From Stressful Experiences to Depression in Chinese Migrant Children: The Roles of Stress Mindset and Coping

The association between a stress-is-enhancing mindset and internet gaming disorder was mediated by behavioral disengagement among medical undergraduate students: a multi-center survey in China

BACKGROUND

The stress-is-enhancing mindset has beneficial effects on physical, psychological, and emotional well-being. However, its association with internet gaming disorder (IGD) had not been investigated. By integrating stress mindset into the cognitive evaluation process of commonly used stress coping theories, this study examined the association between stress mindset and IGD and explored relevant mediation mechanisms via behavioral disengagement. The gender differences in the above associations and mediations were also explored.

METHODS

An online, anonymous, cross-sectional survey was conducted among medical undergraduate students from seven cities (Baotou, Qiqihar, Harbin, Wenzhou, Guangxi, Dali, and Shantou) in China from December 2023 to February 2024. The final sample size was 8,552 (a mean response rate of 71.0%). The DSM-5 IGD Checklist, the Stress Mindset Measure-General, and the behavioral disengagement subscale of Brief-Coping Orientation to Problems Experienced Inventory were used to assess IGD, stress mindset, behavioral disengagement, respectively. Multivariate logistic regression analyses were conducted to test the significance and direction of the determinants of IGD. Path analysis was performed to examine the mediation mechanisms and the moderation effect of gender. All these analyses were adjusted for background factors.

RESULTS

Of all participants, the prevalence of IGD was 7.5%, and males had significantly higher prevalence than females (14.7% versus 7.4%, p < 0.001). Multivariate logistic regression analyses found that the stress-is-enhancing mindset was negatively associated with IGD (ORa = 0.94, 95% CI: 0.92 ~ 0.97) while behavioral disengagement was positively associated with IGD (ORa = 1.66, 95% CI: 1.57 ~ 1.76). Path analysis found that behavioral disengagement fully mediated the association between stress mindset and IGD, i.e., the stress-is-enhancing mindset was negatively associated with behavioral disengagement, which in turn was positively associated with IGD. However, gender did not significantly moderate the associations between stress mindset and behavioral disengagement, between behavioral disengagement and IGD, and between stress mindset and IGD.

CONCLUSIONS

This study observed the relatively high prevalence of IGD among Chinese medical undergraduate students. It also revealed that the stress-is-enhancing mindset was potentially protective against IGD, and behavioral disengagement might fully explain such a beneficial effect. Future longitudinal and interventional studies are needed to verify and extend these findings.

The effect of stress mindset on psychological pain: the chain mediating roles of cognitive reappraisal and self-identity

Background

Psychological pain is the most important factor affecting suicide rates. However, the factors contributing to psychological pain in medical students remain poorly understood.

Objective

This study aimed to investigate the effects of a stress mindset on psychological pain and the mediating roles of cognitive reappraisal and self-identity among Chinese medical students.

Methods

Medical students (N = 2056; 1,369, 66.60% female; 683, 33.40% male) from China completed multiple measures of stress mindset, self-identity, cognitive reappraisal, and psychological pain. Correlation and mediation analyses were conducted using SPSS 29.0 and Mplus 8.3.

Results

(1) The stress mindset was significantly negatively correlated with psychological pain among medical students. (2) Cognitive reappraisal mediated the relationship between the stress mindset and psychological pain. (3) Self-identity mediated the relationship between the stress mindset and psychological pain. (4) Cognitive reappraisal and self-identity jointly mediated the relationship between the stress mindset and psychological pain.

Conclusion

The results of this study deepen the understanding of the psychological processes linking stress mindset and psychological pain and provide a valuable reference for reducing psychological pain and improving the well-being of medical students.

Parent Behaviors as Predictors of Preadolescent Appraisal and Coping

Preadolescent appraisal and coping are significant predictors of youth psychopathology. However, little research examines how parenting behaviors relate to the development of these skills by forming a key context in which children learn to manage stressors. This study examined how observed maternal and paternal behaviors derived from a parent-child interaction task relate to levels of and growth in child appraisal (threat, positive) and coping (active, avoidant) across three years in preadolescence (n = 214, ages 8-12 years old at Time 1). Greater maternal warmth predicted lower threat appraisal and avoidant coping, and greater maternal negativity predicted greater increases in avoidance. Increased paternal warmth predicted lower initial levels of threat appraisal. Boys showed less growth in active coping than girls. These findings suggest parenting behaviors relate to preadolescents' utilization of maladaptive coping strategies such as avoidance and may be important intervention targets for supporting youth managing stressors.

