The bidirectional relationship between sleep disturbance and anxiety: Sleep disturbance is a stronger predictor of anxiety.

BACKGROUND: Both sleep disturbance and anxiety are common problems that significantly affect human health, but little is known about their causal relationship. The aim of this study was to explore the causal relationship between them with a large sample of community-dwelling adults included. METHODS: Data for this study were extracted from the baseline survey of West China Natural Population Cohort Study (WCNPCS) and follow-up in the following year. The sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI), and anxiety was screened using the Generalized Anxiety Disorder Scale (GAD-7). Age, gender, educational level, marital status, smoking status, drinking status, depressive symptoms, loneliness and chronic diseases were taken as covariant factors. Logistic regression and cross-lagged models were used for data analyses. RESULTS: A total of 16699 participants (67.5 % females) were enrolled, with the average age of participants being 57.3 ± 12.7 years. A total of 40.50 % of participants experienced poor sleep quality at baseline and 40.52 % at follow-up. The prevalence of anxiety was 7.58 % at baseline and 4.62 % at follow-up. The results showed that the risk of developing anxiety in individuals with sleep disturbance at baseline was 1.89 times higher than those without (95%CI = 1.43-2.48). Similarly, anxiety increased the risk of developing sleep disturbance by 1.20-fold (95%CI = 1.03-1.39). These results were further supported by the cross-lagged panel models. CONCLUSION: Sleep disturbance and anxiety are mutually causal, and the effect of poor sleep on anxiety seems to be more significant. Timely interventions targeting sleep may help to break the vicious circle between sleep disturbance and anxiety symptoms, and improve the quality of life.

The relationship between health-promoting behaviors and negative emotions in college freshmen: a cross-lagged analysis.

Background: The prevalence of mental health issues has been gradually increasing among college students in recent years. Improvements in mental health can be achieved through changes in daily behavior and the use of psychological counseling. This study aims to investigate the relationship between health-promoting behaviors and negative emotions among college freshmen as they enter the university. It also examines the impact of various sub-dimensions of health-promoting behaviors and other factors on the negative emotions (stress, anxiety, and depression) experienced by college freshmen. Methods: Using the Negative Emotion and Health-Promoting Behavior scales, a 7-month longitudinal study was conducted on 4,252 college freshmen, with collection of data at two time points (T1: November 12, 2021; T2: June 17, 2022). Out of this longitudinal study, 3,632 valid samples were obtained. This research aimed to explore the association and impact between negative emotions and the level of health-promoting behaviors among college students during their time at the university. Results: ① There were significant differences in the levels of health-promoting behaviors and negative emotions over the course of 7 months (P < 0.05). Health-promoting behaviors were found to have a significant negative correlation with negative emotions (P < 0.05). ② Negative emotions at T1 significantly negatively predicted health-promoting behaviors at T2 (ß = -0.11, P < 0.01), while health-promoting behaviors at T1 significantly negatively predicted negative emotions at T2 (ß = -0.12, P < 0.001). ③ Stress management (ß = -0.104, P < 0.05; ß = -0.087, P < 0.05), self-actualization (ß = -0.282, P < 0.01; ß = -0.260, P < 0.05), health responsibility (ß = -0.057, P < 0.05; ß = -0.088, P < 0.05), and interpersonal relations (ß = 0.068, P < 0.01; ß = 0.138, P < 0.05) were important components in improving stress and anxiety. Self-actualization (ß = -0.437, P < 0.001), exercise (ß = 0.048, P < 0.001), nutrition (ß = 0.044, P < 0.001), and interpersonal relations (ß = 0.065, P < 0.001) were important components in improving depression. ④ Gender, place of household registration, and whether the individual is the only child were significant factors affecting negative emotions in college freshmen. Conclusion: The level of health-promoting behaviors is an important indicator for assessing the negative emotional states of college freshmen. Enhancing health-promoting behaviors across various dimensions can help alleviate different types of negative emotions. Gender, place of household registration, and being the only child are significant factors that influence negative emotions.

Relationships among self-esteem, depression and self-injury in adolescents: a longitudinal study.

