Healing grief - an online self-help intervention programme for bereaved Chinese with prolonged grief: study protocol for a randomised controlled trial.

Background: In China, mental health services do not currently meet the needs of bereaved people with symptoms of prolonged grief disorder (PGD). Internet-based grief interventions may help fill this gap, but such programmes have not yet been developed or evaluated in China. The proposed study aims to investigate the effectiveness, acceptability, and feasibility of an online self-help intervention programme named Healing Grief for bereaved Chinese with prolonged grief, and to explore the psychological mechanisms of potential improvements.Methods: We designed a two-arm randomised controlled trial. At least 128 participants will be randomly assigned to either an Internet-based intervention group or a waitlist-control group. The Internet-based intervention will be developed based on the dual process model, integrating techniques of psychoeducation, behavioural activation, cognitive reappraisal, and meaning reconstruction, and will be delivered via expressive writing. The intervention comprises six modules, with two sessions in each module, and requires participants to complete two sessions per week and complete the intervention in 6 weeks. The primary outcomes include effectiveness, acceptability, and feasibility. The effectiveness will be assessed by measures of prolonged grief, posttraumatic stress, anxiety, and depressive symptoms. Acceptability and feasibility will be evaluated using survey and interview on user experience characteristics. Secondary outcomes include moderators and mediators, such as dual process coping, grief rumination, mindfulness, and continuing bond, to explore the psychological mechanisms of potential improvement. Assessments will take place at pre-intervention, post-intervention, and 3-month follow-up.Conclusion: The proposed study will determine the effectiveness, acceptability, and feasibility of the newly developed online self-help intervention for bereaved Chinese with prolonged grief and clarify how the intervention helps with symptom improvements. Such an intervention may play an important role in easing the imbalance between the delivery and receipt of bereavement psychological services in China.

In China, mental health services are not widely available for bereaved people.The proposed study will be the first one to develop and evaluate an Internet-based self-help grief intervention for bereaved Chinese with prolonged grief.The proposed study will determine whether and how the intervention helps to improve the mental health of bereaved Chinese with prolonged grief.

A network analysis of posttraumatic stress symptoms and quality of relationship with deceased in COVID-19 bereaved adults.

OBJECTIVE: Network analyses showed that the posttraumatic stress disorder (PTSD) symptom structures may vary across traumatic events and types of survivors. However, the structure of PTSD symptoms in COVID-19 bereavement remains unknown. This study aimed to depict the structure of the PTSD symptom network and illuminate how the quality of the predeath relationship between the bereaved and the deceased links to the PTSD symptom network. METHOD: Using self-reported data from 408 COVID-19 bereaved adults (225 male and 183 female) collected within 9-month postbereavement, we constructed two graphical lasso networks of PTSD symptoms. RESULTS: Symptoms with the highest centrality were exaggerated startle, negative emotional states, and reckless/self-destructive behavior, with exaggerated startle having relatively low predictability. The strongest connections were found between exaggerated starkness and detachment, and between psychological cue response and thoughts of avoidance. Moreover, closeness to and conflict with the deceased were linked to the PTSD symptom network through nightmares and physiological cue reactivity, respectively. CONCLUSIONS: This study extends our understanding of what PTSD is for people who are bereaved due to the COVID-19 pandemic by unveiling the structure of the PTSD symptom network. It also helps to distinguish the symptom-level links between quality of relationship with deceased and PTSD among the bereaved. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Hyperthermophilic pretreatment significantly accelerates thermophilic composting humification through improving bacterial communities and promoting microbial cooperation.

Thermophilic composting (TC) can effectively shorten maturity period with satisfactory sanitation. However, the higher energy consumption and lower composts quality limited its widespread application. In this study, hyperthermophilic pretreatment (HP) was introduced as a novel approach within TC, and its effects on humification process and bacterial community during food waste TC was investigated from multiple perspectives. Results showed that a 4-hour pretreatment at 90 °C increased the germination index and humic acid/fulvic acid by 25.52% and 83.08%, respectively. Microbial analysis demonstrated that HP stimulated the potential functional thermophilic microbes, and significantly up-regulated the genes related to amino acid biosynthesis. Further network and correlation analysis suggested that pH was the key factor affecting bacterial communities, and higher HP temperatures help to restore bacterial cooperation and showed higher humification degree. In summary, this study contributed to a better understanding of the mechanism towards the accelerated humification by HP.

