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Wang D, Xu B, Qiu Y, Li Y, Chen H, Liu W, Fan F. Longitudinal trajectories of psychotic-like experiences influence adolescent suicidal ideation: The mediating role of depressive symptoms. J Affect Disord 2025; 383:306-314. [PMID: 40262665 DOI: 10.1016/j.jad.2025.04.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Revised: 04/15/2025] [Accepted: 04/18/2025] [Indexed: 04/24/2025]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) are strongly associated with poor mental health among adolescents. This study aims to investigate distinct longitudinal trajectories of the PLEs and their relationship to suicidal ideation (SI), as well as to evaluate the mediating effect of depressive symptoms on this link. METHODS A total of 7529 Chinese adolescents were surveyed on PLEs online during April 21 to May 12, 2021 (Time 1, T1), December 17 to 26, 2021 (Time 2, T2), and May 17 to June 5, 2022 (Time 3, T3). Depressive symptoms and SI were assessed at T1 and T3. RESULTS The prevalence of frequent PLEs across the three surveys was 13.5 %, 13.2 %, and 11.0 %, respectively. Five PLEs trajectories were identified: resistance (74.4 % of the sample), recovery (9.2 %), delayed-dysfunction (6.6 %), relapsing/remitting (7.0 %), and chronic-dysfunction (2.8 %). Adolescents in recovery, delayed-dysfunction, relapsing/remitting, and chronic-dysfunction trajectories compared with those in the resistant group were all more likely to experience SI at T3 after adjusting for a wide range of covariates. Depressive symptoms partially mediated the effects of PLEs trajectories (relative to the resistance trajectory) on SI (95 % CIs: 0.07-0.13, 0.37-0.48, and 0.28-0.41 for relapsing/remitting, delayed-dysfunction, and chronic-dysfunction trajectories, respectively). CONCLUSIONS PLEs are common among adolescents and have heterogeneity of change patterns. The association between PLEs trajectories and SI is partially mediated by depressive symptoms. Timely assessment and targeted interventions for specific PLEs are necessary to reduce the incidence of mental disorders.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Bingna Xu
- School of Marxism, Zhejiang University, Hangzhou, China
| | - Yang Qiu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Yukai Li
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Huanhuan Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Wanting Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
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Zhao M, Xin Y, Bai X, Zhang S, Liu H, Xu W, Duan W, Jin Q, Chen Y, Luo Y, Bai J, Liu Z, Yin H. Risk factors for suicidality among college students: A systematic review and meta-analysis. J Affect Disord 2025; 382:567-578. [PMID: 40280440 DOI: 10.1016/j.jad.2025.04.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Revised: 04/19/2025] [Accepted: 04/22/2025] [Indexed: 04/29/2025]
Abstract
BACKGROUND Suicide is a leading cause of death among college students, but inconsistent data and a lack of meta-analysis make it difficult to identify and recognize the risk factors for suicidal ideation, planning, and attempts in this group. To gain a comprehensive understanding of previous research, this study summarized risk factors for suicidal ideation, planning, and attempts among college students through a review and meta-analysis. METHODS We systematically searched six electronic databases from inception to May 18, 2024, to identify longitudinal studies of factors associated with suicidal ideation, planning, and attempts among college students. The effect sizes of the risk factors were pooled using a random effects model. Based on the results of the meta-analysis, we developed a risk prediction model for suicidal ideation among college students. RESULTS Thirty-three studies involving 193,517 college students were included. This study identified 18 risk factors, such as sexual orientation and traumatic experiences, and identified two protective factors, namely, social support and positive coping. Suicidal ideation is considered an important precursor to suicide. This study developed a predictive model for suicidal ideation with the results of the meta-analysis. CONCLUSIONS This review demonstrated the importance of several risk and protective factors for suicidal ideation, planning, and attempts among college students. A predictive model was developed based on the results of this meta-analysis, thus providing novel insights for translating evidence into clinical practice.
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Affiliation(s)
- Mingzhu Zhao
- Jilin University School of Nursing, Changchun, China
| | - Yongheng Xin
- Jilin University College of Software, Changchun, China.
| | - Xuechun Bai
- Jilin University School of Nursing, Changchun, China
| | - Sitao Zhang
- Jilin University School of Nursing, Changchun, China
| | - Haoying Liu
- Jilin University School of Nursing, Changchun, China.
| | - Wei Xu
- Jilin University School of Nursing, Changchun, China
| | - Wenxi Duan
- Jilin University School of Nursing, Changchun, China
| | - Qingying Jin
- Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, China.
| | - Yingying Chen
- Jilin University School of Nursing, Changchun, China
| | - Ye Luo
- Jilin University School of Nursing, Changchun, China
| | - Jiali Bai
- Jilin University School of Nursing, Changchun, China
| | - Zhibo Liu
- Jilin University School of Nursing, Changchun, China
| | - Huiru Yin
- Jilin University School of Nursing, Changchun, China.
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Peng P, Chen Z, Ren S, He Y, Li J, Liao A, Zhao L, Shao X, Chen S, He R, Liang Y, Tan Y, Chen X, Tang J, Liao Y. Internet gaming disorder predicts the incidence, persistence, and worsening of suicidal ideation: A population-based cohort study of 96,158 Chinese adolescents. J Affect Disord 2025; 379:186-193. [PMID: 40081581 DOI: 10.1016/j.jad.2025.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 02/23/2025] [Accepted: 03/10/2025] [Indexed: 03/16/2025]
Abstract
INTRODUCTION While cross-sectional studies suggest a strong association between internet gaming disorder (IGD) and suicidal ideation, longitudinal evidence is limited. This two-wave longitudinal study investigated whether IGD predicts the one-year incidence, persistence, and worsening of suicidal ideation. METHODS A total of 96,158 Chinese adolescents were assessed in November 2022 and one year later. IGD was measured using the 9-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF), categorizing participants as non-gamers, gamers without IGD, and gamers with IGD. Suicidal ideation and their severity were evaluated using the ninth item of the 9-item Patient Health Questionnaire. Baseline demographics, lifestyle factors, and internalizing and externalizing problems were collected and controlled. Multiple logistic regression models examined associations between IGD and incident, persistent, and worsening suicidal ideation, with subgroup and sensitivity analyses performed. RESULTS The prevalence of baseline suicidal ideation was 21.4 %, including 17.5 % mild, 2.5 % moderate, and 1.3 % severe. The one-year incidence and persistence rates of suicidal ideation were 13.8 % and 50.1 %, respectively. Among 19,254 adolescents with mild or moderate suicidal ideation, 1656 reported worsening over the year. Compared to non-gamers, gamers with IGD had a higher risk of incident (adjusted odds ratio [AOR], 1.95; 95 % CI, 1.57-2.42), persistent (AOR, 1.56; 95 % CI, 1.34-1.82), and worsening suicidal ideation (AOR, 1.75; 95 % CI, 1.37-2.23) (all p < 0.001). CONCLUSIONS IGD contributes to the development, persistence, and worsening of suicidal ideation among Chinese adolescents. Targeted interventions addressing IGD may reduce suicidal ideation in this population. LIMITATIONS Self-reported data potentially introduced bias.
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Affiliation(s)
- Pu Peng
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Zhangming Chen
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China.
| | - Silan Ren
- Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China
| | - Ying He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Jinguang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Aijun Liao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Linlin Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Xu Shao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Shanshan Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Ruini He
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Yudiao Liang
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Youguo Tan
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Xiaogang Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Zhang Y, Ma Z, Chen W, Wang D, Fan F. Network Analysis of Health-related Behaviors, Insomnia, and Depression Among Urban Left-behind Adolescents in China. Child Psychiatry Hum Dev 2025; 56:844-855. [PMID: 37736846 DOI: 10.1007/s10578-023-01607-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
Mental health of urban left-behind adolescents (LBA) is a public issue of growing concern. This study aims to examine the symptom level associations among multiple health-related behaviors, insomnia, and depression in urban LBA. Data on a sample of urban LBA aged 11-19 (N = 3,601) from the Adolescent Mental Health Survey in Shenzhen, China, were used. Health-related behaviors (i.e., Internet use, physical inactivity, social jetlag, smoking, and alcohol consumption), insomnia, and depressive symptoms were assessed using a self-administered questionnaire. Graphical Gaussian Model (GGM) was used to describe key bridging nodes in an undirected network. Directed Acyclic Graph (DAG) was used to construct a directed network and estimate the most likely causal associations among behaviors/symptoms. In the undirected network, Internet use was identified as the key bridging node most strongly associated with insomnia and depression. Two other key bridging nodes include difficulty initiating sleep and appetite change. In the directed network, anhedonia emerged as the most pivotal symptom, which could cause insomnia symptoms and behavioral changes, either directly, or through triggering other depressive symptoms, such as low energy and appetite change. These findings have implications for understanding the occurrence and maintenance process of health-related behaviors, insomnia, and depression in urban LBA. In practice, Internet use should be considered a priority in targeting multiple health behavior interventions. Meanwhile, early screening and treatment for anhedonia are of great significance as well.
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Affiliation(s)
- Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Wanyi Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Shipai Road, Guangzhou, 510631, China.
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5
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Ye H, Chen C, Chen S, Jiang N, Cai Z, Liu Y, Li Y, Huang Y, Yu W, You R, Liao H, Fan F. Profiles of Intolerance of Uncertainty Among 108,540 Adolescents: Associations with Sociodemographic Variables and Mental Health. Child Psychiatry Hum Dev 2025; 56:715-727. [PMID: 37659028 DOI: 10.1007/s10578-023-01603-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
Intolerance of uncertainty (IU) is widely considered a transdiagnostic risk and maintaining factor for psychiatric disorders. However, little is known about the overall nature and profile of IU among adolescents. This study aims to investigate the profiles of IU among Chinese adolescents and explore their associations with sociodemographic characteristics and mental health problems. A sample of 108,540 adolescents provided data on IU, sociodemographic characteristics, and mental health via an online platform. Latent profile analysis revealed three profiles: Low IU, Medium IU, and High IU. Girls, older adolescents, and those with specific sociodemographics were more likely to belong to the "High IU" profile. Furthermore, the "High IU" profile was associated with the highest risk of several mental health problems. These findings provided valuable information for early prevention and intervention strategies targeting IU and highlighted the importance of IU-based interventions for mental health among adolescents.
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Affiliation(s)
- Haoxian Ye
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Chunling Chen
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Shiying Chen
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Nan Jiang
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Zifan Cai
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Yixin Liu
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Yunyi Li
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Yike Huang
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Wanqing Yu
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Ruiyan You
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Haiping Liao
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Fang Fan
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China.
