The network analysis of anxiety, depression and academic burnout symptom relationships throughout early, middle, and late adolescence.

BACKGROUND: Previous research has explored the associations between anxiety, depression, and academic burnout primarily from a variable-level perspective. However, there is limited understanding of which symptoms might play a significant role in anxiety, depression, and academic burnout among adolescents at different stages. METHODS: This study included 7,286 adolescents aged 10 to 18. Questionnaires assessed participants' anxiety, depression, and academic burnout. Network analysis was conducted on the overall sample and segmented by early, middle, and late adolescence to explore relationships between symptoms and variations in symptom expression across these stages, aiming to propose effective interventions targeting anxiety, depression, and academic burnout symptoms in early, middle, and late adolescence. RESULTS: The study found that "feeling that studying is meaningless" emerged as a core symptom in the overall sample. Additionally, "acting or speaking slowly" emerged as a core symptom in early adolescence, while "the thought of dying or hurting" and "feeling bad about yourself, letting your family down" were prominent in middle adolescence, and "easily annoyed or irritable" and "feeling tired" may be prioritized in late adolescence. The varying central symptoms across different adolescent stages suggest the need for targeted interventions. CONCLUSION: These findings underscore the importance of interventions tailored to specific symptoms to meet the unique needs of adolescents at different developmental stages.

Self-Employment Transitions and Health Outcomes in Later Life: Evidence From China.

Background and Objectives: Self-employment is a vital alternative to waged employment for older workers. Recent research has shown that employment transitions frequently occur when individuals approach retirement. However, evidence of how older people's health changes when they switch between self and waged employment is lacking, particularly outside Western contexts. To address this research gap, we explored the health impact of employment transitions for the older working population in China by hukou (urban or rural household registration status), region, and education. Research Design and Methods: We employed fixed effect models to examine the impact of employment transitions on cognitive, mental, and physical health and life satisfaction drawing on data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (N = 4,606). Given China's unique context, we analyzed the results of agricultural and nonagricultural work separately. Results: Individuals transitioning into or remaining in self-employment had lower self-rated health and life satisfaction than those remaining in waged employment. There was no significant difference in cognitive functioning or depressive symptoms. Additionally, those who transitioned from self-employment into waged employment rated their health worse than those who remained in waged employment. The health impacts were more apparent for agricultural than nonagricultural self-employment, particularly for older workers living in urban regions with rural hukou and lower education levels. Discussion and Implications: Most older Chinese transitioning into or staying self-employed are or were pushed into self-employment due to their low human capital and socioeconomic status, which affects their subsequent health. Pension reform and policies supporting older adults to stay in the workforce could help close the economic and health gaps between rural and urban older adults.

Gender differences in the co-occurrence of anxiety and depressive symptoms among early adolescents: A network approach.

Gender differences have been identified in the co-occurrence of anxiety and depressive symptoms. However, the underlying mechanisms that give rise to this gender difference remain unclear, and few studies have examined the issue at the symptom level. The current study employed the 7-item Generalized Anxiety Disorder scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) to assess anxiety and depressive symptoms in a national sample of early adolescents (N = 15 391). A network approach was applied to investigate the gender differences in symptom interconnectivity. Gender differences were found in the co-occurrence of anxiety and depressive symptoms. The results indicated that girls with higher global strength (p < 0.01) exhibited stronger interconnectivity between symptoms. Central symptom PHQ2 (Sad mood) was significantly stronger in girls (p < 0.01), whereas PHQ6 (Guilt) was stronger in boys (p < 0.05). GAD7 (Feeling afraid) was identified as a prominent bridge symptom in girls, while PHQ6 (Guilt) was observed to play a similar role in boys. The directed acyclic graphs (DAGs) demonstrated that one symptom of anxiety triggered a series of emotional symptoms of anxiety and depression, ultimately resulting in a depressive somatic symptom in girls, whereas leading to both depressive somatic and anxiety symptoms in boys. These findings enhance our understanding and provide insights into potential intervention targets to prevent the co-occurrence of anxiety and depressive symptoms at an early stage.

Income inequality, trust, and depressive symptoms among Chinese adults (CFPS): A causal mediation analysis.

