Depression in Children and Adolescents on the Qinghai-Tibet Plateau: Associations with Resilience and Prosocial Behavior

Relationship between time perspective and depressive symptoms in young people working in high-altitude environments

BACKGROUND

Depression rates are significantly higher in high-altitude regions, making it important to understand its underlying mechanisms. Time perspective, which refers to how individuals perceive their past, present, and future, is closely linked to depression in low-altitude areas. However, its relationship with depression in high-altitude regions remains unclear.

METHODS

A cross-sectional survey was conducted with 4942 young male workers from high-altitude regions. The association between time perspectives and depressive symptoms were examined by univariate and multivariate analyses. Network analysis was employed to identify central symptoms and their interactions, and to compare the differences between individuals with and without depression.

RESULTS

The study identified that elevated past negative (PN), reduced past positive (PP), increased present fatalistic (PF) and present hedonistic (PH) orientations, and lower future (F) were significant risk factors for depressive symptoms in plateau populations. In the network structure of the depression group, PN, PF, PH, SDS18 "emptiness", and SDS13 "psychomotor agitation" were key elements influencing depressive symptoms and the strongest edge was F-PP. Significant differences were detected between the depressive and non-depressive groups, with the depressive group demonstrating significantly greater global strength invariance and a more robust network invariance.

CONCLUSIONS

Abnormal time perspectives, especially PN, PF and PH were strongly associated with depression in high-altitude environments, and the strong connection between F-PP provides a potential intervention target. Future research should further explore the causal relationship.

Early adversity and prosocial behavior in adolescents from Bogotá: a cross-sectional study

BACKGROUND

The association between Adverse Childhood Experiences (ACEs), prosocial behavior, and depression (like other negative mental health outcomes) has not been thoroughly understood. This study aimed at evaluating their simultaneous association while controlling for key confounding variables.

METHODS

A cross-sectional study was carried-out with 2918 secondary school students from seven charter schools located in low-resourced neighborhoods in Bogota (Colombia), 54.12% were female, and mean age was 13.81 years. The self-report instrument included demographic variables, well-being, mental health, risk behaviors and symptoms of psychopathology. Assessment of ACEs was done by a series of yes/no questions, prosocial behavior was evaluated with the corresponding subscale in the Strengths and Difficulties Questionnaire, and depression was assessed with the Self-Reporting Questionnaire. Associations were tested using the Spearman correlation coefficient, Z tests and Chi-square tests, and all primary outcome analyses were adjusted for potential confounding variables through multivariate logistic regression using depression as outcome.

RESULTS

Mean exposure to ACEs was 3.15 events; those exposed to four or more obtained lower scores in well-being, satisfaction with life and family functioning, and higher scores in symptoms of psychopathology. For the prosocial behavior scores, 64.35% were classified as close to the average, 17.51% as slightly lowered, 11.91% as low, and 6.23% as very low; participants with higher levels of prosocial behavior showed lower scores in symptoms of psychopathology. While ACEs had a positive association with depressive symptoms (Odds Ratio [OR] 2.21, 95% confidence interval [CI] 1.67-2.94), prosocial behavior did not have a significant association with either ACEs or depressive symptoms in multivariate regression models.

CONCLUSIONS

Novel studies should further elucidate the developmental pathways involving positive and negative mental health constructs to better understand the actual effectiveness of interventions that use these constructs in their design.

Eating disorders symptoms and depressive symptoms in Chinese Tibetan University students: a network analysis

BACKGROUND

Depression is being increasingly acknowledged as a global public health concern, and following this trend, attention towards eating disorders (EDs) has surged within China's national consciousness. EDs symptoms frequently coexist with various mental health conditions, including depression. However, research focusing on EDs symptoms and depressive symptoms among Tibetan students in China remains scant. This study employs network analysis to estimate the relational network between EDs and depressive symptoms.

METHODS

Tibetan (n = 2,582) and Han (n = 1,743) students from two universities in the Xizang Autonomous Region, China, completed the Eating Attitude Test-26 (EAT-26) and the Patient Health Questionnaire-9 (PHQ-9). We estimated the network structure of EDs symptoms and depressive symptoms, identified central and bridge symptoms, and examined whether network characteristics differed by gender and ethnic.

RESULTS

The core symptoms identified within this study were Calorie_awareness, Desire_to_thin and Fatigue. Conversely, bridge symptoms included Appetite, Suicide, Anhedonia, Guilty, Body_fat_awareness, and Food_preoccupation. The study also revealed no significant gender differences within the network model. However, disparities among ethnic groups were observed within the network structure.

CONCLUSIONS

Our study examined the correlation between EDs symptoms and depressive symptoms in Tibetan college students. Focusing on the individual's quest for the perfect body shape and some Tibetan students' appetite problems - potentially stemming from transitioning to a new university environment, adapting to the school canteen's diet, or being away from their hometown - could aid in the prevention and management of EDs and depression symptoms. It could reduce the incidence of complications by helping students maintain good physical and mental health. Concurrently, our research provides insights into the relatively higher levels of depression triggered by the unique plateau environment.

Prosocial Behaviours and Resilience in School Coexistence: Implications of Creative Self-Efficacy and Stress in Adolescents

Adolescence brings with it a number of problems such as school violence. To reduce stress and increase the well-being of students, it is necessary to enhance certain skills such as prosocial behaviours, resilience, and creative self-efficacy. This cross-sectional study investigated the impact of prosocial behaviours and creative self-efficacy on school violence, stress, and resilience in adolescent students. A total of 743 students aged 14-19 years participated. The results revealed positive correlations between the dimensions of prosocial behaviours, creative self-efficacy, and resilience, and negative correlations with perceived stress. Differences were also observed in the relationship between prosocial behaviours, school violence, and stress. Mediation models indicated that creative self-efficacy acted as a mediator between prosocial behaviours and resilience. In addition, stress was found to moderate the relationship between prosocial behaviours and resilience. This study provides evidence on how prosocial behaviours, resilience, and creative self-efficacy act as a positive element in adolescence.

