Family, peer, and individual correlates of depressive symptomatology among U.S. and Chinese adolescents

Changes and relevant factors in depressive and anxiety symptoms among Chinese adolescents after the "Double Reduction" policy: A repeated cross-sectional survey with a nested longitudinal subsample

BACKGROUND

The Chinese government has enacted the "Double Reduction" Policy, which aims to reduce students' academic burden and promote their mental health, but there is limited research examining the policy's impact on students' well-being. This study aims to evaluate changes in students' mental health problems before and after the "Double Reduction" Policy and explore relevant influential factors.

METHODS

A total of 101,976 elementary and junior high school students were recruited before the "Double Reduction" Policy, and 91,832 students were recruited one year later. Through data integration, a total of 36,637 students participated in both web-based surveys and provided complete data on all measures.

RESULTS

As a whole, we found that the prevalence of students' depression (12.1 % to 9.2 %) and anxiety (8.9 % to 6.2 %) tended to decline after the "Double Reduction" Policy. Attending private school, reduced homework, more extracurricular activities, more time with parents, reduced academic stress, and sleep duration ≥8 h/n were associated with the decrease in the likelihood of mental health problems in students. Female gender, negative life events, and negative impact of COVID-19 as risk factors for mental health.

CONCLUSIONS

These findings indicated that the "Double Reduction" Policy has improved the well-being of Chinese students. Reducing students' homework burden and alleviating their academic pressure are beneficial for their mental health. Increasing time for extracurricular activities and interaction with parents, as well as ensuring sufficient sleep for students, are also effective ways to prevent the onset and exacerbation of mental health symptoms in adolescents.

Peer effects on rural children's depression: do online games matter?

With the increasing prevalence of depression among children and adolescents, understanding the role of peer contagion in the spread of emotional distress is a critical area of research. The aim of this study is to examine the effect of classmates' depression on a rural child's own depression in China (aged 9-17, N = 1777). The study controls for possible endogeneity of peer effects through the instrumental variable method (the Wald F statistic is significant at the 1% level) and random class assignment data (all students and teachers are randomly assigned to classes).The results indicate that when the average depression score of a rural child's classmates increases by 1 point, that child's own depression score is likely to increase by 0.345 points (p value < .01).This study further finds that the contagion of depression among classmates is more severe for girls and children who play online games, and less severe for children who are cheerful and good-humored. Online games may be an important mechanism through which peer effects operate. Children's classmates' negative emotions are found to increase the occurrence of the children's internalizing behavior in online games, in turn increasing the occurrence of negative emotions in these children themselves.

Associations of recent stressful life events with anxiety symptoms among Chinese adolescents with a consideration of family functioning

Background: The association between stressful life events (SLEs) and adolescent anxiety symptoms has been extensively studied, but the specific impacts of different SLEs domains remain inconclusive. Moreover, limited research has examined the role of family functioning in these associations.Objective: This study aimed to investigate the associations between various recent SLEs and adolescent anxiety symptoms and explore the role of family functioning.Methods: Data were obtained from the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research in Guangzhou, China. A total of 10,985 students (51.9% boys; mean [SD] age, 15.3 [1.5] years) from forty middle schools participated in the study in 2022 and completed a self-report questionnaire assessing anxiety symptoms, SLEs, and family functioning using the Generalized Anxiety Disorder-7 (GAD-7), Adolescent Self-rating Life Events Checklist (ASLEC; including five subscales: interpersonal stress, academic stress, punishment-related stress, loss-related stress, and adaptation-related stress), and the adapted Chinese version of the Family Assessment Device (FAD), respectively. Linear mixed-effects models were performed and the moderation role of family functioning was also examined.Results: The fully adjusted model revealed that a 1-SD increase in the overall ASLEC score was associated with higher levels of anxiety symptoms (β = 2.23, 95%CI: 2.15-2.32). Among various SLEs domains, the academic domain shows the most significant association (β = 2.25, 95%CI: 2.17-2.33). Family functioning exerted an independent protective influence on anxiety symptoms, with each 1-SD increase in FAD scores negatively associated with anxiety symptoms (β = -2.11, 95%CI: - 2.29 to - 1.93) in the adjusted model. Moreover, family functioning significantly buffered the impacts of overall SLEs and each domain, except for adaptation-related SLEs, on anxiety symptoms.Conclusion: Higher recent SLEs levels were associated with increased anxiety symptoms among adolescents, with academic SLEs showing the greatest association. Positive family functioning had both direct and buffering influences on anxiety symptoms.

The association between urbanization and adolescent depression in China

Background

With the rapid urbanization in many countries, more attention is being paid to the relationship between urbanization and mental health, especially depression. However, in countries with rapid urbanization, few empirical studies exist on the relationship between urbanization and adolescent depression.

Methods

Nationally representative survey data from the China Family Panel Studies in 2012, 2016 and 2018 were used. Data of 1,588 adolescents were obtained from 25 provinces. Depression was measured using the Center for Epidemiology Studies of Depression 20-item score. The urbanization rate was obtained from the National Bureau of Statistics of China. The generalized estimating equation was used to estimate the statistical relationship.

Results

The participants' mean age at baseline was 15 years, and 51.2% (813/1,588) of participants were male. After adjusting for all covariates (gender, age, ethnicity, level of education, marital status, urban/rural areas, body mass index, self-rated health, academic pressure, smoking, drinking and exercise), the rate of urbanization was monotonically and negatively associated with adolescent depression (odds ratio 0.34, 95% CI [0.14-0.79]). Compared with female adolescents, male adolescents had a lower risk of depression (odds ratio 0.80, 95% CI [0.67-0.97]).

Conclusion

In the context of China, urbanization has a positive effect on the mental health of adolescents. Female adolescents are more likely to experience depression than male adolescents.

Predicting Chinese Adolescents' Depressive Symptoms from Their Cultural Orientations and Perceived Parental Psychological Control

Research on adolescents across cultures has suggested a positive link between parental psychological control and adolescent depression. While a few studies have examined psychological outcomes of adolescents in collectivist groups compared to individualist groups, much less is known about the role of cultural orientations in the parental control-depression link at the individual level. The current study examined: (1) both mother and father psychological control as predictors of depressive symptoms in Chinese adolescents, (2) adolescents' cultural orientations of individualism and collectivism as predictors of their depressive symptoms, and (3) the moderating effects of adolescents' cultural orientations on the association between parental control and depressive symptoms. The sample included 3255 adolescents located in southern China. Adolescents reported on their orientations of individualism and collectivism, perceived mothers' and fathers' psychological control, and their depressive symptoms. Analyses revealed that both mother and father psychological control as well as adolescents' individualism were positive predictors of adolescent depressive symptoms, whereas collectivism was a negative predictor of depressive symptoms. Furthermore, the results indicated that cultural orientations had weak moderating effects on the link between parental control and adolescent depressive symptoms. Theoretical and practical implications are discussed.

