1
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Sadeh Y, Graham L, Curtis M, Janson M, Kim J, Schwartz A, Undset A, Denejkina A. Posttraumatic stress and depression symptom classes in parents of trauma-exposed children: a transdiagnostic perspective using pooled individual participant data. Eur J Psychotraumatol 2024; 15:2299194. [PMID: 38197328 PMCID: PMC10783838 DOI: 10.1080/20008066.2023.2299194] [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: 05/25/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024] Open
Abstract
Background: In the aftermath of child trauma, post-traumatic stress (PTS) and depression symptoms often co-occur among trauma exposed children and their parents. Studies have used latent class analysis (LCA) to examine PTS and depression symptoms and identify homogeneous subgroups among trauma exposed children. However, little is known about subgroups or classes of PTS and depression reactions of parents of traumatised children.Objectives: (1) Determine PTS and depression symptom classes at 2-9 months post-trauma, and (2) to examine sociodemographic covariates among parents of trauma exposed children.Methods: Using harmonised individual participant data (n = 702) from eight studies (Australia, UK, US) included in the Prospective studies of Acute Child Trauma and Recovery Data Archive (PACT/R), we modelled these phenomena at the symptom level using LCA.Results: Our LCA yielded three solutions: 'high internalizing symptom' class (11%); 'low PTS-high depression' class (17%); and 'low internalizing symptom' class (72%). Parents of children in the 'low PTS-high depression' class were more likely to have children of older age and be part of an ethnic minority, compared to the 'low internalizing symptoms' class. Mothers were more likely to be in the 'high internalizing symptom' class compared to the 'low internalizing symptoms' class.Conclusions: These findings reveal a qualitative structure and relationship between depression and PTS symptoms that highlights the importance of assessing and targeting a broad range of internalising symptoms in post-trauma psychological treatment.
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Affiliation(s)
- Yaara Sadeh
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Leila Graham
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael Curtis
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Melissa Janson
- Gevirtz Graduate School of Education, Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA, USA
| | - Jeeeun Kim
- Soro Orot Institute, Inc. (Soro Orot Institute – Counselor Group for Counseling and Education of Multicultural and Social Justice Issues), Seoul, Korea
| | - Ashlyn Schwartz
- Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Public Health, University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Andrea Undset
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Anna Denejkina
- Translational Health Research Institute; YouthInsight, Sydney, Australia
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2
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Zhao X, Wang A, Chen J, Zhang J, Li Z. Subtypes of Chinese Shidu parents' (parents who have lost their only child) depressive symptoms and their relationships with resilience and coping styles. Psych J 2023; 12:100-107. [PMID: 36054742 DOI: 10.1002/pchj.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/23/2022] [Indexed: 02/04/2023]
Abstract
We aimed to examine the subtype classification characteristics of depressive symptoms in Shidu parents (SDPs, parents who have lost their only child) and their associations with resilience and coping styles. The sample comprised 182 SDPs (Mean age = 59.93 ± 7.41 years, 61.5% females). Latent profile analysis and logistic regression analysis were used to analyze the data. Three subgroups of depressive symptoms in SDPs were identified: the depression and pessimism group (38.4%), the low depression symptoms group (30.8%), and the well-adapted group (30.8%). The low depression symptoms group had a lower education level and higher family monthly income than the depression and pessimism group. The low depression symptoms group and the well-adapted group scored significantly higher in resilience, and lower in negative coping style than the depression and pessimism group. The results highlighted that target intervention is needed for SDPs with high education levels, low family monthly income, high negative coping style, and low resilience in the depression and pessimism group.