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Wang D, Xu B, Ross B, Qiu Y, Ma Z, Fan Y, Fan F. The effect of sleep disturbance trajectories on psychotic-like experiences among adolescents: the mediating role of depressive symptoms. Eur Child Adolesc Psychiatry 2025:10.1007/s00787-025-02753-2. [PMID: 40423712 DOI: 10.1007/s00787-025-02753-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Accepted: 05/14/2025] [Indexed: 05/28/2025]
Abstract
Previous work supported the opinion that sleep disturbance may cause adolescent PLEs. This study intended to evaluate the mediating effect of depressive symptoms on the relationship between change in sleep disturbance and psychotic-like experiences (PLEs) among adolescents. A total of 7529 adolescents completed three web-based surveys. Surveys were administered from April 21 to May 12, 2021 (Time 1, T1), again 6 months later from December 17 to 26, 2021 (Time 2, T2), and one year later from May 17 to June 5, 2022 (Time 3, T3). A series of self-assessment scales were used to measure sleep disturbance, depressive symptoms, PLEs, and other relevant variables. Mediation analysis was utilized to examine the association between sleep disturbance trajectories, depressive symptoms, and PLEs. Five trajectories of sleep disturbance were identified: no/low (72.2%), remission (8.8%), relapsing/remitting (7.4%), new-onset (8.9%), and persistent (2.7%) trajectories. Depressive symptoms partially mediated the effects of sleep disturbance trajectories (relative to the no/low trajectory) on PLEs (95% CIs: 0.20-0.30, 0.42-0.53, and 0.41-0.58 for relapsing/remitting, new-onset, and persistent trajectories, respectively). This study reveals that the association between sleep disturbance trajectories and PLEs was partially mediated by depressive symptoms. To prevent the onset of PLEs, early screening and interventions targeting sleep disturbance and depressive symptoms are quite essential.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Bingna Xu
- School of Marxism, Zhejiang University, Hangzhou, China
| | - Brendan Ross
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Yang Qiu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
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7
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Gideon P, Bayray A. Exploring anxiety and sleep disorders among Edna Adan university students in Somaliland: associated stressors and insights. BMC Psychol 2025; 13:488. [PMID: 40340813 PMCID: PMC12063232 DOI: 10.1186/s40359-025-02787-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Accepted: 04/23/2025] [Indexed: 05/10/2025] Open
Abstract
BACKGROUND 970 million people around the world are living with mental illness. Mental illness is also one of the chronic diseases prevalent in Somaliland. Anxiety and sleep disturbances are the major types of mental illness commonly observed in young adults. The purpose of this study is to explore the anxiety, sleep disturbances, and their factor associated with Edna Adan University bachelor's students in Hargeisa, Somaliland. METHODS This study has used a cross-sectional study with 307 bachelor students of Edna Adan University as its participants from May to July 2024. GAD-7 was used to evaluate anxiety; MPAI was used to measure mobile phone addiction; and GSDS was used to measure sleep disturbances. Pre-test for associated factors questionnaire was carried to assess the validity and reliability of questionnaire. The acquired data was then univariate and analyzed in SPSS version 26. RESULTS Most 71.30% of the students reported having a good sleep quality, 63.50% had no problem with mobile phone addiction, and 61.20% experienced minimal to no anxiety. Academic stressors, financial pressure, and interpersonal relationships are the most frequently (9.10%) experienced linked factors with a very serious frequency (all of the time), followed by several other factors, such as teaching and learning-related stressors, mental illness and use of psychoactive substances, language barrier, body mass index (BMI) or daily meal problem, having doubt regarding the future or gambling behavior, and travel time to university. CONCLUSION This study shows that the students mainly have minimal to no anxiety, and no addiction to mobile phone while maintaining a good sleep quality. However, sleep disturbances and anxiety-associated factors such as academic stressors, financial pressure, and interpersonal relationships are commonly experienced in a very serious frequency (all of the time).
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Affiliation(s)
- Peiter Gideon
- Department of Master Public Health, Edna Adan University, Hargeisa, Somaliland.
| | - Alemayehu Bayray
- Departement of Epidemiology, School of Public Health, Mekelle University-College of Health Sciences, Mekelle, Tigray, Ethiopia
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Huang M, Wang D, Zhang Y, Li M, Li H, Zhang X, Wang X, Fan F. The association of parental insomnia symptoms with adolescent insomnia and depressive symptoms: A child-parent dyad study. Sleep Med 2025; 128:103-109. [PMID: 39904138 DOI: 10.1016/j.sleep.2025.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 01/20/2025] [Accepted: 01/21/2025] [Indexed: 02/06/2025]
Abstract
Intergenerational transmission may be present in adolescents' sleep and mental health problems, but there is limited evidence currently available. The current study aimed to examine the effects of parental insomnia symptoms on adolescent insomnia and depressive symptoms. From 21 April to May 12, 2021, this study conducted a large-scale cross-sectional survey in south China, 68,751 valid child-parent matched data were collected. The current study measured parental insomnia symptoms, adolescent insomnia symptoms, adolescent depressive symptoms, and demographic characteristics. SPSS 27 statistical software was used to perform Chi-square analysis, binary logistic regression, and indirect effect testing. In this sample, maternal and paternal insomnia has a prevalence of 8.2 % and 7.5 %. Among adolescents whose mother or father had insomnia, the prevalence of insomnia reached to 15.7 % and 15.1 %, and the prevalence of depressive symptoms reached to 17.6 % and 15.6 %. Adolescents whose parents have insomnia were more likely to suffer from insomnia and depressive symptoms. Moreover, parents' insomnia positively influences adolescent depressive symptoms through the mediation of the child's insomnia. This study prompts a reevaluation of family health dynamics in clinical practice and public health policy, leading to a more holistic approach to addressing adolescent sleep patterns and depressive symptoms.
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Affiliation(s)
- Meijiao Huang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
| | - Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Min Li
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Huolian Li
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Xiangting Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Xuan Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
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He Y, Yang T, Guo Q, Wu S, Liu W, Xu T. Innovative Analysis of the Interconnected Network Structure Between Anxiety and Sleep Quality Among College Students. Psychol Res Behav Manag 2025; 18:607-618. [PMID: 40104409 PMCID: PMC11913977 DOI: 10.2147/prbm.s507074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Accepted: 02/21/2025] [Indexed: 03/20/2025] Open
Abstract
Background A complex interplay exists between anxiety and sleep quality. However, there is a scarcity of network analysis studies examining this relationship, particularly among college students. Previous research has relied on sum scores from scales, which fails to capture the nuanced, symptom-level associations between anxiety and sleep quality. This limitation impedes a comprehensive understanding of their interactions. Thus, the objective of this study was to address this research gap by employing network analysis to explore symptom-level associations between anxiety and sleep quality within a college student population. Methods Network analysis was conducted to explore the association between anxiety and sleep quality among college students and identify bridge items of anxiety and sleep quality. Anxiety was assessed via the Self-Rating Anxiety Scale (SAS), and sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI). Results The network structure revealed 47 significant associations between anxiety and sleep quality. "Subjective sleep quality", "daytime dysfunction", "panic", "dizziness", "fatigue" and "sleep disorder" had higher EI values in the network. "fatigue" and "daytime dysfunction" had the highest BEI values in their respective communities. Conclusion From a network analysis perspective, this study identified complex pathways of pathological correlations between anxiety and sleep quality among college students. It also identified "subjective sleep quality", "daytime dysfunction", "panic", and "dizziness", "fatigue" and 'sleep disturbance' may be potential targets for intervention in anxiety-sleep disorder comorbidity. In the future, psychologists and medical professionals may adopt appropriate interventions based on the centrality index and bridging centrality indicators identified in this study to effectively reduce the comorbidity of anxiety and sleep disorders in college students.
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Affiliation(s)
- Yang He
- School of Psychology, Shanghai Normal University, Shanghai, 200234, People's Republic of China
- Department of Military Medical Psychology, Air Force Military Medical University, Xi'an, 710032, People's Republic of China
- Department of Psychology, Second Sanatorium of Air Force Hangzhou Special Recreation Centre, Hangzhou, 310007, People's Republic of China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Military Medical University, Xi'an, 710032, People's Republic of China
| | - Qingjun Guo
- Department of Psychology, Second Sanatorium of Air Force Hangzhou Special Recreation Centre, Hangzhou, 310007, People's Republic of China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Military Medical University, Xi'an, 710032, People's Republic of China
| | - Wei Liu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, People's Republic of China
| | - Tao Xu
- Department of Psychology, Second Sanatorium of Air Force Hangzhou Special Recreation Centre, Hangzhou, 310007, People's Republic of China
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10
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Peng P, Chen Z, Ren S, Liu Y, Li J, Liao A, Zhao L, He R, Liang Y, Tan Y, Tang J, Chen X, Liao Y. Internet gaming disorder and suicidal behaviors mediated by sleep disturbance: a large-scale school-based study in 135,174 Chinese middle school students. Eur Child Adolesc Psychiatry 2025:10.1007/s00787-025-02675-z. [PMID: 40029399 DOI: 10.1007/s00787-025-02675-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 02/15/2025] [Indexed: 03/05/2025]
Abstract
Emerging research suggests a positive association between Internet gaming disorder (IGD) and suicidal behaviors. However, existing studies predominantly focus on suicidal ideation rather than suicide attempts and often do not adequately control for potential psychological confounders. The mechanism linking IGD to suicidality remains unclear. This study aims to assess the independent association between IGD and suicidal behaviors and to examine the mediating role of sleep disturbance among Chinese adolescents. We recruited 135,174 middle school students from Zigong City using cluster sampling. Data on demographics, suicidal ideation, and suicidal attempts were collected. IGD was assessed using the Internet Gaming Disorder Scale-Short Form. Mental distress, including depression, anxiety, hyperactivity/inattention, conduct problems, sleep problems, and psychotic experiences, was evaluated using standardized questionnaires. Multiple logistic regression models and mediation analysis were conducted. The prevalence rates of IGD, suicidal behaviors, suicidal ideation, and suicide attempts were 1.6%, 16.7%, 11.9%, and 9.8%, respectively. Adolescents with IGD showed a significantly higher risk for suicidality: nearly 60% reported suicidal behaviors, 50% reported suicidal ideation, and 40% reported suicide attempts. Both IGD and gaming usage were independently linked to suicidal behaviors. Sleep disturbance partially mediated the relationship between IGD and suicidal behaviors, accounting for 47.0% of the total effect. Our studies call for timely and regular assessments for suicidality and sleep disturbance in IGD. Targeted interventions addressing sleep disturbance might reduce suicidal risk among adolescents with IGD.
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Affiliation(s)
- Pu Peng
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhangming Chen
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Silan Ren
- Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China
| | - Yi Liu
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jinguang Li
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Aijun Liao
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Linlin Zhao
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Ruini He
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Yudiao Liang
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Youguo Tan
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaogang Chen
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- , East Qingchun Road, Hangzhou, Zhejiang, P.R. China.
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Cabral BP, Braga LAM, Conte Filho CG, Penteado B, Freire de Castro Silva SL, Castro L, Fornazin M, Mota F. Future Use of AI in Diagnostic Medicine: 2-Wave Cross-Sectional Survey Study. J Med Internet Res 2025; 27:e53892. [PMID: 40053779 PMCID: PMC11907171 DOI: 10.2196/53892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 05/06/2024] [Accepted: 10/18/2024] [Indexed: 03/09/2025] Open
Abstract
BACKGROUND The rapid evolution of artificial intelligence (AI) presents transformative potential for diagnostic medicine, offering opportunities to enhance diagnostic accuracy, reduce costs, and improve patient outcomes. OBJECTIVE This study aimed to assess the expected future impact of AI on diagnostic medicine by comparing global researchers' expectations using 2 cross-sectional surveys. METHODS The surveys were conducted in September 2020 and February 2023. Each survey captured a 10-year projection horizon, gathering insights from >3700 researchers with expertise in AI and diagnostic medicine from all over the world. The survey sought to understand the perceived benefits, integration challenges, and evolving attitudes toward AI use in diagnostic settings. RESULTS Results indicated a strong expectation among researchers that AI will substantially influence diagnostic medicine within the next decade. Key anticipated benefits include enhanced diagnostic reliability, reduced screening costs, improved patient care, and decreased physician workload, addressing the growing demand for diagnostic services outpacing the supply of medical professionals. Specifically, x-ray diagnosis, heart rhythm interpretation, and skin malignancy detection were identified as the diagnostic tools most likely to be integrated with AI technologies due to their maturity and existing AI applications. The surveys highlighted the growing optimism regarding AI's ability to transform traditional diagnostic pathways and enhance clinical decision-making processes. Furthermore, the study identified barriers to the integration of AI in diagnostic medicine. The primary challenges cited were the difficulties of embedding AI within existing clinical workflows, ethical and regulatory concerns, and data privacy issues. Respondents emphasized uncertainties around legal responsibility and accountability for AI-supported clinical decisions, data protection challenges, and the need for robust regulatory frameworks to ensure safe AI deployment. Ethical concerns, particularly those related to algorithmic transparency and bias, were noted as increasingly critical, reflecting a heightened awareness of the potential risks associated with AI adoption in clinical settings. Differences between the 2 survey waves indicated a growing focus on ethical and regulatory issues, suggesting an evolving recognition of these challenges over time. CONCLUSIONS Despite these barriers, there was notable consistency in researchers' expectations across the 2 survey periods, indicating a stable and sustained outlook on AI's transformative potential in diagnostic medicine. The findings show the need for interdisciplinary collaboration among clinicians, AI developers, and regulators to address ethical and practical challenges while maximizing AI's benefits. This study offers insights into the projected trajectory of AI in diagnostic medicine, guiding stakeholders, including health care providers, policy makers, and technology developers, on navigating the opportunities and challenges of AI integration.