Transforming stress program on medical students' stress mindset and coping strategies: a quasi-experimental study

OBJECTIVE

Stress is a significant concern in medical education, and identifying effective ways to deal with stress may help with students' mental health and professional development. This study aimed to examine the effects of the Transforming Stress Program (TSP) amongst first-year medical students on their stress mindset and coping strategies when confronted with stressors.

METHODS

We conducted a quasi-experimental study at the University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. A total of 409 first-year students at the Faculty of Medicine were divided into intervention group (205 students) and control group (204 students). The 10-week TSP was delivered as an extra-curricular course. The training adopts psychoeducation based on Dialectical Behavioral Therapy with mindfulness as a fundamental practice incorporated into each component of the program. The intervention group received the training in the first semester; the control group received identical program in the second semester. Stress Mindset Measurement and Brief Coping Orientation to Problems Experienced were measured before the intervention (T0), immediately after intervention on Intervention group (T1), and six months after intervention on Intervention group (T2).

RESULTS

At T1, the intervention group showed 65% improvements in stress mindset scores and increases in coping strategies scores in six domains (Problem solving, Social support, Humor, Religion, Venting, and Self-distraction) and decreases in three (Avoidance, Substance use, and Self-blame). The effect sizes were significant in all outcomes (Cohen's d > 0.2). Measurements of the control group did not change significantly in the same period. At T2, effects of the TSP were found decreased in some domains (Avoidance, Substance use, and Self-blame) compared to T1, but largely remained significantly better than T0.

CONCLUSIONS

The TSP is a feasible and effective approach that significantly enhanced medical students' stress mindset and coping strategies. Some effects were still observable 6 months after the intervention. The relatively intensive intervention requires support of the school administration and staff.

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

PURPOSE

Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association.

MATERIALS AND METHODS

A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity.

RESULTS

Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI.

CONCLUSION

This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.

The influence of stressful life events on procrastination among college students: multiple mediating roles of stress beliefs and core self-evaluations

Introduction

Few studies have documented the relationship between stressful life events and procrastination, which is a prevalent and troubling problem among college students. In this regard, the current study examined the association between stressful life events and procrastination through potential mediating effects of stress beliefs and core self-evaluations.

Methods

A cross-sectional design was carried out and data were collected from a total of 794 Chinese college students with measures of stressful life events, core self-evaluations, stress beliefs, and procrastination.

Results

Stressful life events was positively associated with procrastination in college students. Stress beliefs and core self-evaluations played multiple mediating roles in this relationship.

Discussion

The study provided a novel perspective of finding the possible causes of procrastination in college students and highlighted the roles of stress beliefs and core self-evaluations.

Behavioural clusters characteristic of cardiovascular reactivity profiles relate to poorer health outcomes

OBJECTIVES

Blunted cardiovascular reactivity is associated with a distinct behavioural profile of greater exposure to early life adversity, coupled with higher levels of behavioural disengagement and symptoms of depression. The present study sought to extend on this work by investigating if behavioural clusters with distinct patterns of reactivity were related to health and behavioural outcomes at baseline and at a 4-year follow-up.

METHODS

Hierarchical cluster analyses were conducted using longitudinal data drawn from the Midlife Development in the United States (MIDUS 2) Biomarker Project and the MIDUS 3 follow-up 4 years later. During MIDUS, 2 participants (N = 513) underwent a standardized stress testing protocol and had their blood pressure and heart rate monitored throughout. In addition, hierarchical cluster analyses were conducted on responses from measures of early life adversity, behavioural disengagement and depression. Binary logistic regressions were conducted to determine whether cluster membership was related to health and behavioural outcomes which were taken at both time points.

RESULTS

Three behavioural clusters emerged with statistically different blood pressure reactivity patterns. The cluster characterized by greater exposure to early life adversity, higher levels of behavioural disengagement and depressive symptoms, had relatively lower blood pressure reactivity patterns compared with both the exaggerated reactivity cluster and the cluster similar to the sample mean. In fully adjusted models, this cluster was associated with hypertension (p = .050) and depressed affect (p = .033), while Cluster 1 characteristic of an exaggerated blood pressure reactivity profile was associated with depressed affect (p < .001). Cluster membership did not significantly predict future health status.

CONCLUSION

This study extends research on behavioural clusters characteristic of reactivity profiles to demonstrate how they relate to health and behavioural outcomes during MIDUS 2.