More prevalent and more severe: gender differences of depressive symptoms in Chinese adolescents

BACKGROUND

Adolescent depression has become a leading problem around the world, especially as the COVID-19 pandemic has remained prevalent and heavily influenced people's mental health. While gender difference has always been a topic in the field of psychiatry, there are cultural differences across the world that must be taken into account. The current study is examining gender differences in symptoms of Chinese adolescents with depression.

METHODS

The sample was obtained from a total of 574 adolescent patients (172 males and 402 females) diagnosed with depression following the DSM-IV/ICD-10 diagnostic criteria; patients who also had other severe mental or physical illnesses were excluded. The ages of participants ranged from 10 to 19 years. Additionally, independent t-test and one-way ANOVA were used to examine differences in symptoms between different gender and age groups. The LPA was used to examine whether females and males were having different patterns of symptoms.

RESULTS

Our analysis showed that compared to males, females exhibited higher rates of depression and more severe depressive symptoms across age groups. Likewise, the analysis also revealed an earlier onset of depression among Chinese adolescents compared to that in Western countries in previous studies. Finally, the LPA showed that mild to moderate depression was predominant in male patients, while severe depression was predominant in female patients.

CONCLUSION

This study highlights the gender differences in the prevalence and severity of depressive symptoms in Chinese adolescents. The current study highlighted the importance of gender equality and developing gender-friendly interventions in maintaining the overall mental health of adolescents in China.

Peer effects of depression between left-behind and non-left-behind children: quasi-experimental evidence from rural China

PURPOSE

The aim of the study is to investigate the interactive influence of depression on left-behind (LB) and non-left-behind (NLB) children from the perspective of peer effects. The roles of teachers, parents, and friends are also explored.

METHODS

Data on 1817 children, 1817 parents, and 55 teachers were obtained from a field survey in December 2021. All students in the sample were randomly assigned to classrooms. A peer effect model and OLS methods were used to estimate the peer influence of depression. Robustness tests were conducted by randomly removing schools from the sample.

RESULTS

Depression was contagious among different groups of rural children, and the peer effect of the NLB children's depression played a dominant role. Both LB and NLB children were more affected by their NLB classmates' depression. LB children were not significantly affected by depression in other LB children. This conclusion remains robust after robustness testing. In addition, heterogeneity analysis showed that outgoing and cheerful teachers, effective parent-child communication and high-quality friendship all alleviated peer influence on depression.

CONCLUSIONS

LB children have more severe depression than NLB children, but LB children are more affected by depression in their NLB peers. Policymakers should train teachers to engage in positive communication with students to improve mental health in children. In addition, this article recommends that children move and live with their parents when family conditions permit.

Has the "Double Reduction" policy relieved stress? A follow-up study on Chinese adolescents

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.

A Longitudinal Process Model Evaluating the Effects of Cooperative Learning on Victimization, Stress, Mental Health, and Academic Engagement in Middle School

Mental health is a significant concern among young people, particularly during the COVID-19 pandemic. Notably, mental health problems can significantly reduce student performance in school, including both engagement and achievement. Both mental health problems and reduced student performance often arise due to peer victimization, which can include teasing, racial- or gender-based discrimination, and/or physical assault. Stress has been proposed as one mechanism through which victimization influences mental health, and stress can also interfere with academic performance at school, including engagement and achievement. To date, however, no research has evaluated longitudinal associations between victimization and stress, and how these longitudinal patterns may impact adolescent behavior and mental health. In this study, we used data from a 2-year cluster randomized trial of cooperative learning to evaluate an etiological process model that includes (1) longitudinal reciprocal effects between victimization and stress, and (2) the effects of both victimization and stress on student mental health and academic engagement. We hypothesized that victimization and stress would have significant reciprocal effects, and that both would predict greater mental health problems and lower academic engagement. We further hypothesized that cooperative learning would have significant effects on all constructs. We found partial support for this model, whereby stress predicted greater victimization, but victimization did not predict increased stress. While both factors were linked to student outcomes, stress was a more powerful predictor. We also found significant salutary effects of cooperative learning on all constructs. The implications of these results for student behavioral and mental health are discussed.

Reciprocal Influences among Marital Relationship, Parent-Adolescent Relationship, and Youth Depressive Symptoms

OBJECTIVE

Drawing on family systems framework, this study investigated the reciprocal prospective associations between marital relationship quality, parent-adolescent closeness and conflict, and adolescent depressive symptoms among families in Taiwan.

BACKGROUND

The family systems theory posits reciprocity between family subsystems. However, the direction of influences between marital relationship quality, parent-adolescent relationship quality and adolescent well-being may be more unidirectional in Chinese societies due to hierarchical family values.

METHOD

Data were from a longitudinal survey of 2,292 parent-youth dyads in the Taiwan Youth Project. Cross-lagged path models were used to test the bidirectional associations between marital relationship quality, parent-adolescent closeness and conflict, and adolescent depressive symptoms from ages 12 to 18.

RESULTS

Our primary hypothesis that marital relationship quality predicts parent-adolescent relationship quality, which then predicts adolescent depressive symptoms in a unidirectional manner was partially substantiated. Moreover, marital relationship quality directly predicted fewer depressive symptoms from middle to late adolescence and indirectly from early to late adolescence via parent-adolescent relationship quality in middle adolescence. We also found that child depressive symptoms predicted less parent-adolescent closeness, and more conflicts which predicted poorer marital relationship quality, particularly in early adolescence.

CONCLUSION

Extending the family systems theory, findings suggest that marital relationship quality plays a dominant role in the health and well-being of Taiwanese families, especially as adolescents mature. Results highlight the importance of testing theories in families from diverse cultures.

Internet addiction and child physical and mental health: Evidence from panel dataset in China

BACKGROUND

The number of internet users has increased substantially in the last decade and these increasing rates of internet use also apply to children. Children usually have poorer self-control and poorer cognition than college-age populations or adults, the impact of Internet addiction on the health of this group has important implications not only for their individual economic and social outcomes but also the future human capital development in China.

METHODS

We use data from the 2016 and 2018 China Family Panel Survey, a survey that collected data from a large and nationally representative sample of the Chinese population, to construct a sample of children from 25 provinces, and then use DID and PSM-DID methods to investigate whether Internet addiction (increased screen time in this article) impacts the physical and mental health of children (ages 10-15) in China.

RESULTS

Internet addiction has a significant negative impact on child physical and mental health. The mediating effect model shows that Internet addiction impairs child physical and mental health by reducing their sleep and exercise time. The heterogeneity analysis shows that, Internet addiction has a stronger negative effect on urban children than rural children. Additionally, Internet addiction has a significant correlation with the mental health of left-behind children (LBC), but not children living with both parents (CLP).

