Family functioning and resilience in children in mainland China: life satisfaction as a mediator

The relationship between family functioning and depression among adolescents in China during the normalization stage of the COVID-19 epidemic: The mediating role of resilience

BACKGROUND

In May 2020, China shifted its COVID-19 pandemic prevention and control status from "emergency" to "regularization". However, thus far, limited research has investigated the mental health of adolescents in Wuhan during this phase. This study examined the mental health status of adolescents in Wuhan during the regular prevention and control against COVID-19 period and explored whether psychological resilience mediated the relationship between adolescent family functioning and depression.

METHODS

A cross - sectional survey was conducted from September to December 2022 in Wuhan. Using a census methodology, 2,410 students from a secondary vocational school were recruited for the study. Multivariate logistic regression was performed to investigate the independent effect of family functioning and psychological resilience on adolescent depression. Structural equation modeling was used to analyze the mediating role of psychological resilience in the relationship between family functioning and depression.

RESULTS

The detection rate of depression among adolescent students was 35.77%. Both family functioning and psychological resilience were significantly and negatively associated with the prevalence of depression, with OR=0.800 (95%CI: 0.772-0.830) and OR=0.950 (95%CI: 0.938-0.962) respectively. Family functioning was not only directly related to depression (β = -0.575 [95% CI: -0.655, -0.505]), but also through the mediating effect of psychological resilience (β = -0.135 [95% CI: -0.173, -0.099]). Psychological resilience partially mediated the effect of family functioning on depression, with the mediating effect accounting for 19.72% of the total effect.

CONCLUSIONS

The COVID-19 pandemic has substantially exacerbated mental health issues among adolescents in Wuhan, China and further attention is required. The detrimental impact of poor family functioning on adolescents' depression may be reduced by fostering psychological resilience.

Exploring Family Functioning and Adolescent Academic Anxiety: Emotional Stability and Social Support as Mediators

Purpose

With the intensification of social competition, the phenomenon of academic credential inflation has become increasingly severe, highlighting the growing importance of education. Although existing research has focused on individual factors related to academic anxiety, the roles of family functioning, emotional stability, and social support in alleviating academic anxiety remain underexplored. In particular, these factors may exert different influences across diverse cultural contexts. Given the prevalence of academic anxiety in adolescents, this study examines the role of family functioning as mediated by emotional stability and social support. It aims to provide practitioners with effective intervention strategies.

Patients and Methods

This study conducted a questionnaire survey among 456 college students to assess their family functioning, social support, emotional stability, and academic anxiety. Data were analyzed using SPSS software.

Results

The findings revealed significant negative correlations between family functioning, emotional stability, social support, and academic anxiety. After controlling for demographic variables, emotional stability and social support were found to play a chain mediating role in the relationship between family functioning and academic anxiety.

Conclusion

This study highlights the important role of family functioning in reducing academic anxiety among adolescents, mediated by emotional stability and social support. The findings provide actionable insights for parents and educators to foster a supportive environment that reduces academic stress.

The relationship between family functioning and depressive symptoms: Mediating effects of psychological resilience and parent-child interactions

BACKGROUND

This study explores the relationship between family functioning and depressive symptoms, emphasizing the mediating effects of psychological resilience and parent-child interactions. According to Family Systems Theory, interactions and emotional connections within the family have a profound impact on an individual's mental health. Understanding how family dynamics contribute to depressive symptoms and resilience has become a key focus in mental health research.

METHODS

A total of 7092 participants, including middle school students and their parents, were selected for the study using cluster sampling. Data were analyzed using the Actor-Partner Interdependence Model extended to mediation (APIMeM). The model tested the effects of family functioning on depressive symptoms and psychological resilience, accounting for both actor and partner effects.