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Affiliation(s)
- Bernardo Pereira Cabral
- Cellular Communication Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Department of Economics, Faculty of Economics, Federal University of Bahia, Salvador, Brazil
| | - Luiza Amara Maciel Braga
- Cellular Communication Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Bruno Penteado
- Fiocruz Strategy for the 2030 Agenda, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Sandro Luis Freire de Castro Silva
- National Cancer Institute, Rio de Janeiro, Brazil
- Graduate Program in Management and Strategy, Federal Rural University of Rio de Janeiro, Seropedica, Brazil
| | - Leonardo Castro
- Fiocruz Strategy for the 2030 Agenda, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcelo Fornazin
- Fiocruz Strategy for the 2030 Agenda, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fabio Mota
- Cellular Communication Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Vardi I, Hamdan S, Zalsman G, Stukalin Y. The effect of the COVID-19 pandemic and school closures on self-harming and suicidal behaviors in adolescents: A comprehensive meta-analysis. Suicide Life Threat Behav 2025; 55:e13156. [PMID: 39836072 DOI: 10.1111/sltb.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 08/04/2024] [Accepted: 12/04/2024] [Indexed: 01/22/2025]
Abstract
INTRODUCTION The COVID-19 pandemic has significantly affected adolescents' mental health, raising concerns about the potential increase in self-harming and suicidal behaviors (SIB). This study aimed to evaluate the pandemic's impact on SIB among adolescents and explore the effects of school closures and psychiatric vulnerabilities to inform future interventions. METHODS A systematic review and meta-analysis were conducted using PubMed, resulting in 420 studies, of which 36 studies (comprising 53 samples) met the inclusion criteria, encompassing 1,754,106 adolescents. Effect sizes were calculated using proportion effect size. Heterogeneity across studies was assessed using Q-statistics and I², while Egger's test was applied to evaluate publication bias. Differences between clinical and community samples, as well as the influence of psychiatric symptoms or disorders, were examined. RESULTS Clinical samples demonstrated higher rates of SIB compared to community samples, with adolescents having psychiatric symptoms or disorders being more vulnerable. Overall, the pandemic was associated with a decline in SIB rates compared to pre-pandemic levels. Suicidal ideation decreased by 4.14% in combined samples and by 7.13% in community samples. Self-harm rates fell by 5.38% and 6.62% in combined and community samples, respectively. In contrast, clinical samples showed a distinct trend, with suicidal ideation decreasing by 29.39%, while self-harm rates increased by 32.51% and suicide attempts rose by 22.41%. CONCLUSION The COVID-19 pandemic's impact on adolescents' SIB varied significantly across population types and levels of psychiatric vulnerability. While general declines were observed, the pronounced increases in self-harm and suicide attempts among clinical samples highlight the need for tailored mental health interventions. Addressing these disparities is essential for future mental health strategies and crisis preparedness.
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Affiliation(s)
- Ilor Vardi
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv, Israel
| | - Sami Hamdan
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv, Israel
| | - Gil Zalsman
- Geha Mental Health Center of the Clalit HMO, Petah Tiqwa, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Yelena Stukalin
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv, Israel
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Sun M, Scherffius A, Sun M, Chen C, Wang D. Insomnia symptoms as a mediator between school connectedness and suicidal ideation in Chinese adolescents: A three-wave longitudinal model. Early Interv Psychiatry 2025; 19:e13579. [PMID: 38783351 DOI: 10.1111/eip.13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/02/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
AIM School connectedness is related to suicidal ideation (SI) in adolescents. However, little is known about the mediating role of insomnia symptoms in the school connectedness-SI link. This study aimed to examine the longitudinal mediating effect of insomnia symptoms on the relationship between school connectedness and SI as well as the moderating effect of sex using a three-wave longitudinal design. METHODS A total of 3110 adolescents completed three online surveys. Data were collected over the course of 1 year, in three waves 6 months apart. Participants completed the School Connectedness Scale, Youth Self-Rating Insomnia Scale, Self-rating Idea of Suicide Scale, Beck Depression Inventory and a self-compiled demographic questionnaire. Linear regressions and mediation analyses were performed to examine the associations between school connectedness, insomnia symptoms and SI. RESULTS School connectedness had a significant mediating effect on SI through insomnia symptoms (β a×b = -.03, 95% confidence interval = -0.04, -0.02) after controlling for demographics and depressive symptoms. Mediation analyses showed that insomnia symptoms accounted for 23.1% of the total effects in the entire sample, with 13.3% in males and 27.3% in females. Sex had no significant moderating effect on the school connectedness-SI link association. CONCLUSIONS The association between school connectedness and SI appears to be mediated by insomnia symptoms. Assessing and promoting school connectedness, as well as intervening and treating distress associated with insomnia, may have important clinical implications for reducing the risk of SI in adolescents.
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Affiliation(s)
- Mingze Sun
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
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Sun M, Ma Z, Xu B, Chen C, Chen QW, Wang D. Prevalence of cyberbullying involvement and its association with clinical correlates among Chinese college students. J Affect Disord 2024; 367:374-381. [PMID: 39236886 DOI: 10.1016/j.jad.2024.08.198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 08/11/2024] [Accepted: 08/29/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Cyberbullying refers to a modern form of bullying that could be practiced electronically or on the Internet. This study conducted a cross-sectional survey to explore different types of cyberbullying involvement (CI) and the associations of CI with demographic characteristics and mental health problems among Chinese college students. METHODS A total sample of 18,578 Chinese college students were recruited (68.1 % female, mean age = 20.07 years) from October 17 to 29, 2023. All participants completed self-reported web-based questionnaires on demographic characteristics, CI, sleep disturbance, depression, anxiety, and suicidal ideation. RESULTS More than a quarter of participants (27.5 %) have been involved in cyberbullying: specifically speaking, 10.1 % cybervictims, 4.7 % cyberbullies, and 12.7 % both (cyberbully-victims). Males, younger age, left-behind experiences, individuals with poorer family economic status, adolescents with chronic physical illness, and those with family history of mental disorders are more likely to experience CI. Unlike participants without CI, cybervictims and cyberbully-victims reported a higher risk of sleep disturbance, depression, anxiety, and suicidal ideation. Cyberbullies also have a higher rate of sleep disturbance and depression than their peers who are not involved in cyberbullying. CONCLUSION Our findings indicate that CI is widespread among Chinese college students, and CI is associated with the high reported rates of a series of psychopathology. This study highlights the significance of implementing anti-cyberbullying interventions specifically targeted at college students. Furthermore, it underscores the importance of monitoring changes in students' mental health status throughout the intervention process.
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Affiliation(s)
- Mingze Sun
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Bingna Xu
- School of Marxism, Zhejiang University, Hangzhou, China
| | - Chunping Chen
- School of Marxism, Zhejiang University, Hangzhou, China
| | - Qing-Wei Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China; National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China.
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
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15
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Ge MW, Chen HL, Hu FH, Jia YJ, Tang W, Zhang WQ, Yu DJ. COVID-19 impacted the suicidal ideation among health care workers and medical students: An interrupted time-series analysis of data from 30 countries. J Affect Disord 2024; 367:573-582. [PMID: 39242042 DOI: 10.1016/j.jad.2024.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/28/2024] [Accepted: 09/01/2024] [Indexed: 09/09/2024]
Abstract
AIM To investigate the impact of public health emergencies on the prevalence of suicidal ideation among healthcare workers (HCWs) and medical students. METHODS The prevalence of suicidal ideation among HCWs and medical students was searched for analysis. The platforms included PubMed, medRVix, bioRvix, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Interrupted time-series analysis was employed to determine whether the COVID-19 pandemic influenced the prevalence and trends of suicidal ideation. To account for autocorrelation and heteroskedasticity, Newey-West standard errors were utilized with a lag of order one. RESULTS Seventy studies with 145,641 HCWs and medical students from 30 countries were included in the final analysis, with 30 studies before COVID-19 and 40 studies during the pandemic. Before the pandemic outbreak (April 2020), the monthly increasing rate was 0.063 % (95 % CI: -0.009 %, 0.135 %, z = 1.73, P = 0.084). The tendency of suicidal ideation prevalence increased by 1.116 % (95%CI: 0.888 %, 1.344 %, z = 9.60, P < 0.001). In other words, the calculated monthly growth rate of suicidal ideation after the pandemic outbreak is 1.179 % (95%CI: 0.968 %, 1.391 %, z = 10.93, P < 0.001) per month. The overall growing trend of prevalence of suicidal ideation during the pandemic is 1.896 % per month in America; 1.590 % in Europe; 0.443 % (95%CI: 0.213 %, 0.673 %, z = 3.77, P < 0.001) in Asia; 1.055 % in HCWs; and 0.645 % in medical students. CONCLUSION This study highlights that the COVID-19 pandemic can significantly impact the prevalence of suicidal ideation among HCWs and medical students, and the prevalence showed an upward trend.
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Affiliation(s)
- Meng-Wei Ge
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China
| | - Hong-Lin Chen
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China
| | - Fei-Hong Hu
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China
| | - Yi-Jie Jia
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China
| | - Wen Tang
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China
| | - Wan-Qing Zhang
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China
| | - De-Jun Yu
- School of Medical, Nantong University, Nantong, Jiangsu, PR China.
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Mudiyanselage SPK, Tsai YT, Tsai YJ, Yang YH, Lu ZT, Ko NY. Global overview of suicidal behavior and risk factors among the general population during the COVID-19 pandemic: a scoping review. BMC Psychol 2024; 12:727. [PMID: 39639358 PMCID: PMC11619090 DOI: 10.1186/s40359-024-02168-9] [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: 09/25/2024] [Accepted: 11/06/2024] [Indexed: 12/07/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic, declared by the World Health Organization in early 2020, rapidly escalated from a global health crisis to a significant public health issue worldwide. This scoping review aims to provide a comprehensive global overview of suicidal behavior and associated risk factors during the COVID-19 pandemic. METHODS Adhering to the PRISMA 2020 guidelines, literature searches were conducted across five databases: Embase, MEDLINE, CINAHL, Web of Science, and Academic Search Complete. The review encompassed studies published from January 1, 2019, to November 29, 2023. A total of 286 studies met the inclusion criteria, offering a broad perspective on suicidal behaviors during the pandemic. The studies underwent quality assessment using the Joanna Briggs Institute (JBI) Critical Appraisal for Checklist for Prevalence Studies Scale (CACPSS). RESULTS The highest rates of suicidal behavior were observed in the Americas, Europe, and the Western Pacific Region, with China and the United States reporting significant cases. Key risk factors included demographic characteristics, mental health conditions, and social support factors. Suicidal ideation prevalence rates ranged significantly, with the highest in some regions exceeding 50%. Suicide attempts and completed suicides also showed considerable variation across different countries and regions. CONCLUSION The findings emphasize the need for targeted mental health interventions and policies to reduce suicide risk, highlighting the multifaceted nature of suicidal behaviors during the COVID-19 pandemic. Comprehensive, multidisciplinary approaches are necessary to address this pressing concern, and understanding the interplay among diverse risk factors is crucial for developing effective prevention and intervention strategies.
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Affiliation(s)
- Sriyani Padmalatha Konara Mudiyanselage
- Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan (R.O.C.)
- Operation theater department, The National hospital of Sri Lanka, Colombo, Sri Lanka
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan (R.O.C.)
| | - Yi-Tseng Tsai
- Department of Nursing, An Nan Hospital, China Medical University, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan City, 709, Taiwan (R.O.C.).
| | - Yi-Jing Tsai
- Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan (R.O.C.)
| | - Ya-Han Yang
- Department of Nursing, An Nan Hospital, China Medical University, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan City, 709, Taiwan (R.O.C.)
| | - Zan-Ting Lu
- Department of Nursing, An Nan Hospital, China Medical University, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan City, 709, Taiwan (R.O.C.)
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan (R.O.C.)