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Affiliation(s)
- Xian Zhao
- Institute of Education, Hunan University of Science and Technology, Xiangtan, China.,Yongzhou Normal College, Yongzhou, China
| | - Anni Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Jianshi Chen
- Hengnan County No.1 Middle School, HengNan, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Zhihua Li
- Institute of Education, Hunan University of Science and Technology, Xiangtan, China
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3
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Wang D, Deng Q, Chen H, Wang M, Liu Z, Wang H, Ouyang X. Profiles of depressive symptoms and influential factors among people living with HIV in China. BMC Public Health 2023; 23:151. [PMID: 36690976 PMCID: PMC9869583 DOI: 10.1186/s12889-023-15057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Depressive symptoms are highly prevalent among people living with HIV (PLWH). We leveraged Latent Profile Analysis (LPA) to identify profiles of depressive symptoms among PLWHs. We also investigated differences in psychological factors of interest, demographic characteristics, and HIV-related factors across patients' profiles. METHODS A cross-sectional study was conducted at one hospital and two designated prison facilities in Hunan province, China. A total sample of 533 PLWHs (320 recruited from the hospital, 213 recruited from prisons) completed the survey. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9). Family function, resilience, childhood trauma, demographic characteristics, and HIV-related factors were also evaluated. We conducted LPA and multinomial logistic regression analyses to: 1) identify distinct profiles for depressive symptoms; 2) identify demographic characteristics, and HIV-related, and psychological factors predicting PLWHs' likelihood to express a specific profile. RESULTS We identified three distinct profiles of depressive symptoms among PLWHs: severe symptoms (11.8%), moderate symptoms (40.5%), and low/no symptoms (47.7%). Moderate/ severe family dysfunction, low resilience, experiencing emotional abuse and neglect were more likely to fall in the "severe symptoms" rather than the "low/no symptoms" profile. In addition, severe family dysfunction, low resilience, and experiencing emotional neglect indicated a higher likelihood of being classified in the "moderate symptoms" profile, compared to the "low/no symptoms" profile. CONCLUSION Identifying profiles of depressive symptoms among PLWHs using the PHQ-9 items allows for understanding of the distinct paths of development of depressive symptoms and for developing tailored prevention and intervention programs for PLWHs.
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Affiliation(s)
- Dongfang Wang
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, 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, China
| | - Qijian Deng
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Huilin Chen
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Min Wang
- Institute for HIV/AIDS, the First Hospital of Changsha, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Honghong Wang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xuan Ouyang
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China.
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China.
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4
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Eli B, Chen Y, Zhang J, Huang X, Wang Q, Ma Z, Yv Y, Liu Z. Time course of attentional bias and its relationship with PTSD symptoms in bereaved Chinese parents who have lost their only child. Eur J Psychotraumatol 2023; 14:2235980. [PMID: 37493173 PMCID: PMC10599259 DOI: 10.1080/20008066.2023.2235980] [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: 08/14/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 07/27/2023] Open
Abstract
Background: The death of a child is a highly traumatic event for parents and often leads to posttraumatic stress disorder (PTSD). Attentional bias has been demonstrated in the onset and maintenance of PTSD symptoms.Objective: This study aimed to investigate the time course of attentional bias among bereaved Chinese parents who have lost their only child (Shidu parents), and to examine its relationship with PTSD symptoms and symptom clusters.Methods: Shidu parents (n = 38; 50-72 years of age) completed a dot-probe task with negative (trauma-related), positive, and neutral images at four stimulus presentation times (250, 500, 750, and 1250 ms). PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5).Results: We observed difficulty in disengaging from both negative and positive stimuli at 750 ms and attentional bias away from negative stimuli at 1250 ms. At 1250 ms, attentional avoidance of trauma-related stimuli was positively correlated with PCL-5 total and intrusion scores. Difficulty in disengaging from positive stimuli was negatively correlated with PCL-5 total and intrusion scores as well as negative alterations in cogniti and mood scores.Conclusions: These findings enhance our understanding of attentional bias and cognitive-affective processing in PTSD. This study provides evidence that attentional bias (difficulty in disengaging from positive stimuli and bias away from negative stimuli) are correlated with PTSD symptoms and certain symptom clusters.