RESULTS

Family functioning was negatively associated with depressive symptoms in both parents and children, partially mediated by psychological resilience. The strongest mediation occurred in the student pathway (indirect effect = -0.311, 95 % CI [-0.367, -0.258], 38.6 % of total effect). Mothers' family functioning had a stronger indirect effect on depressive symptoms compared to fathers. Higher parental resilience related to fewer depressive symptoms and positively influenced children's mental health.

CONCLUSION

Family functioning significantly relates to depressive symptoms, with notable differences between parental roles. Mothers' family functioning perceptions showed stronger associations with their own and their children's mental health than fathers'. Interventions enhancing family communication and emotional support may be particularly effective when targeting mothers.

Diurnal cortisol profiles and subjective well-being: Longitudinal associations among children and adolescents

There has been evidence suggesting that cortisol is related to subjective well-being. (i.e., positive affect, negative affect, life satisfaction). However, longitudinal associations between diurnal cortisol and subjective well-being remain inadequately explored, and less is known about how combinations of multiple diurnal cortisol indicators may impact subjective well-being. To address these gaps, the current study revealed heterogeneity in diurnal cortisol patterns and examined whether these diurnal cortisol patterns were prospectively associated with subjective well-being six months and one year later among 304 Chinese children and adolescents aged 9-13 (Mage = 10.80, SD = 0.84; 67.1 % boys). Latent profile analysis, a person-centered approach, was conducted using multiple diurnal cortisol indicators (i.e., waking cortisol level, cortisol awakening response, diurnal cortisol slope, area under the curve, and bedtime cortisol level), and identified four distinct diurnal cortisol patterns: steep/medium (57.6 %), moderate/high (25.7 %), flat/high (10.5 %), and steep/low (6.2 %). The flat/high pattern, characterized by sustained elevated cortisol levels throughout the day, was associated with impaired subjective well-being six months and one year later. The moderate/high pattern, which had the same waking cortisol level as the flat/high pattern but demonstrated lower cortisol awakening response and steeper diurnal cortisol slope, was associated with more negative affect six months later. These findings facilitate understanding the heterogeneity in diurnal cortisol rhythm and their implications to subjective well-being over time, which may support targeted psychosocial interventions for promoting subjective well-being among children and adolescents.

Effect of Symptom Burden on Demoralization in Chinese Lung Cancer Patients: The Mediating Roles of Family Function, Resilience, and Coping Behaviors

OBJECTIVE

This study aimed to elucidate the mechanisms by which symptom burden affects demoralization in Chinese lung cancer patients, with a focus on the roles of family functionality, resilience, and coping strategies. The study also explored differences in these pathways between two distinct demoralization categories.

METHODS

A cross-sectional survey was conducted among 567 lung cancer patients who completed questionnaires assessing symptom burden, family functioning, resilience, coping strategies, and demoralization. Data were analyzed using partial least squares structural equation modeling (PLS-SEM), with multigroup structural equation modeling (MG-SEM) employed to compare pathways between the psychological distress-subjective incompetence group (PDSIG) and the low demoralization-emotional disturbance group (LDEDG).

RESULTS

PLS-SEM analysis demonstrated a good model fit. Symptom burden (β = 0.26), confrontation coping (β = 0.11), and acceptance-resignation coping (β = 0.41) had positive direct effects on demoralization, whereas resilience (β = -0.19) and family function (β = -0.27) had negative direct effects. Additionally, family function, resilience, and acceptance-resignation coping mediated the relationship between symptom burden and demoralization. MG-SEM revealed that, in the PDSIG, symptom burden (β = 0.47) and family function (β = -0.46) had similarly strong impacts on demoralization, with stronger family function associated with lower demoralization. In contrast, resilience (β = -1.02) was the most significant factor in the LDEDG.

CONCLUSIONS

These findings highlight the importance of screening for demoralization, particularly among lung cancer patients with a high symptom burden, maladaptive resignation coping, family dysfunction, and low resilience. Effective strategies should focus on symptom management, family support, resilience building, and fostering positive coping mechanisms. Tailored interventions based on demoralization subtypes are essential to improve psychological well-being in this population.

