Parental and Adolescents' Anxiety during the COVID-19 Outbreak in Rural China: The role of Parent-child Communication.

Purpose: It has been suggested that the intergenerational transmission of anxiety may be an important contributor to the high prevalence of anxiety in adolescents. The objectives of this study are to examine whether and how parental anxiety is related to adolescent's anxiety and to explore the associations of parental anxiety and parent-child communication with adolescents' anxiety across different grades. Methods: The current survey was conducted online from February 8th to February 27th, 2020.The questionnaires were distributed and retrieved through a web-based platform. A total of 6196 Chinese rural adolescents from grade seven to twelve (age ranging from 11 to 18 years old) were included. Results: In this study, parental anxiety was significantly associated with higher adolescent anxiety (ß = 0.14, p < 0.001) and this association was statically strongest at grade twelve. Besides, children with problematic parent-child communication related to COVID-19 reported elevated anxiety (ß = 0.05, p < 0.01). In contrast, effective parent-child communication about COVID-19 mitigated the level of anxiety transmitted from parent to child (ß = -0.04, p < 0.05). Conclusions: During the COVID-19 epidemic, parents' anxiety was related to adolescents' anxiety. In addition, parent-child communication plays a moderating role in the above relationship. These findings emphasize the importance of implementing more psycho-education programs that specifically target parents' emotion regulation and effective communication abilities to ameliorate the psychopathological symptoms of parents and their children. Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-023-00609-y.

Marriage matching patterns associated with depressive symptoms among Chinese adults: A nationally representative age-period-cohort modeling study.

BACKGROUND: Little is understood about the relationship between marriage matching patterns and mental health. This study aims to examine the relationship between patterns of marriage matching and depressive symptoms among married Chinese adults, and respectively validate the effects of age, period, and cohort with hierarchical APC models. METHODS: A total of 20,430 couples from the 2012, 2016 and 2018 wave of China Family Panel Studies were included in this study. We investigate patterns of marriage matching from age, personal education, parental education and especially, parental hukou status, which reflects an individual's residential status through urban-rural divide and has vital implications for socioeconomic status in China. RESULTS: Age gap is significantly associated with depressive symptoms both for men and women, yet sorting of parents' hukou status and education presented significant relationship with depressive symptoms only among women. In addition, we found strong age effects that changing trajectories of depressive symptoms across the life course vary among different genders and marital patterns. We did not find significant cohort effects after considering other factors, indicating the stability of depressive symptoms across birth cohorts. LIMITATIONS: The CES-D is a widely used tool for depressive symptoms screening, the self-report instrument may produce results with lesser accuracy. CONCLUSIONS: Marriage matching patterns are significantly associated with depressive symptoms among Chinese adults, and these effects vary significantly across the life course. Our study sheds lights on the public mental health promotion programs from a marital perspective, suggesting that women in less satisfying marriage should be prioritized.

Childhood abuse as a mediator of the relationship between early family socio-economic status and geriatric depression: A population-based study in China.

Previous studies have suggested that childhood socioeconomic status (SES) is linked to geriatric depressive symptoms in many developed countries. However, the potential pathways of the relationship between childhood SES and geriatric depressive symptoms need to be further explored. This study aimed to assess the mediating effect of being abused during childhood on the association between childhood SES and geriatric depressive symptoms, using evidence from a longitudinal study in China. The study cohort included 8137 individuals. Childhood abuse was defined as experiences related to parental violence, sibling abuse, school violence, community violence, and parental quarrel. Results indicated poor childhood SES was associated significantly with geriatric depressive symptoms. The indirect effect of poor childhood SES to high geriatric depressive risk through community violence, sibling abuse, school violence, and parental quarrel were 0.02, 0.01, 0.02, and 0.01, respectively. Our findings shed new light on the literature regarding the impact of childhood SES on elderly depressive symptoms. Furthermore, childhood SES demonstrated a significant correlation with geriatric depressive symptoms through bullying behaviors. The findings highlight the need to promote both childhood social welfare and psychological well-being within the elderly population.

Thirty-year trends of depressive disorders in 204 countries and territories from 1990 to 2019: An age-period-cohort analysis.

