Increasing Trends in Mental Health Problems Among Urban Chinese Adolescents: Results From Repeated Cross-Sectional Data in Changsha 2016-2020

Network Analysis of Basic Psychological Need Frustration and Depressive Symptoms Among Adolescents: A Longitudinal Study

Studies have shown a reciprocal relationship between basic psychological need frustration and depressive symptoms in adolescents. However, the underlying pattern of this relationship remains unclear. This longitudinal study employed network analysis to examine the central nodes, bridge nodes, and dynamic changes in the network structure of psychological need frustration and depressive symptoms among 1,381 Chinese adolescents (51.85% girls; Mage = 15.17, SD = 0.49, range: 13-16). The results revealed that competence frustration, mood, fatigue, and worthlessness were central nodes, exhibiting strong connections with other nodes in the network. Furthermore, competence frustration and worthlessness functioned as bridge nodes, linking psychological need frustration with depressive symptoms. Notably, the network structure remained stable over time, with no significant changes observed. These findings highlight the critical role of competence frustration and worthlessness in the co-occurrence of psychological need frustration and depressive symptoms. Targeting these nodes in interventions may help reduce adolescent distress and improve mental health outcomes.

Exploring the impact of interpersonal sensitivity on anxiety symptoms: the mediating role of psychological capital and social support among nursing students

BACKGROUND

As the demand for healthcare in society continues to rise, nursing students are likely to face various challenges related to their profession in the future. Anxiety symptoms have increasingly become a significant factor affecting their mental health. Given that nursing students are crucial to building the future nursing workforce, it is essential to prioritize their mental well-being. This study aims to explore the relationships between anxiety symptoms, interpersonal sensitivity, psychological capital, and perceived social support among nursing undergraduates.

METHODS

In April 2022, 1,885 nursing undergraduates at a university in eastern China participated in a survey using the Generalized Anxiety Disorder Questionnaire (GAD-7), the interpersonal sensitivity subscale of the SCL-90, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Psychological Capital Questionnaire (PCQ-24). Statistical analysis was conducted using SPSS 24.0 and PROCESS v3.4 macro to assess the impact of interpersonal sensitivity on anxiety and the mediating roles of social support and psychological capital.

RESULTS

Anxiety showed a positive correlation with interpersonal sensitivity (r = 0.43) and negative correlations with perceived social support (r = -0.32) and psychological capital (r = -0.40), all significant (p < 0.001). Interpersonal sensitivity directly affects anxiety (β = 0.306, SE = 0.023, 95% CI [0.260, 0.352]). Psychological capital served as an independent mediator (β = 0.051, SE = 0.011, 95% CI [0.031, 0.075]) and also in a chain mediation with social support (β = 0.050, SE = 0.104, 95% CI [0.031, 0.072]).

CONCLUSION

Interpersonal sensitivity is a positive predictor of anxiety symptoms. Both psychological capital and social support effectively reduce interpersonal sensitivity and anxiety symptoms. Enhancing the availability of psychological capital and social support for nursing students is essential.

Urban-Rural Differences in the Association Between Internet Use Trajectories and Depressive Symptoms in Chinese Adolescents: Longitudinal Observational Study

BACKGROUND

Internet use exhibits diverse trajectories during adolescence, which may contribute to depressive symptoms. Currently, it remains unclear whether the association between internet use trajectories and depressive symptoms varies between urban and rural areas.

OBJECTIVE

This study aimed to investigate the association between internet use trajectories and adolescent depressive symptoms and to explore variation in this association between urban and rural areas.

METHODS

This longitudinal study used 3-wave data from the 2014-2018 China Family Panel Study. Weekly hours of internet use and depressive symptoms were measured using self-reported questionnaires. Latent class growth modeling was performed to identify the trajectories of internet use. Multivariable logistic regressions were used to examine the association between internet use trajectories and depressive symptoms, stratified by rural and urban residence.

RESULTS

Participants were 2237 adolescents aged 10 to 15 years at baseline (mean age 12.46, SD 1.73 years). Two latent trajectory classes of internet use were identified: the low-growth group (n=2008, 89.8%) and the high-growth group (n=229, 10.2%). The high-growth group was associated with higher odds of depressive symptoms (OR 1.486, 95% CI 1.065-2.076) compared to the low-growth group. In the stratified analysis, the association between internet use trajectories and depressive symptoms was significant solely among rural adolescents (OR 1.856, 95% CI 1.164-2.959).