OBJECTIVE: Income inequality has been linked to depressive disorders, but the pathways behind this impact are insufficiently understood. Hence, we aimed to investigate the impact of income inequality on depressive disorders and evaluate the extent to which this impact is mediated by trust. METHODS: Two waves (2012 and 2018) of the China Family Panel Studies (CFPS) were included. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression scale (CESD8) and income inequality was measured using the Gini index calculated with household income. Based on the counterfactual framework, causal mediation analysis was applied with the difference-in-difference (DID) method. The sequential ignorability assumption, an important assumption for mediation analysis, was examined by propensity score matching (PSM) and simulation-based sensitivity analysis. RESULTS: Compared to the control group (Change of Gini index ≤0), CESD8 scores in the treatment group (Change of Gini index >0) increase by 0.233 (95 % CI: 0.039, 0.430), which 10.1 % (95 % CI: 3.1 %, 46.0 %) was mediated by reductions in trusts at the provincial level. At the county level, income inequality influences depressive symptoms through the indirect path (ß=0.008, 95%CI: 0.001, 0.020) instead of the direct path (ß= - 0.146, 95%CI: -0.287, 0.000). Dividing the trust, the significant indirect effect appeared in the trust in neighbors, foreigners, government, and doctors at the provincial level. LIMITATION: This study didn't deal with the impact of post-treatment confounders of the mediator-outcome relationship. CONCLUSIONS: Severe income inequality directly and indirectly exacerbated depressive symptoms. Government should carry out the implementation of decreasing income inequality and improving trust.

Changes in Mental Health Among Adolescents in South Korea Before and After COVID-19: An Interrupted Time Series Analysis From 2015 to 2022.

PURPOSE: This study aimed to examine changes in mental health among adolescents by comparing data from the period following the onset of the COVID-19 pandemic with the period before the pandemic. METHODS: We estimated the annual prevalence of stress perception, depressive symptoms, and suicidal ideation among middle and high school students using data from the Korean Youth Health Behavior Survey spanning from 2015 to 2022. We then compared mental health status across 2 periods-pre-COVID-19 (2015-2019) and during COVID-19 (2020-2022)-employing an interrupted time series analysis. We adjusted for covariates, such as household economic status, residence type, self-rated health, and history of hospitalization, due to violence. RESULTS: We analyzed data from 472,385 adolescents (242,819 boys and 230,016 girls). Stress perception, depressive symptoms, and suicidal ideation showed an increasing trend during the pre-COVID-19 period, followed by a decrease in the first year of the pandemic and an increasing trend in the second and third years. Boys experienced a faster increase in stress and depressive symptoms during the second and third years of the pandemic compared with the pre-COVID-19 period, whereas girls showed trends similar to those observed before the pandemic. Middle school students experienced a more rapid increase in these indicators than high school students during the second and third years. DISCUSSION: Adolescents' mental health initially improved in the first year of COVID-19 but worsened during the second and third years of the pandemic. This suggests a need for intervention policies and programs to support adolescent mental health.

Serum TNFα and IL-17A levels may predict increased depressive symptoms: findings from the Shika Study cohort project in Japan.

BACKGROUND: Low-grade systemic inflammation may be a key player in the immune activation that has been reported for mental health deterioration. We hypothesised that elevated serum levels of inflammatory cytokines increase neuroinflammation and exacerbate depressive symptoms. METHODS: The participants were part of a cohort study for whom data was available for both 2015 and 2019. In 2015, blood samples were collected from 232 participants. Their depressive symptoms were assessed both 2015 and 2019 using the Centre for Epidemiologic Studies Depression Scale (CES-D) (n = 33). The multiplex immunoassay system (Luminex® 200) was used to measure the serum concentrations of IL-6, IL-10, IL-12, IL-17A and TNFα. Data were analysed using linear models with the level of significance considered to be p < 0.05. RESULTS: After controlling for age, BMI, smoking and alcohol consumption, in 2015 the serum concentrations of IL-17A and TNFα in 2015 were significantly positively associated with the CES-D scores of women (standardised ß (B) = .027, p < 0.01 and B = 0.26, p < 0.01, respectively). The serum concentrations of IL-17A and TNFα of men were significantly positively associated with the CES-D scores of 2019 (B = 0.62, p = 0.02 and B = 0.59, p = 0.02, respectively). CONCLUSIONS: In this cross-sectional study, we found a significant positive correlation between the depressive symptoms and serum TNFα and IL-17A levels of women. In addition, our longitudinal findings suggest the possibility that TNFα and IL-17A could elevate the depressive symptoms of men.