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Peng J, He M, Guo Y, Diao J, Chen K, Deng Z, Mo L, Gao R. Recovery trajectories of mental health symptoms among Chinese adolescents following the end of COVID-19. Front Public Health 2024; 12:1396911. [PMID: 39697298 PMCID: PMC11652372 DOI: 10.3389/fpubh.2024.1396911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 11/15/2024] [Indexed: 12/20/2024] Open
Abstract
Background The COVID-19 pandemic has had a profound impact on global mental health, particularly among adolescents. However, little is known about how mental health symptoms recover after the pandemic subsides. This study aims to examine the recovery trajectories of ten mental health problems and suicidal ideation among Chinese adolescents post-pandemic, with a focus on identifying factors that influence different recovery patterns. Methods A total of 2,534 adolescents participated in a three-wave survey, conducted in June 2022, November 2022, and March 2023, using the Mental Health Scale for Chinese Middle School Students. A novel index was developed to account for both the number and severity of mental health risk factors, allowing for the classification of psychological symptoms into three subgroups: no, moderate, and severe. Polynomial regression models were applied to determine the acceleration inflection point, and multivariate logistic regressions identified predictors of trajectory membership. Results Significant declines in psychological symptoms were observed. Seven trajectory patterns were identified: resistance (37.85%), recovery (22.61%), chronic-dysfunction (12.08%), aftermath-deterioration (10.81%), stress-responsiveness (8.21%), vulnerability (5.76%), and remitting (2.68%). Being female, senior high school students, and the oldest child in the family hindered mental health recovery, whereas parenting styles of companionship, empathetic support, promise fulfillment, and behavior intervention served as protective factors. Conclusion This study is one of the first to reveal the post-pandemic mental health recovery trajectories of Chinese adolescents, highlighting the importance of considering both the number and severity of cumulative mental health problems. The findings offer valuable insights into suicide prevention and the development of targeted interventions to support youth mental health recovery.
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Affiliation(s)
- Jun Peng
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
| | - Meihui He
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
| | - Yongxing Guo
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
- DiggMind Psychometric Testing Technology Co., Guangzhou, China
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, China
| | - Jiangdong Diao
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
- Nanjing Gulou District Education Bureau, Nanjing, China
| | - Kun Chen
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
| | - Ziyi Deng
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
| | - Lei Mo
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
| | - Ruixiang Gao
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, and School of Psychology, South China Normal University, Guangzhou, China
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Tubbs AS, Taneja K, Ghani SB, Nadorff MR, Drapeau CW, Karp JF, Fernandez FX, Perlis ML, Grandner MA. Sleep continuity, timing, quality, and disorder are associated with suicidal ideation and suicide attempts among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:3357-3365. [PMID: 36596225 DOI: 10.1080/07448481.2022.2155828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/12/2022] [Accepted: 10/23/2022] [Indexed: 06/17/2023]
Abstract
Objective: To evaluate sleep continuity, timing, quality, and disorder in relation to suicidal ideation and attempts among college students. Participants: Eight hundred eighty-five undergraduates aged 18-25 in the southwestern United States. Methods: Participants completed questionnaires on sleep, suicide risk, mental health, and substance use. Differences in sleep variables were compared by lifetime and recent suicidal ideation and suicide attempts using covariate-adjusted and stepwise regression models. Results: A total of 363 (41.0%) individuals reported lifetime suicidal ideation, of whom 172 (47.4%) reported suicidal ideation in the last 3 months and 97 (26.7%) had attempted suicide in their lifetime. Sleep disturbances were prevalent among those with lifetime suicidal ideation or a lifetime suicide attempt. Insomnia was identified as the best predictor of recent suicidal ideation, but this relationship did not survive adjustment for covariates. Conclusions: Sleep continuity, quality, and sleep disorders are broadly associated with suicidal thoughts and behaviors among college students.
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Affiliation(s)
- Andrew S Tubbs
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Krishna Taneja
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Sadia B Ghani
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Christopher W Drapeau
- Department of Health Policy and Management, School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, Indiana, USA
| | - Jordan F Karp
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | | | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael A Grandner
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
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19
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Zhang X, Zhang Y, Bu L, Li H, Ye H, Wang D, Fan F. The trajectories and associations of sleep disturbance symptoms with suicidal ideation in adolescents: A three-wave longitudinal study. Sleep Med 2024; 124:591-597. [PMID: 39476609 DOI: 10.1016/j.sleep.2024.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 10/17/2024] [Accepted: 10/26/2024] [Indexed: 12/23/2024]
Abstract
BACKGROUND This study aimed to investigate the developmental trajectories of sleep disturbance symptoms and examine whether specific trajectory memberships of sleep disturbance symptoms could prospectively predict suicidal ideation (SI) among a large sample of Chinese adolescents over one year. METHODS A three-wave longitudinal study was conducted from April 2021 to June 2022, with a sample of 19,095 adolescents from Shenzhen in Guangdong Province, China (51.2 % males; mean age = 12.4 ± 1.6 years at baseline). Socio-demographics (at baseline), SI, sleep disturbance symptoms (at each assessment), depressive symptoms (at the last follow-up), and negative life events (at two follow-ups) were assessed. Data were analyzed employing Growth Mixture Modeling and binary logistic regressions. RESULTS The Growth Mixture Modeling identified four trajectories of sleep disturbance symptoms over one year: resistant group (76.2 %), delayed-dysfunction group (8.8 %), recovery group (7.4 %), and chronic-dysfunction group (7.6 %). Binary logistic regression analysis revealed that adolescents in the group of delayed-dysfunction (OR = 2.86, 95 % CI = 2.51-3.27) and chronic-dysfunction (OR = 2.14, 95 % CI = 1.84-2.47) exhibited higher risks of developing SI compared to those in the resistant group, even after controlling for socio-demographics, negative life events, depressive symptoms, and baseline SI. CONCLUSIONS These findings underscore the importance of identifying individuals at higher risks of sleep disturbance and providing personalized and effective mental health services to reduce the incidence of SI.
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Affiliation(s)
- Xiangting Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Luowei Bu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Huolian Li
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Haoxian Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
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20
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Yang Q, Xie J, Li Z, Zhai C, Sheng M, Li S, Gao M. Association between sleep quality, depressive symptoms, and suicidal ideation in college students. PSYCHOL HEALTH MED 2024; 29:1583-1601. [PMID: 38503424 DOI: 10.1080/13548506.2024.2331491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
Suicide among college students is a challenging problem globally. Yet, the association between sleep quality, depressive symptoms, and suicidal ideation remains unclear. This study aims to understand if depressive symptoms mediate the relationship between sleep quality and suicide ideation and whether the interaction between depressive symptoms and sleep quality on suicidal ideation is additive. A total of 1182 college students were recruited, and sleep quality, depressive symptoms, and suicidal ideation were assessed using questionnaires. Univariate analysis, logistic regression analysis, linear regression models, and the Sobel test were performed. The results showed that, among college students, poor sleep quality was positively associated with suicidal ideation, and the association was mediated through depressive symptoms. Moreover, there was a significant additive interaction between poor sleep quality and depressive symptoms on suicidal ideation. These findings suggest that, in the process of preventing and treating suicidal ideation in college students with sleep disorders, we should focus on the evaluation and intervention of depressive symptoms and adopt multidisciplinary team interventions for college students with sleep disorders and depression.
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Affiliation(s)
- Qianqian Yang
- Medical School, Liaocheng University, Liaocheng, Shandong Province, P.R. China
| | - Jiafan Xie
- Medical School, Liaocheng University, Liaocheng, Shandong Province, P.R. China
| | - Zehan Li
- Medical School, Liaocheng University, Liaocheng, Shandong Province, P.R. China
| | - Chenxiao Zhai
- Medical School, Liaocheng University, Liaocheng, Shandong Province, P.R. China
| | - Meiyan Sheng
- Medical School, Liaocheng University, Liaocheng, Shandong Province, P.R. China
| | - Shengpeng Li
- Medical School, Liaocheng University, Liaocheng, Shandong Province, P.R. China
| | - Mengqian Gao
- Medical School, Liaocheng University, Liaocheng, Shandong Province, P.R. China
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21
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Chen Z, Li R, Liu Y, Lian Q. Sufficient sleep and its contributing factors among high school students during the COVID-19 pandemic: results from adolescent behaviors and experiences survey. Front Public Health 2024; 12:1408746. [PMID: 39220458 PMCID: PMC11361944 DOI: 10.3389/fpubh.2024.1408746] [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: 03/28/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Background The COVID-19 pandemic has caused profound changes in adolescent lives, including school closures, social isolation, family economic hardship, and sleep schedule. We aimed to assess the risk and protective factors of sufficient sleep among adolescents during COVID-19. Methods We conducted secondary analysis based on the cross-sectional school-based Adolescent Behaviors and Experiences Survey in 2021 (n = 7,705). The ABES collected information on health-related experiences and behaviors during COVID-19. The outcome was sufficient sleep (eight and more hours of sleep on the average school night). The contributing factors included demographic, mental health, and adverse experiences indicators. We estimated the prevalence of sufficient sleep within each factor, and examined their associations using Chi-square test. We further investigated the contributing factors of sufficient sleep using multivariate logistic regression and reported the adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results During January-June 2021, 23.5% of the U.S. high school students reported getting sufficient sleep. The multivariate logistic regression indicated that younger age (AOR, 2.04; 95%CI, 1.59-2.62), heterosexual identity (AOR, 1.61; 95%CI, 1.19-2.18), no poor mental health during the past 30 days (AOR, 1.37; 95%CI, 1.03-1.82), no persistent feelings of sadness or hopelessness (AOR, 1.34; 95%CI, 1.09-1.66), no food and nutrition insecurity (AOR, 1.47; 95%CI, 1.17-1.85), never been abused by a parent emotionally (AOR, 1.38; 95%CI, 1.16-1.64), and no schoolwork difficulty (AOR, 1.24; 95%CI, 1.01-1.51) were associated with sufficient sleep. Conclusion We estimated the national prevalence of adolescent sufficient sleep during the COVID-19 pandemic and found that younger students, sexual heterosexual students, and students without certain mental health conditions or adverse experiences are at higher likelihood of sufficient sleep. These findings can help develop effective interventions on sleep duration in the response to a possible future pandemic caused by Disease X.
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Affiliation(s)
- Zhengyang Chen
- Preventive Care Department, Jiangyou Fifth People’s Hospital, Sichuan, China
| | - Ruili Li
- Children Health and Development Department, Capital Institute of Pediatrics, Beijing, China
| | - Yuexi Liu
- The Second Clinical Medical College, Dalian Medical University, Dalian, China
| | - Qiguo Lian
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China
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22
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Levi-Belz Y, Blank C, Groweiss Y, Neria Y. The impact of PTSD symptoms on suicide ideation in time of terror and war: A nationwide prospective study on the moderating role of loneliness. Psychiatry Res 2024; 338:115996. [PMID: 38823164 DOI: 10.1016/j.psychres.2024.115996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/03/2024]
Abstract
The terrorist attack of October 7, 2023, and its accompanying war have increased the risk for posttraumatic stress symptoms (PTSS) and suicide ideation (SI). In this national prospective cohort study, we examined the extent to which a sense of loneliness moderates the association between PTSS and SI in the wake of the October 7th attack and the Israel-Hamas war. A representative sample of 710 Israeli adults (362 female, 51.1 %) aged 18-85 (M = 41.01, SD = 13.72) participated in a longitudinal study assessing depression, current SI, and loneliness at two time points: T1, one month before the attack (August 2023) and T2 (November 2023), one month after the attack. We found two significant interactions in which a sense of loneliness at T2 moderated the link between both PTSS at T1 and T2 and current SI at T2. Specifically, the level of PTSS contributed to current SI at T2 more strongly among individuals reporting higher loneliness levels than those reporting low loneliness levels. Clinicians treating individuals coping with high PTSS levels should attend to their patients' sense of loneliness, as it comprises a significant risk factor for current SI and may be considered an important target in treatment.