Objective: Non-suicidal self-injury is a widespread mental health concern among adolescents. This study aimed to examine the relationship between self-esteem, depression, and self-injury among adolescents using a longitudinal research design. Methods: The Self-Esteem Scale (SES), Child Depression Inventory (CDI), and Adolescent Self-Injury Scale (ASIS) were used to follow up 1,265 junior middle school students on three occasions with six-month intervals. Results: At all three time points, there were significant gender differences in self-esteem, depression, and self-injury. Self-esteem was negatively correlated with depression and self-injury at all three time points, while depression and self-injury were significantly positively correlated. Cross-lagged analysis revealed that self-esteem at Time 1 (T1) did not significantly predict self-injury at Time 2 (T2), but self-esteem (T2) significantly predicted self-injury at Time 3 (T3; ß = -0.079, p < 0.05). Similarly, self-injury (T1) significantly predicted self-esteem (T2; ß = -0.140, p < 0.001), and self-injury (T2) significantly predicted self-esteem (T3; ß = -0.071, p < 0.01). Horizontal and longitudinal mediating analysis showed that depression served as a complete mediator in both the pathway from self-esteem to self-injury and from self-injury to self-esteem. Cross-lagged analysis showed that self-esteem (T1) significantly predicts depression (T2; ß = -0.070, p < 0.05), which in turn predict self-injury (T3; ß = 0.126, p < 0.001). Similarly, self-injury (T1) predicted depression (T2; ß = 0.055, p < 0.05), which further predicted self-esteem (T3; ß = -0.218, p < 0.001). Conclusion: The self-esteem, depression, and self-injury of adolescents are closely related; self-esteem and self-injury predict each other; self-esteem indirectly affects self-injury through depression; and self-injury indirectly affects self-esteem through depression. Based on the relationship of bi-directional prediction of self-esteem and self-injury mediated by depression, this study proposes a theoretical model of depression-mediated self-esteem and self-injury cycle.

The relationship between mobile phone addiction and time management disposition among Chinese college students：A cross-lagged panel model.

Previous research has identified a negative association between mobile phone addiction and time management disposition among college students; however, the direction of this relationship remains divergent. This study utilized a cross-lagged panel model to elucidate the directionality of the relationship between mobile phone addiction and time management disposition. A total of 466 college students completed two measures at seven-month intervals. The findings revealed a prevalence of mobile phone addiction at 10.94 % and 13.73 % in the two surveys. Notably, both mobile phone addiction and time management disposition demonstrated stability over time. Furthermore, a discernible negative bidirectional relationship was observed between the two. The present findings underscore the importance of timely intervention for college students facing challenges in mobile phone usage and time management.

The longitudinal relationship between loneliness and both social anxiety and mobile phone addiction among rural left-behind children: A cross-lagged panel analysis.

INTRODUCTION: Left-behind children are a special group that needs urgent attention. Due to enduring separation from their parents, loneliness is considered the most common and prevalent developmental hurdle in the experiences of left-behind children. This longitudinal cross-lagged study examined the direction of the association between loneliness and both internalizing and externalizing symptoms, with considering gender and left-behind status differences. METHODS: A total of 1175 rural Chinese children (48.3% boys, 39.9% left-behind children, Mage = 14.54 ± 1.18 at baseline) completed self-reported loneliness, social anxiety, and mobile phone addiction at two-time points with 6 months intervals. Descriptive statistics, cross-lagged panel analysis, and multiple group analysis were estimated in the present study. RESULTS: Loneliness exacerbated social anxiety and mobile phone addiction, and vice versa. In addition, gender and left-behind status moderated these relationships, with boys more likely to be mobile phone addicted due to loneliness and girls more likely to be lonely due to mobile phone addiction. More importantly, left-behind children with loneliness are more prone to social anxiety and mobile phone addiction, and vice versa, compared with non-left-behind children. CONCLUSIONS: The targeted interventions should be carried out for different genders and left-behind statuses. Particularly for left-behind children, neglecting to address both the symptoms of loneliness and both social anxiety and mobile phone addiction could significantly undermine the efficacy of intervention programs that solely target either one of these afflictions.

Social support, family resilience and psychological resilience among maintenance hemodialysis patients: a longitudinal study.