This study aims to estimate the global, regional, and national burden of depressive disorders in 204 countries and territories from 1990 to 2019. All data were obtained from the 2019 Global Burden of Disease (GBD) study. Age-period-cohort (APC) modeling was conducted to disentangle age, period, and birth cohort effects on depression incidence. We compared these estimates across regions classified based on their socio-demographic index (SDI). The Estimated Annual Percentage Change (EAPC) was calculated for each of the 204 countries and territories to identify the top five countries with increased depression incidence (Spain, Mexico, Malaysia, the United States of America, and Uruguay) and the top five countries with decreased depression incidence (Singapore, Estonia, Cuba, Maldives, and Sri Lanka). The results from APC analysis indicate that although depression incidence has decreased globally, the incidence rate in high SDI regions is still increasing, especially in the younger generations. Findings suggest that currently some populations are in need of receiving more psychological support (i.e., individuals born after 1950s in high SDI regions; males in middle SDI regions). Forthcoming studies could corroborate our findings using individual-level data which may guide future prevention and intervention of depression in high-risk populations or regions.

Do living arrangements and health behaviors associate with anxiety symptoms among Chinese older people? Differences between urban and rural areas.

Living arrangements and health behaviors are considered to be associated with mental health, but their relationship has been less investigated by national survey data in China. The purpose of this study is to explore the relationship of living arrangements and health behaviors with anxiety among Chinese older people and to compare the results between urban and rural areas. The study was based on the Chinese Longitudinal Healthy Longevity Survey conducted in 2018, and a total of 12 726 old-aged respondents were included. Ordinal logistic regression was used to analyze the associations between living arrangements, health behaviors and anxiety. This study found that people living in nursing institutions are likely to be more anxious than their dwelling counterparts. Although we found no significant relationships of health behaviors such as smoking, drinking alcohol and exercise with anxiety, older adults with greater dietary diversity were less likely to experience anxiety. Furthermore, different trends between living arrangements and anxiety, smoking and anxiety were also found among urban versus rural respondents. The findings of this study help to better understand anxiety among Chinese older people and shed light on health policy on older people protection and services.

The associations between cognitive function and depressive symptoms among older Chinese population: A cohort study.

With the rapid development of society, population aging has emerged as a significant global challenge. This study aimed to evaluate the impact of baseline cognitive performance, current cognitive function, and cognitive decline on subsequent depressive symptoms. Data were obtained from participants aged 65 years and older in the Chinese Longitudinal Healthy Longevity Survey (CLHLS), Wave 2014-2018. Of the 7,192 participants in Wave 2014, 1,627 were included in the analysis. Multivariate regressions were conducted to estimate the associations between cognitive measures and depressive symptoms. Our results indicated that baseline cognitive function was not associated with subsequent depressive symptoms, but current cognitive function was. Furthermore, participants who experienced significant cognitive decline were more likely to develop depressive symptoms. Covariates, including marital status, economic status, physical activity, and recreational activity, were also associated with subsequent depressive symptoms. These findings suggest that slowing cognitive decline is an effective strategy for preventing depressive symptoms in older adults, promoting their health and wellbeing.

Self-perceived memory is negatively associated with chronic disease awareness: Evidence from blood biomarker data.

Background and objectives: Cognitive misperception contributed to poor decision-making; yet their impact on health-related decisions is less known. We examined how self-perceived memory was associated with chronic disease awareness among older Chinese adults. Research design and methods: Data were obtained from the China Health and Retirement Longitudinal Study. Nationally representative blood biomarkers were collected in 2015 to identify participants' dyslipidemia and diabetes status. Among participants with biomarker identified dyslipidemia or diabetes, disease awareness was defined as self-reported diagnosis of the conditions as of 2018. The association of self-perceived memory with chronic disease awareness was determined by weighted multivariate logistic regressions adjusting for cognitive ability and covariates. Results: Among 4578 adults aged 60 and over, 1442 and 759 individuals were identified having dyslipidemia and diabetes, with proportions of disease awareness being 38.0% and 58.1%, respectively. The proportions were lower for individuals with better self-perceived memory and those with more impaired cognitive ability, showing opposite patterns. Adjusting for cognitive ability and covariates, self-perceived memory was negatively associated with the dyslipidemia (OR = 0.80, 95%CI: 0.63-1.02) and diabetes (OR = 0.71, 95%CI: 0.55-0.92) awareness. In particular, older adults with the highest level of self-perceived memory had significantly lower disease awareness as compared to those with the lowest level of self-perceived memory (OR = 0.51, 95%CI: 0.28-0.94 for dyslipidemia; and OR = 0.42, 95%CI: 0.21-0.84 for diabetes). The negative association was robust to adjusting for alternative cognitive measures, and was stronger for individuals with rural status, lower education, or living without children. Discussion and implications: Cognitive misperception poses great challenges to chronic disease awareness. Targeted interventions and supports are needed, particularly for those more disadvantaged.

