Relationship between adverse childhood experiences and anxiety symptoms among Chinese adolescents: The role of self-compassion and social support

Self-compassion, self-coldness, and social support and their relationship with depression, anxiety, and PTSD symptoms following a massive terror attack: a prospective study

Background: On 7 October 2023, Israel suffered a massive deadly terror attack with 1400 civilians murdered and 240 kidnapped. Recent studies have documented an increase in depression, anxiety, and posttraumatic symptoms in the aftermath of the attack. In the area of trauma, it has been shown that while some individuals are vulnerable to developing psychopathology following exposure to a traumatic event, the majority are not.Objective: In the present prospective study, we examined the contributions of internal (self-compassion and self-coldness) and external (social support) resources to depression, anxiety, and posttraumatic symptoms among civilians following a massive terror attack.Method: A total of 250 participants - 126 females (50.4%) and 124 males (49.6%); 156 Jews (62.4%) and 94 Arabs (37.6%) - aged 21-60 (M  = 41.7, SD = 10.63) completed questionnaires at two time points: T1 was in September 2023 (3-4 weeks before the attack) and T2 was in February-March 2024 (19-20 weeks after the attack). Participants were assessed using the Multidimensional Scale of Perceived Social Support (MSPSS), Self-Compassion Scale - Short Form (SCS-SF), Depression, Anxiety, and Stress Scale-21 Items (DASS-21), and International Trauma Questionnaire (ITQ).Results: Self-compassion and social support were negatively associated with depression and anxiety, while self-coldness was positively associated with depression and anxiety. In addition, self-coldness uniquely contributed to the prediction of psychopathological outcomes, including the sense of threat symptoms cluster of posttraumatic stress disorder, beyond known risk factors.Conclusions: Our study highlights the role of self-coldness as a vulnerability factor for civilians following a terror attack. It is important to view the distinct facets of self-compassion as a therapeutic target when building both intervention and prevention programs for people exposed directly and indirectly to trauma.

Adverse childhood experiences, adult emotional eating, and the role of self-compassion

Adverse childhood experiences (ACEs) are risk factors for the development of a range of physical and mental health problems throughout the lifetime, including emotional eating. Though the negative effects of ACEs are well established, research on protective factors that may mitigate these effects is limited. Self-compassion, which involves treating oneself kindly during challenges, is linked to greater emotional resilience and better emotion regulation. This study examined if ACEs were associated with adult emotional eating and how self-compassion affected this relationship. Adult participants (N = 98) were recruited nationally and completed self-report measures as part of a larger study on self-compassion, distress tolerance, and health belief change. Participants who passed attention check questions and completed optional measures of ACEs and emotional eating were included in the current sample. ACE scores were dichotomized into high (≥4) and low (<4). Multiple linear regressions examined interactions between variables, and mediation analyses explored self-compassion's indirect effects on the ACEs-emotional eating relationship. When controlling for age and socioeconomic status, high ACEs predicted greater propensity for emotional eating. Contrary to hypotheses, self-compassion did not moderate the ACEs-emotional eating relationship, but lower levels of self-compassion emerged as a significant mediator. Findings suggest that higher ACEs may be related to greater adult emotional eating through reduced self-compassion. Results are limited by potential recall bias, reliance on self-report measures, and the cross-sectional nature of the study. Future work should test interventions that enhance self-compassion to reduce emotional eating in adults with ACEs.

The mediating role of social support on the link between adverse childhood experiences and adult mental health

Adverse childhood experiences (ACEs) have been associated with adult mental health, especially anxiety and depression. We aimed to explain these relationships by investigating perceived social support as a mediating factor. In this model, it is proposed that individuals who experience more ACEs will have less perceived social support in adulthood, which in turn will increase reported anxiety and depression symptoms. Data were collected on ACEs, anxiety, depression, and perceived social support using an anonymous REDCap survey distributed through various social media outlets and relevant listservs. Respondents (N = 494) were caregivers who primarily resided in the United States and identified as White, well-educated, middle class, and female. ACEs were measured using the expanded ACE questionnaire extracted from the Health-Resiliency-Stress Questionnaire. Anxiety and depression were measured by the Generalized Anxiety Disorder 7-item scale and the Patient Health Questionnaire 9-item scale, respectively. Social support was measured with the Multidimensional Scale of Perceived Social Support. Results confirmed partial mediating effects of social support on the relation between (a) ACEs and anxiety and (b) ACEs and depression. Increased exposure to ACEs was associated with less social support in adulthood and, consequently, to greater mental health symptomatology. Implications of these findings highlight the potential role of social support as a preventative strategy and adult social support as a mitigating strategy.