LIMITATIONS

Our research has several weaknesses. First, this article uses time spent online to measure Internet addiction and this measurement method is not perfect. Also, given that the sample is made up of only Chinese children, conclusions about generalizability remain tentative. Future studies should be conducted in other countries.

CONCLUSION

This study systematically studied the effects of Internet addiction on the physical and mental health of Chinese children. This study can help government leaders make targeted programs to prevent children from Internet addiction in the future, especially to reduce internet dependence among students.

Prevalence of depression and stress among the first year students in Suranaree University of Technology, Thailand

The objectives of this study were to evaluate the level of depression and stress among the first-year students at Suranaree University of Technology (SUT) and to compare the level of depression and stress among the samples, classified by demographic factors, including gender, domicile, and problem. This research has been approved by the SUT's Research Ethics Committee. The study period was between July and August 2018. The online, self-report questionnaire was used as a research instrument to collect data from the sample of SUT first-year students. The total number of first-year students at SUT was 3,552 and the response rate was 65.15%. The major findings revealed that 7.0% and 51.1% of them were suffering from depression, and pathological stress, respectively. In addition, the prevalence of depression and pathological stress was higher in female samples than in other gender groups. The findings would suggest that related activities should be organized to promote students' awareness of their suffering and self-control in order to prevent further depression and pathological stress.

The Interaction Effect of Parental Rejection and Oxytocin Receptor Gene Polymorphism on Depression: A Cross-Cultural Study in Non-Clinical Samples

Parental rejection has been consistently empirically implicated in a wide array of developmental, behavioural and psychological problems worldwide. However, the interaction effect between parental rejection in childhood and the oxytocin receptor genotype on psychological adjustment has yet to be investigated. The present study aimed to investigate gene–environment interaction effects between parental rejection (maternal and paternal) and oxytocin receptor (OXTR) gene polymorphisms (rs53576 and rs2254298) on depressive symptoms in adults in different cultural contexts. Adults from Italy and Japan (N = 133, age = 18–27 years, females = 68) were preliminarily genotyped and then completed the Parental Acceptance-Rejection Questionnaire for mothers and fathers and the Beck Depression Inventory. Hierarchical multiple regression analysis showed that paternal rejection was related to self-reported depression and that the effect of parental rejection was moderated by OXTR gene polymorphisms and nationality. Among Italians, OXTR rs2254298 A-carriers showed resilience to negative early parental care, whereas among Japanese, OXTR rs53576 non-A-carriers showed resistance to negative early paternal care. These findings align with expected relations between perceived acceptance–rejection and an individual’s psychological adjustment, as proposed by interpersonal acceptance–rejection theory, and indicate the need for future studies adopting a multicultural and multilevel approach to better understand how the effects of parental rejection extend into adulthood.

Developmental Trajectory of Depressive Symptoms in Chinese College Students: Latent Classes and Gender Effect

Depressive symptoms are prevalent in Chinese college students, but little is known about the heterogeneity in the developmental trajectory of depressive symptoms in China. This study examined heterogeneity in the development of depressive symptoms and examined the effect of gender on the developmental trajectories over a 14-month period among Chinese college students (N = 1163, mean age 20.18, 80.31% female). Three different trajectories, moderate-increasing, high-stable and low-stable, captured the heterogeneity in the development of depressive symptoms. Gender showed significant influence on class membership. Relative to the moderate-increasing class, males emerged as significantly more likely than females to be found in the low-stable class (odds ratio (OR) = 2.73, 95% CI = (1.21, 6.13), p = 0.015) and the high-stable class (OR = 5.10, 95% CI = (1.12, 23.18), p = 0.035). The results provide additional evidence for the conclusion that the trajectories of depressive symptoms are heterogeneous with Chinese samples. Moreover, cultural difference should be paid more attention to when examining the effect of gender and other predictors of the trajectories of depressive symptoms.

Changing parenting style between two generations and its impacts on the severity of behavioral and emotional symptoms

OBJECTIVE

The purpose of this study is to compare the perceived parenting dimensions in mothers and their daughters (differences between two generations), and study the relationship between these dimensions and the severity of daughters' behavioral and emotional symptoms.

MATERIALS AND METHODS

300 participants (150 daughters with their mothers) participated in this study. They responded to the perceived parenting styles questionnaire (PSQ), and mothers were additionally asked to answer the child symptoms inventory-4 (CSI-4). Data analysis was done by the SPSS using the paired sample t-test and multiple regressions.

RESULTS

The results indicated a significant difference between perceived parenting dimensions in mothers and their daughters; specifically, acceptance and control dimensions increased through generation. It was also found that daughters' acceptance-rejection dimension could predict the severity of the symptoms of attention-deficit/hyperactivity disorders, autism spectrum disorders, depression, dysthymia, conduct disorders, and opposite defiant disorders. The control-autonomy dimension could also predict the severity of schizophrenia symptoms.

CONCLUSION

The results indicate the different parenting styles between two generations and the critical role of parenting in developing the children's psychopathology symptoms.

Gender Differences in Depressive Traits among Rural and Urban Chinese Adolescent Students: Secondary Data Analysis of Nationwide Survey CFPS

Many previous studies have indicated that urban adolescents show a higher level of mental health in China compared to rural adolescents. Specifically, girls in rural areas represented a high-risk group prior to the 21st century, demonstrating more suicidal behaviour and ideation than those in the urban areas because of the severe gender inequality in rural China. However, because of the urbanisation process and centralised policy to eliminate gender inequality in recent decades, the regional and gender differences in mental health might decrease. This research aimed to probe the gender and regional differences in depressive traits among adolescent students currently in China. We adopted the national survey dataset Chinese Family Panel Studies (CFPS) conducted in 2018. Accordingly, 2173 observations from 10–15-year-old subjects were included. CFPS utilised an eight-item questionnaire to screen individuals’ depressive traits. Two dimensions of depressive traits were confirmed by CFA, namely depressed affect and anhedonia. The measurement invariance tests suggested that the two-factor model was applicable for both males and females and rural and urban students. Based on the extracted values from the CFA model, MANOVA results revealed that, compared to boys, girls experienced more depressed affect. Moreover, rural students demonstrated more anhedonia symptoms. There was no interaction between gender and region. The results suggest that, even though the gender and regional differences are small, being a female and coming from a rural area are still potential risk factors for developing depressive traits among adolescent students in China.

Academic Stress, Physical Activity, Sleep, and Mental Health among Chinese Adolescents

The purpose of this study was to examine the impacts of academic stress on physical activity and sleep, and subsequently their impacts on anxiety and depression.

METHODS

This cross-sectional study collected data from a convenience sample of 1533 adolescents in an eastern province in China. Surveys were used to collect data on academic stress, anxiety, depression, sleep, physical activity, and demographics. Descriptive statistics, correlation analysis, and path analysis were used to analyze data.