Depressive symptoms, avoidant coping, and alcohol use: differences based on gender and posttraumatic stress disorder in emerging adults.

Trauma exposure and alcohol use often co-occur. Unveiling predictors of drinking behavior, including among those with varying levels of trauma exposure, can inform behavioral health prevention and treatment efforts in at-risk populations. The current study examined associations between depressive symptoms, avoidant coping, gender, and alcohol use among emerging adults with and without trauma exposure and posttraumatic stress disorder (PTSD). Participants were 238 emerging adults between the ages of 21 and 30 years (M = 24.75; SD = 2.61) in one of three groups: trauma-exposed with PTSD (n = 70); trauma-exposed with no PTSD (n = 83); or a no trauma (control) group (n = 85). Demographics, parental alcohol problems, depressive symptoms, and avoidant coping were examined as predictors of drinks per drinking day. Chi-square, t-test, bivariate, and group path analysis were conducted. Among participants, men consumed greater amounts of alcohol than women across all three groups. Group assignment based on trauma history and PTSD significantly moderated the association between avoidant coping and alcohol use such that avoidant coping had a significant effect on alcohol use among participants in the trauma-exposed and PTSD groups. There was also a significant group × gender × avoidant coping interaction such that, among participants in the control group, men had attenuated alcohol use at low levels of avoidant coping and increased at high levels of avoidant coping. No effects of race were observed. Results highlight the importance of avoidant coping as a risk factor for problematic drinking, unveiling a specific intervention target for reducing co-occurring PTSD and problematic alcohol use.

Pathways to depressive symptoms in Chinese pregnant women and their influence on delivery approach: a qualitative comparative analysis.

The aim of this study was to apply complexity theory to explain and understand how risk factors combined in complex ways, eventually leading to a high prevalence of depressive symptoms among pregnant women. We also aimed to evaluate whether depressive symptoms affected delivery approach. The study had a longitudinal design and was conducted between May and September 2017. A total of 481 pregnant women were recruited to participate and completed closed-end surveys at two distinct times: during prenatal care at the hospital after 26 weeks of pregnancy and 1 to 4 weeks after delivery. This study identified eleven different pathways that led to an increase in depressive symptoms. Each pathway differentiated the effects of different influencing factors. Among the 481 pregnant women, 128 (26.6%) had cesarean deliveries without medical indications. Although depressive symptoms could affect delivery approach, it was not the most important factor. Surprisingly, the first production emerged as the key factor determining delivery mode. This study was innovative in that it examined which factors and which combinations of factors were necessary for the development of depressive symptoms. Additionally, this study provided a better understanding of the mechanisms underlying the choice of cesarean section without medical indications.

Depressive symptoms during pregnancy and postpartum: associations with mode of conception and demographic and obstetric factors.

An increasing number of women are conceiving through assisted reproductive technology; however, few studies have investigated their mental health after successful conception. This study investigated the changes in depressive symptoms in women using assisted reproductive technology and the association between the mode of conception and perinatal depressive symptoms. A longitudinal observational study was conducted from 2015 to 2019, 542 pregnant women completed questionnaires on depressive symptoms at eight timepoints during the prepregnancy, pregnancy and first-year postpartum periods. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. A generalized estimating equation regression model was employed for repeated measures. In the assisted reproductive technology group, depressive symptoms were more prevalent during early pregnancy and at 1 month postpartum than before pregnancy, and more prevalent before pregnancy and at 1 month after childbirth than in the spontaneous conception group. No significant association was identified between the mode of conception and depressive symptoms during the antenatal or postnatal period. The lack of full-time employment and prepregnancy depressive symptoms were associated with antenatal depressive symptoms. Primipara status and depressive symptoms during prepregnancy and pregnancy were associated with depressive symptoms during the first-year postpartum. Assisted reproductive technology was not a risk factor for depressive symptoms during the pregnancy and postpartum periods, whereas primipara status, lack of full-time employment and prepregnancy depressive symptoms were negative predictors. Therefore, targeted mental health interventions should address these specific factors to effectively support maternal mental health.

Depressive symptoms and goal pursuit: Between-person and reciprocal within-person effects in a multi-wave longitudinal study.