Catalytic supercritical water oxidation of o-chloroaniline over Ru/rGO: Reaction variables, conversion pathways and nitrogen distribution.

To ascertain the reaction variables on o-chloroaniline (o-ClA) mineralization, total nitrogen (TN) removal rate, and N-species distribution, o-ClA was subjected to catalytic supercritical water oxidation (CSCWO) in a fused quartz tube reactor (FQTR). The findings demonstrated that when the temperature, reaction time, and excess oxidant were 400 °C, 90 min, and 150%, respectively, the mineralization rate of o-ClA could reach more than 95%. Moreover, potential degradation pathways of o-ClA in supercritical water oxidation (SCWO) was proposed according to the GC-MS results. TN removal rate is significantly impacted by Ru/rGO, despite the fact that its catalytic effect on the mineralization of o-ClA was not particularly noteworthy. Compared with no catalyst, the TN removal rate of o-ClA obviously increased from 44.1% to 90.3% at 400 °C, 10 wt% Ru loading, 90 min and 200% excess oxidant. In addition, N-species distribution in SCWO and CSCWO were also investigated. Results indicated that the Ru/rGO catalyst could accelerate the oxidation of ammonia-N and convert it to nitrate-N, promoting N2 generation. Finally, the possible N transformation pathway in CSCWO of o-ClA was proposed. As a result, this work offers fundamental information about o-ClA catalytic oxidation removal in the SCWO process.

New insights into nitrogen control strategies in sewage sludge pyrolysis toward environmental and economic sustainability.

Sewage sludge (SS) contains a certain amount of nitrogen (N), resulting in various content of N in the pyrolysis products. Investigates on how to control the generation of NH3 and HCN (deleterious gas-N species) or convert it to N2 and maximize transforming N in sewage sludge (SS-N) into potentially valuable N-containing products (such as char-N and/or liquid-N) are of great significance for SS management. Understanding the nitrogen migration and transformation (NMT) mechanisms in SS during the pyrolysis process is essential for investigating the aforementioned issues. Therefore, in this review, the N content and species in SS are summarized, and the influencing factors during the SS pyrolysis process (such as temperature, minerals, atmosphere, and heating rate) that affect NMT in char, gas, and liquid products are analyzed. Furthermore, N control strategies in SS pyrolysis products are proposed toward environmental and economic sustainability. Finally, the state-of-the-art of current research and future prospects are summarized, with a focus on the generation of value-added liquid-N and char-N products, while concurrently reducing NOx emission.

Effects of fungal agents and biochar on odor emissions and microbial community dynamics during in-situ treatment of food waste.

The effects of the co-addition of fungal agents and biochar on physicochemical properties, odor emissions, microbial community structure, and metabolic functions were investigated during the in-situ treatment of food waste. The combined addition of fungal agents and biochar decreased cumulative NH3, H2S, and VOCs emissions by 69.37%, 67.50%, and 52.02%, respectively. The predominant phyla throughout the process were Firmicutes, Actinobacteria, Cyanobacteria, and Proteobacteria. Combined treatment significantly impacted the conversion and release of nitrogen from the perspective of the variation of nitrogen content between different forms. FAPROTAX analysis revealed that the combined application of fungal agents and biochar could effectively inhibit nitrite ammonification and reduce the emission of odorous gases. This work aims to clarify the combined effect of fungal agents and biochar on odor emission and provide a theoretical basis for developing an environmentally friendly in-situ efficient biological deodorization (IEBD) technology.

Aggressive parenting behavior among grandparents providing childcare for grandchildren: A case study of Shenzhen, China.

BACKGROUND: Grandparents play an essential role in childrearing and fill the parenting gap for dual-earner Chinese families. Many Chinese grandparents engage heavily in childcare, which may increase the risk of child abuse. OBJECTIVE: This study aimed to examine grandparental use of psychological and physical aggression toward children and explore its associated risk factors. PARTICIPANTS AND SETTING: This was a cross-sectional study which involved purposive sampling of 278 grandparents (204 females and 74 males) taking care of at least one grandchild below 18 years old in Shenzhen, China. METHODS: Information on childcare was collected, including grandparents' use of psychological and physical aggression and their involvement in childcare in terms of intensity and activity. RESULTS: An alarming percentage (57.1 %) of grandparents had used psychological aggression, while 26.5 % had used corporal punishment, in the past year. The average use of psychological aggression and corporal punishment was 16.10 times and 10.08 times per year, respectively. Grandparents taking care of two or more grandchildren were more likely to use psychological aggression and corporal punishment compared to those taking care of only one grandchild. Higher mental and physical health summary scores were associated with lower likelihood of psychological and physical aggression of grandparents. CONCLUSIONS: This study advances our understanding of negative grandparenting behavior in childcare. As grandparents play a significant role in childcare, we need to improve their grandparenting skills, provide more formal childcare services to ease their childcare burden, and support their physical and mental well-being to reduce the risk of child abuse.