RESULTS

The participants reported about 6.77 ± 0.89 h of sleep per day and 1.62 ± 1.79 days of 60 min of physical activity each week. Academic stress was positively correlated with anxiety and depression, which were negatively correlated with physical activity and sleep. The path analysis showed that academic stress directly predicted anxiety (β = 0.54) and depression (β = 0.55), and hours of sleep (β = 0.024) and the number of days of 60 min physical activity (β = 0.014) mediated the relation.

CONCLUSION

The results largely supported our hypotheses and supported the need to lessen academic stress experienced by Chinese adolescents, in effort to enhance mental health indices directly, and by allowing for engagement in health-related behaviors such as physical activity and sleep.

The Cascading Effects of Reducing Student Stress: Cooperative Learning as a Means to Reduce Emotional Problems and Promote Academic Engagement

Adolescents, particularly early adolescents, are vulnerable to stress created by negative peer interactions. Stress, in turn, can lead to increased mental health problems and reduced academic engagement, in addition to negative long-term consequences for cognitive development and physical health. Using four waves (2 years) of data from a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White), we evaluated whether enhancements to peer relations, brought about through carefully structured small-group learning activities (i.e., cooperative learning), could reduce stress and emotional problems and promote academic engagement. We hypothesized that the increased social contact created by cooperative learning would promote greater peer relatedness, reducing student stress and, in turn, reducing emotional problems and promoting academic engagement. Our results confirmed these hypotheses. We conclude that cooperative learning can provide social, behavioral, academic, and mental health benefits for students.

Parent-Child Conflict Profiles in Chinese American Immigrant Families: Links to Sociocultural Factors and School-Age Children's Psychological Adjustment

Research suggests that parent-child conflict is a salient family process in Asian immigrant families and often a stressful experience for Asian American youth due to value discrepancies between Asian and Western cultures. The present study examined ratings of parent-child conflict across conflict topics from parents' and children's perspectives in a sample of Chinese American immigrant families with school-age children (N = 239; age = 7.5-11 years). Latent profile analyses identified three parent-rated conflict profiles and four child-rated conflict profiles. Parent and child conflict profiles were unrelated to each other and differentially related to family sociocultural factors and children's psychological adjustment. Parents' moderate conflict profile scored highest on parent-rated child behavior problems and had the highest household density and lower parent Chinese orientation. Children's moderate-specific and high conflict profiles scored higher on child-reported behavior problems than the low conflict profile. These results highlight the need to assess family conflict from both parents' and children's perspectives and target parent-child conflict communication as a pathway to prevent or reduce behavioral problems in Chinese American children of immigrant families.

Comorbid Depression and Anxiety Symptoms in Chinese Adolescents: Testing the Explanatory Power of a Diathesis-Anxiety Model

Anxiety and depressive symptoms frequently co-occur in adolescence and confer greater distress compared to experiencing either symptom alone. A causal model (anxiety symptoms predicting depressive symptoms), a correlated liabilities model (vulnerabilities interacting with stressors to predict both symptoms), and a diathesis-anxiety model (vulnerabilities interacting with anxiety symptoms to predict depressive symptoms) have all been proposed as explanations for the relation between depression and anxiety. To date, however, research has mostly examined these models among North American/Western European adolescents. In response, the present study sought to identify the best explanatory model concerning the relationship between anxiety and depressive symptoms among Chinese adolescents. 494 10^th grade students were assessed for their perceived levels of family cohesion and conflict, stressors, and depressive and anxiety symptoms. Every 3 months for 18 months, youth reported their symptoms and stressors. Symptoms and stressors were person-mean and grand-mean centered to compare nomothetic and idiographic conceptualizations of vulnerability. Overall, evidence suggested a reciprocal, versus causal, relation between anxiety and depressive symptoms. Further, while cohesion and conflict independently predicted anxiety and depressive symptoms, their interactions with stressors were not supported. Ultimately, strong support was found for a diathesis-anxiety model using an idiographic conceptualization of anxiety, such that low perceived family cohesion interacted with within-subject fluctuations of anxiety to predict prospective depressive symptoms. This study provides cross-cultural support for a diathesis-anxiety model and shows the importance of distinguishing between positive and negative family functioning when examining vulnerability in Chinese adolescents. Research and clinical implications of these findings are discussed.

Psychological Reactivity to Daily Family Experiences During Adolescence: Individual Differences and Developmental Stability

The current study examined adolescent psychological reactivity to daily family experiences, an important feature of emotion regulation that could have significant implications for psychopathology. A total of 428 Mexican-heritage adolescents (M_age  = 15.02 years, range: 13-18 years) completed daily diary checklists for 14 days and again 1 year later. Results revealed that adolescents' family experiences were associated with negative mood, positive mood, and role fulfillment on a daily basis. Only role fulfillment reactivity was stable across 1 year, suggesting instability in individual differences in positive and negative mood reactivity. Sex moderated the relation between positive and negative mood reactivity during the second year of study, with males exhibiting broad psychological reactivity to daily family experiences. However, females who experienced higher negative mood reactivity exhibited less positive mood reactivity. Implications for possible sex differences in depression risk during the high school years are discussed.

Depressive symptoms in Chinese laborers: Prevalence and correlated factors among subgroups

BACKGROUND

China has entered a new economic age, with the government leading economic transformation. Many laborers, such as rural laborers and migrant workers, have developed serious mental health issues. These issues, such as depression, are a significant obstacle to sustainable development in China.

METHODS

We use data from the 2016 China Family Panel Survey, a survey that collected data from a large and nationally representative sample of the Chinese population, to construct a sample of 18,300 laborers from 25 provinces, and then use statistical analysis to gain insight into the prevalence of depression among laborers.

RESULTS

The distribution of depression varies among laborers. Specifically, we find that the prevalence of depression is significantly lower in the population of urban laborers than in migrant laborers or rural laborers. Our results also show that laborers who are women, divorced, widowed, ethnic minorities, low income, low education, long work experience, or who lack medical insurance are more likely to be depressed than other laborers are.

LIMITATIONS

Our research has several weaknesses. First, the CFPS dataset only used self-diagnosed depressive symptoms, which limited us to examining depressive symptoms, rather than medical diagnoses. Also, this paper was unable to explore the causal relationship between depression and other factors. Future research examining the causality between depression and other factors in China is necessary.

CONCLUSION

We propose that there is correspondingly high prevalence of depression among laborers in rural areas compared to urban areas in China. This study can help government leaders make targeted programs for depressed adults in the future, especially those who are members of marginalized groups.

Depressive costs: medical expenditures on depression and depressive symptoms among rural elderly in China

OBJECTIVES

To provide an evaluation of medical expenditures induced by depression and depressive symptoms among rural elderly in China.

STUDY DESIGN

The panel dataset used for this study is taken from the China Family Panel Studies (CFPS) data for the years 2012 and 2016. We examined the case of rural elderly who were 60 years old or older at the time of the 2012 survey and 64 years old or older at the time of the 2016 survey and then created a panel dataset that includes 2938 rural elderly for both years to estimate the influence of depressive symptoms/depression on medical cost.

