The Coronavirus Disease 2019 (COVID-19) pandemic has led to overwhelming levels of distress as it spread rapidly from Wuhan, Hubei province to other regions in China. To contain the transmission of ...COVID-19, China has executed strict lockdown and quarantine policies, particularly in provinces with the highest severity (i.e., Hubei). Although the challenges faced by individuals across provinces may share some similarities, it remains unknown as to whether and how the severity of COVID-19 is related to elevation in depression.
The present study compared depression among individuals who lived in mildly, moderately, and severely impacted provinces in China following the lockdown (
= 1,200) to norm data obtained from a representative sample within the same provinces in 2016 (
= 950), and examined demographic correlates of depression in 2020.
Residents in 2020, particularly those living in more heavily impacted provinces, reported increased levels of depression than the 2016 sample. Subsequent analyses of sub-dimensions of depression replicated the findings for depressed mood but not for positive affect, as the latter only declined among residents in the most severely impacted area. Increased depressed mood was associated with female, younger age, fewer years of education, and being furloughed from work, whereas reduced positive affect was associated with younger age and fewer years of education only.
This study underscored the impact of COVID-19 on depression and suggested individual characteristics that may warrant attention.
Abstract
Background
Global life satisfaction has been consistently linked to physical health. A deeper and culturally nuanced understanding of which domains of satisfaction may be responsible for ...this association has implications for developing novel, scalable, and targeted interventions to improve physical health at the population level.
Objectives
This cohort study draws participants from the China Family Panel Studies (CPFS), a nationally representative cohort of 10,044 Chinese adults to assess the
independent
associations between three important domains of life satisfaction (and their changes) and indicators of physical health.
Results
A total of 10,044 participants were included in the primary analysis (4,475 female 44.6%; mean SD age, 46.2 12.1 years). Higher baseline levels of satisfaction with job, marriage, and medical services were independently associated with better perceived physical health (0.04 < β values < 0.12). Above and beyond their baseline levels, increases in satisfaction with job, marriage, and medical services were independently associated with better perceived physical health (0.04 < β values < 0.13). On the contrary, only higher baseline levels of and increases in satisfaction with marriage showed prospective associations with lower odds of incidence of chronic health condition and hospitalization (0.84 < ORs < 0.91).
Conclusions
These findings provide policymakers and interventionists interested in leveraging psychological health assets with rich information to rank variables and develop novel interventions aimed at improving wellbeing at the population level.
Background: Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) are two highly comorbid psychological outcomes commonly studied in the context of stress and potential trauma. In ...Hubei, China, of which Wuhan is the capital, residents experienced unprecedented stringent lockdowns in the early months of 2020 when COVID-19 was first reported. The comorbidity between PTSD and MDD has been previously studied using network models, but often limited to cross-sectional data and analysis.
Objectives: This study aims to examine the cross-sectional and longitudinal network structures of MDD and PTSD symptoms using both undirected and directed methods.
Methods: Using three types of network analysis - cross-sectional undirected network, longitudinal undirected network, and directed acyclic graph (DAG) - we examined the interrelationships between MDD and PTSD symptoms in a sample of Hubei residents assessed in April, June, August, and October 2020. We identified the most central symptoms, the most influential bridge symptoms, and causal links among symptoms.
Results: In both cross-sessional and longitudinal networks, the most central depressive symptoms included sadness and depressed mood, whereas the most central PTSD symptoms changed from irritability and hypervigilance at the first wave to difficulty concentrating and avoidance of potential reminders at later waves. Bridge symptoms showed similarities and differences between cross-sessional and longitudinal networks with irritability/anger as the most influential bridge longitudinally. The DAG found feeling blue and intrusive thoughts the gateways to the emergence of other symptoms.
Conclusions: Combining cross-sectional and longitudinal analysis, this study elucidated central and bridge symptoms and potential causal pathways among PTSD and depression symptoms. Clinical implications and limitations are discussed.
This study examined the cross-sectional and longitudinal network structures of depression and post-traumatic disorder symptoms using undirected and directed methods.
The most central depressive symptoms included sadness and depressed mood, whereas the most central post-traumatic disorder symptoms changed from irritability and hypervigilance to difficulty concentrating and avoidance of reminders over time.