INTRODUCTION: Depressive symptoms, goal progress, and goal characteristics are interrelated, but the directionality of these relationships is unclear. METHODS: In a 6-wave longitudinal study (N = 431; 2002 total surveys), we examine the bidirectionality of the relationships between depressive symptoms, goal characteristics (commitment, self-efficacy, and perception of other's support), and goal progress for academic and interpersonal goals at 2-week intervals. Separate random-intercept cross-lagged panel models were tested for each goal characteristic across both goals. RESULTS: At the within-person level, goal progress significantly positively predicted commitment, self-efficacy, and perception of others' support for the goal. Most of the other hypothesized paths were nonsignificant, including paths between depressive symptoms and progress. At the between-person level, all variables were significantly correlated, with some effects significantly larger for the interpersonal than the academic goal. DISCUSSION: The results suggest that when it comes to depressive symptoms and goal pursuit, general tendencies may be more important than variations over 2-week intervals.

Neural Circuitry and Therapeutic Targeting of Depressive Symptoms in Schizophrenia Spectrum Disorders.

OBJECTIVE: Conceptual similarities between depressive and negative symptoms complicate biomarker and intervention development. This study employed a data-driven approach to delineate the neural circuitry underlying depressive and negative symptoms in schizophrenia spectrum disorders (SSDs). METHODS: Data from three studies were analyzed (157 participants with SSDs) to assess brain-behavior relationships: two neuroimaging studies and a randomized trial of repetitive transcranial magnetic stimulation (rTMS). Partial least squares correlation (PLSC) was used to investigate associations between resting-state functional connectivity and depressive and negative symptoms. Secondary analyses of rTMS trial data (active, N=37; sham, N=33) were used to assess relationships between PLSC-derived symptom profiles and treatment outcomes. RESULTS: PLSC identified three latent variables (LVs) relating functional brain circuitry with symptom profiles. LV1 related a general depressive symptom factor with positive associations between and within the default mode network (DMN), the frontoparietal network (FPN), and the cingulo-opercular network (CON). LV2 related negative symptoms (no depressive symptoms) via negative associations, especially between the FPN and the CON, but also between the DMN and the FPN and the CON. LV3 related a guilt and early wakening depression factor via negative rather than positive associations with the DMN, FPN, and CON. The secondary visual network had a positive association with general depressive symptoms and negative associations with guilt and negative symptoms. Active (but not sham) rTMS applied bilaterally to the dorsolateral prefrontal cortex (DLPFC) reduced general depressive but not guilt-related or negative symptoms. CONCLUSIONS: The results clearly differentiate the neural circuitry underlying depressive and negative symptoms, and segregated across the two-factor structure of depression in SSDs. These findings support divergent neurobiological pathways of depressive symptoms and negative symptoms in people with SSDs. As treatment options are currently limited, bilateral rTMS to the DLPFC is worth exploring further for general depressive symptoms in people with SSDs.

DepActive: study protocol for a randomised controlled multicentre trial of telephone-delivered behavioural activation for the treatment of depression in older adults in primary care.

BACKGROUND: Depression is common in older adults and is related to reduced quality of life and functional ability as well as increased mortality and morbidity. Current guidelines recommend psychological treatments for the treatment of depression in adults. Studies show that about 30% of older adults with depression in Sweden receive pharmacological treatment and about 3% receive psychological treatment. However, a majority receive no treatment at all. There is a need for effective and scalable psychological treatment options for older adults with depression in primary care. Behavioural activation is an extensively evaluated, effective, and relatively simple treatment for depression that can be delivered by health care professionals without comprehensive training in psychological treatment. METHODS: We will conduct a randomised controlled 2-armed parallel group multicentre trial comparing treatment as usual in primary care to a five-session telephone-delivered behavioural activation treatment as add on to treatment as usual. The current trial is open labelled. In all, 250 older adults (≥ 65 years) with depression will be recruited from primary healthcare centres in three Swedish regions. The primary outcome is depressive symptoms measured with the Montgomery Åsberg Depression Rating Scale - Self rating version (MADRS-S) after treatment and at 3- and 6-month follow-up. Secondary outcomes include depression diagnoses, activity level (self-rated and measured with accelerometer), and self-rated anxiety, daily functioning, quality of life, self-efficacy, and loneliness. DISCUSSION: There is a need for fully powered studies of brief behavioural activation for older adults with depression delivered by telephone in a primary care context. This study has the potential to improve first-line treatment of depression in older adults in primary care, consequently reducing morbidity and mortality within this population. Increasing the availability and accessibility to effective psychological treatment for depression in older adults is needed to meet future demographic changes. TRIAL REGISTRATION: ClinicalTrials.gov: NCT06284889 . Registered February 28, 2024.