Gas transport in landfill cover system: A critical appraisal.

Landfill gas (LFG) emission is gaining more attention from the scientific fraternity and policymakers recently due to its threat to the atmosphere and human health of the populace living in surrounding premises. Though landfill cover (LFC) (viz., daily, intermittent and final cover) is widely used by landfill operators to mitigate or reduce these emissions, their overall performance is still under question. A critical analysis of available literature, primarily pertaining to (i) the composition of the landfill gases and their migration in the LFC system, (ii) experimental and mathematical investigations of the transport mechanism of gas and (iii) the impact of additives to cover soils on transport and fate of gas, has been conducted and presented in this manuscript. Investigation of the efficiency of modified soil was mainly focused on laboratory test. More field tests and application of amended cover soils should be conducted and promoted further. Studies on nitrous oxide and emerging pollutants, including poly-fluoroalkyl substances transport in landfill cover system are limited and need further research. The transport mechanisms of these unconventional contaminants should be considered regarding the selection of LFC materials including geomembrane and geosynthetic clay liners. The existing analytical and numerical models can provide a basic understanding of LFG transport mechanisms and are able to predict the migration behaviour of LFG; however, there are still knowledge gaps concerning the interaction between different species of the gas molecule when modeling multi-component gas transport. Gas transport through fractured cover should also be considered when evaluating LFG emission in the future. Simplified design method for landfill cover system regarding LFG emission based on analytical models should be proposed. Overall, mathematical models combined with experiments can facilitate more visualized and intensive insights, which would be instrumental in devising climate adaptive landfill covers.

Prevalence of social anxiety disorder and symptoms among Chinese children, adolescents and young adults: A systematic review and meta-analysis.

The objective of the study is to provide a reliable estimate of the pooled prevalence of social anxiety disorder (SAD) and social anxiety symptoms (SAS) among children, adolescents, and young adults (CAYA) in China. Meta-analysis is used to provide pooled-prevalence rate of SAD and SAS. Literature searches were conducted in both English and Chinese databases from the database's inception to April 2019. Eleven studies were identified for SAD, and 17 were included for SAS. The results revealed a pooled prevalence of SAD of 2.1% (95% CI: 1.2-3.8%) with high between-studies heterogeneity (Q = 1,055.2, I 2 = 99.1%, p < 0.001). The pooled prevalence estimate of SAS was 23.5% (95% CI: 18.6-29.3%), also with significant heterogeneity (Q = 1,019.3, I 2 = 98.4%, p < 0.001). Different diagnostic tools or self-report scales reported significant different prevalence of SAD or SAS. Further analysis stratified by gender, age, sampling methods, economic status, and risk of bias were performed. Limitations include the high level of heterogeneity between studies, inadequate number of the studies, and significant differences in prevalence caused by measurements. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020149591, identifier: PROSPERO CRD42020149591.

The loss and return of self: An interpretative phenomenological analysis of coping and recovery from chronic hepatitis B in China.

Chronic hepatitis B (CHB) is a prevalent disease with various negative consequences. The lived experience of coping and recovery of a patient with Chronic hepatitis B was explored in this study. A semistructured interview was conducted with one participant who had been recovered from Chronic hepatitis B for 10 years. Data were analyzed using interpretative phenomenological analysis. Five superordinate themes emerged, including lingering in the shadow of death anxiety, diminished functioning of the self, adopting a highly disciplined lifestyle, receiving social support, and the return of the self with scars. The findings revealed that the disease is deeply associated with moral standing, which means the diagnosis of Chronic hepatitis B might imply a loss of moral face for Chinese people living with the condition. Our findings point to the need for increasing knowledge about chronic hepatitis B, decoupling the disease from a moral standpoint, and providing a supportive environment.

Relations between parental response to children's negative emotions and suicidal ideation in chinese adolescents: Internalizing problems, emotion regulation, and perceived relationship quality with parents as mediators.