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Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel; Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel.
| | - Carmel Blank
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel; Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - Yoav Groweiss
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Yuval Neria
- Department of Psychiatry and New York State Psychiatric Institute, Columbia University Irving Medical Center, NY, USA
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23
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Zheng D, Qin Q, Peng Y, Zhong H, Huang Y, Wang H, Tan Q, Li Y. Pre-COVID-19 short sleep duration and eveningness chronotype are associated with incident suicidal ideation during COVID-19 pandemic in medical students: a retrospective cohort study. Front Public Health 2024; 12:1406396. [PMID: 39109162 PMCID: PMC11300336 DOI: 10.3389/fpubh.2024.1406396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Cross-sectional evidence suggests that sleep problems increased the risk of suicide during the 2019 coronavirus disease (COVID-19) pandemic. However, a lack of longitudinal studies examined the relationship between pre-COVID-19 sleep duration, chronotype and incident suicide during the COVID-19 pandemic. Thus, we examined these associations in a longitudinal study of medical students. Methods From the Shantou College Student Sleep Cohort, a total of 333 first and second grade medical students (age 19.41 ± 0.82 years, female 61.26%), without suicidal ideation (SI) at pre-COVID-19 period, were followed up during the COVID-19 pandemic. Incident SI was defined by their response to the 9th question from the Beck Depression Inventory. Short sleep duration was defined as less than 7 h/night. The Morningness-Eveningness Questionnaire was used to evaluate the participants' chronotype. Logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) was used to examine the association between sleep and SI. Results The incidence of SI during the COVID-19 pandemic was 5.71%. Logistic regressions with confounding factors adjustment showed that both short sleep duration (AOR = 4.91, 95% CI = 1.16-20.74) and eveningness (AOR = 3.80, 95% CI = 1.08-13.30) in the pre-COVID-19 period were associated with increased risk of incident SI during the COVID-19 pandemic. Conclusion Pre-COVID-19 short sleep duration and eveningness predict incident SI during the COVID-19 pandemic in medical students. Prolonging sleep duration may help to decrease SI during major public health crises.
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Affiliation(s)
- Dandan Zheng
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
- Faculty of Medicine of University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou University Medical College, Shantou, Guangdong, China
| | - Qingsong Qin
- Laboratory of Human Virology and Oncology, Shantou University Medical College, Shantou, Guangdong, China
| | - Yingyin Peng
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Hao Zhong
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yerui Huang
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Hongjie Wang
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Qiqing Tan
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yun Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
- Faculty of Medicine of University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou University Medical College, Shantou, Guangdong, China
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24
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Ye H, Chen S, Cai Z, Jiang N, Liu Y, He S, Chen C, Zou L, Li Y, Huang Y, Yang L, Fan F. Negative life events and sleep disturbance among adolescents: Intolerance of uncertainty as mediator and moderator. Sleep Med 2024; 117:79-86. [PMID: 38518586 DOI: 10.1016/j.sleep.2024.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND While negative life events (NLEs) have been linked to an increased risk of sleep disturbance among adolescents, the mechanisms of this impact still lack further examination. The current study aimed to explore whether intolerance of uncertainty (IU), a dispositional transdiagnostic vulnerability factor for psychopathology, could act as a mediator and/or moderator in the link from NLEs to sleep disturbance. METHODS A longitudinal nested subsample of 54,240 Chinese adolescents (aged 9-19) were surveyed at baseline (Timepoint 1) and six months later (Timepoint 2). They completed questionnaires to assess their IU, NLEs, sleep disturbance and sociodemographic characteristics. Mediation and moderation analyses were conducted to test our hypotheses. RESULTS Upon adjusting for covariates, IU was found to mediate the relationship between NLEs and residual changes in sleep disturbance over a six-month period, with the mediation effect accounting for 31.8%. Additionally, the moderating role of IU in this relationship was also identified, suggesting that a high level of IU exacerbated the effect of NLEs on sleep disturbance. CONCLUSIONS In conclusion, our findings shed light on the dual roles of IU in the link from NLEs to sleep disturbance, holding significant practical implications for preventing and intervening in sleep disturbance among adolescents. To mitigate the risk of sleep disturbance among adolescents experiencing NLEs, timely assessments of IU and tailored interventions to enhance uncertainty tolerance are necessary.
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Affiliation(s)
- Haoxian Ye
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Shiying Chen
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Zifan Cai
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Nan Jiang
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Yixin Liu
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Sisi He
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Chunling Chen
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Linmao Zou
- Centre for Teacher Development in Gaozhou, Maoming, China
| | - Yunyi Li
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Yike Huang
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Le Yang
- School of Computer, South China Normal University, Guangzhou, China
| | - Fang Fan
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, China.
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25
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Ye H, Jiang N, He S, Fan F. Sleep disturbance and internalizing symptoms in adolescents: a moderated mediation model of self-control and mindfulness. BMC Psychiatry 2024; 24:310. [PMID: 38658904 PMCID: PMC11040859 DOI: 10.1186/s12888-024-05750-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES Despite accumulating evidence regarding the impact of sleep disturbance on internalizing symptoms among adolescents, the underlying psychological mechanisms remain inadequately explored. This study aimed to investigate a conceptual framework elucidating how sleep disturbance influences internalizing symptoms in adolescents through the mediating role of self-control, with mindfulness as a moderator. METHODS In this cross-sectional study, 1876 Chinese adolescents (Mage = 14.88 years, SD = 1.47 years, range = 12-19 years, 44.7% boys) completed the Youth Self-Rating Insomnia Scale (YSIS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Brief Self-control Scale (BSCS), and Mindful Attention Awareness Scale-Children (MAAS-C) to provide data on sleep-related variables, internalizing symptoms (anxiety and depression), self-control, and mindfulness, respectively. The PROCESS macro for SPSS was applied to perform moderated mediation analysis. RESULTS Sleep disturbance demonstrated a significant positive correlation with internalizing symptoms in adolescents, including anxiety (β = 0.481, p < 0.001) and depression (β = 0.543, p < 0.001). Self-control served as a mediator between sleep disturbance and two forms of internalizing symptoms. Moreover, mindfulness moderated the pathways from self-control to internalizing symptoms (for anxiety symptoms: β = 0.007, p < 0.001; for depression symptoms: β = 0.006, p < 0.001), and the mediating relationships were weaker for adolescents exhibiting higher levels of mindfulness. CONCLUSIONS Our findings enhance understanding of the impact, pathways, and influencing factors of sleep disturbance on adolescent internalizing symptoms, suggesting the importance of enhancing mindfulness levels in addressing self-control deficits and subsequently reducing internalizing symptoms among adolescents.
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Affiliation(s)
- Haoxian Ye
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, 510631, Guangzhou, China
| | - Nan Jiang
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, 510631, Guangzhou, China
| | - Sisi He
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, 510631, Guangzhou, China
| | - Fang Fan
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, 510631, Guangzhou, China.
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26
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Bu L, Wang D, Fan Y, Ye H, Liu W, Fan F. Sleep disturbance and suicidal ideation mediated by psychotic-like experiences in adolescents: a two-wave longitudinal study. Sleep 2024; 47:zsae013. [PMID: 38230742 DOI: 10.1093/sleep/zsae013] [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: 09/18/2023] [Revised: 01/10/2024] [Indexed: 01/18/2024] Open
Abstract
STUDY OBJECTIVES Sleep disturbance may cause suicidal ideation (SI). This study aimed to examine their co-occurrence rate among adolescents and investigate whether psychotic-like experiences (PLEs) mediate this association. METHODS A total of 17 722 Chinese adolescents were included in this two-wave longitudinal study. The baseline survey (time 1, T1) was conducted between April 21 and May 12, 2021, and the follow-up survey (time 2, T2) was implemented between December 17 and 26, 2021. At T1, participants completed questionnaires to assess their sleep disturbance, sleep duration, PLEs, SI, depressive symptoms, and sociodemographic characteristics. At T2, participants reported their PLEs, SI, and negative life events. RESULTS The SI prevalence decreased from 20.2% (T1) to 18.4% (T2). Participants with SI showed significantly higher prevalence of sleep disturbance and short sleep duration compared to those without SI. Baseline sleep disturbance and short sleep duration were both associated with the increased risk of SI 6 months later. These longitudinal links were mediated by PLEs, independent of baseline covariates and negative life events. CONCLUSIONS These findings provide a novel insight into the mechanism linking sleep problems and suicidality, and stress the significance of assessing and addressing sleep problems and PLEs for adolescent suicide prevention and intervention.
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Affiliation(s)
- Luowei Bu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Haoxian Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
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27
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Xu B, Chen C, Wang D. Current Psychotic-Like Experiences Among Chinese College Students: Prevalence, Correlates, and Its Relationship with Suicidal Ideation. Psychol Res Behav Manag 2024; 17:799-811. [PMID: 38434958 PMCID: PMC10908336 DOI: 10.2147/prbm.s451889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Current psychotic-like experiences (PLEs) are prevalent among adolescents. However, epidemiological data on the prevalence rate of current PLEs among college students and its clinical correlates are scarce and limited. To address this study gap, this study aimed to investigate the prevalence and correlates of current PLEs among Chinese college students. Methods A cross-sectional study was designed with a sample of 18,578 college students in China. Each participant completed a survey on social-demographic characteristics variables, PLEs, sleep disturbance, depression, anxiety, and suicidal ideation. Logistic regression analyses were conducted to explore the influential factors for PLEs among all participants and suicidal ideation among those with PLEs. Results Among Chinese college students, 40.3% of the participants reported having at least one PLE in the past month, while 7.5% had frequent PLEs. Males, age, residence location in town, left-behind experiences, poor family economic status, chronic physical illness, family history of mental disorder, BMI ≥ 28 [obesity], sleep disturbance, depression, anxiety, and suicidal ideation were independent correlates for frequent PLEs. Furthermore, the prevalence of suicidal ideation among participants with frequent PLEs was 32.1%. Lower grades, sleep disturbance, depression, and anxiety were independent predictors of suicidal ideation among college students who experience PLEs frequently. Conclusion Current PLEs are widespread among Chinese college students. Suicidal ideation is largely prevalent among individuals who suffer frequent PLEs, suggesting that special measures and attention should be provided to these students based on relevant factors to prevent their suicidal ideation and behavior.
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Affiliation(s)
- Bingna Xu
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Dongfang Wang
- School of Psychology, South China Normal University, Guangzhou, People’s Republic of China
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People’s Republic of China
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Wiguna T, Dirjayanto VJ, Maharani ZS, Faisal EG, Teh SD, Kinzie E. Mental health disturbance in preclinical medical students and its association with screen time, sleep quality, and depression during the COVID-19 pandemic. BMC Psychiatry 2024; 24:85. [PMID: 38297243 PMCID: PMC10832144 DOI: 10.1186/s12888-024-05512-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Affected by various hurdles during COVID-19, preclinical medical students are at an elevated risk for mental health disturbances. However, the effects of modern mental health problems on preclinical medical students have not been adequately researched. Thus, this study was aimed to identify the proportions and implications of current mental health problems for depression, sleep quality and screen time among Indonesian medical preclinical students during the COVID-19 pandemic. METHODS This cross-sectional study was conducted using crowdsourcing between October 2020 and June 2021. During the study period, 1,335 subjects were recruited, and 1,023 datasets were identified as valid. General Health Questionnaire-12 (GHQ-12) was used to measure current mental health disturbances (categorized as without current mental health disturbances, psychological distress, social dysfunction, or both). The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, the Pittsburgh Sleep Quality Index (PSQI) was employed to assess sleep quality, and a questionnaire devised for this study was used to assess screen time length per day. Multivariate data analysis was conducted using SPSS version 24 for Mac. RESULTS According to the findings, 49.1% of the 1,023 participants had current mental health disturbances: 12.8% had psychological distress, 15.9% had social dysfunction, and the rest (20.4%) had both psychological distress and social dysfunction. The statistical analysis provided strong evidence of a difference (p < 0.001) between the medians of depression and sleep quality with at least one pair of current mental health disturbance groups, but the difference for screen time was not significant (p = 0.151). Dunn's post-hoc analysis showed that groups without current mental health problems had significantly lower mean ranks of depression and sleep quality compared to groups that had current mental health problems (p < 0.001). CONCLUSION Current mental health disturbances during the COVID-19 pandemic were significantly associated with preclinical medical students' depression and sleep quality in preclinical medical students. Thus, mental health programs for this specific population should be tailored to integrate mindfulness therapy, support groups, stress management, and skills training to promote mental wellbeing.