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Affiliation(s)
- Buzohre Eli
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Jing Zhang
- Gengdan Institute of Beijing University of Technology, Beijing, P.R. China
| | - Xin Huang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
| | - Qian Wang
- Beijing Key Laboratory of Behavior and Mental Health, Clinical and Health Psychology Department, School of Psychological and Cognitive Sciences, Peking University, Beijing, P.R. China
| | - Zhujiang Ma
- Beijing Wisdom Spirits Technology Co., Ltd, Beijing, P.R. China
| | - Yang Yv
- Yv Yang Psychological Service Center, Economic and Technological Development Zone, Huai'an, Jiangsu Province, P.R. China
| | - ZhengKui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P.R. China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, P.R. China
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5
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Ma H, Zhao S, Long M, Diao Y, Liu M, Feng Z, Wu H, Wang Y. The relationship between culture-related grief beliefs, prolonged grief disorder and suicide ideation among Shidu parents in rural China. Clin Psychol Psychother 2023; 30:54-63. [PMID: 35776076 DOI: 10.1002/cpp.2768] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/28/2022] [Accepted: 06/27/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND There are many one-child families in China due to the one-child policy. Parents who have lost their only child and are unable to conceive another child or unwilling to adopt a child are called Shidu parents in China. The death of an only child puts Shidu parents at the risk of mental illness and even suicide. Few studies have explored the influence of cultural beliefs and prolonged grief disorder on suicide ideation. METHODS This study involved rural Shidu parents from Sujiatun district of Shenyang, China. Questionnaires consisted of the Prolonged Grief questionnaire - 13 (PG-13), the Culture-related Grief Beliefs of Shidu Parents Questionnaire (CBSQ), one question from the baseline National Comorbidity Survey (NCS) to measure suicide ideation and demographic and bereavement-related information. Bivariate logistic regression analyses were conducted to explore associated factors of suicide ideation. RESULTS Sixty-nine (28.8%) of the 240 Shidu parents reported having suicide ideation. Having chronic disease (OR = 5.509, p < 0.01), having religious belief (OR = 3.923, p < 0.05) and having a grandchild (OR = 2.552, p < 0.05) were associated with an increased risk of suicide ideation. Destiny belief (a subscale of CBSQ) was negatively associated with suicide ideation (OR = 0.818, p < 0.05). Prolonged grief disorder (OR = 9.280, p < 0.01) and perceived stigma (a subscale of CBSQ) (OR = 1.200, p < 0.05) was positively associated with suicide ideation after adjusting for controlling variables. CONCLUSIONS Suicide ideation is prevalent in rural Shidu parents. Reducing perceived stigma and alleviating prolonged grief disorder may decrease the risk of suicide among rural Shidu parents.
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Affiliation(s)
- Hongfei Ma
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Shuang Zhao
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Meijun Long
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Yucong Diao
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Minghui Liu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Ziyi Feng
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Hui Wu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Yang Wang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
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6
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Eli B, Zhou Y, Chen Y, Huang X, Liu Z. Symptom Structure of Depression in Older Adults on the Qinghai-Tibet Plateau: A Network Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13810. [PMID: 36360690 PMCID: PMC9659106 DOI: 10.3390/ijerph192113810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Previous studies have confirmed that depression among residents in high-altitude areas is more severe, and that depression may be more persistent and disabling in older adults. This study aims to identify the symptom structure of depression among older adults on the Qinghai-Tibet Plateau (the highest plateau in the world) from a network perspective. This cross-sectional study enrolled 507 older adults (ages 60-80 years old) from the Yushu Prefecture, which is on the Qinghai-Tibet Plateau, China. Depressive symptoms were self-reported using the shortened Center for Epidemiological Studies-Depression Scale (CES-D-10). Then, a Gaussian graphical model (GGM) of depression was developed. Poor sleep, fear, and hopelessness about the future exhibited high centrality in the network. The strongest edge connections emerged between unhappiness and hopelessness about the future, followed by hopelessness about the future and fear; hopelessness about the future and poor sleep; fear and unhappiness; and then poor sleep and unhappiness in the network. The findings of this current study add to the small body of literature on the network structure and complex relationships between depressive symptoms in older adults in high-altitude areas.