Past work points to the crucial role of parents' responses to children's negative emotions (PRCNE) in adolescents' socioemotional adjustment. The presence of suicidal ideation (SI) is an important sign of significant distress and suicide risk. However, research on the relations between PRCNE and adolescents' SI is lacking. This research aimed to investigate whether parental reactions to children's negative emotions (PRCNE) was related to adolescents' SI and, if so, through which processes. This research utilized data from a sample of Chinese adolescent families (N = 4,574; Parents: 35.81% males, M = 44.07 years old; Adolescents: 55.40% males, M = 16.28 years old), with parents giving their reports on PRCNE and adolescents self-evaluating their psychosocial development (i.e., internalizing problems, emotion regulation, perceived relationship quality with parents) and SI. We examined the relations between six types of PRCNE and adolescents' SI, and analyzed the mediating roles of adolescents' internalizing problems, emotion regulation (i.e., cognitive reappraisal and expressive suppression), and perceived relationship quality with parents. The results showed that emotion-focused response, problem-focused response, and expression encouragement negatively predicted, while punitive response and distress response positively predicted adolescents' SI. However, no statistically significant association emerged between minimization and adolescents' SI. Moreover, adolescents' internalizing problems, usage of expressive suppression, and perceived relationship quality with parents could mediate the relations between PRCNE and adolescents' SI. Contrary to our hypothesis, the results did not support an indirect effect of PRCNE on adolescents' SI through adolescents' cognitive reappraisal. The present research illuminates adolescents' SI by emphasizing the roles of PRCNE. The findings also highlight the importance of paying attention to adolescents' internalizing problems, expressive suppression, and perceived relationship quality with parents in relation to PRCNE in interventions aimed at reducing adolescents' SI.

Characterization of Acinetobacter indicus ZJB20129 for heterotrophic nitrification and aerobic denitrification isolated from an urban sewage treatment plant.

The Acinetobacter indicus strain ZJB20129 isolated from an urban sewage treatment plant demonstrated the heterotrophic nitrification-aerobic denitrification (HN-AD) ability. Strain ZJB20129 could remove 98.73% of ammonium-N, 97.26% of nitrite-N and 96.55% of nitrate-N, and the maximum removal rate was 3.66, 4.62 and 5.21 mg/L/h, respectively. Ammonium was preferentially used during simultaneous nitrification and denitrification. Strain ZJB20129 exhibited highest ammonium removal capability when carbon source was sodium succinate, C/N ratio was 15, pH was 8.0, and temperature was 35 ℃. Key enzymes involved in HN-AD including hydroxylamine oxidase, periplasmic nitrate reductase and nitrite reductase as well as their encoding genes were detected, and the metabolic pathway of HN-AD was subsequently predicted. Our results suggested that Acinetobacter indicus ZJB20129 displayed superior nitrogen removal performance on actual wastewater and thus made it have a good application prospect in wastewater biological treatment.

Profiles of grief, post-traumatic stress, and post-traumatic growth among people bereaved due to COVID-19.

BACKGROUND: COVID-19 deaths elevate the prevalence of prolonged grief and post-traumatic stress symptoms among the bereaved, yet few studies have examined potential positive outcomes. Moreover, how COVID-19 bereavement affects individual-level mental health outcomes is under-researched. OBJECTIVE: This is the first study to use latent profile analysis (LPA) to identify heterogeneous profiles of prolonged grief, post-traumatic stress and post-traumatic growth among people bereaved due to COVID-19 and to identify predictors of latent class membership. METHODS: Four hundred and twenty-two Chinese participants who were bereaved due to COVID-19 completed an online survey between September and October 2020. The survey included the International (ICD-11) Prolonged Grief Disorder Scale (IPGDS), the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Post-traumatic Growth Inventory (PTGI). LPA was run in Mplus, and the 3-step auxiliary approach was used to test the predicting effects of potential predictors of latent class membership identified with chi-square tests and ANOVAs. RESULTS: Four latent profiles were identified: resilience (10.7%), growth (20.1%), moderate-combined (42.2%) and high-combined (27.0%). The bereaved who shared a close relationship with the deceased and identified COVID-19 as the fundamental cause of death were more likely to be in the high-combined group. A conflictful bereaved-deceased relationship reduces the chance of being in the growth group. Moreover, the death of a younger person and loss of a partner attributed to maladaptive outcomes. CONCLUSIONS: Serious attention needs to be paid to the mental health issues of people bereaved due to COVID-19 because nearly 70% of this group would have a moderate-combined or high-combined symptom profile. Special care should be given to those who lost someone younger, lost a partner or shared a close relationship with the deceased. Grief therapies that work on the conflicts between the deceased and the bereaved and unfinished business can be applied to facilitate growth.