The Self-Compassion Scale Short Form for Children Aged 8-12: Validation of the Italian Version

BACKGROUND

Although self-compassion has been consistently linked to positive outcomes in adults and adolescents, only a few studies have explored self-compassion in children and early adolescents due to a lack of measures specifically designed for younger populations.

METHODS

The current study explored the psychometric properties of the Italian translation of the Self-Compassion Scale for Children (SCS-C) in a sample of 230 children (mean age = 10.52, SD = 1.33).

RESULTS

The results revealed a two-factor solution for our data, with a positive self-compassion factor and a negative self-compassion factor, which were shown to be internally consistent. The SCS-C scores correlated with the children's mindfulness, self-esteem, and narcissistic traits in the assumed directions.

CONCLUSIONS

Overall, our study preliminarily supports the reliability and validity of the Italian version of the SCS-C.

Perceived social support and psychological wellbeing: testing the moderated mediation model of self-compassion and culture

Introduction

Self-compassion and self-coldness mediate the relationship between perceived social support and wellbeing, depression, anxiety and stress. However, this mediation has not been studied in intercultural contexts yet. The current crosssectional study explores the mediation effects of both constructs among Arabs and Jews in Israel.

Methods

Participants were 496 adults-309 Jews (62.3%) and 187 Arabs (37.7%) with an average age of 40.3. Respondents completed online standardized measures of self-compassion, self-coldness, perceived social support, wellbeing, depression, anxiety, and stress. The data were analyzed using PROCESS macro model 4 and 59.

Results

Testing the indirect effects of self-compassion and self-coldness on the relationship between perceived social support and wellbeing facets, we found a mediation effect for both constructs. We also found that culture moderated the mediation processes and found a stronger mediation effect for self-compassion among Arabs than Jews, but no moderation of culture on the mediation effect of self-coldness.

Discussion

These results emphasize the importance of considering cultural context when designing support interventions aimed at promoting wellbeing by enhancing self-compassion. The differential mediation effect by self-compassion and self-coldness contributes to growing research pointing to a need to further explore the influence of different components of self-compassion in different cultures.

Age-varying associations of parent-adolescent relationship and school connectedness with adolescent self-compassion: Differences by gender

INTRODUCTION

Parent-adolescent relationships and school connectedness are critical promotive factors for adolescent self-compassion. However, little is known about how the magnitude of the associations between these protective factors and self-compassion changes across continuous age groups and whether gender differences exist in the age-varying associations. This study aims to investigate (1) the age-varying associations of parent-adolescent relationships and school connectedness with self-compassion using time-varying effect modeling and (2) how their age-varying associations may differ by gender.

METHODS

A total of 14,776 adolescents aged 10-18 (mean age = 13.53 ± 2.08, 52.3% males) from Shenzhen, China participated in this study. All adolescents completed the online questionnaires in the school computer rooms.

RESULTS

The results showed that both parent-adolescent relationships and school connectedness were positively associated with adolescent self-compassion, and the magnitudes fluctuated with age. Specifically, the association between parent-adolescent relationships and self-compassion peaked for adolescents in early adolescence, with the key timing for girls (age group of 10 years old) being slightly earlier than boys (age group of 11 years old). The association between school connectedness and self-compassion was stronger for boys in the early years of adolescence (in the age group of 12.7 years), while stronger for girls during middle adolescence (in the age group of 14.0 years). Overall, girls were more sensitive to connections with parents and schools than boys during most age groups.

CONCLUSIONS

The findings demonstrated differential key timing for boys and girls regarding family- and school-based intervention to cultivate self-compassion and highlighted the importance of maintaining strong connections with families and schools for cultivating adolescent self-compassion, particularly for girls.

Assessing adverse childhood experiences in young refugees: a systematic review of available questionnaires

Today, various questionnaires are available to assess Adverse Childhood Experiences (ACEs) in children; however, it is uncertain if these questionnaires are comprehensive in addressing adversities of vulnerable subgroups, specifically refugee children. This review's objectives are to (1) identify current ACE questionnaires and determine if they are suitable in assessing refugee children's adversities, and (2) identify those previously used within a refugee population. A systematic literature search was conducted across five databases for articles published since 2010, including studies using an ACE-questionnaire that recognized multiple adversities in healthy children and were published in English. A total of 103 ACE questionnaires were identified in 506 studies. Only 14 of the 103 questionnaires addressed a refugee-specific adversity. Their ability to capture refugee children's experiences was limited: available questionnaires used a maximum of three items to assess refugee-specific adversities, covering only a fraction of forms of adversities relevant to refugee children. Psychometric characteristics were rarely reported. In addition, only two ACE questionnaires were used within a refugee population. With the tools currently available, it is not possible to comprehensively assess the exposure to and severity of the adversities faced by refugee children. The perpetuation of ongoing crises necessitates assessing refugee children's adversities to understand how their wellbeing is affected and to identify children at risk.