A 2-year longitudinal study of the association between unhealthy lifestyle factors and the development of depressive symptoms in university students.

Aim: The aim of this study was to investigate the association between unhealthy lifestyle factors and the development of depressive symptoms with adjustment for sociodemographic characteristics in university students using health checkup data. Methods: Among information obtained from university student health checkups conducted in 2017 and 2019, we analyzed both the clinical data and responses to questionnaires. The subjects used for analysis were 3190 individuals (2382 men and 808 women, mean age 19.0 years) who had been free of depressive symptoms in the 2017 survey and were available for a 2-year follow-up. The Patient Health Questionnaire (PHQ-2) was used as a self-rating scale for depressive symptoms. Multivariable logistic regression analysis was conducted to investigate the association between lifestyle factors (such as body mass index, self-rated health, whether breakfast was taken, degree of exercise, satisfaction with sleep, smoking, and alcohol drinking) in the 2017 survey and any development of depressive symptoms revealed in the 2019 survey, adjusting for sociodemographic variables and other lifestyle factors. Results: Multivariable logistic analysis showed that poor satisfaction with sleep (odds ratio [OR), 4.09; 95% confidence interval [CI), 1.96-8.53; p < 0.01) and female gender (OR, 2.16; 95% CI, 1.01-4.60; p = 0.05) were significantly associated with the development of depressive symptoms 2 years later. Conclusion: This study has revealed an association between poor satisfaction with sleep and the development of depressive symptoms. We believe that these findings may be useful for the prevention and treatment of depressive symptoms in university students.

Time trends in adolescent depressive symptoms from 2010 to 2019 in Norway: real increase or artifacts of measurements?

BACKGROUND: Whether the recent rise in adolescent self-reported depressive symptoms is influenced by changing reporting behavior is much debated. Most studies use observed sum scores to document trends but fail to assess whether their measures are invariant across time, a prerequisite for meaningful inferences about change. We examined whether measurement noninvariance, indicative of changing perceptions and reporting of symptoms, may influence the assessment of time trends in adolescent depressive symptoms. METHODS: Data stem from the nationwide repeated cross-sectional Ungdata-surveys (2010-2019) of 560 712 responses from adolescents aged 13 to 19 years. Depressive symptoms were measured with the Kandel and Davies' six-item Depressive Mood Inventory. Using structural equation modeling, we examined measurement invariance across time, gender and age, and estimated the consequences of noninvariance on cross-cohort time trends. RESULTS: Across most conditions, the instrument was found measurement invariant across time. The few noninvariant parameters detected had negligible impact on trend estimates. From 2014, latent mean depressive symptom scores increased among girls. For boys, a U shaped pattern was detected, whereby an initial decrease in symptoms was followed by an increase from 2016. Larger issues of noninvariance were found across age in girls and between genders. CONCLUSIONS: From a measurement perspective, the notion that changed reporting of symptoms has been an important driver of secular trends in depressive symptoms was not supported. Thus, other causes of these trends should be considered. However, noninvariance across age (in girls) and gender highlights that depressive symptoms are not necessarily perceived equivalently from early to late adolescence and across gender.

Lagged effects of childhood depressive symptoms on adult epigenetic aging.

BACKGROUND: Cross-sectional studies have identified health risks associated with epigenetic aging. However, it is unclear whether these risks make epigenetic clocks 'tick faster' (i.e. accelerate biological aging). The current study examines concurrent and lagged within-person changes of a variety of health risks associated with epigenetic aging. METHODS: Individuals from the Great Smoky Mountains Study were followed from age 9 to 35 years. DNA methylation profiles were assessed from blood, at multiple timepoints (i.e. waves) for each individual. Health risks were psychiatric, lifestyle, and adversity factors. Concurrent (N = 539 individuals; 1029 assessments) and lagged (N = 380 individuals; 760 assessments) analyses were used to determine the link between health risks and epigenetic aging. RESULTS: Concurrent models showed that BMI (r = 0.15, PFDR < 0.01) was significantly correlated to epigenetic aging at the subject-level but not wave-level. Lagged models demonstrated that depressive symptoms (b = 1.67 months per symptom, PFDR = 0.02) in adolescence accelerated epigenetic aging in adulthood, also when models were fully adjusted for BMI, smoking, and cannabis and alcohol use. CONCLUSIONS: Within-persons, changes in health risks were unaccompanied by concurrent changes in epigenetic aging, suggesting that it is unlikely for risks to immediately 'accelerate' epigenetic aging. However, time lagged analyses indicated that depressive symptoms in childhood/adolescence predicted epigenetic aging in adulthood. Together, findings suggest that age-related biological embedding of depressive symptoms is not instant but provides prognostic opportunities. Repeated measurements and longer follow-up times are needed to examine stable and dynamic contributions of childhood experiences to epigenetic aging across the lifespan.