Antecedentes: Las muertes por COVID-19 elevan la prevalencia de síntomas de duelo prolongado y estrés postraumático entre las personas en duelo, sin embargo, pocos estudios han examinado los posibles resultados positivos. Además, la forma en que el duelo por COVID-19 afecta los resultados de salud mental a nivel individual está poco investigada.Objetivo: Este es el primer estudio que utiliza el análisis de perfil latente (LPA) para identificar perfiles heterogéneos de duelo prolongado, estrés postraumático y crecimiento postraumático entre personas en duelo debido al COVID-19 y para identificar predictores de pertenencia a una clase latente.Métodos: Cuatrocientos veintidós participantes chinos que estaban en duelo debido a COVID-19 completaron una encuesta en línea entre septiembre y octubre de 2020. La encuesta incluyó la Escala Internacional de Trastorno por Duelo Prolongado (ICD-11) (IPGDS), la Lista de verificación de trastornos por estrés para el DSM-5 (PCL-5) y el Inventario de crecimiento postraumático (PTGI). Se ejecutó LPA en Mplus y se usó el enfoque auxiliar de 3 pasos para probar los efectos de concordancia de posibles predictores de pertenencia a una clase latente identificados con pruebas de chi-cuadrado y ANOVA.Resultados: Se identificaron cuatro perfiles latentes: resiliencia (10,7%), crecimiento (20,1%), combinado moderado (42,2%) y combinado alto (27,0%). Los deudos que compartían una relación cercana con el fallecido e identificaron al COVID-19 como la causa fundamental de muerte tenían más probabilidades de estar en el grupo de alta combinación. Una relación conflictiva con el fallecido reduce la posibilidad de estar en el grupo de crecimiento. Además, la muerte de una persona más joven y la pérdida de una pareja se asocian a resultados desadaptativos.Conclusiones: Se debe prestar mucha atención a los problemas de salud mental de las personas en duelo debido a COVID-19 porque casi el 70% de este grupo tendría un perfil de síntomas combinados moderados o combinados altos. Se debe prestar especial atención a quienes perdieron a alguien más joven, perdieron a una pareja o tuvieron una relación cercana con el fallecido. Las terapias de duelo que trabajan en los conflictos entre el fallecido y los deudos y en temáticas no resueltas, se pueden aplicar para facilitar el crecimiento.

Correlates of Mental Health After COVID-19 Bereavement in Mainland China.

CONTEXT: Pioneering empirical studies show that people bereaved due to COVID-19 experience elevated acute grief, posttraumatic stress, anxiety, and depressive symptom levels, which relate to functional impairment. However, studies focused on Western samples and multivariate analyses of relations between potential risk factors and mental health in this population are lacking. OBJECTIVES: To assess the mental health of Chinese adults bereaved due to COVID-19. To elucidate the associations of demographic and loss-related characteristics with mental health after COVID-19 bereavement. METHODS: Four hundred twenty-two Chinese adults (56% male; Mean age: 32.73 years) recently bereaved due to COVID-19 completed an online survey. Demographic and loss-related characteristics and prolonged grief, posttraumatic stress, anxiety, and depressive symptoms were assessed. RESULTS: Clinically relevant prolonged grief (49%, n = 207), posttraumatic stress (22%, n = 92), depressive (70%; n = 294), and anxiety symptoms (65%; n = 272) were reported by a substantial group of participants. In four multiple regressions predicting each mental health indicator, Fs(15,406) = 5.08-7.74, Ps < 0.001, loss-characteristics (i.e., a shorter time since loss, ßs =  -.12-.11, loss of a first-degree relative, ßs =  .18-.37) and subjective loss experiences (i.e., feeling traumatized by the loss, ßs =  .13-.18, or a close and/or conflictual relation with the deceased, ßs =  .12-.23) related most consistently to mental health problems. CONCLUSION: Many Chinese adults bereaved due to COVID-19 experience severe mental health problems. The recent loss of first-degree relatives, feeling traumatized by the loss, and having a close and/or conflictual relationship with the deceased may elevate risk for these mental health problems, which could require indicated psychological treatment.

