Sagittal Spinal Alignment in People with Chronic Spinal Cord Injury and Normal Individual: A Comparison Study Using 3D Ultrasound Imaging.

The aim of this study was to compare the sagittal spinal alignment of people with chronic spinal cord injury (SCI) with normal individuals and to determine whether transcutaneous electrical spinal cord stimulation (TSCS) could cause a change in the thoracic kyphosis (TK) and lumbar lordosis (LL) to re-establish normal sagittal spinal alignment. A case series study was conducted, wherein twelve individuals with SCI and ten neurologically intact subjects were scanned using 3D ultrasonography. In addition, three people with SCI having complete tetraplegia participated further to receive a 12-week treatment (TSCS with task-specific rehabilitation) after evaluation of sagittal spinal profile. Pre- and post-assessments were conducted to evaluate the differences in sagittal spinal alignment. The results showed that the TK and LL values for a person with SCI in a dependent seated posture were greater than those of normal subjects for: standing (by TK: 6.8° ± 1.6°; LL: 21.2° ± 1.9°), sitting straight (by TK: 10.0° ± 4.0°; LL: 1.7° ± 2.6°), and relaxed sitting (by TK: 3.9° ± 0.3°; LL: 7.7° ± 1.4°), respectively, indicating an increased risk for spinal deformity. In addition, TK decreased by 10.3° ± 2.3° after the TSCS treatment, showing a reversible change. These results suggest that the TSCS treatment could be used to restore normal sagittal spinal alignment for individuals with chronic SCI.

Exploring the gender difference in relationships between narcissism, competitiveness, and mental health problems among college students.

ObjectiveThe current research examined the gender difference in relationships in terms of overt and covert narcissism, hypercompetitiveness, personal development competitiveness, and mental health problems, such as anxiety, depression, and stress symptoms among college students. Participants: 195 college students (mean age = 21.55 years) in Hong Kong. Method: Participants were invited to fill in standardized psychological instruments. Results: In all, 125 (62.1%) were females. The results revealed that males had higher levels of narcissism and competitiveness than females. Narcissism was associated with competitiveness in both genders. Covert narcissism was independently and positively related with depression, anxiety, and stress in both males and females. Hypercompetitiveness was independently and positively associated with mental health problems in females, but independent associations were not found in males. Conclusions: For the well-being of college students, those with covert narcissism and females with hypercompetitiveness should be monitored closely as they are more likely to have mental health problems.

Disordered eating behaviors and psychological health during the COVID-19 pandemic.

This study aims to investigate dietary changes, psychological well-being, symptoms of anxiety and depression occurring during the 2019 novel coronavirus disease (COVID-19) and their associations with symptoms of eating disorders. A sample of 316 Hong Kong Chinese was assessed using standardized instruments from March to April 2020. 86.1% of participants indicated that they had made at least one dietary change due to the pandemic. 26.5% of participants have a possible case of eating disorders. Participants with a possible case of eating disorders reported significantly higher levels of depression and anxiety symptoms and lower levels of three dimensions of psychological well-being (environmental mastery, purpose in life and self-acceptance). The result pointed to the need for more clinical attention to eating disorders during the COVID-19 Pandemic.

Hypomanic symptoms in early pregnancy: prevalence and associated factors.

Given that the perinatal period is a time of increased risk for pregnant women to manifest mental health problems, the identification of antenatal hypomanic symptoms is particularly important. However, data on antenatal hypomanic symptoms is lacking. The present study was aimed at filling this research gap by investigating the prevalence of hypomanic symptoms, including the "active-elated" and "irritable/risk-taking" sides of hypomanic symptoms at the first trimester, and examining their associations with anxiety and depressive symptoms at the following time points: the first trimester, the second trimester, and up to 6-week postpartum. A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 229 pregnant Chinese women in Hong Kong was assessed. Hypomanic symptoms were assessed with the Hypomania Checklist-32 (HCL-32). Of the sample, 43.6% had elevated levels of hypomanic symptoms in the first trimester. Multiple regression analysis showed that after adjusting for potential confounding factors, irritable/risk-taking symptoms were independently associated with higher anxiety symptoms in the first and second trimesters and in the 6-week postpartum period. Primary healthcare practitioners should be made aware of antenatal hypomanic symptoms in pregnant women to facilitate early identification and intervention for anxiety and depression to improve the well-being of both mothers and infants.

Validation of the Chinese version of the Pregnancy-related Anxiety Questionnaire-Revised (PRAQ-R) and its distinction from general anxiety and depression in pregnant women.

Objective: This study aims to evaluate the reliability and validity of the translated Chinese-Cantonese version of the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R) in a sample of pregnant women in Hong Kong, China. It also aims to determine whether pregnancy-related anxiety changes significantly across trimesters and if it is differentiated from general anxiety and depression.Method: This study adopts a prospective longitudinal design with a quantitative approach. A consecutive sample of 186 Chinese pregnant women from hospitals in Hong Kong are assessed using the translated Chinese-Cantonese version of the PRAQ-R and other standardized instruments at three time points during the first to third trimester.Results: A confirmatory factor analysis revealed a three-factor structure of the Chinese-Cantonese version of the PRAQ-R, including fear of giving birth, fear of bearing a physically or mentally handicapped child, and concern about one's appearance. The internal consistency was excellent (α = 0.88 to 0.91) for all of the items in the PRAQ-R across the three trimesters. The average variance extract (AVE) and composite reliability (CR) for each factor were greater than the recommended level of CR > 0.70 and AVE > 0.50. Multiple regression analyses showed that a combination of general anxiety and depression explained a small proportion of the variance (10-29%) in the PRAQ-R subscales during the three trimesters.Conclusions: The Chinese-Cantonese version of the PRAQ-R has good validity and reliability, and the results provide evidence of its relevance for Chinese pregnant women with pregnancy-related anxiety in Hong Kong. The finding also shows that pregnancy-related anxiety is a relatively distinctive form of anxiety that is different from general anxiety and depression.