Relationship Between Work-Family Conflict and Depressive Symptoms Among Male Firefighters in China: Job Types and Family Structure as Moderators.

OBJECTIVES: This study aims to examine the relationship between work-family conflict and depressive symptoms while considering job types and family structure as moderators. METHODS: In July and August 2021, 1328 male Chinese firefighters completed an online cross-sectional survey. RESULTS: The results indicated that work-family conflicts among Chinese firefighters presented a significant association with worse depressive symptoms. More specifically, strain conflict and behavioral conflict had positive relationships with worse depressive symptoms, while time conflict had a negative relationship. In addition, job types moderated the association between work-family conflict, strain conflict, and behavior conflict with depressive symptoms. CONCLUSIONS: This study shows that work-family conflict is significantly associated with depressive symptoms among Chinese firefighters. Our findings advocate working system reform for Chinese firefighters, and more attention is needed on their mental health protection in the future.

The Relationship Between Effort-Reward Imbalance and Depressive Symptoms Among Chinese Firefighters: Moderating by Coping Styles.

OBJECTIVES: This study aims to examine the association between effort-reward imbalance (ERI) and depressive symptoms among Chinese firefighters and the moderating role of positive and negative coping styles in the above association. METHODS: A cross-sectional study including 1328 male firefighters was conducted in China. We adopted the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. RESULTS: Results showed that ERI was associated with depressive symptoms. Individuals with a higher ERI ratio and greater overcommitment were likely to have higher level of depressive symptoms. Furthermore, negative coping style strengthened the relationship between ERI ratio and overcommitment with depressive symptoms, whereas the positive coping style presented none significant moderation. CONCLUSIONS: These findings indicate that reforming the effort-reward system might be helpful for mental health promotion among Chinese firefighters.

Network analysis of COVID-19-related PTSD and depressive symptoms among Chinese general population and comorbidity subgroup.

OBJECTIVE: Posttraumatic stress disorder (PTSD) and depressive symptoms are prevalent and highly correlated mental health outcomes of traumatic events, but their comorbidity in the COVID-19 pandemic has not been examined with evidence from Chinese culture. METHOD: With information from 2,858 Chinese adults, this study used a network analysis to investigate the relationship between PTSD and depressive symptoms along with their symptoms-structure associations. RESULTS: Results indicated similar positive connections among similar cluster symptoms (i.e., positive affect) in both general and comorbidity-reported populations. Self-destructive/reckless behaviors were core symptoms in the general population, and interpersonal difficulties were core symptoms in the comorbidity subgroup. Finally, the very strong communication seen between "arousal and reactivity alterations" and "depressed affect" deserves more attention. CONCLUSION: Our results indicated interpersonal symptoms can be important targets when intervening or treating PTSD and depressive symptoms related to COVID-19 in the clinical population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The associations of pandemic-related difficulties with depressive symptoms and psychological growth among American older adults: Social support as moderators.

The COVID-19 pandemic brought social, health-related, and financial risks to older adults, yet their associations with depressive symptoms and posttraumatic growth (PTG) were not systematically examined. With 3504 respondents aged 60 and over from Health and Retirement Survey, this study found pandemic-related healthcare delay and financial hardship associated with elevated depressive symptoms and decreased PTG, whereas social disruption predicted greater PTG. When confronted with multidimensional difficulties, a higher level of social support buffered depressive symptoms and enhanced PTG following healthcare delay, while those from immediate family members carried the weighing of moderation. Additionally, the moderation effect varied between support types, as exclusive instrumental support engendered more depressive symptoms and squeezed PTG by stimulating a sense of incompetence for older adults. Inversely, receiving both instrumental and emotional support helped individuals of older age against financial-related depressive symptoms. These findings shed light on older adults' mental health promotion in a pandemic context.

Relationship among Child Maltreatment, Parental Conflict, and Mental Health of Children during the COVID-19 Lockdown in China.