Who suffered most after deaths due to COVID-19? Prevalence and correlates of prolonged grief disorder in COVID-19 related bereaved adults.

BACKGROUND: Deaths by COVID-19 have left behind nearly 12 million recent bereaved individuals worldwide and researchers have raised concerns that the circumstances of COVID-19 related deaths will lead to a rise prevalence of prolonged grief disorder (PGD) cases. However, to date, no studies have examined the prevalence of PGD among people bereaved due to COVID-19. This study aimed to estimate the prevalence of PGD and investigated demographic and loss-related factors associated with prolonged grief symptoms among Chinese individuals bereaved due to COVID-19. METHODS: This was a cross-sectional online survey conducted between September 1 and October 3, 2020. A total of 422 Chinese participants (55.5% males; 32.73 [9.31] years old) who lost a close person due to COVID-19 participated in the study. Demographic and loss-related information was collected, and self-reported prolonged grief symptoms were measured by a 13-item International Prolonged Grief Disorder Scale (IPGDS: 1-65) and a 17-item Traumatic Grief Inventory Self Report (TGI-SR: 1-85). Multiple linear regression analysis was used to determine the associated factors of levels of grief symptoms. RESULTS: Prevalence of PGD was 37.8% screened by IPGDS and 29.3% by TGI-SR. No difference was found in levels of grief symptoms between participants whose close one died more than 6 months ago and those who experienced the loss less than 6 months ago. More severe prolonged grief symptoms assessed by IPGDS was associated with losing a close person by COVID-19 rather than complications (B: 5.35; 95% CI: 0.54-10.05), losing a partner (B: 7.80; 95% CI: 3.24-12.37), child (B: 8.15; 95% CI: 1.03-15.26), and parent (B: 5.49; 95% CI: 1.49-9.48) rather than losing a relative or a person with other relationship, feeling more traumatic about the loss (B: 1.71; 95% CI: 0.52-2.90), being closer with the deceased (B: 1.60; 95% CI: 0.34-2.86). Moreover, Losing a grandparent (B: 6.62; 95% CI: 0.53-12.71) and having more conflicts with the deceased (B: 1.05; 95% CI: - 0.008-2.11) were related to higher levels of grief symptoms assessed by TGI-SR. CONCLUSIONS: Echoing researchers' concerns, the prevalence of PGD is high among people bereaved due to COVID-19. Individuals with a higher risk of developing PGD should be identified and bereavement support should be offered as early as possible.

Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parent-child discussion.

BACKGROUND: School closures due to the COVID-19 outbreak have affected 87% of the world's students physically, socially, and psychologically, yet rigorous investigation into their mental health during this period is still lacking. METHODS: A cross-sectional online survey of 4-342 primary and secondary school students from Shanghai, China was conducted during March 13-23, 2020. Besides demographic information, psychological distress (including depression, anxiety, and stress), life satisfaction, perceived impact of home quarantine, and parent-child discussions on COVID-19 were assessed. RESULTS: The three most prevalent symptoms were: anxiety (24.9%), depression (19.7%), and stress (15.2%). Participants were generally satisfied with life and 21.4% became more satisfied with life during school closures. Senior grades were positively correlated with psychopathological symptoms and negatively associated with life satisfaction, whereas the perceived benefit from home quarantine and parent-child discussions on COVID-19 were negatively correlated with psychopathological symptoms and positively correlated with life satisfaction. Among participants who perceived no benefit from home quarantine, those who had discussions with their parents about COVID-19 experienced less depression, anxiety, and stress. LIMITATIONS: Limitations included the inability to infer the casual relationship, no parental report for mental health of children aged 6 to 9, and the inadequate measurement of parent-child discussion. CONCLUSIONS: Mental health problems and resilience co-existed in children and adolescents during the COVID-19 outbreak. Given the important role of parent-child discussions, open communication between parents and children about the pandemic should be encouraged to help children and adolescents cope with mental health problems in public health crisis.

Predictive factors for differential changes in grief symptoms following group bereavement intervention for Chinese widowed older adults.