Digital Health Innovations for Screening and Mitigating Mental Health Impacts of Adverse Childhood Experiences: Narrative Review

Background

Exposures to both negative and positive experiences in childhood have proven to influence cardiovascular, immune, metabolic, and neurologic function throughout an individual's life. As such, adverse childhood experiences (ACEs) could have severe consequences on health and well-being into adulthood.

Objective

This study presents a narrative review of the use of digital health technologies (DHTs) and artificial intelligence to screen and mitigate risks and mental health consequences associated with ACEs among children and youth.

Methods

Several databases were searched for studies published from August 2017 to August 2022. Selected studies (1) explored the relationship between digital health interventions and mitigation of negative health outcomes associated with mental health in childhood and adolescence and (2) examined prevention of ACE occurrence associated with mental illness in childhood and adolescence. A total of 18 search papers were selected, according to our inclusion and exclusion criteria, to evaluate and identify means by which existing digital solutions may be useful in mitigating the mental health consequences associated with the occurrence of ACEs in childhood and adolescence and preventing ACE occurrence due to mental health consequences. We also highlighted a few knowledge gaps or barriers to DHT implementation and usability.

Results

Findings from the search suggest that the incorporation of DHTs, if implemented successfully, has the potential to improve the quality of related care provisions for the management of mental health consequences of adverse or traumatic events in childhood, including posttraumatic stress disorder, suicidal behavior or ideation, anxiety or depression, and attention-deficit/hyperactivity disorder.

Conclusions

The use of DHTs, machine learning tools, natural learning processing, and artificial intelligence can positively help in mitigating ACEs and associated risk factors. Under proper legal regulations, security, privacy, and confidentiality assurances, digital technologies could also assist in promoting positive childhood experiences in children and young adults, bolstering resilience, and providing reliable public health resources to serve populations in need.

"All you need is compassion?" a latent profile analysis of neglect and self-compassion on child mental health

BACKGROUND

Neglect is a common form of child maltreatment and profoundly affects children's mental health globally. Self-compassion may help children cope with neglect but the role of self-compassion in neglect context has been understudied. This study identifies distinct patterns of self-compassion and child neglect and explores how neglect and self-compassion profiles correlate with child mental health.

METHODS

The sample includes 3342 children aged 8-16 (49.6 % female) from a national survey of 29 provinces in China using a multistage sampling method. We used latent profile analysis to identify distinct profiles of self-compassion and neglect and examine their combined effects on child mental health, including both positive indicators (hope, resilience) and negative indicators (anxiety, depression, academic burnout, and peer problems).

RESULTS

We identified four neglect/self-compassion profiles: Adaptable Self-Carers (average neglect/high self-compassion), Vulnerable Languishers (high neglect/low self-compassion), Stable Self-Soothers (low neglect/average self-compassion), and Opportune Thrivers (low neglect/high self-compassion). The Vulnerable Languishers group exhibited the poorest mental health outcomes, whereas the Opportune Thrivers showed the best outcomes. Adaptable Self-Carers, although experiencing more neglect than Stable Self-Soothers, had better mental health than the latter, possibly due to their greater self-compassion.

LIMITATIONS

The cross-sectional design limits our ability to determine causality, and the use of self-reported measures increases response bias risk.

CONCLUSIONS

More self-compassion and less neglect are associated with more positive mental health outcomes. Moreover, self-compassion is a potential protective factor against the adverse effects of neglect on child mental health. Fostering self-compassion may boost positive adjustment in children who have experienced neglect.

Clinical Signs and Symptoms of Anxiety Due to Adverse Childhood Experiences: A Cross-Sectional Trial in Adolescents

BACKGROUND

Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents.

METHODS

A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State-Trait Anxiety Inventory for Children-STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale.

RESULTS

The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001).

CONCLUSIONS

This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.

Belief in a just world and fair behavior among clinical nurses: a moderated mediation model of empathy and observer justice sensitivity

BACKGROUND

Exploration of the relationship between nursing staffs' justice in belief world and fair behavior is important to promote equity and access to health services in health organizations, as well as to enhance the quality of care. In order to further dissect the influencing factors of fair behavior among clinical nurses, the current study aims to investigate how belief in a just world influences the fair behavior among nurses. Based on the belief in a just world theory, the empathy-altruism theory and the protective-protective model, the current study aimed to provide a deeper understanding of the effect of belief in a just world on fair behavior by investigating the mediating role of empathy and the moderating role of observer justice sensitivity.