Children are more likely to experience maltreatment and parental conflict in a pandemic context, which can exacerbate their vulnerability to psychological disorders. The purpose of the present study was to examine mental health symptoms in children aged 0 to 10 years and consider related factors from the perspectives of maltreatment and parental conflict during the COVID-19 lockdown. Participants were 1286 parents aged 18 years and over with children aged 0 to 10 years were included. Several multivariable linear regressions were used to analyze the data. The largest variance in child mental health was explained by child maltreatment, as more maltreatment predicted higher reported psychological problems (standardized beta = 0.49, P < 0.001). Comparatively, parental conflict predicted less variance in mental health problems than maltreatment (standardized beta = 0.18, P < 0.001). Children who experienced more maltreatment experience and exposure to COVID-19 showed elevated levels of mental health symptoms (standardized beta = 0.06, p < 0.05), as did those who experienced parental conflict and pandemic exposure (standardized beta = 0.06, p < 0.05). The findings highlight that tailored programs that focus on a healthy family environment and strategic parental support services may be particularly effective in reducing children's mental health problems due to COVID-19 exposure.

The Relationship Between Job Burnout and Depressive Symptoms Among Chinese Firefighters: Colleagueship as a Moderator.

OBJECTIVES: This study aims to investigate the association between job burnout and depressive symptoms among Chinese firefighters, assuming colleagueship to play a moderating role in the aforementioned relationship. METHODS: This study is based on an online survey recruiting 1328 Chinese male firefighters from July 1 to August 31, 2021. Multiple linear regressions were used to examine the associations. RESULTS: This study revealed that all dimensions of job burnout were associated with worse depressive symptoms. Cynicism (ß = 0.30; 95% confidence interval [CI], 0.236, 0.356) had the strongest association with depressive symptoms, followed by emotional exhaustion and inefficacy. Moreover, firefighters with better affective colleagueship (ß = -0.10; 95% CI, -0.141, -0.061) and better obligatory colleagueship (ß = -0.07; 95% CI, -0.115, -0.034) were less likely to have depressive symptoms when confronted with job burnouts. CONCLUSIONS: This study suggests employers and practitioners should target their intervention efforts at both job burnout and colleagueship.

Six-year changes of posttraumatic stress symptoms and depressive symptoms among Chinese earthquake survivors: A network analysis.

BACKGROUND: The risk factors of Posttraumatic Stress Symptoms (PTSS) and depressive symptoms have been well-established, but whether the network structure of their symptoms changes over time remains unclear. This study aims to examine the six-year changes of network structure of PTSS and depressive symptoms among Wenchuan earthquake adult survivors in China. METHODS: In this pooled cross-sectional study, respondents were sampled from the same population at each of the five waves (N = 1343, 1205, 1177, 1376, and 1339). The network structure of them was investigated using network analyses. RESULTS: The study shows network connections stable across waves were the positive connections between hyperarousal and intrusions, hyperarousal and somatic symptoms, and two dimensions of positive effects. Stable negative connections were those between depressed affects and positive effects, avoidance and depressed affects, avoidance with interpersonal symptoms and avoidance with somatic symptoms. Across waves, fearful emotion consistently was the strongest bridge symptom connecting with PTSS symptoms. However, for PTSS the strongest bridge symptom varied across time as it was avoidance in wave 1 but were hyperarousal in other four waves. LIMITATIONS: This study was based on a pooled cross-sectional survey, which inhibits conclusions regarding causal influences between symptoms at the individual patient level. CONCLUSIONS: The network structure of PTSS and depressive symptoms was partly stable, yet also varied across survey waves. Core symptom clusters for PTSS and depressive symptoms were avoidance and depressed affect, respectively. The central role of these clusters in PTSS and depressive symptoms has important implications to future psychiatric programs.

Associations of youth mental health, parental psychological distress, and family relationships during the COVID-19 outbreak in China.

BACKGROUND: The COVID-19 pandemic has brought significant changes in society and family life, which could be particularly difficult for parents. The present study examines the relationship between youth mental health and parental psychological distress after the first peak of the COVID-19 Outbreak in China. The parent-child and marital relationships were examined as moderators of the above relationship. METHODS: Parents and their children aged 10 to 18 years were recruited for this study. The parents completed the Depression Anxiety Stress Scales-21 (DASS-21), the Strengths and Difficulties Questionnaire (SDQ), and a subset of items from the questionnaire of the COVID-19 Supporting Parents, Adolescents, and Children in Epidemics (Co-SPACE) survey of parental mental health, child's psychological symptoms, parent-child, and marital relationship. Several multiple linear regressions were used to analyze the data. RESULTS: The largest variance in parental mental health was explained by the child's psychological symptoms (effect size beta = 0.27). Parent-child (effect size beta = -0.13) and marital relationship (effect size beta = -0.21) were negatively associated with parental mental health. The relationship between child's psychological symptoms and parental mental health was moderated by marital relationship (effect size beta = -0.07). Both parent-child and marital relationships presented with a significant interaction with impact scores, while only parent-child relationships with burden scores. CONCLUSIONS: Youth mental health problems were significantly associated with parental psychological symptoms during the early phase of the COVID-19 pandemic The parent-child and marital relationship moderated the association between youth psychological symptoms and parental mental health. Interventions for alleviating parenting stress and support services that improve family relationships may be particularly effective in reducing parental psychological distress associated with future COVID-19 or related crises.