This study aimed to delineate changes in the patterns of prolonged grief severity in widowed adults following group bereavement interventions and to identify the predictive factors impacting these patterns. We performed a secondary analysis of data from a randomized trial of 125 Chinese widowed older adults who participated in either LOGBI or DPGBI. Self-ratings of prolonged grief symptoms via Inventory of Complicated Grief (ICG) were subjected to latent class growth analysis to identify subgroups according to symptomatic changes among baseline, post-treatment, and 8-week follow-up. Multinomial regression analysis examined whether participant classification could be predicted by demographics, loss-related characteristics, and the relationship with the deceased and baseline symptom severity. In the results, intervention sample comprised 96 completers with an attendance greater than 60%. A three-class categorization yielded the best model fit for changes in prolonged grief severity for both randomized and intervention samples: improved class (41.6% in the randomized sample, 42.8% in the intervention sample), partial responded class (48.1%/45.5%), and relapse class (10.3%/11.8%). Older widowed adults experiencing a high level of grief at baseline and bereavement following chronic illness had an elevated risk of symptomatic relapse after the completion of intervention. These findings indicated that Chinese widowed adults experienced different changing patterns of prolonged grief severity following group bereavement interventions. Practically, widowed adults with a higher risk of symptomatic relapse might need more intensive or longer term intervention or follow-up support.

Trajectories of depression symptoms in Chinese elderly during widowhood: a secondary analysis.

Objectives: This study aims to identify heterogeneous depressive symptom trajectories among the widowed elderly in China, to explore predictive variables of latent class membership, and to detect between-classes differences in life satisfaction across time.Method: Data of 198 individuals widowed between 2011 and 2013 were drawn from The China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. Latent class growth analysis was employed to identify depressive symptom trajectories across 2011, 2013, and 2015, and a three-step auxiliary approach was applied to detect predictive variables of latent class membership. Mixed Analysis of Variances was followed to make between-class comparisons on life satisfaction across time.Results: Four grieving trajectories were identified: resilient (54.6%), chronic grief (23.7%), depressed-improved (11.6%), and chronic depression (10.1%). Older age, living exclusively with spouse before widowhood, and agricultural Hukou were significant predictors of depressed-improved, chronic grief, and chronic depression patterns, respectively. Life satisfaction in all groups except for the resilient one remained stable across time, and that of the chronic depression group was significantly lower than those of all the remaining groups.Conclusion: Consistent depressive symptom trajectories during late-life widowhood exist across nations while the specific culture, values, and resources in the Chinese context may have contributed to a particularly high proportion of the chronic grief trajectory. More efforts should be made to identify patterns with predictors before support are provided, and interventions need to be tailored to target specific needs in each subgroup of the elderly during their transitions to widowhood.

Can grief be a mental disorder? An online survey on public opinion in mainland China.

This study investigates Chinese people's opinions about the diagnosis of grief and the factors associated with their opinions. Among 1041 participants who completed the online survey, over half (56.5%) agreed that grief could be a mental disorder under certain circumstances, such as harm to self or others, functional impairment, and persistent grief. Primary reasons against the diagnosis were that grief is normal and its intensity decreases over time. A small proportion of opponents also expressed concerns about stigmatization resulting from labeling grief as being pathological. Younger, male, and full-time employed adults tended to support diagnosing grief as a mental disorder.

Psychosocial risk factors associated with depressive symptoms among adolescents in secondary schools in mainland china: A systematic review and meta-analysis.

BACKGROUND: The objective of the study is to systematically estimate the effect size of psychosocial risk factors for depressive symptoms among adolescents in secondary schools in mainland China. METHOD: A literature search was conducted in both English and Chinese databases. This meta-analysis used a random-effects model to estimate the effect size. RESULTS: Fifteen psychosocial risk factors were identified in a total of 164 articles. The results revealed the absolute value of effect size ranging from 0.16 to 0.43. Among them, poor parent-child communication (r = 0.43), negative life events (r = 0.40), academic pressure (r = 0.40), abuse (r = 0.33), poor family functioning (r = 0.33), bullying (r = 0.32), and poor family cohesion (r = 0.32) were associated with depression with a medium to large effect. Moderator analysis shows that grade, study quality, mean age, and gender were significant moderators of at least one factor for depression. LIMITATIONS: Limitations included the heterogeneity which is largely unexplained, and the inability to investigate the interactions of different factors and to determine the direction of causal relationships between psychosocial factors and depression in the present meta-analysis. CONCLUSIONS: This study suggests that family-related factors and school-related factors may be significantly associated with depressive symptoms in Chinese secondary school students. Further research is needed to develop effective strategies to modify these factors in depression prevention programmes.