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Affiliation(s)
- Buzohre Eli
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yueyue Zhou
- Department of Psychology, Henan University, Kaifeng 475004, China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xin Huang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
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7
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Gu J, Cai X, Yan W, Zhan J, Sun L, Xing C, Jia Y, Liu W, Huang L, Shang Z. PTSD Among Shidu Parents in China: The Roles of Personality Types and Social Support. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:33-44. [PMID: 35370492 PMCID: PMC8961702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The psychological problems of Shidu Parents (SDP) under the China's One-Child Policy have been documented. The purpose of this study was to investigate the relationships among personality types, social support, and post-traumatic stress disorder (PTSD) in SDP. Methods: The PTSD Checklist-Civilian Version (PCL-C), The Big Five Personality Traits (NEO), and Social Support Revalued Scale (SSRS) were administered to the sample of 149 SDP who were over 50 years old and had lost their only child more than one year ago. Results: Among SDP, mothers were more likely to develop PTSD than fathers (χ2 = 11.16, p < 0.01). Parents who were extraverted had a lower risk of developing PTSD-related symptoms (χ2 = 8.58, p < 0.01), and the effect of neuroticism was significant (χ2 = 23.73, p < 0.01). The more social support parents utilized, the lower the incidence of PTSD (t = 4.56, p < 0.01). The result of multilevel linear regression showed that sex, neuroticism, and objective social support remained significantly different after combining all personality types and social support systems in the same model. Social support partially mediated the relationship between neuroticism and PTSD. Meanwhile, it was a complete mediator between extraversion and PTSD. Conclusions: Female sex/gender, neuroticism, and introversion were risk factors of developing PTSD, while receiving social support protected SDP from developing PTSD symptoms. Losing an only child is undoubtedly an enormous disaster for the family, which has become a huge, unavoidable social problem that must be addressed in China.
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Affiliation(s)
- Jingwen Gu
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Battalion 3 of Cadet Brigade, School of Basic
Medicine, Naval Medical University, Shanghai, China
| | - Xiaojie Cai
- Department of Radiology, Changshu Hospital Affiliated
to Suzhou University, Changshu, China
| | - Wenjie Yan
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Emotion & Cognition Lab, Faculty of Psychology
and Mental Health, Naval Medical University, Shanghai, China
| | - Jingye Zhan
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Emotion & Cognition Lab, Faculty of Psychology
and Mental Health, Naval Medical University, Shanghai, China
| | - Luna Sun
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Emotion & Cognition Lab, Faculty of Psychology
and Mental Health, Naval Medical University, Shanghai, China
| | - Chenqi Xing
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Emotion & Cognition Lab, Faculty of Psychology
and Mental Health, Naval Medical University, Shanghai, China
| | - Yanpu Jia
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Emotion & Cognition Lab, Faculty of Psychology
and Mental Health, Naval Medical University, Shanghai, China
| | - Weizhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Emotion & Cognition Lab, Faculty of Psychology
and Mental Health, Naval Medical University, Shanghai, China,To whom all correspondence should be addressed:
Zhilei Shang, ; Weizhi Liu, Lab for PTSD,
Faculty of Psychology and Mental Health, Naval Medical University, Shanghai
200433, China, ; Lijun Huang,
Department of Radiology, Changshu Hospital Affiliated to Suzhou University,
Changshu 215500, China,
.
| | - Lijun Huang
- Department of Radiology, Changshu Hospital Affiliated
to Suzhou University, Changshu, China,To whom all correspondence should be addressed:
Zhilei Shang, ; Weizhi Liu, Lab for PTSD,
Faculty of Psychology and Mental Health, Naval Medical University, Shanghai
200433, China, ; Lijun Huang,
Department of Radiology, Changshu Hospital Affiliated to Suzhou University,
Changshu 215500, China,
.