Reliability and validity validation of the Chinese version of the family vitiligo impact scale

BACKGROUND

The Family Vitiligo Impact Scale (FVIS) is the first reliable and valid instrument to evaluate the psychological and social impact on family members with vitiligo. However, the FVIS has not yet been validated in China.

OBJECTIVE

This study aimed to adapt the FVIS across cultures and utilize a cross-sectional design to validate its reliability and validity in evaluating the quality of life of family members with vitiligo in China.

METHODS

The original version scale was first translated into Chinese using Brislin back- translation method. This study was conducted among adult individuals in China (N = 348). The participants were aged 18 to 70 years, with a mean age of 33.6 years (SD = 11.3). The sample consisted of 50.9% females (n = 177) and 49.1% males (n = 171). Respondents completed the Chinese versions of the FVIS and Family Dermatology Life Quality Index (FDLQI). Exploratory factor analysis (EFA) and confrmatory factor analysis (CFA) were used to test the construct validity of the scale, and the content validity of the scale was assessed through the content validity index. The internal consistency of the scale was assessed by calculating Cronbach's alpha coefcient, Omega coefcient, split-half reliability, and test-retest reliability.

RESULTS

EFA supported a three-factor structure, explaining 79.208% of cumulative variance. CFA demonstrated satisfactory construct validity for the FVIS, with excellent model fit: chi-square degree of freedom (χ2/df) = 2.019, root mean square error of approximation (RMSEA) = 0.072, standardized root mean square residual (SRMR) = 0.0145, Comparative Fit Index (CFI) = 0.983, and Tucker Lewis Index (TLI) = 0.978. The content validity index of the scale was 0.979. The Cronbach's alpha coefcient was 0.975, Omega coefcient was 0.964, the split-half reliability coefcient was 0.977, and the test-retest reliability was 0.959.

CONCLUSION

The Chinese FVIS showed satisfactory reliability and validity for assessing vitiligo's psychosocial impact on family membersin Chinese clinical and research settings.

Association between positive youth development and family functioning in the Chinese context: a four-wave longitudinal survey in mainland China

Introduction

There is a notable scarcity of research examining the developmental trajectories of positive youth development (PYD) attributes among Chinese preadolescents and adolescents and the predictive effect of family functioning on these trajectories over time.

Methods

Using four waves of data, this longitudinal study investigated preadolescents and adolescents in China in January 2020 (T1), June 2020 (T2), June 2021 (T3), and June 2022 (T4). The study utilized the 90-item "Chinese Positive Youth Development Scale" and the 33-item "Chinese Family Assessment Instrument" to assess PYD and family functioning, respectively. The final matched sample comprised 2,652 Chinese students from grades 4 to 8, with an average age of 10.9 years (SD = 1.32; range 9-15) at the first wave of the survey, and with 51.1% male (n = 1,354).

Results

The Latent Growth Curve Modeling (LGCM) revealed that the PYD developmental trajectories of preadolescents and adolescents followed a quadratic U-shaped curve, characterized by an initial decline from T1 to T3, followed by a rebound from T3 to T4. Although the time-invariant covariate LGCM indicated no significant gender difference in the initial level of PYD, girls exhibited a slower decline rate and a faster growth rate in PYD over time than did boys. The parallel LGCM demonstrated that initial levels of family functioning significantly and positively predicted both the initial level and the rate of change in PYD over time.

Discussion

This study highlights the critical importance of considering the direct and sustained impact of family functioning within Chinese contexts on positive developmental outcomes among Chinese preadolescents and adolescents. This study also suggests that when designing and formulating specific programs or interventions, it is essential to consider gender differences in the development of competencies to ensure the optimal development of young individuals of different genders.

Recovery trajectories of mental health symptoms among Chinese adolescents following the end of COVID-19

Background

The COVID-19 pandemic has had a profound impact on global mental health, particularly among adolescents. However, little is known about how mental health symptoms recover after the pandemic subsides. This study aims to examine the recovery trajectories of ten mental health problems and suicidal ideation among Chinese adolescents post-pandemic, with a focus on identifying factors that influence different recovery patterns.