Reciprocal associations between early maladaptive schemas and depression in adolescence: long-term effects of childhood abuse and neglect

BACKGROUND

Adolescent depression has grown to be a major social concern in China. During the coronavirus pandemic, the incidence of depression among Chinese adolescents increased substantially. More research is required to inform the prevention and intervention of adolescent depression in China. Depression is associated with Early Maladaptive Schemas (EMSs). Childhood abuse and neglect are distal antecedents of adolescent depression. It is not known how depression and EMSs interact in adolescence and how childhood abuse and neglect contribute to this relationship. This study aimed to examine the reciprocal relationships between depression and EMSs, as well as the long-term effects of childhood abuse and neglect on depression and EMSs during adolescence. The work also investigates gender differences in these mechanisms.

METHODS

Using a two-wave longitudinal design, we recruited 3,485 Chinese adolescents (Mage = 13.2; 43.2% females) from three Shanxi Province, China middle schools. All participants completed self-report questionnaires addressing childhood abuse and neglect, depression, and EMSs. Structural equation models examined reciprocal relationships between depression and EMS, as well as the effect of childhood abuse and neglect on depression and EMSs. Multi-group analysis addressed gender differences.

RESULTS

Results indicated that greater depression predicted more EMSs measured later, but EMSs did not predict subsequent depression. Childhood abuse and neglect had different effects on depression and EMSs during adolescence. Specifically, exposure to childhood abuse related to more severe depression and EMSs in adolescence and contributed to the perpetuation of EMSs by increasing depression. Exposure to childhood neglect showed a direct effect on depression and indirectly reinforced subsequent EMSs through depression. There were no gender differences.

CONCLUSION

These findings contribute to a better understanding of the emergence and course of depression in early adolescence, suggesting that childhood abuse and neglect are critical early risk factors. Additionally, depression plays a key role in promoting schema perpetuation among adolescents exposed to childhood maltreatment, providing important implications for relevant prevention and intervention in early adolescence.

Prevalence of depression and depressive symptoms at high altitudes: A systematic review and meta-analysis

BACKGROUND

The aim of the present study was to determine the prevalence of depression or depressive symptoms in people residing in high-altitude regions.

METHODS

Eleven databases were searched for studies on depression and depressive symptoms: PubMed, ISI Web of Science, CINAHL, Embase, Scopus, PsycINFO, Psychology and Behavioral Sciences Collection, Psychology Database, Academic Search Ultimate, SciELO and LILACS. Systematic review and meta-analysis were performed based on the inclusion of these articles measuring the prevalence of depressive symptoms in people living at high altitude (≥1500 m above sea level [masl]). The protocol was registered in PROSPERO (CRD42021271069).

RESULTS

Eight articles with >40,000 participants from 4 different countries were included. Among the samples treated, the combined prevalence of depressive symptoms was 17.9 % (I²: 99 %) and the only estimate by subpopulation at the country level was possible for China, with >36,000 participants, being 28.7 % (I²: 4 %).

LIMITATIONS

Considerable heterogeneity was reported in the estimation of overall prevalence due to the quality of the studies and the instruments used to screen for depressive symptoms.

CONCLUSION

Almost two out of every 10 people living at high-altitude regions suffer from depressive symptoms. Therefore, it is necessary to adapt interventions to this condition and further research in the field is required.

Symptom Structure of Depression in Older Adults on the Qinghai-Tibet Plateau: A Network Analysis

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.

Relationship between stress response and depression in vocational medical school students in the COVID-19 epidemic: A moderated mediation model

To investigate the relationship between stress response and depression in vocational medical school students at the initial stage of COVID-19 epidemic, and to explore the mediating role of meaning in life and the moderating role of prosocial behavior. The COVID-19 Stress Response Questionnaire, the Meaning in Life Questionnaire, the Prosocial Behavior Scale and the Depression Scale, were used to investigate 3526 vocational medical school students. The results showed that: (1) The relationship between stress response and depression in vocational medical school students was partially mediated by presence of meaning and search for meaning. Stress response has indirect effect on depression of vocational medical school students through meaning in life. (2) Prosocial behavior moderated the relationship between meaning in life and depression. Specifically, meaning in life has a more significant effect on depression for college students with higher levels of prosocial behavior.

Parental warmth predicts more child pro-social behaviour in children with better emotion regulation

Parental warmth and child emotion regulation have each been implicated in the development of child pro-social behaviours; however, their interactive benefits remain unclear. In this multi-method, multi-cohort longitudinal study, we examined the effect of parental warmth on child pro-social behaviours at different levels of child emotion regulation. We collected data from 6- and 10-year-olds in Canada (N_T1  = 233; M_age  = 8.41; SD = 2.08) and their parents. Parental warmth, child emotion regulation, and child pro-social behaviours were assessed via parent report. Children's baseline respiratory sinus arrhythmia (RSA; an indicator of cardiac regulatory capacity) was assessed as a correlate of emotion regulation. Child pro-social behaviours were assessed concurrently and 1 year later. Results showed that higher parental warmth was related to higher concurrent prosocial behaviours and greater increases in prosocial behaviours over 1 year. These effects were strengthened for children with higher emotion regulation whether measured by parent report or RSA. We discuss implications for understanding pro-social development in middle childhood from a strengths-based perspective.