BACKGROUND: Psychological distress is common in maintenance hemodialysis patients, and high psychological resilience can promote psychological well-being. The current research focuses on psychological resilience protective factors such as family resilience and social support. However, the trajectories of psychological resilience, family resilience, and social support over time and their longitudinal relationships in maintenance hemodialysis patients have not been fully explored yet. Therefore, this study aims to explore the longitudinal relationship between these factors. METHODS: Patients who received regular hemodialysis treatment for more than three months at dialysis centers of three tertiary hospitals in Zhejiang, China, were recruited from September to December 2020. A total of 252 patients who met the inclusion and exclusion criteria completed three follow-up surveys, including social support, family resilience, and psychological resilience assessments. A repeated measures ANOVA was used to explore differences in their respective scores at different time points. The cross-lagged analysis was performed in AMOS using the maximum likelihood method to examine the the reciprocal predictive relationships between these factors. RESULTS: Social support and psychological resilience remained relatively stable over time, whereas family resilience indicated a little increasing trend. According to the cross-lagged analysis, higher T1 social support predicted higher family resilience at T2 [ß = 0.123, 95% CI (0.026-0.244)]. Further, the effects of T2 social support to T3 family resilience [ß = 0.194, 95%CI (0.039-0.335)] and psychological resilience [ß = 0.205, 95%CI (0.049-0.354)] were significant. Finally, the effects of T2 family resilience to T3 social support [ß = 0.122, 95%CI (0.010-0.225)] and psychological resilience [ß = 0.244, 95%CI (0.119-0.359)] were also significant. CONCLUSIONS: The study showed that the directionality of the relationship appears to be from social support or family resilience to patients' psychological resilience but not vice versa. This finding reminds healthcare professionals to emphasize the vital role of social and family resources in providing appropriate support and interventions for maintenance hemodialysis patients to promote psychological resilience and mental health development.

Temporary relationship between sleep duration and depression and its impact on future risk of cardiovascular disease.

BACKGROUND: Although sleep duration and depression were correlated, their temporal sequence and how the sequence influence on future risk of cardiovascular disease (CVD) remained undetermined. This study aimed to explore the temporal relationship between sleep duration and depression, and its association with future CVD risk. METHODS: We included 10,629 middle-aged and elderly participants with repeated measurements of sleep duration and depressive symptoms (measured by Center for Epidemiological Studies-Depression scale [CESD]) at the first two visits from the China Health and Retirement Longitudinal Study. Cross-lagged analysis and mediation analysis were used to examine the temporal relationship between sleep duration and depression and its impact on future risk of CVD. RESULTS: The adjusted cross-lagged path coefficient from baseline sleep duration to follow-up CES-D (ß1 = -0.191; 95 % confidence interval [CI], -0.239 to -0.142) was significantly greatly than that from baseline CES-D to follow-up sleep duration (ß2 = -0.031; 95 % CI, -0.031 to -0.024) (Pdifference < 0.0001). Similarly, the path coefficient from baseline sleep duration to annual changes in CES-D was significantly greater than that from baseline CES-D to annual changes in sleep duration (ß1 = -0.093 versus ß2 = -0.015, Pdifference < 0.0001). The path coefficient from baseline sleep duration to follow-up CES-D in CVD group was significantly greater than that in those without CVD (Pdifference of ß1 = 0.0378). Furthermore, 27.93 % of the total association of sleep duration with CVD was mediated by depression symptoms. CONCLUSIONS: The findings provide evidence that decrease in sleep duration probably precedes the increased in depressive symptoms, and depression partially mediated the pathway from sleep duration to incident CVD.

The Relationship Between Negative Coping Styles, Psychological Resilience, and Positive Coping Styles in Military Personnel: A Cross-Lagged Analysis.

Background: Military personnel experience prolonged exposure to high-stress environments. Positive coping styles can assist in maintaining their mental and behavioral well-being, whereas negative coping styles cannot. Health behavior change theory specifies that an individual can transition from a negative to a positive coping style. The psychological resilience concept may prove vital in this transition. Methods: In a longitudinal study design, two questionnaires were administered to 233 military personnel twice, the first at T1 in April 2023 and the second at T2 in July 2023. The questionnaire measured individual negative coping style, positive coping style and psychological resilience. Results: The data showed that the negative coping style at T1 negatively predicted the level of psychological resilience at T2 (γ= - 0.26, p < 0.001) and the positive coping style at T2 (γ= - 0.16, p < 0.001). The level of psychological resilience at T1 positively predicted the positive coping style at T2 (γ= 0.22, p < 0.01). Psychological resilience played a mediating role between negative coping style and positive coping style. In addition, there was an interaction between psychological resilience and positive coping style in military personnel at the two time points. Conclusion: The negative coping styles that presently exist among military personnel have the potential to diminish their future positive coping styles by lowering their psychological resilience. This highlights the need to focus on the development and training of psychological resilience for military personnel, as it can effectively counteract negative coping styles and promote positive coping styles.

