity, access to transportation, availability of healthcare professionals, the status of education, and employment as well as immigration. Additional issues involved with health equity in pediatrics that are reviewed will include the impact of the COVID-19 pandemic, behavioral health concepts, and the negative health effects of climate change. Recommendations that are presented include reflection of one's own attitudes on as well as an understanding of these topics, consideration of the role of various healthcare providers (i.e., community health workers, peer health navigators, others), the impact of behavioral health integration, and the need for well-conceived curricula as well as multi-faceted training programs in pediatric health equity at the undergraduate and postgraduate medical education levels. Furthermore, ongoing research in pediatric health equity is needed to scrutinize current concepts and stimulate the development of ideas with an ever-greater positive influence on the health of our beloved children. Clinicians caring for children can serve as champions for the optimal health of children and their families; in addition, these healthcare professionals are uniquely positioned in their daily work to understand the drivers of health inequities and to be advocates for optimal health equity in the 21st century for all children and adolescents.
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Affiliation(s)
- Cheryl A Dickson
- Department of Pediatric & Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Berrin Ergun-Longmire
- Department of Pediatric & Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Donald E Greydanus
- Department of Pediatric & Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Ransome Eke
- Department of Community Medicine, Mercer University School of Medicine, Columbus, GA, United States
| | - Bethany Giedeman
- Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Nikoli M Nickson
- Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Linh-Nhu Hoang
- Department of Psychology, Western Michigan University, Kalamazoo, MI, United States
| | - Uzochukwu Adabanya
- Department of Community Medicine, Mercer University School of Medicine, Columbus, GA, United States
| | - Daniela V Pinto Payares
- Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Summer Chahin
- Department of Psychology, C.S. Mott Children's Hospital/Michigan Medicine, Ann Arbor, MI, United States
| | - Jerica McCrary
- Center for Rural Health and Health Disparities, Mercer University School of Medicine, Columbus, GA, United States
| | - Katie White
- Department of Pediatric & Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Jin Hyung Moon
- Department of Community Medicine, Mercer University School of Medicine, Columbus, GA, United States
| | - Nizoramo Haitova
- Department of Educational Leadership, Research and Technology, Western Michigan University, Kalamazoo, MI, United States
| | - Jocelyn Deleon
- Department of Pediatric & Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Roger W Apple
- Department of Pediatric & Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
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Banerjee S, Lev-Wiesel R, De S. Poverty, Somatisation Tendency and Potency in Low-Income Adolescent Groups of India and Israel: Explorations from the Field. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1104. [PMID: 37508601 PMCID: PMC10377797 DOI: 10.3390/children10071104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023]
Abstract
Poverty increases vulnerability towards somatisation and influences the sense of mastery and well-being. The present study on adolescents living in relative poverty in a high-income group country (Israel) and a low-middle-income group country (India) explored the nature of somatisation tendency (ST) and its relationship with potency and perception of poverty (PP). Potency, a buffer against stress-induced negative health effects, was hypothesized to be negatively related to ST and mediate the link between PP and ST. Purposive sampling was used to collect questionnaire-based data from community youth (12-16 years) of two metropolitan cities-Kolkata (India, N = 200) and Tel-Aviv (Israel, N = 208). The nature of ST, PP and potency was analysed using descriptive and inferential statistics and correlation-regression statistics and mediation analysis were used to understand the relationship among them. A clinically significant level of ST was reported by both Indian and Israeli youth experiencing 5-7 somatic symptoms on average. Potency was found to be a significant predictor of ST in both countries (p < 0.05) and emerged as a significant mediator (p < 0.001) in the PP and ST relationship among Indian adolescents. The present study highlights potency as a protective buffer in economically vulnerable community adolescents and re-establishes a high prevalence of ST among them, irrespective of their country's global economic position.
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Affiliation(s)
- Saoni Banerjee
- Emili Sagol Research Center for CAT (Creative Arts Therapies), University of Haifa, Haifa 3498838, Israel
| | - Rachel Lev-Wiesel
- Emili Sagol Research Center for CAT (Creative Arts Therapies), University of Haifa, Haifa 3498838, Israel
- Body & Mind Psychotherapy Track, Social Work, Tel Hai Academic Center, Qiryat Shemona 1220800, Israel
- National Center for Children at Risk Assessment, The Sagol Center for Hyperbaric Treatment and Research, Shamir Hospital, Be'er Ya'akov 60930, Israel
- FAA-Emili Sagol Creative Arts Research and Innovation for Well-Being Center at Chulalongkorn University (CARIW), Bangkok 10330, Thailand
| | - Sonali De
- Department of Psychology, Calcutta University, Kolkata 700009, India
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Xie L, Zou W, Wang H. School adaptation and adolescent immigrant mental health: Mediation of positive academic emotions and conduct problems. Front Public Health 2022; 10:967691. [PMID: 36568771 PMCID: PMC9773839 DOI: 10.3389/fpubh.2022.967691] [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: 06/13/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Immigrant adolescents must adapt their physical and mental attitudes to attain healthy development due to dramatic changes in their living and learning environments after relocation. From the perspective of positive psychology, this study explored the specific influence of school adaptation on mental health among immigrant adolescents, mainly focusing on the mediating effects of positive academic emotions and conduct problems. Methods We selected primary and secondary school students from five relocated resettlement schools in Qianxinan Buyi and Miao Autonomous Prefecture, which has the largest population of relocated people in Guizhou Province, China. Using cluster sampling, 550 relocated students in Grades 5-12 from the five schools were recruited to complete a battery of questionnaires, including the Immigrant Adolescents' School Adaptation Scale, the General Health Scale, and the Positive Academic Emotions Questionnaire, and the Adolescents' Behavioral Tendency Questionnaire. In addition, this study used the bias-corrected bootstrap method to explore the chain-mediating effect of positive academic emotions and conduct problems between school adaptation and mental health. Results The results showed that immigrant adolescents had significant gender differences only in conduct problems. However, significant learning stage differences existed in school adaptation, mental health, positive academic emotions, and conduct problems. School adaptation, positive academic emotions, and mental health were significantly positively correlated. In contrast, conduct problems were significantly negatively correlated with mental health. School adaptation influenced mental health through the mediation effects of positive academic emotions and conduct problems. These effects contained three paths: the separate mediation effects of positive academic emotions and conduct problems and the chain mediation effect of positive academic emotions and conduct problems.
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Affiliation(s)
- Lingping Xie
- School of Educational Sciences, Minzu Normal University of Xingyi, Xingyi, China,College of Education for the Future, Beijing Normal University, Zhuhai, China
| | - Weixing Zou
- School of Educational Sciences, Minzu Normal University of Xingyi, Xingyi, China,School of Psychology, Guizhou Normal University, Guiyang, China
| | - Hongli Wang
- School of Educational Sciences, Minzu Normal University of Xingyi, Xingyi, China,School of Psychology, Guizhou Normal University, Guiyang, China,*Correspondence: Hongli Wang
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