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Affiliation(s)
- Tjhin Wiguna
- Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Valerie Josephine Dirjayanto
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | | | | | - Sylvie Dominic Teh
- Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Erik Kinzie
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, USA
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Zhang Y, Wang D, Ma Z, Liu W, Su Y, Wang W, You Z, Fan F. Problematic internet use and suicide ideation among Chinese adolescents: The indirect effects of insomnia, nightmares, and social jetlag. J Affect Disord 2024; 344:347-355. [PMID: 37838270 DOI: 10.1016/j.jad.2023.10.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Problematic Internet use (PIU) is related to suicide ideation (SI) in adolescents, but little is known about the potential mechanisms between them. This study aimed to examine the mediation roles of insomnia, nightmares, and social jetlag in the association of PIU with SI in adolescents. METHODS A total of 39,731 adolescents (mean age = 13.49 ± 0.76 years, 54.4 % males) from Shenzhen, China, participated in a cross-sectional survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. PIU was measured by the Revised Chinese Internet Addiction Scale. A self-administered questionnaire was used to assess insomnia symptoms, nightmare frequency, social jetlag, sleep duration, psychological distress, and social-demographical characteristics. Logistic regression and path analyses were performed to examine the associations between PIU, insomnia symptoms, nightmares, social jetlag, and SI. RESULTS The prevalence of PIU and SI were 14.9 % and 18.6 %, respectively. PIU, insomnia symptoms, frequent nightmares, and social jetlag were significantly associated with SI. Path analyses showed that the indirect effects of PIU on SI through insomnia symptoms, frequent nightmares, and social jetlag were significant. Conversely, social jetlag significantly mediated the pathway from SI to PIU. The mediation effect sizes of these sleep and circadian problems were slightly larger in females than in males. LIMITATIONS Cross-sectional design limited the capacity to infer causal relationships. CONCLUSIONS The associations between PIU and SI were mediated by sleep and circadian problems. These findings underscore the importance of assessing and intervening in sleep and circadian problems among adolescents with PIU or SI.
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Affiliation(s)
- Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yunlin Su
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wei Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zhenli You
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Liu W, Wang D, Fan Y, Ye H, Bu L, Fan F. Changes in sleep disturbance among Chinese adolescents: A population-based online survey. J Psychosom Res 2023; 175:111515. [PMID: 37856932 DOI: 10.1016/j.jpsychores.2023.111515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/17/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Sleep disturbance is prevalent among adolescents but little is known about the short-term changes among Chinese adolescents. The study aimed to explore the prevalence and change patterns of sleep disturbance and identify its risk and protective factors. METHODS Data were collected online from April 21st to May 12th, 2021 (Time 1, T1) and December 17th to 26th, 2021 (Time 2, T2). The final sample comprised 34,260 adolescents. Self-administrated questionnaires were used to assess socio-demographic variables, sleep disturbance, depression, anxiety, life events, family function, and resilience. RESULTS The prevalence of sleep disturbance was 12.0% at T1 and 11.8% at T2, with higher rates in females than males. Four groups of sleep disturbance change patterns were identified: non-sleep disturbance group (80.4%), persistent group (4.2%), new-onset group (7.6%), and remission group (7.8%). Risk factors for new-onset sleep disturbance included being in junior high school (AOR = 1.26, 95%CI = 1.15-1.38), family history of mental disorders (AOR = 1.49, 95%CI = 1.03-2.15), and moderate (AOR = 1.24, 95%CI = 1.13-1.36) and severe (AOR = 1.48, 95%CI = 1.27-1.72) family dysfunction. Risk factors for persistent sleep disturbance included being in junior (AOR = 1.25, 95%CI = 1.08-1.45) and senior (AOR = 1.53, 95%CI = 1.15-2.03) high school, parental currently unmarried status (AOR = 1.34, 95%CI = 1.05-1.73), moderate (AOR = 1.19, 95%CI = 1.02-1.39) and severe (AOR = 1.28, 95%CI = 1.06-1.55) family dysfunction. Medium (AOR = 0.48, 95%CI = 0.43-0.53) and high (AOR = 0.34, 95%CI = 0.29-0.40) levels of resilience were protective factors against new-onset sleep disturbance, as well as against persistent sleep disturbance (medium level: AOR = 0.51, 95%CI = 0.43-0.60; high level: AOR = 0.32, 95%CI = 0.25-0.43). CONCLUSIONS Interventions aimed at promoting family functions and enhancing resilience may improve sleep disturbance among adolescents.
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Affiliation(s)
- Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Haoxian Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Luowei Bu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Yao ZY, Wang T, Yu YK, Li R, Sang X, Fu YN, Gong XJ, Sun WJ, Liu JJW, Wong JPH, Fung KPL, Jia CX. Mental health literacy and suicidal ideation among Chinese college students: The mediating role of depressive symptoms and anxiety symptoms. J Affect Disord 2023; 339:293-301. [PMID: 37437723 DOI: 10.1016/j.jad.2023.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Mental health literacy (MHL) is essential to mental health. Symptoms of depression and anxiety are significant antecedents and closely related to suicide among college students. Few studies have explored the mediating role of depressive and anxiety symptoms between MHL and suicidal ideation. METHODS 5578 college students were included in the analysis. The online Wenjuanxing platform was used to collect data from November 2020 to March 2021. The bootstrapping method was used to test the mediating role of depressive and anxiety symptoms in the links between MHL and suicidal ideation. RESULTS Approximately 18.8 % of Chinese college students in our study reported having suicidal ideation. MHL exhibited a significant and negative correlation with depressive symptoms, anxiety symptoms, and suicidal ideation, whereas depressive and anxiety symptoms correlated significantly and positively with suicidal ideation. Compared with the lowest MHL quartile, the 3rd and 4th quartiles of MHL were associated with a significantly lower risk of suicidal ideation after adjusting for various confounding factors. Depressive and anxiety symptoms partially mediated the relationship between MHL and suicidal ideation, and the mediating effect of depressive symptoms was significantly greater than that of anxiety symptoms. LIMITATIONS This study was a cross-sectional survey. Future longitudinal studies on this relation are needed. CONCLUSIONS Depressive and anxiety symptoms mediate the relationship between MHL and suicidal ideation. Comprehensive school-based specific psychological education programs are needed to improve college students' MHL and change their attitudes toward mental health services.
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Affiliation(s)
- Zhi-Ying Yao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Tao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yao-Kun Yu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Ran Li
- Center of Students' mental health and Consultation, Liaocheng University, Liaocheng 252000, China
| | - Xiao Sang
- Student Mental Health Education Center, Shandong Jianzhu University, Jinan 250101, China
| | - Yi-Na Fu
- School of Management, Shandong University, Jinan 250100, China
| | - Xiao-Jie Gong
- Department of Sociology, School of Political Science and Law, University of Jinan, Jinan 250022, China
| | - Wen-Jun Sun
- Student Work Office, College of Textile and Clothing, Qingdao University, Qingdao 266071, China
| | - Jenny Jing-Wen Liu
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Josephine Pui-Hing Wong
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Kenneth Po-Lun Fung
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
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Du W, Jia YJ, Hu FH, Ge MW, Cheng YJ, Qu X, Chen HL. Prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic: A meta-analysis of 113 studies from 31 countries. J Psychiatr Res 2023; 166:147-168. [PMID: 37774666 DOI: 10.1016/j.jpsychires.2023.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/12/2023] [Accepted: 07/29/2023] [Indexed: 10/01/2023]
Abstract
The purpose of this study was to estimate the prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic. Web of Science (WOS) and PubMed were searched according to a pre-set strategy. A total of 132 studies were identified, 104 of which were included in the meta-analysis. The prevalence of suicidal ideation was approximately 14.7% (95%CI: 12.5%, 16.8%, P < 0.01) in the general population, approximately 22.4% (95%CI: 17.1%, 27.8%, P < 0.01)in adolescents, approximately 21.0% (95%CI: 12.8%, 29.2%, P < 0.01) in psychiatric patients, approximately 20.6% (95%CI: 18.7%, 22.5%, P < 0.01)in university students, approximately 18.9% (95%CI: 8.3%, 29.5%, P < 0.01) in younger adults, approximately 10.6% (95%CI: 1.0%, 20.2%, P = 0.031) in COVID-19 patients and approximately 7.4% (95%CI: 4.3%, 10.5%, P < 0.01) in healthcare workers. The prevalence in North America was approximately 16.0% (95%CI: 13.6%-18.4%, P < 0.001), approximately 14.5% in Asia (95%CI: 9.5%-19.4%, P < 0.001), approximately 10.5% in Europe (95%CI: 8.5%-12.4%, P < 0.001), and approximately 20.5% in South America (95%CI: 19.5%-21.5%, P < 0.001). The following were risk factors which might be correlated with suicidal ideation: severe anxiety symptoms, mild to moderate depression, a strong feeling of loneliness/social isolation, poor sleep quality, having COVID-19-related experience, having quarantine or lockdown experience, being female, being single or divorced, having financial problems and having a history of suicidal ideation/attempt. This article reports the prevalence of suicidal ideation and discussing potential risk factors during the pandemic among general population and vulnerable groups. Early detection and follow-up were necessary for the noteworthy population.
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Affiliation(s)
- Wei Du
- Nantong University Medical School, PR China
| | - Yi Jie Jia
- Nantong University Medical School, PR China
| | | | | | | | - Xin Qu
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Hong Lin Chen
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China.
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Kang M, Xu B, Chen C, Wang D. Internet addiction and suicidal ideation among Chinese college students: the mediating role of psychotic-like experiences. Front Public Health 2023; 11:1276496. [PMID: 37841710 PMCID: PMC10568022 DOI: 10.3389/fpubh.2023.1276496] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Background Individuals with Internet addiction (IA) are at significant risk of suicide-related behaviors. This study aimed to investigate the relationships among IA, psychotic-like experiences (PLEs), and suicidal ideation (SI) among college students. Methods A total of 5,366 college students (34.4% male, mean age 20.02 years) were assessed using the self-compiled sociodemographic questionnaires, Revised Chinese Internet Addiction Scale (CIAS-R), 15-item Positive subscale of the Community Assessment of Psychic Experiences (CAPE-P15), Self-rating Idea of Suicide Scale (SIOSS), and 2-item Patient Health Questionnaire (PHQ-2). Results The prevalence of IA and SI were 9.3 and 12.1% among Chinese college students, respectively. There were direct effects of IA and PLEs on SI. The total effect of IA on SI was 0.18 (p < 0.001). PLEs mediated the relationship between IA and SI (Indirect effect = 0.07). Conclusion IA had both direct and indirect effects on SI. These findings enable us to elucidate the mechanism of how IA influences individual SI, which can provide vital information for developing and implementing targeted interventions and strategies to alleviate SI among Chinese college students.
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Affiliation(s)
- Meng Kang
- Graduate Institute for Taiwan Studies, Xiamen University, Xiamen, China
| | - Bingna Xu
- Institute of Education, Xiamen University, Xiamen, China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
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34
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Luo X, Yu T, Yang Z, Wang D. Psychotic-Like Experiences and Suicidal Ideation Among Adolescents: The Chain Mediating Role of Insomnia Symptoms and Resilience. Psychol Res Behav Manag 2023; 16:3519-3530. [PMID: 37675191 PMCID: PMC10478937 DOI: 10.2147/prbm.s426363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
Background Individuals who experience psychotic-like experiences (PLEs) are at significant risk of suicide-related behaviors. This two-wave longitudinal study aimed to investigate the relationships among PLEs, insomnia symptoms, resilience, and suicidal ideation (SI) among adolescents. Methods A total of 2231 college students [mean age (standard deviation) = 20.02 (1.39) years] completed two web-based surveys. Participants completed self-report measures of sample characteristics, PLEs, insomnia symptoms, resilience, and SI. Results The findings indicated a significantly positive correlation between PLEs and SI that was sequentially mediated by insomnia symptoms and resilience. Furthermore, insomnia symptoms and resilience played a chain-mediating role between PLEs and adolescent SI. Conclusion These findings suggest potential mechanism for the PLEs-SI link, which helps us better understand how PLEs can influence individual SI and provides important information for early prevention.