Adverse Childhood Experiences, Family Support, and Depression: Evidence from Internal Migrants in China

Previous studies have linked poor family support and adverse childhood experiences (ACEs) to increased risk of depression; however, little is known about the interplay between the two when it comes to their effects on depression. Therefore, the current study examined if family support moderated the cumulative effect of ACEs on depression. Based on data from a migrant survey in Shiyan, Hubei Province, in 2019 (N = 1,326), this study used the ordinary least squares method to analyze the effect of ACEs on depression and evaluate whether family support moderated this effect. Higher exposure to ACEs and lower scores of family support were associated with higher depression levels in adulthood. The moderation model indicated that family support significantly moderated the relationship between ACEs and depression. Appropriate interventions to reduce depression should target internal migrants with history of ACEs. Community nurses should consider ACEs as an integral part of psychosocial assessment. Negative effects of ACEs can be reduced through teaching skills that increase effective family interaction and maintain supportive family networks. [Journal of Psychosocial Nursing and Mental Health Services, 61(3), 19-25.].

The impact of current failures on predicted well-being for future success: Different mechanisms of action in high and low self-threat situations

This study explored the effect of current performance on the predicted well-being for future success and its mechanism. This empirical research consists of two experiments. In Study 1, the individual's predicted well-being of future performance in the tests was lower in good feedback condition compared with bad feedback condition. It means that individuals have a higher expectation of future success after an unimportant loss. Study 2 focused on the moderating role of self-threat situations and the mediating role of affect and self-esteem in the effect of current performance feedback on predicted well-being. The results showed that individuals who got bad feedback have a low predicted well-being of future success only in a high self-threatening condition. Self-threat plays a moderating role between current performance and predicted well-being. The serial mediation role of affect and self-esteem in the negative effect of current performance on predicted well-being holds in high self-threat situations. By specifying the behavioral consequences and analyzing the psychological process in high and low self-threat situations, this research expands the literature on development of appropriate cognitive theories and propose novel measures and practical implications of enhancing predicted well-being.

Social Support and Loneliness among Chinese Rural-to-Urban Migrant Children: A Moderated Mediation Analysis of the Roles of Social Competence and Stress Mindset

Social support has been an important social-contextual protective factor against loneliness. However, how individual-level protective factors, such as social competence and a positive stress mindset, may jointly influence the relationship between social support and loneliness is less known. This study examined to what extent the link between social support and loneliness would be mediated by social competence and moderated by stress mindset among migrant children. In total, 198 rural-to-urban migrant children aged 10-14 years (56.1% girls) in Beijing, China, completed a set of self-reported questionnaires. A moderated mediation analysis was performed. We found that perceived social support was associated with a lower level of loneliness, and this association was significant only for migrant children holding a positive stress mindset (indicated by a high ratio of the stress-is-a-challenge mindset to the stress-is-a-threat mindset). Notably, across children with different stress mindsets, perceived social support was indirectly related to a lower level of loneliness through greater social competence. Our findings suggest that social competence and a stress-is-a-challenge mindset are important individual-level protective factors for migrant children to overcome loneliness. Social competence can carry the effect of social support, and a stress-is-a-challenge mindset can optimize the effect of environmental resources on mental health.

Examining the mediator and moderator of the link between Migration-Related stress and depression amongst Chinese migrant children

Migration-related stress is detrimental to children's mental health, yet little is known about the potential mechanisms behind this association. This study examines the mediating role of inflow city identity in the association between migration-related stress and depression and the moderating role of social participation amongst Chinese migrant children. A sample of 484 migrant children aged 8-17 years is randomly recruited through a cross-sectional survey in Kunming, China. Inflow city identity partially mediates the association between migration-related stress and migrant children's depression. Moreover, social participation moderates the above relationship. The direct and indirect effects are significant for migrant children with low social participation but insignificant for migrant children with high social participation. This study deepens the theoretical understanding of the underlying mechanism between migration stress and psychological distress and provides practical implications for preventing mental disorders in Chinese migrant children.

Pathways Linking the Big Five to Psychological Distress: Exploring the Mediating Roles of Stress Mindset and Coping Flexibility

Personality affects the vulnerability to the emotional symptoms of depression and anxiety. This study investigated whether stress mindset (general belief about the nature of stress) and coping flexibility (the ability to terminate ineffective coping strategies and adopt alternative ones) mediate the relations of the Big Five personality traits to psychological distress. A total of 260 undergraduate students (60.4% female) in Singapore completed self-reported questionnaires. A series of path analyses was performed. Firstly, a dual-pathway model of stress coping was established, which consisted of (a) a stress-threat-distress pathway where a stress-is-a-threat mindset mediated the association between stressful experiences and psychological distress and (b) a challenge-flexibility-enhancement pathway where coping flexibility mediated the relation of a stress-is-a-challenge mindset to a lower level of psychological distress, without being influenced by stressful experiences. Furthermore, Neuroticism was associated with the stress-threat-distress pathway, with stressful experiences and a stress-is-a-treat mindset mediating the relation of Neuroticism to psychological distress. Conscientiousness was associated with the challenge-flexibility-enhancement pathway, with a stress-is-a-challenge mindset and coping flexibility mediating the relation of Conscientiousness to less psychological distress. Extraversion, Agreeableness, and Openness were directly associated with greater coping flexibility. The findings enrich the literature on personality and stress coping and inform future interventions to promote mental health.