The longitudinal associations between internet addiction and ADHD symptoms among adolescents.

Background and aims: Internet addiction has been linked to ADHD-related symptoms. However, the direction of the relationship and its potential for reciprocal relations is not well understood. This study examined the potential reciprocal relations between the three components of ADHD and Internet addiction, as well as the moderating effects of gender on these relations. Methods: Using a longitudinal design, we collected data of 865 Chinese adolescents across three waves (Mage = 13.78, SD = 1.56 in wave 1), with a time interval of 6 months. Results: Cross-lagged analyses revealed bidirectional associations between hyperactivity, inattention, impulsivity, and Internet addiction over time. Multi-group analyses did not yield any significant gender differences in these relationships. Discussion and conclusions: These findings enhance our understanding of the complex link between ADHD components and Internet addiction and have implications for interventions aimed at reducing the prevalence of Internet addiction and ADHD.

Association of Abnormal Sleep Duration and Sleep Disturbance with Physical Activity in Older Adults: Between- and within-Person Effects.

OBJECTIVES: Sleep is associated with physical activity (PA), yet the nature and directions of this association are less understood. This study aimed to disentangle the long-term temporal sequences between sleep duration/disturbance and PA in older adults, distinguishing between- and within-person effects. DESIGN: Longitudinal panel study. SETTING AND PARTICIPANTS: We conducted a longitudinal study using 3 waves of data collected in 2008/09 (T1), 2012/13 (T2), and 2016/17(T3) from adults aged ≥50 years in the English Longitudinal Study of Ageing (N = 10,749 individuals). MEASURES: Sleep duration, sleep disturbance, and PA were assessed by self-reported questionnaires. We used cross-lagged panel models (CLPMs) to examine between-person effects and random intercept cross-lagged panel models (RI-CLPMs) to examine within-person effects. RESULTS: Our analyses revealed a reciprocal relationship between abnormal sleep duration and low PA levels at between-person level (abnormal sleep duration to PA: ßT1-T2 = -0.053, ßT2-T3 = -0.058, all P < .001; PA to abnormal sleep duration: ßT1-T2 = -0.040, ßT2-T3 = -0.045, all P < .05), with abnormal sleep duration being the driving force in the dynamic association. In addition, there was a unidirectional effect of more severe sleep disturbance on lower levels of PA at both between- and within-person levels (between-person level: ßT1-T2 = -0.032, ßT2-T3 = -0.028, all P < .001; within-person level: ßT1-T2 and T2-T3 = -0.031, all P = .011). CONCLUSIONS AND IMPLICATIONS: This study adds novel insights into the temporal directionality of sleep and PA among community-dwelling older adults and highlights poor sleep as a potential risk factor for PA. Intervention strategies should aim to improve sleep to promote PA levels and successful aging.

Relationship between family function, self-perceived burden and loneliness in patients with type 2 diabetes mellitus: a cross-lagged analysis.

AIMS: To explore the inter-predictive role and causal relationship between family functioning, self-perceived burden and loneliness in people with type 2 diabetes. METHODS: In this study, patients with type 2 diabetes admitted to two tertiary care hospitals in China were selected for an 8-month follow-up, and the patients' scores on the Family Functioning, Self-perceived Burden, and Loneliness scales were measured repeatedly at three time periods: during hospitalisation (T1), 1 month after discharge (T2), and 3 months after discharge (T3). RESULTS: The results showed that family function at the T1 time point had a negative predictive effect on self-perceived burden at the T2 time point, ß = - 0.43, P = 0.005. Loneliness at the T1 time point had a positive predictive effect on self-perceived burden at the T2 time point, ß = 0.08, P = 0.021. Unlike the pathway at time point T1, family functioning at time point T2 negatively predicted loneliness at time point T3, ß = - 0.32, P = 0.013. Loneliness at time point T2 positively predicted family functioning at time point T3, ß = 0.025, P = 0.013. Loneliness at time point T2 negatively predicted self-perceived burden at time point T3 (P = 0.011). CONCLUSIONS: The results of the cross-lagged analysis show that there is a mutually predictive and moderating relationship between family functioning and loneliness in patients with type 2 diabetes. Loneliness can predict the level of self-perceived burden at the next time point.