Associations of body dissatisfaction with anxiety and depression in the pregnancy and postpartum periods: A longitudinal study.

BACKGROUND: Pregnancy is a time of increasing vulnerability to the development of body dissatisfaction, anxiety, and depression. The present study aims to examine associations of body dissatisfaction with anxiety and depression at the following points: 6 months before pregnancy (retrospective report); in the first, second, and third trimesters of pregnancy; and up to 6 weeks postpartum. METHODS: A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,371 Chinese pregnant women in Hong Kong was assessed using standardized instruments at four time points. RESULTS: A mixed-effects model with repeated measures revealed that body dissatisfaction and depression symptoms changed across different stages of pregnancy. Hierarchical multiple regressions showed that, after adjusting for the identified risk factors, body dissatisfaction before and during pregnancy were positively associated with antenatal anxiety and depression symptoms. Concurrent body dissatisfaction was positively associated with postpartum depression symptoms. LIMITATIONS: There was a high attrition rate in the follow-up assessments. Antenatal anxiety symptoms were assessed using the scale for general anxiety, which may not adequately capture the experience of anxiety among pregnant women. CONCLUSIONS: Primary healthcare practitioners should be made aware of body dissatisfaction among pregnant women in order to facilitate early intervention for anxiety and depression, because untreated psychological disturbance during pregnancy may persist into the postpartum period.

Course, risk factors, and adverse outcomes of disordered eating in pregnancy.

OBJECTIVE: Although eating disorders in pregnancy have been studied extensively, little research attention has been given to disordered eating. The objectives of the present study were to determine the prevalence and levels of disordered eating in the perinatal period, and to identify risk factors and adverse outcomes of disordered eating during pregnancy. METHOD: A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,470 Chinese pregnant women from hospitals in Hong Kong was assessed using standardized instruments at five time points from the first trimester to 6 months postpartum. RESULTS: The levels of disordered eating changed significantly across trimesters. Higher levels of disordered eating in pregnancy were significantly associated with higher levels of disordered eating at 6 weeks and 6 months postpartum, greater anxiety and depressive symptoms, lower 1-min Apgar scores, and abnormal birth weight. DISCUSSION: The present study pointed to the need for more research and clinical attention to antenatal disordered eating given that it is associated with anxiety, depression, postpartum disordered eating and obstetric outcomes.

The influence of resilience and coping strategies on suicidal ideation among Chinese undergraduate freshmen in Hong Kong.

INTRODUCTION: The purpose of this study was to examine the relationship between resilience and suicidal ideation, with coping strategies regarded as a mediator. METHODS: A total of 422 Hong Kong undergraduate students were recruited with convenience sampling. RESULTS: Simple linear regression was used to verify the negative relationship between resilience and suicidal ideation (P < 0.001). The results revealed that two out of four tested mediation models were accepted, with the coping strategies of approach and reappraisal acting as mediators (P < 0.001); the other two models were rejected when the coping strategies of emotional regulation and avoidance were the mediators. Regression analysis was performed to explore the effectiveness in reducing suicidal ideation in terms of the reappraisal coping strategy and the approach coping strategy, and the results indicated that the reappraisal coping strategy had greater effects than the approach coping strategy. DISCUSSION: Overall, the results of this study confirmed previous findings in the literature that resilience can alleviate the degree of suicidal ideation. Additionally, these results suggest further implications that adopting the approach and reappraisal coping strategies might make significant contributions to reducing the number of suicidal cases in society.

Associations of paternal postpartum depressive symptoms and infant development in a Chinese longitudinal study.

Although fathers actively provide infant care and support to their partners in modern societies, data on fathers' difficulties and mental health problems is still limited. This study examined paternal postpartum depression and its adverse impact on infants, and the possible mediating role of father-infant attachment in the link between fathers' depressive symptoms and infants' outcomes. Pregnant women and their partners were recruited from the antenatal clinics of two public hospitals in Hong Kong. Information about paternal and maternal depression, paternal-infant attachment, and infant development were collected at antenatal period, 6 weeks and 6 months postpartum. Linear regression was employed to examine risk factors for paternal depression symptoms, and mediation analysis was conducted to examine the mediating mechanisms. 121 couples joined the longitudinal study and completed all the assessments. Paternal postpartum depression symptoms were associated with fathers' prenatal depression symptoms, and mothers' postpartum depression symptoms. Fathers with postpartum depression symptoms experienced reduced paternal-infant attachment, which also acted as mediators between postpartum depression in fathers and adverse infants' social development. Effective assessment and interventions targeted at preventing or identifying and reducing paternal postpartum depression and improving father-infant relationship would help to lower the risk of infant disorders and poor development. Strategies improving the fathers' mental health during antenatal period and their partner's psychosocial well-being may also reduce paternal postpartum depression.