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Affiliation(s)
- Xi Luo
- School of Educational Science, Hunan Normal University, Changsha, Hunan Province, People’s Republic of China
- Cognition and Human Behavior Key Laboratory of Hunan Province, Changsha, Hunan Province, People’s Republic of China
- Hunan First Normal University, Changsha, Hunan Province, People’s Republic of China
| | - Taowen Yu
- Department of Applied Psychology, Changsha Normal University, Changsha, Hunan Province, People’s Republic of China
| | - Zilu Yang
- College of Education, Hunan Agricultural University, Changsha, Hunan Province, People’s Republic of China
| | - Dongfang Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, Guangdong Province, People’s Republic of China
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35
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McLeish AC, Hartson KR, Walker KL, Hart JL. Associations between sleep disturbance, physical activity, and anxiety sensitivity among college students during the COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:2512-2525. [PMID: 36799461 DOI: 10.1080/13548506.2023.2179082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023]
Abstract
The present study sought to examine associations between anxiety sensitivity and both sleep and physical activity among college students, who are particularly vulnerable to sleep disturbance, decreased physical activity, and the development of psychopathology, especially in the wake of the COVID-19 pandemic. Participants were 683 college students (Mage = 20.33, SD = 3.58; 72% female; 70.3% White) who completed self-report measures online for course credit. Results indicated that after controlling for the effects of age, gender identity, and race, greater sleep disturbance was significantly associated with higher overall anxiety sensitivity (7% unique variance; β = 0.27, t = 6.67, p < .001) as well as its three subdomains (physical concerns: 4% variance; β = 0.21, t = 4.97, p < .001; cognitive concerns: 6% variance; β = 0.25, t = 6.17, p < .001; social concerns: 6% variance; β = 0.26, t = 6.22, p < .001). Additionally, more time spent walking was associated with greater anxiety sensitivity physical concerns (1% variance; β = 0.11, t = 2.52, p = .012) and greater vigorous intensity physical activity was associated with lower anxiety sensitivity social concerns (1% variance; β = -0.13, t = -2.76, p = .006). These findings suggest that sleep problems may be more universally relevant to anxiety sensitivity than physical activity and interventions to promote healthier sleep may be useful for decreasing anxiety sensitivity in college students.
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Affiliation(s)
- Alison C McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | | | - Kandi L Walker
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Department of Communication, University of Louisville, Louisville, KY, USA
| | - Joy L Hart
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Department of Communication, University of Louisville, Louisville, KY, USA
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Yang Z, Wang D, Fan Y, Ma Z, Chen X, Zhang Y, Fan F. Relationship between sleep disturbance and burnout among Chinese urban teachers: Moderating roles of resilience. Sleep Med 2023; 108:29-37. [PMID: 37311321 DOI: 10.1016/j.sleep.2023.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/16/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sleep disturbance and burnout are prevalent among primary and secondary school teachers. Nevertheless, little is known about the relationship between sleep disturbance and burnout, and the mechanisms connecting this link. Our study aimed to explore the relationship between sleep disturbance and burnout among urban teachers, as well as to investigate this influencing mechanism further with resilience as a moderator. METHODS 14,218 primary and secondary school teachers provided valid data. We assessed demographic information, sleep disturbance, burnout, and resilience. Multivariable logistic regression, Spearman correlation, and moderation analyses were used to evaluate the relationship between sleep disturbance and burnout and the moderating role of resilience. RESULTS Of the participants, the prevalence of sleep disturbance and sleep deprivation among teachers was 20.0% and 31.7%, respectively. Additionally, 58.4% of teachers reported moderate or severe burnout, and 15.3% had both sleep disturbance and burnout. Sleep disturbance was significant and positively related to burnout. Resilience was found to moderate the association between sleep disturbance and burnout. CONCLUSIONS These findings suggested strong associations between sleep disturbance and burnout. Interventions in improving resilience may protect teachers with sleep disturbance from burnout.
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Affiliation(s)
- Zheng Yang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Xiaoyan Chen
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Yifan Zhang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China.
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Zhang Y, Pan Y, Ma Z, Wang D, Zou R, Fan F. Cross-sectional and longitudinal associations of adherence to the 24-hour movement guidelines with mental health problems among Chinese adolescents. J Psychosom Res 2023; 170:111352. [PMID: 37182437 DOI: 10.1016/j.jpsychores.2023.111352] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE This study aimed to examine the cross-sectional and longitudinal associations between meeting the 24-Hour Movement Guidelines (recommendations for the optimal amount of moderate-to-vigorous physical activity, screen time, and sleep duration per day) and mental health problems among Chinese adolescents. METHODS A two-wave longitudinal survey was conducted in Huizhou, Guangdong province. A total of 906 junior high school students were recruited in the six-month follow-up survey. Moderate-to-vigorous physical activity, screen time, sleep duration, anxiety symptoms (GAD-7 score), and depressive symptoms (PHQ-9 score) were measured using a self-administered questionnaire. At baseline, participants were classified as meeting: 1) no recommendation, 2) one recommendation, 3) two recommendations, or 4) all three recommendations. RESULTS Overall, the proportions of adolescents meeting moderate-to-vigorous physical activity, screen time, and sleep recommendations at T1 were 33.3%, 68.2%, and 64.7%, respectively. Cross-sectionally, the severity of anxiety and depressive symptoms at T1 significantly decreased as the number of recommendations met increased (adjusted regression coefficients [95% CI] for three recommendations met versus none: -2.80 [-4.05, -1.55] and - 3.42 [-4.85, -1.99], respectively). Longitudinally, adolescents who met three recommendations at T1 displayed lower anxiety and depressive symptoms six months later than those who did not (adjusted regression coefficients [95% CI]: -1.00 [-1.98, -0.02] and - 1.43 [-2.53, -0.32], respectively). Furthermore, meeting three recommendations was associated with the alleviation of depressive symptoms (adjusted OR [95% CI]: 0.39 [0.17, 0.90]). CONCLUSIONS Promoting adolescents to adhere to the 24-Hour Movement Guidelines could be considered an intervention target for mental health problems at a population level.
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Affiliation(s)
- Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Ye Pan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Ruoping Zou
- Moral Education Research Office, Huidong County Education Bureau, Huizhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Wang D, Chen H, Chen J, Ye H, Chen X, Ye L, Yao K, Tu N, Dai H, Fan F. A comparative study of mental health status among left-behind, migrant, and local adolescents in China. J Affect Disord 2023; 324:521-528. [PMID: 36586615 DOI: 10.1016/j.jad.2022.12.134] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/13/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Influence of migration on mental impairments among adolescents has been well assessed. However, there lack empirical data on multiple mental health problems and comparisons of children who suffer from different parental migration. This study aims to compare the mental health status among left-behind adolescents (LBA), migrant adolescents (MA), and local adolescents (LA). METHODS A total of 67,532 adolescents were investigated on depression, anxiety, sleep disturbance, and psychotic-like experiences (PLEs). The LBA were registered in Shenzhen's hukou (household register system) and are living in Shenzhen while their parent(s) has/have migrated to work elsewhere for over 6 months. MA, defined as adolescents who immigrated with parents from other places, are living but not registered in Shenzhen hukou. LA referred to adolescents who were registered in Shenzhen hukou and are living with their parents. Social-demographics, family function, and school climate were also evaluated as influential factors. RESULTS The prevalence of overall mental health problems was 37.4 % for LBA, which was higher than that of MA (27.9 %) and LA (27.1 %). Females, adolescents with chronic physical illness, and with family history of mental disorders are all contributed to the increased occurrence of mental health issues. Poorer family function and school climate were also negatively associated with mental health among the three types of adolescents. CONCLUSION LBA is at a higher risk for poor mental health than other adolescents. Interventions that promoting family function and improving school climate may be helpful, especially for girls with chronic physical illness, or with family history of mental disorders.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Huilin Chen
- Department of Psychiatry, University of Oxford, UK
| | - Jiaqiao Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Haoxian Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Xinwen Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Liqun Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Kun Yao
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Nanping Tu
- Shenzhen Bao'an Institute of Education Sciences, Shenzhen, China
| | - Huamei Dai
- Fenghuang School, Bao'an District, Shenzhen, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Li S, Liu S, Zhang P, Lin Y, Cui Y, Gu Y, Wang J, Liu Z, Zhang B. Suicidal ideation in the general population in China after the COVID-19 pandemic was initially controlled. J Affect Disord 2023; 323:834-840. [PMID: 36529410 PMCID: PMC9754752 DOI: 10.1016/j.jad.2022.12.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 11/06/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The COVID-19 pandemic increases the risk of psychological problems including suicidal ideation (SI) in the general population. In this study, we investigated the risk factors of SI after the COVID-19 pandemic was initially controlled in China. METHODS We conducted an online questionnaire via JD Health APP in China in June 2020. Demographic data, feelings and experiences related to the COVID-19 pandemic and psychological problems were collected. The participants (n = 14,690) were divided into the non-SI and SI groups. A binary logistic regression analysis was used to examine the correlates of SI. RESULTS Nine percent of the participants (1328/14690) reported SI. The regression analysis showed that SI was positively associated with ethnic minority (OR = 1.42 [1.08-1.85]), age (e.g. 18-30 years: OR = 2.31 [1.67-3.20]), having history of mental disorders (OR = 2.75 [2.27-3.35]), daily life disturbance due to health problems (OR = 1.67 [1.38-2.01]), being around someone with the COVID-19 (OR = 1.58 [1.30-1.91]), being uncertain about effective disease control (OR = 1.23 [1.03-1.46]), and having depressive symptoms (OR = 4.40 [3.59-5.39]), insomnia symptoms (OR = 2.49 [2.13-2.90]) or psychological distress (OR = 1.87 [1.59-2.18]). LIMITATIONS The main limitation is that the cross-sectional design of this study could not allow us to further explore the causality of SI. CONCLUSIONS The prevalence of SI was relatively high in general population after the COVID-19 pandemic was initially controlled in China. SI should be monitored continually after the COVID-19 pandemic.
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Affiliation(s)
- Shuangyan Li
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong - Hong Kong - Macao Greater Bay Area Center for Brain Science and Brain - Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Shuai Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong - Hong Kong - Macao Greater Bay Area Center for Brain Science and Brain - Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Puxiao Zhang
- First Clinical Medical College, Xinjiang Medical University, Urumqi, China
| | - Yanmei Lin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong - Hong Kong - Macao Greater Bay Area Center for Brain Science and Brain - Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Yingru Cui
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong - Hong Kong - Macao Greater Bay Area Center for Brain Science and Brain - Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Yue Gu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong - Hong Kong - Macao Greater Bay Area Center for Brain Science and Brain - Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Jiajia Wang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong - Hong Kong - Macao Greater Bay Area Center for Brain Science and Brain - Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong - Hong Kong - Macao Greater Bay Area Center for Brain Science and Brain - Inspired Intelligence, Southern Medical University, Guangzhou, China.
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Nan J, Salina N, Chong ST, Jiang HJ. Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma. BMC Psychiatry 2023; 23:90. [PMID: 36747156 PMCID: PMC9900550 DOI: 10.1186/s12888-023-04582-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The aim of this study was to understand the longitudinal trajectory of suicidal ideation (SI) among Chinese medical students and the role of childhood trauma (CT). METHODS Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI. RESULTS A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p < 0.001) and showed a slowly increasing trend. Emotional neglect (EN), physical neglect (PN), emotional abuse (EA) and physical abuse (PA) all had significant positive predictive effects for the high risk, continuous group (B = 0.18-0.65, P < 0.01). CONCLUSION The trajectory of SI among medical students can be divided into a low risk, slowly rising group and a high risk, continuous group; the more EN, PN, EA and PA experienced during childhood, the more likely medical students are to develop a high risk, continuous state of SI.
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Affiliation(s)
- Jiang Nan
- grid.412113.40000 0004 1937 1557Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia ,grid.443397.e0000 0004 0368 7493Hainan Medical University, Haikou, 571199 China
| | - Nen Salina
- grid.412113.40000 0004 1937 1557Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia ,grid.412113.40000 0004 1937 1557Counselling Program, Postgraduate Secretariat, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Sheau Tsuey Chong
- Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia. .,Counselling Program, Postgraduate Secretariat, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia.
| | - Hong-juan Jiang
- grid.443397.e0000 0004 0368 7493Hainan Medical University, Haikou, 571199 China ,grid.443397.e0000 0004 0368 7493The First Affiliated Hospital of Hainan Medical University, Haikou, 571199 China
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Wang D, Ma Z, Zhai S, Sun M, Fan F. Sleep disturbance and psychotic-like experiences among urban adolescents with and without parental migration. Front Public Health 2023; 10:1037963. [PMID: 36684951 PMCID: PMC9846600 DOI: 10.3389/fpubh.2022.1037963] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Aim Sleep disturbance was closely associated with an increased risk of psychotic-like experiences (PLEs). This study aims to explore the association between sleep disturbance and PLEs among urban adolescents with and without parental migration. Methods A total of 67, 532 urban Chinese adolescents were recruited in a large web-based survey during April 21st to May 12th, 2021. In our study, sleep disturbance, PLEs, family function, school climate, and a series of socio-demographic were assessed. And hierarchical logistic regression analyses were performed to examine influential factors associated with PLEs. Results Urban left-behind children (LBC) had a higher prevalence of sleep disturbance and PLEs than non-LBC. After controlling for confounders, parental migration was associated to PLEs with weak significance (OR = 1.19). Meanwhile, sleep disturbance was found to be a robust risk factor for PLEs (OR = 3.84 and 4.09), with or without the effect of parental migration. In addition, better family function and school climate has significant association with decreased risk of PLEs. Conclusion Adolescents with sleep disturbance are more likely to report PLEs. Adolescents' PLEs preventive strategies could focus on reducing sleep disturbance related symptoms as well as improving family function and school climate.