Methods

A total of 2,534 adolescents participated in a three-wave survey, conducted in June 2022, November 2022, and March 2023, using the Mental Health Scale for Chinese Middle School Students. A novel index was developed to account for both the number and severity of mental health risk factors, allowing for the classification of psychological symptoms into three subgroups: no, moderate, and severe. Polynomial regression models were applied to determine the acceleration inflection point, and multivariate logistic regressions identified predictors of trajectory membership.

Results

Significant declines in psychological symptoms were observed. Seven trajectory patterns were identified: resistance (37.85%), recovery (22.61%), chronic-dysfunction (12.08%), aftermath-deterioration (10.81%), stress-responsiveness (8.21%), vulnerability (5.76%), and remitting (2.68%). Being female, senior high school students, and the oldest child in the family hindered mental health recovery, whereas parenting styles of companionship, empathetic support, promise fulfillment, and behavior intervention served as protective factors.

Conclusion

This study is one of the first to reveal the post-pandemic mental health recovery trajectories of Chinese adolescents, highlighting the importance of considering both the number and severity of cumulative mental health problems. The findings offer valuable insights into suicide prevention and the development of targeted interventions to support youth mental health recovery.

Addressing psychological resilience and its determinants among university students during the COVID-19 pandemic: a three-wave longitudinal study in Shandong Province, China

BACKGROUND

The relationship between public health emergencies and psychological distress had been well known, yet none research had been conducted on the trend in psychological resilience and its longitudinal determinants during the pandemic. This study aimed to explore the changes of psychological resilience of university students during COVID-19 pandemic, and further clarify the longitudinal relationship between family factors, mental health, social mentality and psychological resilience.

METHODS

Questionnaires were distributed to students from five universities in Shandong Province, China during the COVID-19. A total of 1635 students were finally included in this three-wave follow-up study using stratified random sampling method. Mental health was assessed by Depression Anxiety Stress Scale, social mentality was measured by the Bi-Dimensional Structure Questionnaire of Social Mentality, psychological resilience was evaluated by the Chinese version of the Psychological Resilience Scale. Repeated-measures analysis of variance was used to analyze the longitudinal changes of psychological resilience, generalized estimating equation (GEE) was conducted to estimate the determinants of psychological resilience.

RESULTS

Psychological resilience changed from 28.37 in Wave 1, 29.10 in Wave 2, and 29.15 in Wave 3 among the university students. The students who majored in Art (β = 0.872, P = 0.032), parents (mother β = 0.546, P = 0.035; father β = 0.718, P = 0.012) had a greater influence on children's personality, and positive social mentality (β = 5.725, P < 0.001) were more likely to report a higher psychological resilience. Being female (β=-0.932, P < 0.001), not being a student leader (β=-0.911, P < 0.001), being anxious (β=-1.845, P < 0.001) and depressed (β=-1.846, P < 0.001), and negative social mentality (β=-0.803, P < 0.001) were less likely to report a higher psychological resilience.

CONCLUSIONS

The psychological resilience of the university students in Shandong Province, China increased significantly from Wave 1 to Wave 3 during the COVID-19 pandemic. Majoring in Art, parents having a greater influence on children's personality, better mental health, positive social mentality were more likely to report a higher psychological resilience, while female, not student leader, worse mental health, and negative social mentality were less likely to report a higher the psychological resilience.