METHOD

This was a cross-sectional study. 571 registered clinical nurses were included from five hospitals in Fuzhou through a convenience sampling method. Measurements included Chinese translations of belief in a just world scale, empathy scale, observer justice sensitivity scale, fair behavior scale. SPSS 22.0 was used to describe descriptive statistics and the variables' Pearson correlation coefficient. SPSS PROCESS macro Model 4 and model 14 were used to examine the mediation and the moderation between the relationship of belief in a just world and fairness behavior.

RESULT

The results shower that fairness behavior was positively correlated with one's belief in a just world (r = 0.26, p < 0.01); (2)empathy mediated the relationship between belief in a just world and fair behavior. The mediation model explains 20.83%; (3) Observer justice sensitivity moderated the relationship between empathy and fair behavior.

CONCLUSIONS

Belief in a just world, empathy, and observer justice sensitivity were motivations for nurses' fair behavior. Nursing administrators should focus on cultivating nurses' belief in a just world, their empathy abilities, and positive qualities of justice sensitivity to enhance fair behavior in a healthcare setting.

Harsh Childhood Discipline and Developmental Changes in Adolescent Aggressive Behavior: The Mediating Role of Self-Compassion

Harsh discipline during childhood (psychological aggression and corporal punishment) has been found to be an early risk factor for adolescent aggressive behavior. However, previous studies have mainly examined the relationship between harsh discipline as a whole and the level of adolescent aggressive behavior. This study investigates the effects of childhood psychological aggression and corporal punishment on the initial levels and rate of change in adolescent aggressive behavior, as well as the mediating role of self-compassion in this relationship. Using cluster sampling, a three-wave follow-up assessment was conducted on 1214 high-school students (60.7% boys; mean age at Wave 1 = 15.46 ± 0.71). The results showed that childhood psychological aggression and corporal punishment had a positive predictive effect on the development level of adolescent aggressive behavior. However, only childhood psychological aggression significantly directly attenuated the decline rate of adolescent aggressive behavior. In addition, both childhood psychological aggression and corporal punishment indirectly affected the initial levels and growth rate of adolescent aggressive behavior through self-compassion. These findings could provide potential targets for prevention and intervention programs aimed at improving aggressive behavior in Chinese adolescents.

Adverse childhood experiences and deviant behaviors among Chinese rural emerging adults: the role of social support

BACKGROUND

ACEs hurt subsequent physical and mental health outcomes. However, still little has been known about the rate of ACEs among rural Chinese emerging adults and the different buffering effects of the three types of social support on different kinds of ACEs. This study described the rate of ACEs among Chinese rural emerging adults, examined the relationship between ACEs and deviant behaviors, and tested the moderating effect of three different sources of perceived social support on this relationship. We hope these results will be helpful in further interventions.

METHODS

We used the second wave of a longitudinal survey that included ACEs variables in 2018. A total of 1031 emerging adults aged 18 to 25 participated in the current study.

RESULTS

we found that (1) the rate of abuse, neglect, and household dysfunction was 10.0, 30.0, and 24.9%, respectively among Chinese rural emerging adults; (2) abuse and household dysfunction experience were significantly and positively associated with deviant behaviors; (3) friend support moderated the relationship between three types of ACEs and deviant behaviors. Other support moderated the relationship between abuse/household dysfunction and deviant behaviors.

CONCLUSIONS

ACEs could increase the risk of deviant behaviors. Perceived friend support could reduce the negative effect of three types of ACEs. Other support could reduce the negative impact of abuse and household dysfunction. These results suggest that reducing ACEs to make children's family environments safer and enhancing social support for emerging adults from rural areas are beneficial, which could prevent or reduce their deviant behaviors.

Participation in community seniors' organizations and mental health among retired adults in urban China: The mediating role of interpersonal needs

Purpose

This study aimed to investigate the association between participation in community seniors' organizations (CSOs) and mental health among retired adults in urban China, and illustrate the causal mechanism.

Methods

We collected data on participation from a community seniors' organization and mental health survey in Shenzhen City, China, in July 2022. The survey used a two-stage cluster sample design, based on administrative divisions as the primary sampling unit and communities as the second sampling unit, where retired adults were randomly sampled. The inclusion criteria were individuals >60 years old (the mandatory age for retirement in China) or women who retired early at the age of 45 years. We used three multivariable regression models to estimate the effects of participation in CSOs on mental health. Furthermore, we used structural equation models to examine the mediator of acquired interpersonal needs in the association between CSOs participation and mental health.