METHODS

Both two part model and four part model were used to estimate the influence of depressive symptoms and depression on medical expenditure. Then a counter-factual method was used to calculate the cost of depressive symptoms and depression among rural elderly in China.

RESULTS

Mental health status has significant effects on individual medical expenses, and they aggregately contribute to 47.26% of total personal expected medical expenditures. Specifically, the rural group, the female group, the widowed group, and the poorly educated group have higher medical expenditures because of depressive status than the other groups.

CONCLUSIONS

Mental health status significantly increased both the chance of undergoing medical care and the degree of medical expenditure among rural elderly in China. This situation is more serious in some vulnerable groups. Therefore, the Chinese government needs to reform its mental health of rural elderly and insurance institutions to eliminate the policy-caused barriers to mental health resources, especially for vulnerable groups.

Psychosocial risk factors associated with depressive symptoms among adolescents in secondary schools in mainland china: A systematic review and meta-analysis

BACKGROUND

The objective of the study is to systematically estimate the effect size of psychosocial risk factors for depressive symptoms among adolescents in secondary schools in mainland China.

METHOD

A literature search was conducted in both English and Chinese databases. This meta-analysis used a random-effects model to estimate the effect size.

RESULTS

Fifteen psychosocial risk factors were identified in a total of 164 articles. The results revealed the absolute value of effect size ranging from 0.16 to 0.43. Among them, poor parent-child communication (r = 0.43), negative life events (r = 0.40), academic pressure (r = 0.40), abuse (r = 0.33), poor family functioning (r = 0.33), bullying (r = 0.32), and poor family cohesion (r = 0.32) were associated with depression with a medium to large effect. Moderator analysis shows that grade, study quality, mean age, and gender were significant moderators of at least one factor for depression.

LIMITATIONS

Limitations included the heterogeneity which is largely unexplained, and the inability to investigate the interactions of different factors and to determine the direction of causal relationships between psychosocial factors and depression in the present meta-analysis.

CONCLUSIONS

This study suggests that family-related factors and school-related factors may be significantly associated with depressive symptoms in Chinese secondary school students. Further research is needed to develop effective strategies to modify these factors in depression prevention programmes.

Parental warmth interacts with several genes to affect executive function components: a genome-wide environment interaction study

Background

Executive function (EF) is vital to human beings. It has been linked to many genes and family environmental factors in separate studies, but few studies have examined the potential interactions between gene(s) and environmental factor(s). The current study explored the whole genome to identify SNPs, genes, and pathways that interacted with parental warmth (PW) on EF.

Results

Nine EF tasks were used to measure its three components (common EF, updating, shifting) based on the model proposed by Miyake et al. (2000). We found that rs111605473, LAMP5, SLC4A7, and LRRK1 interacted significantly with PW to affect the updating component of EF, and the GSE43955 pathway interacted significantly with PW to affect the common EF component.

Conclusions

The current study is the first to identify genes that interacted with PW to affect EF. Further studies are needed to reveal the underlying mechanism.

Prevalence and Interpersonal Correlates of Internet Gaming Disorders among Chinese Adolescents

This study investigated the prevalence and interpersonal correlates of Internet gaming disorders (IGD) among Chinese adolescents. A cross-sectional survey was conducted in two cities (Shanghai and Xi’an) in China. A total of 2666 (Mean_age = 12.77 ± 0.75) year-one students from eight middle schools completed a self-reported questionnaire. It tested their levels of IGD, parental psychological control, negative interpersonal events (physical/verbal abuse by parents, verbal abuse by teachers, peer/online bullying), social support from parents/peers, and positive relationships with parents/peers. Results showed that 346 participants (13.0%) were classified as having IGD. Gender, city, single-parent family, family socio-economic status, and mother’s education level were significantly associated with the risk of IGD. Logistic regression analyses with and without controlling for the significant background variables showed that the studied interpersonal variables were significantly associated with IGD, respectively. Forward stepwise logistic regression showed that the significant correlates of IGD included parental psychological control, physical/verbal abuse by parents, verbal abuse by teachers, and peer/online bullying. Results highlight the importance of addressing interpersonal risk factors to reduce adolescent IGD. Limitations and implications of this study are discussed.

A tangled web: The reciprocal relationship between depression and educational outcomes in China

Research on depression and education usually focuses on a unidirectional relationship. This paper proposes a reciprocal relationship, simultaneously estimating the effects of depression on education and of education on depression. China, which has the world's largest education system, is used as a case study. This paper applies structural equation modeling to three datasets: the China Family Panel Studies, the China Education Panel Survey, and the Gansu Survey of Children and Families. Analyses reveal a reciprocal and negative relationship between depression and educational outcomes. Specifically, early depression reduces later educational achievement, and higher educational achievement also lowers the level of subsequent depression by resulting in less peers' unfriendliness, less pressure from parents' expectations, and less teachers' criticism. More time spent on studies is not associated with higher educational achievement but significantly increases the level of depression. Children from lower SES families bear more pressure and spend more time on studies, which does not correspond to higher educational achievement but rather to higher levels of depression. In the long term, prior depression lowers educational attainment and, after controlling for prior depression, lower educational attainment is also associated with higher levels of subsequent depression. This paper shows that the lower achievers, not the high achievers, bear the major psychological burden of the education system's quest to produce high achievement. This situation reinforces these students' educational disadvantage.

Depressive Symptoms and Migrant Worker Wages: Estimation Based on a Nationally-Representative Panel Dataset

In recent years, migrant workers, defined as people who move from Chinese rural areas to cities in other parts of the country to find work, have experienced slowed wage growth. An important question that has emerged is whether depressive symptoms have a significant relationship with migrant worker wages. This paper uses a nationally representative panel dataset to examine the overall association of depressive symptoms and migrant worker wages in China and explores the indirect mechanisms through which these impacts occur. Using the Coarsened Exact Matching method, our results show that depressive symptoms have a significant direct negative relationship with migrant worker wages, and that this relationship is consistent. Furthermore, we also find that depressive symptoms can reduce migrant worker wages indirectly by increasing the frequency of job conversion or by shortening work duration.

Depression among Chinese Left-Behind Children: A systematic review and meta-analysis

BACKGROUND

In China, there are approximately 70 million children, nearly 25% of the child population, who are left behind in the care of other family members when their parents migrate to urban areas, for increased economic opportunities. This paper presents a systematic review and a meta-analysis of studies that have examined the phenomenon of depression among these left-behind children (LBC).

METHODS

Six hundred three papers published between 2000 and 2017 were retrieved from five databases (China National Knowledge Infrastructure, Wanfang, Weipu, PubMed, and Web of Science).