Sibling Relationship and Behavioral Adjustment in Families of Disabled Children: Cross-Lagged Associations.

Cross-lagged panel designs were used to examine longitudinal and potential (bi)directional relationships between primary caregiver reported sibling relationship quality and the behaviors of children with intellectual disability (n = 297) and their closest in age siblings. The behavioral and emotional problems of the child with intellectual disability positively predicted sibling conflict over time. When accounting for control variables, this relationship was no longer present. Sibling warmth positively predicted the prosocial behaviors of the child with intellectual disability over time. When accounting for control variables, both sibling warmth and sibling conflict positively predicted the prosocial behaviors of the child with intellectual disability over time. Future research directions and clinical implications are discussed.

Temporal relationship between arterial stiffness and blood pressure variability and joint effect on cardiovascular disease.

Although arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) and blood pressure (BP) significantly correlated, the relationship between baPWV and BP variation (BPV) was unclear. This study aimed to examine the temporal relationship between brachial-ankle pulse wave velocity (baPWV) and systolic blood pressure variation (SBPV) and their joint effect on the development of cardiovascular disease (CVD). This study included 6632 participants with repeated assessments of baPWV and BP during 2006 to 2018. The baseline and follow-up SBPV was calculated as absolute SBP difference divided by mean SBP over sequential visits, using data between 2006-2010 and 2014-2018, respectively. Cross-lagged analysis was used to assess the temporal relation between baPWV and SBPV, and logistic analysis was used to assess the joint effect of baPWV and SBPV on CVD. After adjustment for confounder, the path coefficient from baseline baPWV to follow-up SBPV (ß1 = 0.040; P = 0.0012) was significantly had greater than the path from baseline SBPV to follow-up baPWV (ß2 = 0.009; P = 0.3830), with P = 0.0232 for the difference between ß1 and ß2. This unidirectional relationship from baseline baPWV to follow-up SBPV was consistent in patients without hypertension, with isolated systolic, high systolic and diastolic, uncontrolled and controlled hypertension. In addition, participants with high levels of baseline baPWV and follow-up SBPV had greater risk of CVD (odds ratio, 5.82; 95% confidence interval, 2.50-12.60) than those with low-low levels. The findings suggested that arterial stiffness appeared to precede the increase in SBPV and their joint effect is predictive of the development of CVD.

Thyroid hormone sensitivity and diabetes onset: a longitudinal cross-lagged cohort.

Purpose: Thyroid hormones sensitivity is a newly proposed clinical entity closely related with metabolic health. Prior studies have reported the cross-sectional relationship between thyroid hormones sensitivity and diabetes; however, the longitudinal association is unclear to date. We aimed to explore the relationship between impaired thyroid hormone sensitivity at baseline and diabetes onset using a cohort design. Methods: This study enrolled 7283 euthyroid participants at the first visit between 2008 and 2009, and then annually followed until diabetes onset or 2019. Thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were measured to calculate thyroid hormone sensitivity by thyroid feedback quantile-based index (TFQI), Chinese-referenced parametric thyroid feedback quantile-based index (PTFQI), thyrotropin index (TSHI), thyrotroph thyroxine resistance index (TT4RI) and FT3/FT4 ratio. Cox proportional hazard model and cross-lagged panel analysis were used. Results: The mean baseline age was 44.2 ± 11.9 years, including 4170 (57.3%) male. During a median follow-up of 5.2 years, 359 cases developed diabetes. There was no significant association between thyroid hormones sensitivity indices and diabetes onset, and adjusted hazard ratios per unit (95% CIs) were 0.89 (0.65-1.23) for TFQI, 0.91 (0.57-1.45) for PTFQI, 0.95 (0.70-1.29) for TSHI, 0.98 (0.70-1.01) for TT4RI and 2.12 (0.17-5.78) for FT3/FT4 ratio. Cross-lagged analysis supported the temporal association from fasting glucose to impaired thyroid hormones sensitivity indices. Conclusions: Our findings could not demonstrate that thyroid hormones sensitivity status is a predictor of diabetes onset in the euthyroid population. Elevated fasting glucose (above 7.0 mmol/L) appeared to precede impaired sensitivity indices of thyroid hormones.

