Association between parental control and depressive symptoms among college freshmen in China: The chain mediating role of chronotype and sleep quality

Reduced Health-Related Quality of Life Due to Mobile Phone Dependence in a Sample of Chinese College Students: The Mediating Role of Chronotype and Sleep Quality

PURPOSE

Presenting a chain mediation model to investigate whether mobile phone dependence results in a reduction in health-related quality of life (HRQoL) among Chinese college students, through the mediating effect of chronotype and sleep quality.

DESIGN AND SETTING

A cross-sectional survey was conducted on students from a Chinese university using a validated structured questionnaire.

SAMPLE

2014 freshmen.

MEASURES

The study measured the students' level of mobile phone dependence using the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use. Chronotype and sleep quality were measured by the Chinese version of the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI), respectively. HRQoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L), including a descriptive system and a visual analog scale (VAS).

ANALYSIS

Descriptive statistical analysis, correlation analysis, and mediation analysis.

RESULTS

Mobile phone dependence had a significant negative effect on HRQoL as indicated by both the EQ-5D-5L index score and EQ-VAS score (P < .001 for both). Additionally, it was found to significantly predict chronotype (MEQ score) (β = -.546, P < .001) and sleep quality (PSQI score) (β = .163, P < .001). Chronotype negatively predict sleep quality (β = -.058, P < .001), and sleep quality was a significant negative predictor of HRQoL (EQ-5D-5L index score, β = -.008, P < .001; EQ-VAS score, β = -1.576, P < .001).

CONCLUSION

Mobile phone dependence negatively impacts students' HRQoL through chronotype and sleep quality, and there is a chain mediating effect. Students should consider making lifestyle changes to improve their HRQoL and promote health.

Corneal stress‒strain index in relation to retinal nerve fibre layer thickness among healthy young adults

BACKGROUND/OBJECTIVES

To determine the relationship between corneal stress-strain index (SSI) and retinal nerve fibre layer (RNFL) thickness.

SUBJECTS/METHODS

1645 healthy university students from a university-based study contributed to the analysis. The RNFL thickness was measured by high-definition optical coherence tomography (HD-OCT), axial length (AL) was measured by IOL Master, and corneal biomechanics including SSI, biomechanical corrected intraocular pressure (bIOP), and central corneal thickness (CCT) were measured by Corvis ST. Multivariate linear regression was performed to evaluate the relationship between the SSI and RNFL thickness after adjusting for potential covariates.

RESULTS

The mean age of the participants was 19.0 ± 0.9 years, and 1132 (68.8%) were women. Lower SSI was significantly associated with thinner RNFL thickness ( β =8.601, 95% confidence interval [CI] 2.999-14.203, P  = 0.003) after adjusting for age, CCT, bIOP, and AL. No significant association between SSI and RNFL was found in men, while the association was significant in women in the fully adjusted model. The association was significant in the nonhigh myopic group ( P for trend = 0.021) but not in the highly myopic group. Eyes with greater bIOP and lower SSI had significantly thinner RNFL thickness.

CONCLUSIONS

Eyes with lower SSI had thinner RNFL thickness after adjusting for potential covariates, especially those with higher bIOP. Our findings add novel evidence of the relationship between corneal biomechanics and retinal ganglion cell damage.

Associations of chronotype with anxiety, depression and insomnia among general adult population: A cross-sectional study in Hubei, China

BACKGROUND

The relationship between chronotype and anxiety, depression, and insomnia was inconsistent. We aimed to assess the association between chronotype and mental health and the potential moderating effect of age and socioeconomic status (SES).

METHODS

A multi-stage sampling cross-sectional study with 12,544 adults was conducted. Chronotype, anxiety, depression, and insomnia were investigated by 5-item Morning and Evening, 7-item Generalized Anxiety Disorder, 9-item Patient Health, and the 7-item Insomnia Severity Index Questionnaires. Logistic regression was conducted.

RESULTS

The predominant chronotype was morning chronotype (69.2 %), followed by 27.6 % intermediate and 3.2 % evening chronotype. The prevalence of anxiety, depression, and insomnia was 0.7 %, 1.9 %, and 9.6 %, respectively. Compared with intermediate chronotype, morning chronotype participants had a lower risk of anxiety (OR = 0.28,95%CI:0.18-0.44), depression (OR = 0.54,95%CI:0.41-0.72) and insomnia (OR = 0.67,95%CI:0.58-0.77), while evening chronotype participants had a higher risk of depression (OR = 1.98,95%CI:1.06-3.71) but not anxiety or insomnia. Interactions between chronotype with age and SES on insomnia (Pinteraction < 0.05) were found. A more profound association between morning chronotype and insomnia was observed in <65 years participants (OR = 0.59,95%CI:0.50-0.71) and those with monthly household income ≥10,000yuan (OR = 0.21,95%CI:0.12-0.35), compared with their counterparts.