RESULTS

Twenty-one studies (18 in Chinese and 3 in English) met the criteria for inclusion in this meta-analysis. The pooled estimate of depression among LBC was 26.4%. A significant heterogeneity has been found in reported findings, and this heterogeneity was associated with three types of study characteristics, including using an unclear definition of LBC and using invalidated depression instruments, and the geographic location.

CONCLUSIONS

The risk of mental health problems among this large number of LBC suggests the need to quantify the extent and distribution of their mental health state. Implications for methodological improvements for future research have been discussed.

Economic Pressure and Loneliness in Migrant Children in China: The Mediating Roles of Parent-Child Communication and Parental Warmth

The purpose of the current study was to examine the mediating roles of parent-child communication and parental warmth in the relationship between economic pressure and loneliness in a sample of migrant children in China. A total of 437 participants were selected from two public schools for migrant children in Zhejiang Province, China. All participants were asked to complete four measures, including the Perceived Economic Strain Scale, the Parent-Child Communication Questionnaire, the Parental Warmth Scale, and the Children's Loneliness Scale. The results showed that economic pressure was positively and directly related to loneliness. Furthermore, parent-child communication and parental warmth partially mediated the relationship between economic pressure and loneliness in migrant children. Thus, parent-child communication and parental warmth play important roles in reducing the negative effect of economic pressure on loneliness in migrant children.

Workaholism on Job Burnout: A Comparison Between American and Chinese Employees

Past research frequently reports significant relation between workaholism and job burnout, and some studies further indicate workaholism varies across countries. Surprisingly, there is no study that directly examines whether country moderates the workaholism-burnout association. To address this research question, we have collected independent work samples from two culturally diverse countries, namely the People's Republic of China and the United States. A total of 2243 participants (1243 American respondents and 1000 Chinese respondents) were recruited. Preliminary group comparison suggested that there were statistical differences among participants from different industries on the key variables, including workaholism, job demands, autonomy and emotional exhaustion. Therefore, we have divided our participants into three subsamples [i.e., (1) natural resources, mining and construction industry, (2) manufacturing industry, and (3) service industry] and separate analyses were conducted. In the moderated regression analyses, workaholism significantly predicted two dimensions of job burnout, namely emotional exhaustion and depersonalization, even when job demand and job autonomy were controlled. Finally, although two significant moderating effects were found, there was a lack of consistent empirical support to the hypothesized moderating effect of country on workaholism-burnout association. Implications and limitations were discussed.

Parent-child communication and self-esteem mediate the relationship between interparental conflict and children's depressive symptoms

BACKGROUND

Previous research has paid little attention to the series mediating effect of parent-child communication and self-esteem in the relationship between interparental conflict and child outcomes, although several other mechanisms have been found to involve in this relationship. Thus, the purpose of the present study is to test these two factors' serial mediation of the relationship between interparental conflict and children's depressive symptoms in a sample of migrant children in China.

METHODS

Four hundred thirty-seven participants from two public schools for migrant children in Zhejiang Province, China, were administered four measures including the Children's Perceptions of Interparental Conflict Scale, the Parent-child Communication Questionnaire, the Global Self-esteem Scale, and the Centre for Epidemiologic Studies Depression Scale for Children.

RESULTS

Results showed that interparental conflict was positively related to depressive symptoms in migrant children, which was partially and serially mediated by parent-child communication and self-esteem in that order.

CONCLUSIONS

Parent-child communication and self-esteem play potential roles in the relationship between interparental conflict and depressive symptoms of migrant children in China. This finding has important implications for psychological service providers working with this group of children or children in similar situations.

Depressive Symptoms of Chinese Children: Prevalence and Correlated Factors among Subgroups

Economic growth and socioeconomic changes have transformed nearly every aspect of childhood in China, and many are worried by the increasing prevalence of mental health issues among children, particularly depression. To provide insight into the distribution of depressive symptoms among children in China and identify vulnerable groups, we use data from the 2012 China Family Panel Survey (CFPS), a survey that collected data from a large, nationally representative sample of the Chinese population. Using the CFPS data, we construct a sample of 2679 children aged 10–15 years old from 25 provinces in China. According to our results, the incidence of depression varies by geographic area. Specifically, we find that rates of depressive symptoms are significantly lower in urban areas (14% of sample children) than in rural areas (23% of sample children). Our results also show that children from ethnic minorities, from poorer families, and whose parents are depressed are more likely to be depressed than other children. In contrast, we find that depressive symptoms do not vary by gender.

Prevalence of Depression, Anxiety and Stress among school going adolescent in Chandigarh

Context

Depressive disorders often start at a young age. There is a need for early identification of depression, anxiety, and stress (DAS) and prevention. The present study was undertaken to find the magnitude of DAS among adolescents.

Aims

To find the mental health status of school going adolescents in Chandigarh. The objectives were (i) to study the prevalence of DAS among school going adolescents and (ii) to study the correlates of DAS.

Settings and Design

A Cross-sectional survey of students of four classes from 9^th to 12^th studying in government schools.

Subjects and Methods

Ten government schools in Chandigarh were randomly selected through lottery method. In each school, for each of the four classes, a section was randomly selected again by the lottery method. Forty students were selected from each school reaching sample size of 470. DAS scale 21 questionnaires were used.

Statistical Analysis Used

The data entry was done in MS Office Excel 2007. The analysis was done in the form of frequency tables, charts cross tables. For statistical significance, Chi-square test and correlation was found between various factors.

Results

The prevalence of DAS was 65.53%, 80.85%, and 47.02%, respectively. Overall, comorbidity between depression and anxiety was 57.65%. Extremely severe depression was very less (3%). The prevalence of DAS was higher in females. For depression and anxiety, the peak age was 18 years.

Conclusions

The prevalence of DAS was high among school going adolescents in Chandigarh. There is a need for early and effective identification of DAS that can prevent many psychiatric disorders at their nascent stage.

Trajectories of Personal Well-Being Attributes Among High School Students in Hong Kong

How personal well-being of adolescents changes over the high school period is not entirely clear in the scientific literature. Using 15 positive youth development (PYD) attributes as indicators of well-being, the current study investigated the related developmental trajectories among a large sample of Hong Kong adolescents from Grade 7 to Grade 12. Individual growth curve modeling revealed that while variation existed across different PYD attributes, nine out of 15 positive youth development attributes declined in the early adolescence but showed a rebound or a slower rate of decline in the late adolescence. The current study serves as a pioneering attempt to chart the normative profiles of Chinese adolescents' personal well-being over time. The theoretical and practical implications of the findings are discussed.