Health Status and Association With Interpersonal Relationships Among Chinese Children From Urban Migrant to Rural Left-Behind

Background

To date, numerous studies have examined the health status of Chinese left-behind children and migrant children. However, the impact of children's diverse migration/left-behind experiences on their health is still unclear.

Methods

A cross-sectional survey was conducted in 2020 in Nanling country (Anhui province) and Kaihua country (Zhejiang province) in China. School children from grade 5 to 8 reported their socio-demographic, interpersonal relationships, self-rated health, suicidal ideation, and depression. Participants were divided into four groups based on their migrant patterns, namely rural left-behind children with previous migration experience (ME-LBC), rural children with previous migration experience (ME-NLBC), rural left-behind children without migration experience (LBC), and rural children without migration experience (NLBC).

Results

Among 2,323 participants included in the present study, there were 336 ME-LBC (14.5%), 283 ME-NLBC (12.2%), 561 LBC (24.1%) and 1,143 NLBC (49.2%). Compared with NLBC, ME-LBC reported significantly poorer self-rated health (OR = 0.72, 95% CI [0.53-0.97], p < 0.05), higher risk of depression (β = 0.90, 95% CI [0.02-1.77], p < 0.05) with adjustment of socio-demographic and interpersonal relationships. There was no significant difference in suicidal ideation among different groups of children. The better interpersonal relationship was associated with a better self-rated health, and lower prevalence of depression and suicidal intention.

Conclusions

Compared to ordinary rural children, ME-LBC tended to experience higher levels of depression and poorer self-rated health. These research findings imply developing intervention programs about psychological adjustment tailored to different migrant patterns of Chinese rural children. The keys might be to strengthen the relationships with peer and teacher in school and improve the quality of parent-child communication in family for LBC.

COVID-19: Factors associated with psychological distress, fear, and coping strategies among community members across 17 countries

Background

The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally.

Objectives

We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping.

Methods

We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed.

Results

A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]).

Conclusions

The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12992-021-00768-3.

Opportunity or Risk? Appraisal and Affect Mediate the Effect of Task Framing on Working Memory Performance in University Students

Working memory (WM) is crucial for reasoning, learning, decision-making and academic achievement. In diverse contexts, how a task is framed pertaining to its demands and consequences can influence participants' task performance by modifying their cognitive appraisals. However, less is known about the effect of task framing on WM performance and the mechanisms. This study examined whether opportunity- and risk-focused task framing would influence university students' WM performance by altering their cognitive appraisals and affective experiences. Ninety-seven university students were randomly assigned to one of the three framing conditions (Opportunity, Risk, vs. Null), and received instructions that differed in consequences (gain for top performers, loss for poor performers, vs. null), goals (approach, avoidance, vs. neutral), and feedback on personal competence (adequate, inadequate, vs. null). Challenge and threat appraisals, affect, and WM performance were measured before and after task framing. Results showed that opportunity-focused task framing improved students' WM performance, whilst risk-focused task framing increased threat appraisal and decreased positive affect, and that challenge appraisal was not altered in any condition. Female students were influenced by task framing to a greater extent than were male students. Mediation analysis revealed that the alteration of threat appraisal and the change in positive affect mediated the effect of task framing on WM performance. Findings highlight the important role of modifying cognitive appraisals and affective responses in optimizing cognitive performance.

Impacts of internal migration experience on health among middle-aged and older adults-Evidence from China

As a life course factor, internal migration plays a role in shaping health condition in middle age and later life. Using data from the 2014 and 2015 China Health and Retirement Longitudinal Study (CHARLS), the present study examined the impacts and mechanism of internal migration experience on the health of middle-aged and older adults in China. Internal migration experience had significant negative impacts on health, whether in relation to self-reported health or number of chronic diseases. The impact increased with the frequency of internal migration. Compared to individuals that had not migrated, those who first migrated between age 18-35 had a worse overall health status. Initial internal migration occurring below age 18 significantly increased the number of chronic diseases. Medical service was found to be an important mechanism in the impact of internal migration experience on health. Given the insufficient protections related to internal migration, enhanced formal social support, especially healthcare services, should be implemented to mitigate the health disparities associated with internal migration.