Results

The study examined the values of CSOs, generated explicitly for older adults and explained how participation in such organizations benefits retired adults' mental health. Mental health is defined in three dimensions: aggregate mental health, positive emotions, and negative emotions. The results show that constituting social networks with like-minded individuals and perceiving interpersonal needs are the two main benefits of CSOs on mental health. The retired individual who participated in CSOs with a higher level of diversity and frequency, joined specific types such as health- and study-related CSOs, could receive more interpersonal needs and were probably mentally healthier. The mediating mechanism of interpersonal needs associated with participation in mental health was significant. Besides, mental health is generally affected by physical health, sleep quality, and socioeconomic status.

Conclusion

This study suggested that CSOs have expanded the social interaction channels of retired adults and affected their mental health by providing basic interpersonal needs such as inclusion, dominance, and affection. Among the types of CSOs, health and study organizations might enhance mental health most effectively, while semi-official organizations have no effect.

How School Travel Affects Children's Psychological Well-Being and Academic Achievement in China

Previous research on the role of school travel in children's well-being (WB) has paid little attention to developing countries. Using national survey data across China, this study examines how children's psychological well-being (PWB) and academic performance differ across commute duration and mode among urban, rural, and urban fringe areas. Our findings show that commute times are significantly negatively associated with children's PWB and academic achievements, and this correlation varies across areas. Children living in the urban fringe have the longest average one-way commuting time (18.6 min), but they have a better acceptance of longer commuting duration, whereas commuting time is more influential in the city center and rural areas. Regarding travel mode, walking to school is positively associated with PWB in the center area, while bicycles and public transport positively affect the rural student scores. Results from quantile regression show that students on the lower quantiles of the conditional distribution of PWB tend to suffer more than the others when commuting time increases; students with middle scores respond similarly to marginal changes in commuting time. Recommendations for urban planners and policymakers to enhance child WB include fostering school-home balance, improving public transit services, and investing in pedestrian and bicycle infrastructure for those vulnerable groups.

Adverse Childhood Experiences among a Sample of Youth Living with HIV in the Deep South

The southern region of the United States, often referred to as the Deep South, is disproportionately affected by HIV. In fact, the highest rates of new HIV infections occur in the Deep South. Approximately one in five new HIV infections are among youth. Youth living with HIV (YLWH) have several behavioral health risks, including co-occurring mental health and substance abuse disorders, which negatively affect medication adherence, contribute to less engagement in HIV care, and result in poor health outcomes. Research suggests that adverse childhood experiences (ACEs) contribute to HIV risk behaviors and that people living with HIV may be more vulnerable to the negative health outcomes and adverse effects of stressors. Using existing program evaluation data, we examined data from 41 YLWH aged 17-24 screened for ACEs in an integrated care setting. Most participants were Black/African American young men who identified as homosexual, bisexual, or questioning, and who acquired HIV behaviorally. Approximately, one-third of YLWH screened positive or in the high-risk range on an ACEs screener. Scores fell in the intermediate range for nearly half of the sample. Results did not reveal a significant relationship between ACEs and HIV biological indicators. In this paper, we describe these findings and the importance of incorporating trauma-informed approaches into HIV prevention and treatment programs targeting youth in the Deep South.

The Relationship Between Negative Life Events and Nonsuicidal Self-Injury Among Chinese Adolescents: A Moderated-Mediation Model

OBJECTIVE

This study aimed to investigate whether anxiety mediates the relationship between negative life events and nonsuicidal self-injury (NSSI) in adolescents and whether this mediating role is moderated through social support.

METHODS

The model consisted of an anonymous questionnaire survey of 506 Chinese adolescents (253 boys and 253 girls, mean age 15.11 years (SD = 1.83, range 11-18 years)). Self-designed questionnaires were used to collect demographic data. The frequency of NSSI, state anxiety, and social support degree of adolescents was assessed by the Adolescent Life Events Scale, the Chinese version of the Beck Anxiety Inventory, and the social support scale, respectively.

RESULTS

Negative life events were significantly and positively correlated with anxiety and the frequency of NSSI, and anxiety was significantly and positively correlated with the frequency of NSSI. The positive association between negative life events and the frequency of NSSI among adolescents was mediated by anxiety after controlling for demographic variables. Furthermore, this mediated relationship was moderated by social support.

CONCLUSION

Anxiety was a potential mechanism linking negative life events to NSSI in adolescents and low social support important risk factor for amplifying this indirect effect. Our findings provide an empirical basis for reducing NSSI in adolescents.