Bridge symptoms showed similarities and differences between cross-sessional and longitudinal networks with irritability/anger as the most influential bridge longitudinally.
The coronavirus disease 2019 (COVID-19) has disrupted multiple domains of life including sleep. The present study used a longitudinal dataset (N = 671) and a person-centered analytic approach – ...latent profile analysis (LPA) – to elucidate the relationship between sleep and depression. We used LPA to identify profiles of sleep patterns assessed by Pittsburg Sleep Quality Index (PSQI) at the beginning of the study. The profiles were then used as a predictor of depression magnitude and variability over time. Three latent profiles were identified (medicated insomnia sleepers MIS, inefficient sleepers IS, and healthy sleepers HS). MIS exhibited the highest level of depression magnitude over time, followed by IS, followed by HS. A slightly different pattern emerged for the variability of depression: While MIS demonstrated significantly greater depression variability than both IS and HS, IS and HS did not differ in their variability of depression over time. Medicated insomnia sleepers exhibited both the greatest depression magnitude and variability than inefficient sleepers and healthy sleepers, while the latter two showed no difference in depression variability despite inefficient sleepers’ greater depression magnitude than healthy sleepers. Clinical implications and limitations are discussed.
In Hubei, China, where the coronavirus disease (COVID-19) epidemic first emerged, the government has enforced strict quarantine and lockdown measures. Longitudinal studies suggest that the impact of ...adverse events on psychological adjustment is highly heterogenous. To better understand protective and risk factors that predict longitudinal psychopathology and resilience following strict COVID-19 lockdowns, this study used unsupervised machine learning to identify half-year longitudinal trajectories (April, June, August, and October, 2020) of three mental health outcomes (depression, anxiety, and posttraumatic stress disorder PTSD) among a sample of Hubei residents (N = 326), assessed a broad range of person- and context-level predictors, and applied least absolute shrinkage and selection operator (LASSO) logistic regression, a supervised machine learning approach, to select best predictors for trajectory memberships of resilience and chronic psychopathology. Across outcomes, most individuals remained resilient. Models with both person- and context-level predictors showed excellent predictive accuracy, except for models predicting chronic anxiety. The person-level models showed either good or excellent predictive accuracy. The context-level models showed good predictive accuracy for depression trajectories but were only fair in predicting trajectories of anxiety and PTSD. Overall, the most critical person-level predictors were worry, optimism, fear of COVID, and coping flexibility, whereas important context-level predictors included features of stressful life events, community satisfaction, and family support. This study identified clinical patterns of response to COVID-19 lockdowns and used a combination of risk and protective factors to accurately differentiate these patterns. These findings have implications for clinical risk identifications and interventions in the context of potential trauma.
Public Significance Statement
As coronavirus disease (COVID-19) continues to impact the world, it is critical to understand protective and risk factors contributing to psychological adjustment following strict lockdowns. This article reports longitudinal patterns of mental health among residents in Hubei, China, where COVID-19 first emerged, and key individual and contextual predictors of these trajectories. This study holds the potential to inform research directions and clinical approaches in the era of pandemic and long after.
Adverse childhood experiences (ACEs) elevate the risk of poor health later in life.
This study aims to provide a more comprehensive investigation of the multidimensional health risks associated with ...ACEs, to address a gap in the understanding of their longitudinal impact on mental, physical, and behavioral health domains.
This study included 6, 504 participants (51.61 % females) from the National Longitudinal Study of Adolescent to Adult Health (1994–2018).
We utilized latent class growth analysis to identify trajectories from adolescence to adulthood in three health domains: depression (Mental Health, MH), self-report physical health (SRH), and binge drinking frequency (BDF). Binary logistic regression was then used to assess the unique contributions of different types of ACEs to these longitudinal health trajectories.
Three to four trajectories were identified for MH (consistently low, decreasing, increasing), SRH (consistently low, decreasing, increasing, consistently high), and BDF (consistently low, decreasing, moderate). Regression results showed that experience of emotional abuse and witnessed community violence elevated the risk associated with unfavorable trajectories in the mental health and behavioral health domains, respectively.