Genetic and environmental influences on the relationship between ADHD symptoms and internalizing problems: A Chinese twin study

Several twin studies have investigated the overlap between attention deficit hyperactivity disorder (ADHD) and externalizing problems; however, limited information is known regarding the genetic and environmental contribution to the overlap between ADHD and internalizing problems. This study examined the genetic and environmental influences on the variation in and covariation between ADHD symptoms and internalizing problems by using the Child Behavior Checklist (CBCL). We investigated 1,316 child and adolescent twins, including 780 monozygotic twins and 536 dizygotic twins, aged 6 years to 18 years from the Chinese Child and Adolescent Twin Registry. ADHD symptoms and internalizing problems were quantified through parent rating by using the Attention Problems Scale and other three scales, which include Anxious/Depressed, Withdrawn, and Somatic Complaints of CBCL. Genetic and environmental susceptibilities common to ADHD symptoms and internalizing problems were examined through bivariate twin modeling. Results showed that genetic factors substantially influenced the ADHD symptoms with a heritability of 72%. Modest genetic influences and substantial shared environmental influences (20-77%) were observed in the three internalizing problem scales. Common genetic and shared environmental influences were essential for the overlap between ADHD and the three internalizing problems respectively. Approximately one-fifth of the genetic variance of ADHD symptoms was shared with anxiety/depression. In conclusion, substantial genetic and shared environmental influences on ADHD symptoms and internalizing problems were observed in Chinese children and adolescents. Our finding supports a common etiology between ADHD and internalizing problems. This finding can also help explain the co-existence of these behavior problems. © 2015 Wiley Periodicals, Inc.

The Effects of Self-Efficacy and Relationship Harmony on Depression Across Cultures

Cross-cultural theories of individualism and collectivism have stimulated the development of the personal constructs of independence and interdependence to help us understand the working out of their cultural dynamics. To delineate the contributions of both personal or independent and interpersonal or interdependent predictors of depressive symptomatology, this study assessed self-efficacy and relationship harmony (peer and family) among adolescents in Hong Kong and the United States. By applying both level- and structure- oriented techniques, the authors tested cultural differences in the levels of the constructs and their linkage across gender and culture. The path leading from self-efficacy to depressed symptoms was significantly stronger for American adolescents than for Hong Kong adolescents, whereas the path of relationship harmony was statistically equivalent across the two cultures. Both pathways supplemented one another in their effects on depressive symptomatology in both cultures, underscoring the importance of managing both agency and communion in promoting psychological health.

The Role of Peer Relations in Adolescent Development in Two Cultures

The aims of this study were (a) to compare peer relations, developmental expectations, self-perceived competence, and well-being in Dutch and Japanese adolescents; and (b) to examine whether relationships among these constructs vary as a function of different cultures, that is, whether the same developmental model applies in both countries. The sample included 253 Dutch and 308 Japanese adolescents between 15 to 18 years of age. The same questionnaires assessing peer relations, developmental expectations, competence, and well-being were completed by adolescents individually in both samples. The results show that Dutch adolescents are more satisfied with their relationships with peers, expect to achieve developmental tasks at earlier ages, feel more competent about their abilities, and report a higher level of well-being than Japanese adolescents. Evidence with regard to different developmental processes in the two cultures was also found. Peer relations bear stronger associations with developmental expectations and well-being in Japanese than in Dutch adolescents.

Adolescent Self-Esteem in Cross-Cultural Perspective

Theorists and researchers have raised the question of whether self-esteem has similar meanings and correlates in individualistic and collectivist cultures. This study examined the cross-cultural equivalence of the Rosenberg Self-Esteem Scale in four countries and compared its association with parental warmth and acceptance and depressed mood. Participants were 11th graders in the United States ( n = 422), the Czech Republic ( n = 490), China ( n = 502), and Korea ( n = 497). Cross-cultural similarities in the factor structure of the self-esteem scale and in the relations of self-esteem to other variables were more striking than cross-cultural differences. Across cultures, parental warmth was significantly related to both positive and negative self-image, each of which in turn was related significantly to depressive symptomatology. There was little evidence for the hypothesis that self-esteem would more strongly mediate the relation between parental warmth and adolescent depressive symptoms in the more individualistic(as opposed to collectivist) cultures.

Applicability of Baumrind's parent typology to collective cultures: Analysis of cultural explanations of parent socialization effects

This article reviews studies that have examined whether Baumrind's parenting styles are related to child outcomes similarly in cultures where independence is said to be emphasized versus cultures where interdependence is said to be emphasized. I present evidence showing that Baumrind's parenting styles have similar function in both collectivist and individualist cultures. Based on these studies, I argue against the claim of some researchers that authoritarian parenting is not detrimental or authoritative parenting beneficial to the development of young people in cultures that are said to emphasize interdependence. However, more research is needed before conclusions can be reached about the extent to which the culture construct explains child-rearing effects on child development. Future directions for research, which include the importance of identifying diverse forms of parenting within interdependent cultures so as to distinguish the influence of functional and dysfunctional forms of parenting on child outcomes, are suggested.

Screen Time on School Days and Risks for Psychiatric Symptoms and Self-Harm in Mainland Chinese Adolescents

Objective: To investigate associations of television and of video game or non-educational computer use (VG/CU) exposure volumes in a typical school day with psychiatric symptoms and suicidal ideation/self-injurious behavior (self-harm), in mainland Chinese adolescents.

Methods: Secondary school pupils (N = 13,659; mean age: 15.18 ± 1.89) from 10 urban areas sampled from different regions of mainland China were recruited. The subjects were divided into the following four screen exposure volume groups for television and VG/CU respectively based on a self-administered questionnaire: 0 h/day, >0 to ≤1 h/day, >1 to ≤2 h/day, and >2 h/day. Demographic and psychiatric symptoms were recorded for each respondent. Odds ratios (ORs) and 95% confidence intervals (CIs) for several types of psychological problems and self-harm were calculated.

Results: More than 2 h per school day television watching was associated with higher risk of depression in both boys (OR = 1.33, 95%CI: 1.02–1.73) and girls (OR = 1.62, 95%CI: 1.19–2.21), of anxiety in boys (OR = 1.43, 95%CI: 1.05–1.95), of general emotional, behavioral, and social problems (GEBSPs; OR = 1.55, 95%CI: 1.01–2.39), and of oppositional defiant problems (OR = 1.65, 95% CI: 1.09–2.50) in girls, compared with no television exposure. Conversely, television exposure of no more than 1 h per school day was associated with lower self-harm risk in boys (OR = 0.81, 95%CI: 0.67–0.99) compared with no television exposure. High school day VG/CU time (>2 h) compared with no VG/CU were associated with higher risks of anxiety (OR = 1.40, 95%CI: 1.06–1.86) and of attention deficit/hyperactivity problems (ADHPs; OR = 1.56, 95%CI: 1.02–2.38) in boys. And any school day VG/CU exposure was associated with higher risks of self-harm and all other psychiatric problems in boys and all psychiatric problems (including anxiety and ADHPs) in girls (ORs, 1.44–3.69), compared to no VG/CU exposure.

Conclusion: For secondary school students, associations of psychiatric problems and self-harm were more strongly associated with exposure to VG/CU than with exposure to television. The findings suggest that VG/CU and television exposure on weekdays should be considered in psychiatric interventions for adolescents.