Problematic social media use and mental health risks among first-year Chinese undergraduates: a three-wave longitudinal study.

Introduction: The association between social media use and mental health risks has been widely investigated over the past two decades with many cross-sectional studies reporting that problematic social media use (PSMU) is associated with higher mental health risk such as anxiety and depression. The present study examined the relationship between PSMU severity and mental health risks (depression, anxiety, stress, and loneliness) using a three-wave longitudinal design. Methods: A total of 685 first-year Chinese undergraduate students (Mean age = 19.12 years, SD = 0.92) completed surveys at three times points with intervals of 3 to 4 months. Results revealed that PSMU was positively correlated with all the mental health risk variables over the three time points. Results: The prevalence of PSMU increased over the three research waves. Cross-lagged models identified bi-directional relationships between PSMU and mental health risks, while such links were not consistent between different mental health risk variables and can change over different research intervals. Discussion: This study indicates that PSMU and mental health risks could predict each other in a vicious loop, but the differences between specific mental health risks and the research context (e.g., different term times and experiences in university) should not be ignored. Further research attention should be paid to the prevalence of PSMU and mental health conditions among Chinese first-year undergraduates who appear to have difficulties in adapting to university life.

The effect of hearing impairment and social participation on depressive symptoms in older adults: a cross-lagged analysis.

Objective: This study aimed to investigate the relationship between hearing impairment, depressive symptoms, and social participation in older adults. Methods: The study used data from the China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2018, which included 3,980 samples. The analysis was conducted using cross-lagged structural equation modeling with SPSS 23.0 and Mplus 7.4. Results: The findings show that from 2013 to 2018, older people had significantly more hearing impairment and depressive symptoms and significantly less social participation. Hearing impairment was a significant negative predictor of social participation, and older adults with hearing impairment were less likely to participate in social activities. In addition, there may be a bidirectional relationship between hearing impairment and depressive symptoms, with both being positive predictors of each other. Finally, the study found that social participation played an important mediating role in the relationship between hearing impairment and depressive symptoms. Conclusion: The study's findings highlight the complex interplay between hearing impairment, social participation, and depressive symptoms in older adults. Therefore, it is important to intervene promptly when hearing impairment is detected in the elderly; pay attention to patient guidance and comfort for the elderly with hearing impairment, give them positive psychological support, encourage them to get out of the house and participate in more social activities to avoid depressive symptoms. The study's results may inform the development of targeted interventions to address the mental health needs of older adults with hearing impairment.

The more you avoid, the worse you will get: a cross-lagged panel model of shyness, mobile phone dependence and depression.

BACKGROUND: The current situation of adolescent depression is relatively serious, and has aroused widespread concern. Aim: This study aimed to examine the relationship between shyness, mobile phone dependence and depression through a 12-month longitudinal survey. METHODS: A total of 1214 adolescents participated in the study. Cross-lagged models were adopted for data analysis. RESULTS: The results showed that significant positive relationships exist among shyness, mobile phone dependence and depression. Shyness at W2 mediated the relationship between mobile phone dependence at W1 and depression at W3. Mobile phone dependence at W2 played a mediating role between depression at W1 and depression at W3. CONCLUSION: This study revealed the possible reciprocal associations between shyness, mobile phone dependence and depression in adolescents. This enlightened us that incorporating shyness and mobile phone dependence interventions into prevention designs for depression in adolescents may be beneficial.

Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease.