LIMITATIONS

The cross-sectional design limited causal conclusions. Only adults were included; the findings could not be generalized to children.

CONCLUSIONS

The morning chronotype might be protective for anxiety, depression, and insomnia, while the evening chronotype might be a risk factor for depression. Future studies are needed to assess the efficacy of chronotype-focused intervention for mental health. Insomnia prevention efforts should pay more attention to the elderly and those with lower incomes.

Distribution and determinants of corneal volume among healthy young Chinese adults: a cross-sectional study

BACKGROUND

Several studies have previously reported the normal values of corneal volume (CV) in various populations, whereas little is known about the CV distribution in healthy young Chinese adults. Our study aimed to investigate the distribution of CV and its relationships with other ocular biometric parameters among healthy young Chinese adults.

METHODS

A total of 1645 eyes from 1645 students at Dali University in Yunnan Province, China, were analyzed. Pentacam was used to measure CV. Central corneal thickness (CCT) and biomechanically corrected intraocular pressure (bIOP) were evaluated by Corvis-ST. Other biometrical parameters, including axial length (AL), keratometry, and white-to-white (WTW) distance, were measured using IOL Master.

RESULTS

The mean age of the study population was 19.01 ± 0.92 years, and 68.81% of them were women. The CV was normally distributed in the whole sample, with a mean value of 61.23 ± 3.22 mm3. CV and CCT were significantly smaller in the Yi ethnic group than in the Han ethnic group (p < 0.01). CCT (coefficient: 0.085; p < 0.001) and keratometry (coefficient: 0.422; p < 0.001) were positively correlated with CV, while AL (coefficient: -0.204; p < 0.001), WTW distance (coefficient: -0.236; p < 0.001) and bIOP (coefficient: -0.06; p < 0.001) were inversely associated with CV.

CONCLUSIONS

Our study provides an age-specific distribution of CV among healthy young Chinese adults. CCT, keratometry, AL, WTW distance and bIOP were important factors associated with CV.

Parental control and college students' depressive symptoms: A latent class analysis

We examined how maternal and paternal parental control (helicopter parenting, behavioral control, and psychological control) among college students are related to their depressive symptoms. We collected data from college students who attended a private university in Upstate New York (n = 455) and analyzed it using three-step latent class analysis. Latent class analysis identified four parental control latent classes: weak parental control, strong psychological control, strong helicopter parenting, and strong parental control. College students in the weak parental control class reported lower depressive symptoms than those in strong psychological control and strong parental control classes. In addition, college students in the strong helicopter parenting class reported lower depressive symptoms than those in strong psychological control and strong parental control classes. College students' depressive symptoms were not significantly different between weak parental control and strong helicopter parenting classes. Future researchers are encouraged to continue to acknowledge the characteristics of different forms of parental control and their influence on college students' quality of life in the transition to adulthood, considering the unique approaches of both parents.

Refractive associations with corneal biomechanical properties among young adults: a population-based Corvis ST study

PURPOSE

To assess the associations of corneal biomechanical properties as measured by the Corvis ST with refractive errors and ocular biometry in an unselected sample of young adults.

METHODS

A total of 1645 healthy university students underwent corneal biomechanical parameters measurement by the Corvis ST. The refractive status of the participants was measured using an autorefractor without cycloplegia. Ocular biometric parameters were measured using the IOL Master.

RESULTS

After adjusting for the effect of age, sex, biomechanical-corrected intraocular pressure and central corneal thickness, axial length was significantly associated with A1 velocity (A1v, β = -10.47), A2 velocity (A2v, β = 4.66), A2 deflection amplitude (A2DeflA, β = -6.02), HC deflection amplitude (HC-DeflA, β = 5.95), HC peak distance (HC-PD, β = 2.57), deformation amplitude ratio max (DA Rmax, β = -0.36), Ambrósio's relational thickness to the horizontal profile (ARTh, β = 0.002). For axial length / corneal radius ratio, only A1v (β = -2.01), A1 deflection amplitude (A1DeflA, β = 2.30), HC-DeflA (β = 1.49), HC-PD (β = -0.21), DA Rmax (β = 0.07), stress-strain index (SSI, β = -0.29), ARTh (β < 0.001) were significant associates. A1v (β = 23.18), HC-DeflA (β = -15.36), HC-PD (β = 1.27), DA Rmax (β = -0.66), SSI (β = 3.53), ARTh (β = -0.02) were significantly associated with spherical equivalent.

CONCLUSION

Myopic eyes were more likely to have more deformable corneas and corneas in high myopia were easier to deform and were even softer compared with those in the mild/moderate myopia.