The Associations Between Parental Burnout and Mental Health Symptoms Among Chinese Parents With Young Children During the COVID-19 Pandemic.

The Coronavirus Disease 2019 (COVID-19) pandemic has caused numerous unexpected changes for families and societies, which have likely contributed to higher amounts of stress for most parents. This study aimed to examine the relationship between burnout and mental health among parents during the COVID-19. Pandemic exposure and household factors (e.g., family structure, family function) were examined as moderators. An online cross-sectional survey recruiting 1,209 adults was conducted from April 21st to April 28th, 2020 during the COVID-19 lockdown in China. The multivariable linear regression analysis was employed to test the association between burnout, household factors, and mental health among parents. Findings suggested that for parents with a young child, poorer mental health was related to a higher level of burnout (ß = 0.220, P < 0.001) and greater exposure to the pandemic. Mothers of a single and/or young child had considerably poorer mental health. Moreover, the relationship between mental health and burnout among parents was significantly moderated by epidemic exposure (ß = 2.561, P < 0.001), family structure (number of children: ß = -1.257, P < 0.001; first child age: ß=-1.116, P < 0.001) and family function (ß = -0.574, P < 0.05). This study indicated that burnout symptoms were significantly associated with worse mental health among parents in China. Besides, exposure to the pandemic, family structure, and family function was found to moderate the association between burnout and mental health among parents. Therefore, the present study stressed enhanced access to mental health resources and emotional supports for parents during a public crisis to reduce the deleterious effects of burnout.

The Relationship Between Being Bullied and Addictive Internet Use Among Chinese Rural Adolescents: The Mediating Effect of Adult Attachment.

Internet addiction among adolescents is an emerging public health issue. The aim of this study was to examine the relationship between being bullied and internet addiction, and further to test the mediating effect of adult attachments on this relationship among Chinese rural adolescents. A total of 1,270 adolescents from three high schools in Henan province were recruited as subjects. Internet addiction was measured by Young's internet addiction scale. This study showed that the prevalence of being bullied and addictive internet use among the recruited Chinese rural adolescents were 41.97% and 11.34%, respectively. Being bullied was significantly associated with internet addition. Adult attachment was found to mediate the association between being bullied and internet addiction. Higher anxiety attachment and lower close-dependent attachment partially explained the higher risk of internet addiction among the Chinese rural adolescents being bullied. This study suggests that the experience of being bullied can increase the risk of addictive internet use and that this risk can be mediated through adult attachments. This discovery supports the adoption of effective prevention programs to decrease school bullying and to improve adult attachments for adolescents in China and other countries.

Does the attribution of responsibilities modify the relationship between coping styles and mental health? A survey of Chinese adults during the COVID-19 pandemic.

The COVID-19 pandemic is associated with Posttraumatic Stress Symptoms (PTSS) and self-reported Posttraumatic Growth (PTG) in the general population. This study used linear regressions for analyses, based on an online survey conducted during the COVID-19 lockdown among 2441 Chinese adults in February 2020. The results showed negative coping and attributing responsibilities to individuals were associated with more PTSS, while both positive and negative coping, as well as attributing responsibilities to individuals were related to more PTG. Moreover, attribution of responsibilities modified the association between coping and PTSS, but not PTG. These findings shed light on mental health interventions in a pandemic context.

Network analysis of COVID-19-related PTSD symptoms in China: the similarities and differences between the general population and PTSD sub-population.