BACKGROUND: Although hyperuricemia and hypertension are significantly correlated, their temporal relationship and whether this relationship is associated with risk of cardiovascular disease (CVD) are largely unknown. This study aimed to examine temporal relationship between hyperuricemia and hypertension, and its association with future risk of CVD. METHODS: This study included 60,285 participants from the Kailuan study. Measurement of serum uric acid (SUA), systolic and diastolic blood pressure (SBP and DBP) were obtained twice at 2006 (baseline) and 2010. Cross-lagged and mediation analysis were used to examine the temporal relationship between hyperuricemia and hypertension, and the association of this temporal relationship with CVD events risk after 2010. RESULTS: After adjusting for covariates, the cross-lagged path coefficients (ß1) from baseline SUA to follow-up SBP and DBP were significantly greatly than path coefficients (ß2) from baseline SBP and DBP to follow-up SUA (ß1=0.041 versus ß2=0.003; Pdifference<0.0001 for SBP; ß1=0.040 versus ß2=0.000; Pdifference<0.0001 for DBP). The path coefficients from baseline SUA to follow-up SBP and DBP in group with incident CVD were significantly greatly than that in group without incident CVD (Pdifference of ß1 in the two groups was 0.0018 for SBP and 0.0340 for DBP). Furthermore, SBP and DBP partially mediated the effect of SUA on incident CVD, the mediation effect was 57.64% for SBP and 46.27% for DBP. Similar mediated results were observed for stroke and myocardial infarction. CONCLUSION: Increased SUA levels probably precede elevated BP, and BP partially mediates the pathway from SUA to incident CVD.

Menstrual pain mediated the association between daytime sleepiness and suicidal risk: A prospective study.

BACKGROUND: Adolescents with daytime sleepiness have been demonstrated to have a higher level of suicidal risk than those without. Currently, few studies had examined the pathway from daytime sleepiness to suicidal risk among female adolescents. This study aimed to explore the association among menstrual pain, daytime sleepiness, and suicidal risk among female adolescents in China. METHODS: Of 7072 adolescents who participated in the follow-up survey of Shandong Adolescents Behavior & Health Cohort (SABHC), 3001 were female adolescents who had begun to menstruate and included for the analysis. A structured self-administrated questionnaire was used to measure menstrual pain, daytime sleepiness, suicidal risk and demographic characteristics. Participants were first surveyed in November-December 2015 and resurveyed 1 year later. RESULTS: Of 3001 participants, 11.43 % had suicidal risk, 79.8 % experienced menstrual pain. Cross-lagged analysis showed that there was cause-and-effect relationship between menstrual pain and daytime sleepiness. Moderate (OR = 1.79, 95%CI: 1.22-2.63) and severe (OR = 2.73, 95%CI: 1.80-4.12) menstrual pain (follow-up) were associated with suicidal risk (follow-up). Daytime sleepiness (baseline: OR = 1.04, 95%CI: 1.02-1.06, follow-up: OR = 1.07, 95%CI: 1.05-1.09) had effects on suicidal risk (follow-up). Mediation analysis showed that menstrual pain played a partially mediating role between daytime sleepiness and suicidal risk, with the indirect effect being 0.002 (95%CI: 0.001-0.004). LIMITATIONS: All data were self-reported. CONCLUSIONS: Menstrual pain and daytime sleepiness had effects on each other, and they both were the risk factors of suicidal risk. Among female adolescents, the association between daytime sleepiness and suicidal risk could be partially mediated by menstrual pain. Releasing the menstrual pain of female adolescents with daytime sleepiness could reduce their suicidal risk.

Cross-lagged analysis of problematic social media use and phubbing among college students.

BACKGROUND: Phubbing is a commonly seen phenomenon that has emerged in recent years among groups of college students, posing a rising challenge to educators. We conduct research in which the reciprocal relationship between problematic social media use and phubbing is explored and analysed quantitatively, aiming to discover reliable theoretical support to work out an appropriate intervention on students' phubbing for students' mental health concerns. METHODS: Using the problematic social media use scale and the phubbing scale, 328 college students from four universities in Shandong Province were enrolled in a two-stage longitudinal follow-up study for 20 months from December 2019 to August 2021. A cross-lagged model was constructed to explore the reciprocal relationship between problematic social media use and phubbing. The results of correlation analysis showed that problematic social media use was positively correlated with phubbing at both time points (r = 0.51, 0.53, P < 0.01). RESULTS: The results of cross-lagged regression analysis showed that the predictive effect of pretest problematic social media use on posttest problematic social media use was statistically significant (ß = 0.24, P < 0.01). There was statistical significance in the prediction effect of pretest phubbing on posttest phubbing (ß = 0.16, P < 0.05). Pretest problematic social media use had statistical significance in predicting posttest phubbing (ß = 0.22, P < 0.01), and there was no statistical significance in the prediction of pretest phubbing on posttest problematic social media (ß = 0.16, P < 0.05). CONCLUSION: The problematic social media use of college students is closely related to phubbing, and problematic social media use can predict phubbing.