CONCLUSIONS

This study elucidates urban-rural differences in the associations between trajectories of internet use and adolescent depressive symptoms. Our findings underscore the importance of prioritizing interventions for rural adolescents' internet use behaviors to mitigate negative effects on their mental health.

The relationship between physical activity and sleep disorders in adolescents: a chain-mediated model of anxiety and mobile phone dependence

BACKGROUND

Adolescent sleep disorders have emerged as a significant global public health issue. This study aims to investigate the relationship between physical activity and sleep disorders in adolescents, and to further analyze the chain mediating effects of anxiety and mobile phone dependence, with the goal of providing empirical evidence for related clinical research.

METHODS

This cross-sectional study collected data through an offline questionnaire survey conducted in 2024. The survey assessed physical activity, sleep disorders, anxiety, and mobile phone dependence. Descriptive statistics and correlation analyses were utilized to construct a chain mediation model.

RESULTS

A total of 495 valid samples were obtained, with 227 girls (45.9%) and 268 boys (54.1%). The average age of the participants was 13.37 years (SD = 1.05). The results indicated significant negative correlations between physical activity and adolescent anxiety, mobile phone dependence, and sleep disorders. Anxiety and mobile phone dependence fully mediated the relationship between physical activity and sleep disorders.

CONCLUSION

This study provides further insight into the underlying mechanisms linking physical activity and sleep disorders in adolescents. Physical activity not only has a direct negative effect on sleep disorders but also indirectly predicts sleep disorders through its impact on anxiety and mobile phone dependence. It is recommended that families and schools encourage increased physical activity among adolescents, as it can reduce anxiety and mobile phone dependence, thereby alleviating sleep disorders.

A cognitive script perspective on how early caregiving experiences inform adolescent peer relationships and loneliness: A 14-year longitudinal study of Chinese families

Leveraging data from a longitudinal study of Chinese families (n = 364), this research aims to understand the role of secure base script knowledge as a cognitive mechanism by which early caregiving experiences inform adolescents' friendship quality and feelings of loneliness. Results showed that observed maternal sensitivity at 14 and 24 months old was negatively associated with adolescents' self-reported conflicts with close friends (β = -0.17, p = 0.044) at 15 years old, and this association was partially mediated by their secure base script knowledge assessed at 10 years old. Further, secure base script knowledge moderated the link between adolescents' friend conflict and feelings of loneliness (β = -0.15, p = 0.037). The results support a cognitive script perspective on the association between early caregiving experiences and later socio-emotional adjustment. Furthermore, this study adds to the developmental literature that has previously focused on more stringent and authoritarian aspects of parenting in Chinese families, thereby contributing to our understanding of how sensitive and supportive parenting practices contribute to socio-emotional development outside of Western contexts. RESEARCH HIGHLIGHTS: Maternal sensitivity during infancy and toddlerhood has a long-term association with adolescents' friendship quality and adolescents' secure base script partially explains the association. First evidence to demonstrate that the secure base script in attachment relationships mediates the association between early maternal caregiving and socio-emotional development in Chinese adolescents. Adolescents lacking secure base script knowledge are particularly vulnerable to feelings of loneliness when facing high levels of conflict in close friendships.

The relationship between physical activity and mental health of middle school students: the chain mediating role of negative emotions and self-efficacy

Objective

To explore the relationship between mental health and physical activity (PA) in middle school students, and examining the roles of negative emotions and self-efficacy in the relationship.

Methods

Data from 1,134 Chinese middle school students (50.2% females, 49.8% males; M age = 15.18, SDage = 2.00) were collected using the Physical Activity Rating Scale (PARS-3), Positive and Negative Affect Scale (PANAS), General Self-Efficacy Scale (GSES), and Middle School Student Mental Health Scale (MSSMHS).

Results

(1) There is a significant positive correlation between PA and mental health (r = 0.16, p < 0.01), and the direct path of PA on mental health is significant (t = 2.101, p < 0.01). (2) PA negatively predicts negative emotions (r = -0.12, p < 0.01), and is significantly positively correlated with self-efficacy (r = 0.24, p < 0.01). Negative emotions negatively predict self-efficacy (r = -0.23, p < 0.01) and mental health (r = -0.67, p < 0.01). Self-efficacy positively predicts mental health (r = 0.30, p < 0.01). (3) Negative emotions and self-efficacy play a significant mediating role between PA and mental health. The mediating effect includes three paths: PA → negative emotion → mental health (effect value: 0.130); PA → self-efficacy → mental health (effect size: 0.052); PA → negative emotions → self-efficacy → mental health (effect size: 0.006).