Refractive Associations With Whole Eye Movement Distance and Time Among Chinese University Students: A Corvis ST Study

Purpose

Eye movement has been frequently studied in clinical conditions, but the association with myopia has been less explored, especially in population-based samples. The purpose of this study was to assess the associations of eye movement measured by the Corvis ST with refractive status in healthy university students.

Methods

A total of 1640 healthy students were included in the study (19.0 ± 0.9 years). Eye movement parameters (whole eye movement [WEM]; whole eye movement time [WEMT]) were measured by the Corvis ST. Spherical equivalent (SE) was measured using an autorefractor without cycloplegia. IOL Master was used to assess axial length (AL).

Results

AL was negatively correlated with WEM and WEMT (rWEM = -0.28, rWEMT = -0.08), and SE was positively correlated with WEM and WEMT (rWEM = 0.21, rWEMT = 0.14). For the risk of high myopia, breakpoint analysis and restricted cubic spline model showed that the knots of the significant steep downward trend of WEM and WEMT were 0.27 mm and 20.4 ms, respectively. The piecewise linear regression model revealed a significant correlation between AL, SE, and WEM when the value of WEM was below 0.27 mm. Additionally, when WEMT exceeded 20.4 ms, a significant decrease in AL and an increase in SE were observed with increasing WEMT.

Conclusions

A larger distance and longer duration of eye movement were correlated with a lower degree of myopia and shorter AL, and there was a threshold effect.

Translational Relevance

The findings might aid in understanding the pathogenesis of myopia and provide a theoretical foundation for clinical diagnosis and prediction.

Chronotypes and their association with sleep quality among Chinese college students of Anhui Province: a cross-sectional study

OBJECTIVES

To describe the prevalence of chronotype and sleep quality among Chinese college students and explore the relationship between chronotype and sleep quality.

DESIGN

A cross-sectional study.

SETTING

Four colleges and universities in Anhui, China, between November and December 2020.

PARTICIPANTS

A total of 4768 college students were recruited using a stratified, multistage, cluster sampling survey.

OUTCOME MEASURES

Morningness-Eveningness Questionnaire 19 was used to determine the chronotype of the students and the Pittsburgh Sleep Quality Index (PSQI) was used to measure their sleep quality. The multiple logistic regression model was used to explore the potential association between chronotype and sleep quality.

RESULTS

The self-reported proportions of evening-type (E-type), neutral-type and morning-type among college students were 51.17%, 45.14% and 3.69%, respectively. The mean PSQI score was 4.97±2.82 and the prevalence of poor sleep quality was 18.2%. After adjusting the covariates by multiple logistic regression analysis, E-type was positively associated with subjective sleep quality (OR=1.671, 95% CI 1.414 to 1.975), sleep latency (OR=1.436, 95% CI 1.252 to 1.647), sleep duration (OR=2.149, 95% CI 1.506 to 3.067), habitual sleep efficiency (OR=1.702, 95% CI 1.329 to 2.180), daytime dysfunction (OR=1.602, 95% CI 1.412 to 1.818) and overall poor sleep quality (OR=1.866, 95% CI 1.586 to 2.196).

CONCLUSIONS

College students mainly exhibited E-type, and an elevated prevalence of poor sleep quality existed among these students. The E-type was positively associated with poor sleep quality.

The effect of duration of youth/parent communication on depression and anxiety during COVID-19 isolation in China

The current study examines the mediating roles of self-efficacy and sleep disturbance and the moderating role of gender in the association between the duration of youth/parent communication on depression and anxiety during the COVID-19 isolation period in China. We used the self-designed demographic variable questionnaire, General Self-Efficacy Scale, the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, and the Self-Rating Anxiety Scale with 1,772 youths aged 15-24 from 26 provinces in China during the COVID-19 lockdown. We performed demographic variable analysis, correlation analysis, mediation analysis, and moderated analysis. The duration of daily communication with parents was significantly positively correlated with self-efficacy and significantly negatively correlated with sleep disturbance, depression, and anxiety. The chain mediation analysis revealed that the duration of communication with parents directly affected depression and anxiety. Self-efficacy, sleep disturbance, and self-efficacy sleep disturbance had significant mediating and chain-mediating effects on the duration of communication with parents, depression, and anxiety. The interactions between sleep disturbance and gender (B = 0.35, 95% CI 0.06 to 0.64, p = .02 < .05) were significant. The duration of parent/youth communication directly affected depression and anxiety and indirectly affected depression and anxiety via the chain-mediating effect of self-efficacy and sleep disturbance. Gender moderates the relationships between sleep disturbance and depression.