Family Functioning and Adolescent Mental Health: The Mediating Role of Bullying Victimization and Resilience

This study aimed to understand the current state of adolescent mental health, explore the mediating effect of bullying victimization and resilience in the relationship between adolescent family functioning and mental health, and investigate gender differences in this association. A total of 4319 students (2347 boys and 1972 girls) completed the questionnaire. Mediating effects were analyzed using the framework of structural equation modeling and bootstrapping. The results revealed that family functioning is significantly associated with adolescent mental health, and that bullying victimization and resilience have significant independent and chain mediating effects on this relationship. Multiple group analysis revealed that the independent mediating role of resilience was more significant for male adolescents. Furthermore, the chain-mediated effects of bullying victimization and resilience were observed only in the relationship between family functioning and mental health in male adolescents. To improve the mental health of adolescents, special attention should be given to the impact of family life on adolescents' school life. Early detection and intervention for adolescents with poor family functioning are also important to effectively prevent bullying victimization and reduce the emergence of mental health problems.

Psychometric properties of the Chinese Family Assessment Instrument: evidence from mainland China

Regarding the assessment of family functioning in Chinese people, there are several research gaps. First, although there are some instruments in the field, there are very few validated instruments. Second, while some translated measures have been developed, there are very few assessment tools based on indigenous Chinese concepts. Third, compared to Hong Kong, research on family assessment is relatively inactive in mainland China. Fourth, there are very few family assessment tools to assess perceived family functioning in older children and early adolescents. Fifth, few studies used large samples to validate family assessment tools. Sixth, researchers seldom utilized longitudinal data to examine the psychometric properties of family assessment tools. Finally, few studies have examined factorial validity across samples and time to demonstrate the stability of Chinese family assessment measures. In Hong Kong, based on focus group data (i.e., indigenous concepts of family functioning) and an integration with the family science literature, we have developed the Chinese Family Assessment Instrument (C-FAI) to assess perceived family functioning according to the perception of adolescents. Results showed that the C-FAI possessed good reliability and validity. Specifically, five dimensions of the measure (mutuality, communication, conflict, parental concern and parental control) were supported via exploratory factor analysis and confirmatory factor analysis. Convergent validity and reliability of the C-FAI were illustrated. To understand the psychometric properties of the C-FAI in mainland China, we collected three waves of data from students in the period of preadolescence and early adolescence in mainland China (N = 3,732). Based on the data, we examined the psychometric properties of the measure, particularly factor invariance in different samples and at different times. Confirmatory factor analysis provided support for the five dimensions in C-FAI, including factorial invariance in terms of configuration, factor loading, intercepts, and over time. There was evidence for convergent validity and discriminant validity of the measure. Finally, reliability analyses showed that the total C-FAI scale and its subscales are internally consistent. The present findings suggest that family researchers and practitioners can use the C-FAI to objectively assess perceived family functioning in preadolescence and early adolescence in different Chinese communities.

Family Communication as a Mediator between Family Resilience and Family Functioning under the Quarantine and COVID-19 Pandemic in Arabic Countries

The coronavirus pandemic has become an unprecedented world crisis in which we have struggled against the most potent threat of the twenty-first century. This pandemic has had a profound impact on individuals and families. Therefore, the study aimed to examine family communication as a mediator of the relationship between family resilience and family functioning under the quarantine and coronavirus pandemic in Algeria and Iraq. This study was conducted among individuals in Iraq and Algeria (N = 361). The respondents completed the Family Communication Scale (FCS), Walsh Family Resilience Questionnaire (WFRQ), and Family Functioning Scale (FFS). Structural equation modeling (SEM) with the bootstrapping method was used to conduct the mediated effects of family communication. Using the bootstrapping method in SEM, family resilience and communication significantly affected family functioning (coefficient = 0.808). Moreover, the direct effect and indirect effect (via family functioning) of family resilience on family functioning were both significant, with coefficients of 0.682 and 0.126. In addition, numerous groups from Iraq and Algeria have been analyzed as a sample and have shown no differences in the relationships between family resilience, family communication, and family functioning. In conclusion, the results showed that family communication mediated the relationship between family resilience and family functioning. Moreover, the type of this mediation seemed to be partial because of the significant direct relationship between family resilience and family functioning. According to the findings, healthcare providers should consider improving family resilience and communication to achieve good family functioning.