Conclusion

PA among middle school students can indirectly affect mental health through negative emotions and self-efficacy. Middle school students should be encouraged to participate in PA to reduce their negative emotions and increase their self-efficacy, thus improving their mental health.

Sex differences in human brain networks in normal and psychiatric populations from the perspective of small-world properties

Females and males are known to be different in the prevalences of multiple psychiatric disorders, while the underlying neural mechanisms are unclear. Based on non-invasive neuroimaging techniques and graph theory, many researchers have tried to use a small-world network model to elucidate sex differences in the brain. This manuscript aims to compile the related research findings from the past few years and summarize the sex differences in human brain networks in both normal and psychiatric populations from the perspective of small-world properties. We reviewed published reports examining altered small-world properties in both the functional and structural brain networks between males and females. Based on four patterns of altered small-world properties proposed: randomization, regularization, stronger small-worldization, and weaker small-worldization, we found that current results point to a significant trend toward more regularization in normal females and more randomization in normal males in functional brain networks. On the other hand, there seems to be no consensus to date on the sex differences in small-world properties of the structural brain networks in normal populations. Nevertheless, we noticed that the sample sizes in many published studies are small, and future studies with larger samples are warranted to obtain more reliable results. Moreover, the number of related studies conducted in psychiatric populations is still limited and more investigations might be needed. We anticipate that these conclusions will contribute to a deeper understanding of the sex differences in the brain, which may be also valuable for developing new methods in the treatment of psychiatric disorders.

Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors

BACKGROUND

Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors.

METHODS

The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS.

RESULTS

There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01).

CONCLUSIONS

The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.

Gender differences in Russian adolescent mental health from 1999 to 2021

This study examined secular trends in Russian adolescent mental health, the specific effects of the COVID-19 pandemic, and associations with country-level indicators. A cross-sectional survey of 12,882 adolescents aged 11-18 years was carried out between 1999 and 2021 using the Strengths and Difficulties Questionnaire. The results showed an incline in girls' internalizing problems with a two-fold increase in the gender gap. There was a decline in girls' prosocial behavior and an incline in peer problems, with decreasing gender differences. Conduct problems showed a reversal of gender differences. Changes during the pandemic were not greater than over-time changes, with the exception of inclines in hyperactivity-inattention in both genders. Time trends in adolescent mental health were associated with over-time changes in national indicators of wealth and gender equality. The findings provide a strong basis for further research into the determinants of gender differences in adolescent mental health and for gender-specific interventions.

Psychological Capital and Its Factors as Mediators Between Interpersonal Sensitivity and Depressive Symptoms Among Chinese Undergraduates

Purpose

Current interpersonal sensitivity among college students is easily linked to mood disorders such as anxiety, depression and other mood disorders. This study aims to examine the mediating role of psychological capital and its dimensions in the relationship between interpersonal sensitivity and depressive symptoms among undergraduates.

Methods

The cross-sectional survey was conducted by using cluster stratified random sampling method across six Chinese universities between November and December 2022. The questionnaire consists of the Interpersonal Sensitivity sub-scale, the Patient Health Questionnaire, the Psychological Capital Questionnaire and the Socio-Demographic Feature Questionnaire.

Results

A total of 2580 respondents participated in the survey, with the majority being females (69.73%) and an average age of 19.22±1.28 years. Descriptive and correlation analyses were performed using SPSS v24.0, while direct and indirect effects were analyzed using PROCESS v3.4 macro. The findings revealed that interpersonal sensitivity had a significant direct effect on depression symptoms among undergraduates (β =0.416, 95% Boot CI [0.380, 0.453], p < 0.001) Additionally, psychological capital and its components were found to be negatively correlated with depression (p < 0.001). Further analysis demonstrated that hope, optimism, and resilience significantly mediated the association between interpersonal sensitivity and depressive symptoms (indirect effect: hope = 0.056, optimism = 0.074, resilience = 0.099; p < 0.001 for all).