Cultural considerations for the adaptation of an Internet-based intervention for depression prevention in Mainland China

Internet-based interventions to prevent depression during adolescence have been implemented in Western countries, but there is a lack of research about its adaptation for use in other countries. Project Competent Adulthood Transition with Cognitive-Behavioral, Humanistic and Interpersonal Training (CATCH-IT) is an Internet-based intervention targeting teens at risk for developing depression. This study explored cultural adaptation of the intervention for use in Mainland China. A pilot study using the English version of CATCH-IT was conducted in Wuhan, China, with adolescents from the Wuhan School of Medicine in 2013. Participants completed a feedback survey to evaluate the format and socio-cultural relevance for each component of the intervention. Twenty students were surveyed (age range 19-23 years). In 2014, Chinese physicians evaluated CATCH-IT and completed a feedback questionnaire. Data obtained were collected and analyzed for recurrent themes. Both groups recommended new modules focusing on Chinese-relevant themes like pressure for academic excellence, filial piety, and balancing school and social life. Physicians agreed to retain the cognitive behavior therapy (CBT) and behavioral activation (BA) modules, and were split on the use of interpersonal therapy (IPT). All experts recommended translation of the content into Mandarin and a majority suggested interactive features and less text. All agreed the Internet serves well as a delivery model; however, dissemination through schools was preferred. The results support cultural adaptation of basic facets of the intervention like language and visuals, and also deeper aspects like IPT and the delivery model. Development of an adaptation should build upon the findings from this study and work to maintain fidelity.

The Effects of Being an Only Child, Family Cohesion, and Family Conflict on Behavioral Problems among Adolescents with Physically Ill Parents

Background: This study aimed to examine the parental physical illness’ effect on behavioral problems among adolescents, and the effects of being an only child, family cohesion, and family conflict on behavioral problems among adolescents with physically ill parents in Liaoning province, China. Methods: This cross-sectional study was performed in 2009. A questionnaire including two dimensions of the Family Environment Scale (family cohesion and family conflict), self-reported Strength and Difficulties Questionnaire (SDQ), and demographic factors was distributed to the subjects. Results: Among the 5220 adolescents, 308 adolescents lived with physically ill parents. The adolescents with physically ill parents had more behavioral problems than adolescents with healthy parents. Among the girls who lived in families with physically ill parents, the SDQ score and the prevalence of SDQ syndromes were higher in the girls with siblings than the girls without siblings after adjusting for variables; the effect of family cohesion on SDQ was significant after adjusting for variables. Conclusion: Interventions targeting family cohesion may be effective to reduce behavioral problems of adolescents with physically ill parents.

Self-reported depression and anxiety symptoms in school-aged Singaporean children

INTRODUCTION

Few studies have examined anxiety and depression experiences of primary (middle) school-aged children from ethnically diverse backgrounds, and most have relied on parents or others as informants. The present study aimed to investigate self-reported anxiety and depression symptoms in Singaporean primary school-aged children. Age, gender, and ethnic differences and interactions were explored as well as similarities and differences between Singaporean children and US norms.

METHODS

A large representative community sample of 1655 8- to 12-year-old Singaporean children (Chinese, Malay, and Indian) completed the Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI) as part of a larger epidemiological study of mental health in Singaporean children.

RESULTS

Rates of clinically elevated symptoms of anxiety and depression were 9.3% and 16.9% on the MASC and the CDI, respectively. Separation and social anxieties were most common. Evidence of a gender difference in levels of emotional symptoms was most evident in Indian children, with girls reporting more symptoms than boys. The relationship between age and internalizing problems was weak.

DISCUSSION

A substantial minority of primary school-aged Singaporean children reported elevated anxious and depressive symptoms. Better understanding of the factors that contribute to the development and maintenance of these problems can help the development of culture-specific interventions and facilitate the planning of community-tailored services and initiatives.

Genetic variations in the serotoninergic system and environmental factors contribute to aggressive behavior in Chinese adolescents

Aggressive behavior is a major public health problem worldwide and has been associated with many gene variants, especially those related to the serotonin (5-hydroxytryptamine, 5-HT) system, and environmental factors. However, the overall contribution of serotonin-related genes to aggressive behavior is not well understood. With a sample of 478 healthy Chinese volunteers, this study investigated the relation between aggressive behavior and genetic variations of the serotoninergic system (as characterized by 129 representative polymorphisms) interacting with environmental factors (parental warmth and acceptance; stressful life events). We adopted a system-level approach to identify SNPs and environmental factors associated with aggressive behavior, and estimated their overall contribution to aggressive behavior using multiple regression, which was then verified by permutation analysis. We identified 12 SNPs that made statistically significant contributions to aggressive behavior. Next, main effects, interactions among these SNPs, and interactions between these SNPs and environmental factors were assessed using multiple regression. The final model accounted for approximately 19% of the variance for aggressive behavior. Permutation analysis confirmed that the probability of obtaining these findings by chance was low (p=0.045, permuted for 1000 times). These results showed that genetic variations in the serotoninergic system, combined with environmental risk factors, made a moderate contribution to individual differences in aggressive behavior among a healthy population sample.

Symptoms of depression and rates of neurocognitive impairment in HIV positive patients in Beijing, China

BACKGROUND

In China an estimated 780,000 people are living with HIV (PLWH). In high-income countries PLWH are at increased risk of depression, with subsequent adverse consequences for quality of life, and HIV-related morbidity and mortality. There are few data from low-and middle-income countries. The aims of this country-specific investigation of the Asia Pacific NeuroAIDS Consortium (APNAC) study were to establish the point prevalence, severity and HIV-related and non-HIV related correlates of depressive symptoms in PLWH, in Beijing, China.

METHOD

PLWH attending an outpatient clinic at Ditan Hospital, Beijing were recruited consecutively. Data sources were: study-specific questions about demographic characteristics, and health behaviours, the Centre for Epidemiological Studies Depression Scale (CES-D), the World Health Organisation Self-Reporting Questionnaire (SRQ-20) translated into Mandarin and administered as structured individual interviews, and a screen battery of four standard neuropsychological tests.

RESULTS

In total 50/51 (98%) eligible patients agreed to participate. Overall 28% scored CES-D≥16 or SRQ20≥10 and 18% in these clinical ranges on both measures; 69% were classified as being neuropsychologically impaired (scoring below 1 SD of the control value on at least two tests). Higher depressive symptom scores were associated with lower education, alcohol overuse and diminished motor ability (all p<0.05), but not neuropsychological impairment

CONCLUSION

Clinically significant depressive symptoms among this cohort of PLWH in Beijing occurred at 5 times the rate reported among a general Chinese urban population. No participants had been assessed for depression prior to the study and none were treated, indicating that consideration of psychological morbidity and its consequences for health behaviours should be incorporated into routine HIV care in China.