| | - Zhilei Shang
- Lab for Post-traumatic Stress Disorder, Faculty of
Psychology and Mental Health, Naval Medical University, Shanghai, China,The Emotion & Cognition Lab, Faculty of Psychology
and Mental Health, Naval Medical University, Shanghai, China,To whom all correspondence should be addressed:
Zhilei Shang, ; Weizhi Liu, Lab for PTSD,
Faculty of Psychology and Mental Health, Naval Medical University, Shanghai
200433, China, ; Lijun Huang,
Department of Radiology, Changshu Hospital Affiliated to Suzhou University,
Changshu 215500, China,
.
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8
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Jung H, Lee D, Lee D. Longitudinal transitions in patterns of post-traumatic stress disorder symptoms and psychological distress among South Korean adults with traumatic experiences. Stress Health 2021; 37:871-886. [PMID: 33740290 DOI: 10.1002/smi.3046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/07/2022]
Abstract
This study aimed to investigate transitions in patterns of post-traumatic stress disorder (PTSD) symptoms and psychological distress among South Koreans with traumatic experiences. This study consists of two parts: In Part 1 the time since trauma ranged between 0 and 41 years, while in Part 2 participants experienced at least one traumatic event within the previous three years. We identified subgroups and transitions between classes over a one-year period using latent profile analysis and latent transition analysis. First, in Part 1, four classes were identified at T1 and T2. Second, we explored whether age, sex, time since trauma, and time perspective (TP) predicted class membership at T1. Age, past-negative (PN), present-fatalistic, and future TPs were significant predictors of class membership at T1. Finally, sex, PN, and future TPs were identified as significant predictors of class transition over time. The same analysis was conducted in Part 2 with individuals chosen from the Part 1 participants. Differential effects of TP on class membership and transitions in PTSD symptoms and psychological distress indicated the need for intervention programs that consider the TP profiles of individuals with traumatic experiences.
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Affiliation(s)
- Hayoung Jung
- Department of Education, College of Education, Sungkyunkwan University, South Korea
| | - DongHun Lee
- Department of Education, College of Education, Sungkyunkwan University, South Korea
| | - Deokhee Lee
- Department of Education, College of Education, Sungkyunkwan University, South Korea
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9
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Eli B, Liang Y, Chen Y, Huang X, Liu Z. Symptom structure of posttraumatic stress disorder after parental bereavement - a network analysis of Chinese parents who have lost their only child. J Affect Disord 2021; 295:673-680. [PMID: 34509783 DOI: 10.1016/j.jad.2021.08.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The death of a child is a highly traumatic event and often leads to mental health problems, including posttraumatic stress disorder (PTSD). Previous studies have focused on overall PTSD after the loss of an only child; however, little attention has been given to PTSD at the symptom level. This study aims to identify the network structure of PTSD symptoms in bereaved parents who have lost their only child, known as Shidu parents in Chinese society. METHODS A cross-sectional study enrolled 385 bereaved individuals who had lost an only child across 10 cities in China from November 2016 to July 2017. PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5). Network analysis was implemented by using the R packages qgraph and bootnet. RESULTS The PTSD network revealed that diminished interest, exaggerated startle, irritability/anger, and nightmares were the most central symptoms. The strongest connections emerged between the symptoms of recurrent thoughts and nightmares, irritability/anger and reckless/self-destructive behavior, and hypervigilance and exaggerated startle. LIMITATIONS We utilized cross-sectional data, and it is therefore not possible to infer the evolution of the symptom network over time. In addition, participants were limited to parents who had lost an only child, and the findings of this study must be interpreted with caution. CONCLUSIONS The current study provides further clarity regarding how PTSD symptoms relate to each other in bereaved parents who have lost an only child. Symptoms with high centrality and connectedness may be viable targets for intervention in bereaved parents who have lost an only child.