Conclusion

These results suggest that psychological capital, including its dimensions of hope, optimism, and resilience plays a crucial role in mitigating the negative effects of interpersonal sensitivity on depressive symptoms among undergraduates.

Profile and mental health characterization of childhood overprotection/overcontrol experiences among Chinese university students: a nationwide survey

INTRODUCTION

The childhood experiences of being overprotected and overcontrolled by family members have been suggested to be potentially traumatic. However, the possible associated factors of these experiences among young people are still not well studied. This study aimed to partly fill such gaps by a relatively large, nationwide survey of Chinese university students.

METHODS

A total of 5,823 university students across nine different provinces in China were included by the convenience sampling method in the data analyses. All participants completed the overprotection/overcontrol (OP/OC) subscale in a recently developed 33-item childhood trauma questionnaire (CTQ- 33). Data were also collected on all participants' socio-demographic profiles and characterization of mental health. Binary logistic regression was conducted to investigate the associated socio-demographic and psychological factors of OP/ OC.

RESULTS

The prevalence of childhood OP/OC was estimated as 15.63% (910/5,823) based on a cutoff OP/OC subscale score of  ≥ 13. Binary logistic regression suggested that being male, being a single child, having depression, having psychotic-like experiences, lower family functioning, and lower psychological resilience were independently associated with childhood OP/OC experiences (all corrected-p < 0.05). The OP/OC was also positively associated with all the other trauma subtypes (abuses and neglects) in the CTQ-33, while there are both shared and unique associated factors between the OP/OC and other trauma subtypes. Post-hoc analyses suggested that OP/OC experiences were associated with depression in only females and associated with anxiety in only males.

DISCUSSION

Our results may provide initial evidence that childhood OP/OC experiences would have negative effects on young people's mental health which merits further investigations, especially in clinical populations.

Hypertension in China: epidemiology and treatment initiatives

The past two to three decades have seen a steady increase in the prevalence of hypertension in China, largely owing to increased life expectancy and lifestyle changes (particularly among individuals aged 35-44 years). Data from the China hypertension survey conducted in 2012-2015 revealed a high prevalence of grade 3 hypertension (systolic blood pressure ≥180 mmHg and diastolic blood pressure ≥110 mmHg) in the general population, which increased with age to up to 5% among individuals aged ≥65 years. The risk profile of patients with hypertension in China has also been a subject of intense study in the past 30 years. Dietary sodium and potassium intake have remained largely the same in China in the past three decades, and salt substitution strategies seem to be effective in reducing blood pressure levels and the risk of cardiovascular events and death. However, the number of individuals with risk factors for hypertension and cardiovascular disease in general, such as physical inactivity and obesity, has increased dramatically in the same period. Moreover, even in patients diagnosed with hypertension, their disease is often poorly managed owing to a lack of patient education and poor treatment compliance. In this Review, we summarize the latest epidemiological data on hypertension in China, discuss the risk factors for hypertension that are specific to this population, and describe several ongoing nationwide hypertension control initiatives that target these risk factors, especially in the low-resource rural setting.

Network structure of mobile phone addiction and anxiety symptoms among rural Chinese adolescents

BACKGROUND

The incidence of mobile phone addiction among adolescents in rural areas of China is increasing year by year, and has already exceeded that of some cities. And phone addiction increases the risk of anxiety and poor sleep. Therefore, this study used network analysis to investigate the relationship between mobile phone addiction and anxiety symptoms, and the predictability to sleep quality.

METHODS

From September 2021 to March 2022, a total of 1920 rural adolescents in Xuzhou, China were included. The survey included information on phone addiction, anxiety symptoms, and sleep quality. Network analysis was used to estimate the network structure of adolescents' mobile phone addiction and anxiety symptoms. LOWESS curve and linear regression were used to test the predictive ability of node-centrality on sleep quality.

RESULTS

In the network of mobile phone addiction-anxiety symptoms, the most influential symptoms were Failure to cut down the time, Anxiety if not used for some time, and Alleviate loneliness. Irritability was the most prominent bridging symptom. Gender difference had no effect on network structure. Nodes in the network are not predictive of sleep quality.

CONCLUSION

Failure to cut down the time is the most important symptom, suggesting that measures should be taken to reduce the amount of time spent on mobile phones. For example, increase outdoor exercise, increase the real company of friends and family, in order to reduce the occurrence of mobile phone addiction and anxiety.