Individual ACEs differentially predicted mental, physical, and behavioral health trajectories, potentially through various pathways. Prevention of ACEs could mitigate health risks for adolescents and young adults across these domains.
•The effects of teacher-student relationships (TSR) and peer relationships (PR) on the classroom engagement (CE) of low-achieving students were examined.•Positive and negative TSR predicted CE at ...both between- and within-person levels.•PR disliking negatively predicted CE at both between- and within-person levels.•PR liking positively predicted CE only at the between-person level.•The associations between TSR and CE were stronger for students with lower levels of PR disliking.
Although both teacher-student relationship (TSR) and peer relationship (PR) have been found important for the development of students’ classroom engagement, little research has been done regarding the joint operations of these two factors. Guided by a developmental systems framework, this study examined longitudinal between-person and within-person associations between TSR/ PR and classroom engagement in a sample of 784 low-achieving students in the first three years of elementary school. A multidimensional approach was used to distinguish positive and negative dimensions of TSR, as well as peer liking and disliking. At the between-person level, results showed that students’ classroom engagement was positively predicted by positive TSR and PR liking and was negatively predicted by negative TSR and PR disliking. Both positive and negative TSR interacted with PR disliking at the between-person level, such that the associations between positive/negative TSR and classroom engagement were stronger for students with lower levels of PR disliking. At the within-person level, changes in classroom engagement were associated with contemporaneous year-to-year changes in positive/negative TSR and PR disliking. No within-person level interaction effects were found. Cross-level interaction showed that the effects of within-person negative TSR on classroom engagement were stronger for students with lower overall levels of PR disliking. Findings highlighted the importance of using a multilevel multidimensional approach to understand the joint operations of TSR and PR in the development of classroom engagement in low-achieving students in early elementary school.
During the COVID-19 pandemic, Chinese international students (CISs) experienced distress associated with both unique and universal stressors, among which everyday discrimination may be especially ...harmful.
Cross-sectional design.
We compared distress between CISs (N = 381) and Chinese students in Chinese colleges (CSCCs; N = 305) and examined correlates of distress including the association between everyday discrimination and distress as well as moderators on this link.
Compared to CSCCs, CISs reported greater depression and anxiety. Sensitivity analyses - multiple regressions controlling for covariates and coarsened exact matched (CEM) comparisons - replicated the results. 28.6% CISs reported suicidal ideation (PHQ-9 item 9) at least several days during the past two weeks. Within CISs, depression was associated with being older, female, non-heterosexual, increased everyday discrimination, decreased self-esteem, coping flexibility, perceived social support, and satisfaction with online learning. Anxiety was associated with being in undergraduate years, female, increased discrimination, decreased self-esteem, coping flexibility, and satisfaction with online learning. High perceived social support and being heterosexual weakened the association between discrimination and anxiety and depression, while high self-esteem strengthened the association between discrimination and anxiety.
Our study underscored the distress experienced by CISs and highlighted risk/protective factors that may warrant attention.
Hong Kong youth and young adults experienced unprecedented stress amid social unrest and the COVID-19 pandemic. Few studies have examined how these stressors were related to psychological distress ...among youth and young adults. This study assessed how psychological distress is associated with stress from social unrest, financial circumstances, and the COVID-19 pandemic, and whether poor sleep quality may explain these associations.
Participants of a representative phone survey included 1,501 Hong Kong youth and young adults (Mage = 26.1 (4.0); 48.2% female). We examined the associations between psychological distress and three types of stress (social unrest, financial, and COVID-19 stress), and the indirect effect of poor sleep.
Eleven point nine percent, 4.1%, and 9.7% of respondents reported feeling very seriously distressed by social unrest, financial circumstances, and the COVID-19 pandemic, respectively. All three forms of stress were associated with poor sleep. The indirect effects of poor sleep on the association between all three forms of stress and psychological distress were identified. Moderated indirect effect analysis indicated that being female intensified the effect of COVID-19-related stress on psychological distress and that younger female youth and older male youth were more vulnerable to financial stress and social unrest stress (vs. older female youth and younger male youth).
Sleep may be one mechanism that accounts for the association between psychological distress and protracted stressors among Hong Kong youth and young adults. These results suggest the importance of prioritizing sleep improvement in mental health interventions during times of societal change.
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