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Affiliation(s)
- Buzohre Eli
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yiming Liang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xin Huang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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10
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Xu X, Wen J, Skritskaya NA, Zou X, Mauro C, Wang J, Shear MK. Grief-related beliefs in shidu parents with and without prolonged grief disorder: Psychometric properties of a Chinese version of the Typical Beliefs Questionnaire. Clin Psychol Psychother 2021; 29:512-523. [PMID: 34235799 DOI: 10.1002/cpp.2641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 12/17/2022]
Abstract
The Typical Beliefs Questionnaire (TBQ) assesses common grief-related cognitions, which demonstrated satisfactory psychometric properties in a treatment-seeking sample with prolonged grief disorder (PGD). Chinese shidu parents (bereaved parents over the age of 49 who have lost their only child) are at a high risk of PGD. The current study aimed to examine psychometric properties of the Chinese version of the TBQ (TBQ-C) in a community sample of shidu parents with and without PGD, to compare this to the original validation clinical sample in the United States bereaved of any close relationship and to consider its use as a clinical tool. We examined the rate of positive endorsement, factor structure, internal consistency and validity of the TBQ-C in 310 community-based shidu parents (including 102 who met the criteria for PGD). Results showed that the rate of positive endorsement for each item ranged from 7.2% to 48.6% among non-PGD participants and from 20.6% to 92.2% among PGD participants. Confirmatory factor analysis indicated that the original five-factor structure fit both the non-PGD and PGD shidu parents. The TBQ-C showed acceptable internal consistency and satisfactory convergent and concurrent validity in both groups. It had good discriminant validity and can be helpful in distinguishing shidu parents with and without PGD. The TBQ-C can be used to investigate common grief-related beliefs that may be problematic for both shidu parents with and without PGD.
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Affiliation(s)
- Xin Xu
- Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jun Wen
- Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | | | - Xinyan Zou
- Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Christine Mauro
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jianping Wang
- Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - M Katherine Shear
- Center for Complicated Grief, Columbia School of Social Work, New York, NY, USA
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Zhao S, Long M, Diao Y, Ma H, Liu M, Feng Z, Wang Y. Culture-related grief beliefs and social support influence depressive symptoms of Shidu parents in rural China. Eur J Psychotraumatol 2021; 12:1945748. [PMID: 34367525 PMCID: PMC8312613 DOI: 10.1080/20008198.2021.1945748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Parents who have lost their only child are known as Shidu parents in China. Losing an only child is an enormous tragedy for parents that can trigger severe depressive symptoms. Few studies have explored the influence of cultural beliefs and social support on depressive symptoms. OBJECTIVE This study aimed to explore the relationship between culture-related grief beliefs, social support and depressive symptoms among Shidu parents in rural China. METHOD This cross-sectional study was conducted in Sujiatun district of Shenyang, China. Data were collected from November 2019 to February 2020 from 228 rural Shidu parents. Questionnaires consisted of the Center for Epidemiologic Studies Depression Scales (CES-D), the Culture-related Grief Beliefs of Shidu Parents Questionnaire (CBSQ), the Social Support Rating Scale (SSRS), and demographic and bereavement-related information. Hierarchical multiple linear regression analysis was conducted to examine the associations among culture-related grief beliefs, social support and depressive symptoms. RESULTS Of the 228 Shidu parents, 87.0% reported depressive symptoms (CES-D ≥ 16). The mean age of the participants was 62.91 years, ranging from 50 to 86. Regression analysis indicated that parents' younger age, lower education level and debts were prominent risk factors for depressive symptoms. Perceived stigma (a subscale of CBSQ) was positively associated with depressive symptoms. Social support was negatively associated with depressive symptoms. CONCLUSIONS Given the high prevalence of depressive symptoms in rural Shidu parents, there is a critical need to reduce perceived stigma and increase social support to alleviate depressive symptoms among Shidu parents in rural China.
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Affiliation(s)
- Shuang Zhao
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Meijun Long
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Yucong Diao
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Hongfei Ma
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Minghui Liu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Ziyi Feng
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Yang Wang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
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