Association between depression and dysmenorrhea among adolescent girls: multiple mediating effects of binge eating and sleep quality.

BACKGROUND: Dysmenorrhea has a significant negative impact on teenagers' quality of life, and its prevalence is increasing annually. Although studies have explored the factors affecting dysmenorrhea, it remains unclear how these factors interact with one another. This study aimed to explore the mediating role of binge eating and sleep quality between depression and dysmenorrhea. METHODS: This cross-sectional study recruited adolescent girls from the Health Status Survey of adolescents in Jinan, Shandong Province, and used multistage stratified cluster random sampling. Data was collected using an electronic questionnaire between March 9, 2022, and June 20, 2022. The Numerical Rating Scale and Cox Menstrual Symptom Scale were used to assess dysmenorrhea and the Patient Health Questionnaire-9 to assess depression. The mediation model was tested by Mplus 8.0, and the mediating effect was analyzed using the Product of Coefficients approach and the Bootstrap method. RESULTS: Among the total of 7818 adolescent girls included in this study, the prevalence of dysmenorrhea is 60.5%. A significant positive association was found between dysmenorrhea and depression. Binge eating and sleep quality seemingly mediate this association. The mediating effect of sleep quality (21.31%) was greater than that of binge eating (6.18%). CONCLUSIONS: The findings of this study point in the right direction for preventing and treating dysmenorrhea in adolescents. For adolescent dysmenorrhea, mental health should be considered and proactive steps taken for educating adolescents on healthy lifestyles to reduce negative consequences of dysmenorrhea. Longitudinal studies on the causal link and influence mechanisms between depression and dysmenorrhea should be conducted in the future.

What Affects the Livelihood Risk Coping Preferences of Smallholder Farmers? A Case Study from the Eastern Margin of the Qinghai-Tibet Plateau, China

As the smallest livelihood unit in rural areas, farmers often face multiple risks. Rational responses to livelihood risks not only prevent households from falling into poverty, but also improve the sustainability of family livelihoods. This is essential to the sustainable development of rural areas. This paper takes the region located in the eastern margin of the Qinghai-Tibet Plateau in China as an example, using household survey data to analyze farmers’ livelihood risk coping strategies and their key factors through a binary logistic model. The results show that 92.80% of farmers face the shock of multiple livelihood risks. The main livelihood risks of farmers are family capacity building risk, health risk and social risk. When faced with multiple livelihood risks, farmers have the strongest preference to give priority to health risks, followed by family capacity building risks and social risks. Among them, farmers’ health risk coping preferences are stronger in farming areas than those in purely pastoral and farming-pastoral areas. There are differences in the factors for farmers’ preferences for coping with different livelihood risks. Human capital is a key factor for health risk coping preferences. Human capital and social capital are key factors for social risk coping preferences. Social capital is a key factor for family capacity building risk coping preferences. Finally, this paper puts forward countermeasures and suggestions to provide reference for farmers rationally coping with livelihood risks.