Background and Objectives: Prevalent Post-traumatic Stress Disorder (PTSD) negatively affected individuals during the COVID-19 pandemic. Using network analyses, this study explored the construct of PTSD symptoms during the COVID-19 pandemic in China to identify similarities and differences in PTSD symptom network connectivity between the general Chinese population and individuals reporting PTSD. Methods: We conducted an online survey recruiting 2858 Chinese adults. PTSD symptoms were measured using the PCL-5 and PTSD was determined according to the DSM-5 criteria. Results: In the general population, self-destructive/reckless behaviours were on average the most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) avoidance of thoughts and avoidance of reminders, 2) concentration difficulties and sleep disturbance, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviours, and 5) hypervigilance and exaggerated startle responses. Besides, negative connections were found between intrusive thoughts and trauma-related amnesia and between intrusive thoughts and self-destructive/reckless behaviours. Among individuals reporting PTSD, symptoms such as flashbacks and self-destructive/reckless behaviours were on average most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) concentration difficulty and sleep disturbance, 2) intrusive thoughts and emotional cue reactivity, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviour, and 5) detachment and restricted affect. In addition, a negative connection was found between intrusive thoughts and self-destructive/reckless behaviours. Conclusion: Our results indicate similarly positive connections between concentration difficulty and sleep disturbance, negative beliefs and negative trauma-related emotions, and irritability/anger and self-destructive/reckless behaviours in the general and PTSD-reported populations. We argue that self-destructive/reckless behaviours are a core symptom of COVID-19 related PTSD, worthy of more attention in future psychiatric programmers.

Antecedentes y Objetivos: El Trastorno de Estrés Postraumático (TEPT) prevalente afectó negativamente a los individuos durante la pandemia del COVID-19. Usando análisis de redes, este estudio exploró el constructo de síntomas de TEPT durante la pandemia de COVID-19 en China para identificar las similitudes y diferencias en la conectividad de red de síntomas de TEPT entre la población general china y los individuos que reportan TEPT.Métodos: Realizamos una encuesta en línea que reclutó 2.858 adultos chinos. Los síntomas de TEPT se midieron usando el PCL-5 y el TEPT se determinó de acuerdo a los criterios del DSM-5.Resultados: En la población general, las conductas autodestructivas/ imprudentes fueron, en promedio, las más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) evitación de pensamientos y evitación de recordatorios, 2) dificultades en la concentración y trastornos del sueño, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes y 5) hipervigilancia y respuestas de sobresalto exageradas. Además, se encontraron conexiones negativas entre pensamientos intrusivos y amnesia relacionada con el trauma y entre pensamientos intrusivos y conductas autodestructivas/ imprudentes. Entre los individuos que reportaron TEPT, los síntomas como flashbacks y conductas autodestructivas/ imprudentes estuvieron, en promedio, más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) dificultades en la concentración y trastornos del sueño, 2) pensamientos intrusivos y reactividad emocional a ciertas señales, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes, y 5) desapego y afecto restringido. Además, se encontró una conexión negativa entre pensamientos intrusivos y conductas autodestructivas/ imprudentes.Conclusión: Nuestros resultados indican conexiones igualmente positivas entre dificultades en la concentración y trastornos del sueño, creencias negativas y emociones negativas relacionadas con el trauma, e irritabilidad/ ira y conductas autodestructivas/ imprudentes en la población general y la que reporto TEPT. Argumentamos que las conductas autodestructivas/imprudentes son un síntoma central de TEPT relacionado con COVID-19, que merece más atención en futuros programas psiquiátricos.

Gender differences in trajectories of mental health symptoms among Chinese earthquake survivors.

BACKGROUND: Posttraumatic stress symptoms and depressive symptoms are prevalent after natural disasters. However, in a Chinese trauma context, little research examined the long-term trajectories of these two symptoms with a gender perspective. METHODS: Data came from an 8-year longitudinal survey of 3522 Wenchuan earthquake adult survivors. We used multilevel growth-curve models to investigate the trajectories of PTSS and depressive symptoms; adopted conditional growth-curve models to explore the gender differences in trajectories together with gendered factors associated with mental health symptoms; conducted Chow tests to examine the significance of gender differences. Standardized coefficients, P values, and effect sizes were reported. RESULTS: With covariates controlled, both linear (ß = -1.33, p < 0.001, Cohen's d = 0.79) and quadratic effects (ß = 1.03, p < 0.001, Cohen's d = 0.59) of time were significant in PTSS trajectory, whereas quadratic effect (ß = 0.27, p < 0.001, Cohen's d = 0.14) in the declining depressive trajectory was clinically nonsignificant. Compared with men, women are at higher risk of PTSS (ß = 0.12, p < 0.001, Cohen's d = 0.21) and depressive symptoms (ß = 0.10, p < 0.001, Cohen's d = 0.20), but also with a faster-declining rate in PTSS within first five years after the disaster. No gender difference was found regarding depressive trajectory. Additionally, poor education and income associate with more PTSS in women, while sickness predicts severer depression in women and more PTSS in men. CONCLUSIONS: This study proposes a gendered U-shape trajectory for PTSS and a declining depressive trajectory without gender difference. The findings of this study shed light on mental health intervention in future natural disasters.