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Affiliation(s)
- Dongfang Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
| | - Shuyi Zhai
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Fang Fan
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
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Wang D, Ma Z, Scherffius A, Liu W, Bu L, Sun M, Fan F. Sleep disturbance is predictive of psychotic-like experiences among adolescents: A two-wave longitudinal survey. Sleep Med 2023; 101:296-304. [PMID: 36470165 DOI: 10.1016/j.sleep.2022.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/03/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Psychotic-like experiences (PLEs) are prevalent among adolescents and are the most significant predictor of future mental disorders. This study aims to examine the cross-sectional and longitudinal associations between sleep disturbance and PLEs in a large cohort of adolescents. METHODS The 17,722 adolescents in our study were assessed from April 21 to May 12, 2021 (Time 1, T1) and again 6 months later from December 17 to 26, 2021 (Time 2, T2). The Youth Self Rating Insomnia Scale and 8-item Positive Subscale of the Community Assessment of Psychic Experiences were used to assess sleep and PLEs, respectively. Sample characteristics and depression were also evaluated at T1, and negative life events were measured at T2. Sleep duration ≤6 h per night was considered as sleep deprivation, and sleep disturbance was defined as having insomnia or poor sleep quality. RESULTS The prevalence of sleep disturbance and frequent PLEs at T1 were 14.1% and 14.5%, respectively. Sleep disturbance and sleep deprivation at T1 were significantly associated with increased risk for PLEs at T2 after adjusting for sample characteristics, depression, and negative life events. Furthermore, sleep disturbance and sleep deprivation also predicted the new onset and persistence of PLEs. CONCLUSION Sleep disturbance predicts the development and persistence of PLEs. Early assessment and treatment of sleep disturbance may therefore contribute to a comprehensive strategy for the successful prevention and treatment of PLEs in adolescents.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, United States
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Luowei Bu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Wang D, Chen XY, Ma Z, Liu X, Fan F. Has the "Double Reduction" policy relieved stress? A follow-up study on Chinese adolescents. Child Adolesc Psychiatry Ment Health 2022; 16:91. [PMID: 36443852 PMCID: PMC9707210 DOI: 10.1186/s13034-022-00530-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 11/18/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE "Double Reduction" Policy requires schools to reduce the burden of excessive homework and off-campus training for Chinese students to reduce their academic stress and promote mental health. We conducted a study in compulsory education students before and after the "Double Reduction" Policy to explore changes in mental health problems and relevant influential factors. METHODS A total of 28,398 elementary and junior high school students completed both waves of the survey through electronic questionnaires. Depressive symptoms were assessed using the Patient Heath Questionnaire (PHQ-9), and anxiety symptoms were assessed using the Generalized Anxiety Disorder Scale (GDA-7). Demographic information was evaluated at baseline, and "Double Reduction" related factors and negative life events were measured at follow up. RESULTS The overall depression and anxiety levels significantly decreased after the "Double Reduction" Policy. Girls, poor parental marital quality, chronic physical illness, and psychiatric family history were related to increased occurrence of mental health. Sleep duration > 8 h/night, reduced homework, more extracurricular activities more time with parents, and reduced academic stress were protective factors against mental health problems. CONCLUSIONS The "Double Reduction" Policy has improved the mental health symptoms of students to a certain extent. Appropriately increasing sleep time, participating in more extracurricular activities and parental involvement, and reducing the burden of homework are effective ways to promote the development of students' mental health.
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Affiliation(s)
- Dongfang Wang
- grid.263785.d0000 0004 0368 7397Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631 China
| | - Xiao-Yan Chen
- grid.263785.d0000 0004 0368 7397Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631 China
| | - Zijuan Ma
- grid.263785.d0000 0004 0368 7397Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631 China
| | - Xianchen Liu
- grid.25879.310000 0004 1936 8972Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA USA
| | - Fang Fan
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China.
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Wang D, Zhao J, Zhai S, Ye H, Bu L, Fan F. Does sleep disturbance predicts posttraumatic stress disorder and depression among college students during COVID-19 lockdown? A longitudinal survey. Front Public Health 2022; 10:986934. [PMID: 36176529 PMCID: PMC9514232 DOI: 10.3389/fpubh.2022.986934] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/22/2022] [Indexed: 01/26/2023] Open
Abstract
Aim To examine the cross-sectional and longitudinal associations between self-reported sleep disturbances, posttraumatic stress disorder (PTSD) and depression in a large cohort of Chinese adolescents experiencing the COVID-19 pandemic. Methods Participants were 67905 Chinese college students in the two-wave longitudinal web-based survey during early COVID-19 outbreak (Time1, T1: Feb 3rd to 10th, 2020) and initial remission period (Time2, T2: March 24th to April 3rd, 2020). The Youth Self Rating Insomnia Scale (YSIS), 6-Item Impact of Event Scale (IES-6), and 9-Item Patient Heath Questionnaire (PHQ-9) were used to assess adolescents' sleep, PTSD, and depressive symptoms, respectively, at T1 and T2. Results Self-reported PTSD and depression prevalence at T1 were 34.6% and 21.6% respectively. While depressive symptoms worsened as the lockdown time increased, while PTSD symptoms decreased. After adjusting for confounding factors, sleep disturbance and sleep deprivation at T1 were significantly associated with increased PTSD and depressive symptoms at T2. Furthermore, sleep disturbance and sleep deprivation also predicted the new onset and persistence of PTSD and depression. Conclusion Sleep disturbance predicts the development and persistence of PTSD and depression. Early assessment and treatment of sleep disturbance may be an important strategy for prevention and intervention of PTSD and depression in adolescents after experiencing the special public health emergency.
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Affiliation(s)
- Dongfang Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
| | - Jingbo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Shuyi Zhai
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Haoxian Ye
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
| | - Luowei Bu
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
| | - Fang Fan
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
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Ma Z, Wang D, Zhao J, Zhu Y, Zhang Y, Chen Z, Jiang J, Pan Y, Yang Z, Zhu Z, Liu X, Fan F. Longitudinal associations between multiple mental health problems and suicidal ideation among university students during the COVID-19 pandemic. J Affect Disord 2022; 311:425-431. [PMID: 35597475 PMCID: PMC9116974 DOI: 10.1016/j.jad.2022.05.093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent research suggested that COVID-19-related multiple mental health problems were associated with an increased risk for suicidal ideations (SIs), but population-based data demonstrating these associations are scarce. This study aimed to estimate the cumulative effects of psychological risk factors on SIs during the outbreak and remission periods of COVID-19 using a cumulative risk model, as well as sex differences. METHODS A total of 68,685 college students in China participated in the survey during two phases of the pandemic (T1 and T2). Mental health risks (acute stress, depression, anxiety, insomnia, and obsessive-compulsive symptoms) and sociodemographic characteristics were measured at T1, and SIs were assessed at T1 and T2. Hierarchical regression analysis was used to determine the combined effect of multiple mental health problems on SIs at T1 and T2. RESULTS The prevalence of SIs increased from the early periods of the COVID-19 pandemic (7.6%) to the later periods (10.0%). Depression was a powerful risk factor for SIs during the COVID-19 pandemic. Individuals with >3 mental risks would be most likely to experience rapidly increasing SIs during the early periods of the COVID-19 pandemic. Sex exerted different effects on the cumulative risk model of SIs. CONCLUSIONS Interventions, such as mental health education and improving utilization of student support services, should be implemented. There is a crucial need for early intervention and prevention efforts aimed at males with greater than three mental health problems.
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Affiliation(s)
- Zijuan Ma
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Dongfang Wang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Jingbo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yuanyuan Zhu
- School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
| | - Yifan Zhang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Zihao Chen
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Jiaqi Jiang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Ye Pan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Zheng Yang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Zhiyi Zhu
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China.
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Li G, Conti AA, Qiu C, Tang W. Adolescent mobile phone addiction during the COVID-19 pandemic predicts subsequent suicide risk: a two-wave longitudinal study. BMC Public Health 2022; 22:1537. [PMID: 35962376 PMCID: PMC9372972 DOI: 10.1186/s12889-022-13931-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
Both the rate of mobile phone addiction and suicidality among adolescents have increased during the pandemic lockdown. However, the relationship between mobile phone addiction and suicide risk and the underlying psychological mechanisms remains unknown. This study examined the associations between mobile phone addiction in adolescents during the first month of lockdown and the suicide risk in the subsequent five months. A two-wave short-term longitudinal web-based survey was conducted on 1609 senior high school students (mean age = 16.53 years, SD = 0.97 years; 63.5% female). At Time 1 (T1), the severity of mobile phone addiction and basic demographic information was collected from Feb 24 to 28, 2020 in Sichuan Province, China (at the pandemic's peak). Five months later, between July 11 and July 23 (Time 2, T2), mobile phone addiction, daytime sleepiness, depression, and suicidality were measured within the past five months. The regression analysis revealed that mobile phone addiction during quarantine directly predicted suicidality within the next five months, even after controlling for the effect of depression and daytime sleepiness. Meanwhile, mobile phone addiction at T1 also indirectly predicted suicidality at T2, with depression and daytime sleepiness mediating this association. Programs targeting improvement of daytime sleepiness and depressive symptoms may be particularly effective in reducing suicide risk among adolescents with mobile phone addiction.
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Affiliation(s)
- Gangqin Li
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Aldo Alberto Conti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Changjian Qiu
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China.
| | - Wanjie Tang
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China.
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Wang D, Zhou L, Wang J, Sun M. The Bidirectional Associations Between Insomnia and Psychotic-Like Experiences Before and During the COVID-19 Pandemic. Nat Sci Sleep 2021; 13:2029-2037. [PMID: 34795544 PMCID: PMC8593841 DOI: 10.2147/nss.s335508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022] Open
Abstract
STUDY OBJECTIVES Previous literature supports that insomnia is predictive of subsequent psychotic-like experiences (PLEs) in the general population. However, there is a lack of empirical data on the reverse causality between the two variables and on the correlation between the symptom severity of insomnia and PLEs. This study aimed to explore the bidirectional associations between insomnia and PLEs before and during the COVID-19 pandemic. METHODS A total of 938 students aged 14-25 years completed both waves of the survey before and during the pandemic (the first wave: October 2019 to November 2019; the second wave: April 2020 to May 2020). PLEs were assessed using the 15-item positive subscale of the community assessment of psychic experiences (CAPE-P15), and insomnia was assessed using three questions on difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening. RESULTS Students with baseline insomnia were more likely to exhibit new-onset PLEs during the pandemic (OR: 5.13, 95% CI: 2.54-10.38), while no significant predictive effect of insomnia was found for the persistence and severity of PLEs. Meanwhile, baseline PLEs not only predicted the presence of insomnia during the pandemic (OR: 2.14, 95% CI: 1.25-3.65) but also correlated with its severity (B: 0.89, 95% CI: 0.47-1.31). CONCLUSION The study provides the first piece of evidence for the bidirectional association between insomnia and PLEs in the general population. However, although insomnia has an important predictive role in the occurrence of PLEs, it does not predict the persistence and development of PLEs, suggesting that there is a more complex mechanism underlying the process.
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Affiliation(s)
- Dongfang Wang
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China.,School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People's Republic of China
| | - Liang Zhou
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
| | - Jiali Wang
- Xiangya School of Public Health, Central South University, Changsha, People's Republic of China
| | - Meng Sun
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, People's Republic of China
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