Identification of high-risk patterns of myopia in Chinese students based on four major behavioral risk factors: a latent class analysis

BACKGROUND

Myopia is prevalent in children and adolescents. Understanding the effect of multiple behaviors and their latent patterns on ocular biometric parameters may help clinicians and public health practitioners understand the behavioral risk pattern of myopia from a person-centered perspective. The purpose of this study was to identify the patterns of four major behavioral risk factors associated with myopia, including time spent outdoors, digital screen time, sleep duration, and performance of Chinese eye exercises. The study also examined the relationships between these behavioral patterns and myopia as well as ocular biometric parameters in a sample of Chinese college students.

METHODS

This study included 2014 students from the Dali University Students Eye Health Study. The average age of the subjects was 19.0 ± 0.9 years old, ranging from 15.7 to 25.1 years old. Each participant's refractive status was measured using an autorefractor without cycloplegia and ocular biometric parameters were measured using an IOL Master. Behavioral risk factors were collected using a pre-designed self-administered questionnaire. Latent class analysis (LCA) was performed to identify cluster patterns of various behaviors.

RESULTS

The prevalence of myopia was 91.8% in this population. The 2-class model was selected for the LCA based on goodness-of-fit evaluation metrics. Among the overall study sample, 41.1% and 58.9% were assigned into the high-risk and low-risk class, respectively. The risk of myopia [odds ratio (OR) = 2.12, 95% confidence interval (CI) = 1.52-3.14], high myopia (OR = 1.43, 95% CI = 1.14-1.78) and axial length/corneal radius (AL/CR) ratio of more than 3.0 (OR = 1.82, 95% CI = 1.22-2.72) were significantly higher in the high-risk compared with low-risk class.

CONCLUSIONS

Chinese university students showed differential risks of myopia and could be subdivided into high- and low-risk clusters based on four behavioral variables.

Associations between sleep characteristics, chronotype and body mass index among Chinese college freshmen

Research indicates that sleep problem is a behavioral risk factor of obesity. However, few research have applied a multi-dimensional approach to investigate the relationship between sleep health and adiposity. Therefore, the current study aimed to examine the associations of sleep characteristics (duration, quality) and chronotype with overweight/obesity as measured by body mass index. Data were obtained from 2014 college students from the Dali University in the Yunnan province of China in the year 2021. Sleep characteristics and chronotype were measured using self-reported questionnaires. The presence of overweight/obesity was assessed by anthropometric measurements. Multiple logistic regression models and restricted cubic spline hazard models were established to examine associations between sleep characteristics, chronotype and adiposity. After adjusting for demographic characteristics and other obesity-related behavioral risk factors, evening type was positively associated with overweight/obesity, and an L-shaped dose-effect relationship was observed between chronotype scores and the presence of overweight/obesity. However, sleep duration and quality were not associated with the presence of overweight/obesity in the logistic regression models and restrictive cubic splines models. This study indicated that Chinese college students who had the evening chronotype were more likely to be affected by overweight/obesity. Chronotype as an important dimension of sleep health should be incorporated in obesity intervention programs.

Association between Chronotype and Sleep Quality among Chinese College Students: The Role of Bedtime Procrastination and Sleep Hygiene Awareness

Chronotype and sleep quality have been shown to play significant roles in influencing people's physical and mental health. The current study focuses on examining the relationship between chronotype and sleep quality among Chinese college students and exploring the mediating role of bedtime procrastination and the moderating role of sleep hygiene awareness. A sample of 2822 college students (female = 71.4%) aged between 17 and 29 years (M = 19.77, SD = 1.41) were included and completed the measures of the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), Bedtime Procrastination Scale (BPS) and Sleep Hygiene Awareness Scale (SHAS). The results showed that evening-type students reported the lowest sleep quality and highest levels of bedtime procrastination. In contrast, the highest sleep quality and lowest levels of bedtime procrastination were shown by morning-type, exhibiting the neither-type students' intermediate chronotype. Bedtime procrastination partially mediated the relationship between chronotype and sleep quality. Furthermore, sleep hygiene awareness moderated the direct effect of chronotype on sleep quality and the effect of chronotype in the path from chronotype to bedtime procrastination. Specifically, higher levels of sleep hygiene awareness could buffer the adverse effect of chronotype on self-reported sleep quality but bolstered the negative effect of chronotype on bedtime procrastination. Our results suggest that individuals with an evening preference are inclined to postpone their bedtime and further experience poorer sleep quality at night. Sleep hygiene awareness may serve as a protective factor for poor nocturnal sleep. Overall, the findings highlight the importance of reducing bedtime procrastination and improving sleep hygiene awareness in the interventions designed to help college students to own a better sleep quality, especially for those with evening chronotypes.