Association between parental phubbing and short-form video addiction: A moderated mediation analysis among Chinese adolescents.

BACKGROUND: Short-form video applications have spread rapidly and gained popularity among adolescents for their interactivity, sociality, and personalization. However, excessive and uncontrolled use has also caused some adolescents to develop short-form video addiction (SFVA). Although parental phubbing has been shown to be a risk factor for SFVA in adolescents, its intermediate mechanisms, particularly the emotional mediation mechanisms, remain unclear. Therefore, this study aims to explore the relationships among parental phubbing, SFVA, symptoms of depression and anxiety, and neuroticism in adolescents. METHODS: Adolescents aged 13-19 (N = 5785) were recruited from Shandong Province, China, as participants in 2023. Participants were asked to complete five self-report questionnaires, including the Parental Phubbing Behavior Questionnaire (PPBQ), Short-Form Video Addiction (SFVA) Scale, The Center for Epidemiological Studies Depression Scale (CESD20), Generalized Anxiety Disorder 7-item (GAD-7) Scale, and Chinese Big Five Personality Inventory (Brief Version) (CBF-PI-B). RESULTS: The results indicate that the influence of parental phubbing on short-form video addiction among adolescents is mediated by symptoms of depression and anxiety. Additionally, neuroticism moderates the association between parental phubbing and symptoms of depression and anxiety. LIMITATIONS: Cross-sectional design limits causal inferences. Reliance on self-report scales. CONCLUSIONS: These findings contribute to a better understanding of the systemic impact mechanisms of negative family interactions on SFVA. Moreover, prevention and intervention strategies targeting high neuroticism and symptoms of depression and anxiety may help prevent the developmental pathway from parental phubbing to SFVA.

Association between parental educational involvement and adolescent depressive symptoms: a systematic review and meta-analysis.

BACKGROUND: Adolescents in their school-age period undergo rapid changes in various aspects, such as physiological development, academic pressure, and interpersonal relationships, constitute a high-risk group for depression. Parental educational involvement, as a critical family variable, influences not only children's academic achievement but also their psychological well-being. However, previous research has shown significant discrepancies regarding the relationship between parental educational involvement and adolescent depressive symptoms. METHODS: To elucidate the overall strength of the association between parental educational involvement and adolescent depressive symptoms, this study systematically searched Web of Science, Medline, PubMed, CNKI, and other Chinese and English databases. A meta-analysis was conducted on 22 selected studies encompassing 36 effect sizes and involving 390,094 participants. RESULTS: The results revealed a moderate negative correlation between parental educational involvement and adolescent depressive symptoms (r = -0.200, 95% CI [-0.26, -0.14]). Additionally, the relationship between parental educational involvement and adolescent depressive symptoms was found to be moderated by factors such as adolescent age, grade level and the reporter of parental educational involvement. However, it was not influenced by the female ratio or cultural background. CONCLUSIONS: This study offers the inaugural comprehensive assessment of the relationship between parental educational involvement and adolescent depressive symptoms, with variations observed across different ages, grade levels, and reporter of parental educational involvement.

Effectiveness of Walking Exercise in Improving Physical Fitness and Depression in Patients With Schizophrenia.

Patients with schizophrenia often lack physical activity, which, together with physical complications, can lower their expected lifespan. Exercise strengthens their physical and mental health. The primary aim of this study was to examine the effectiveness of a walking exercise intervention in improving physical fitness, body mass index, waist-to-hip ratio, and depressive symptoms in patients with schizophrenia. A quasi-experimental study design was used. Seventy-six participants were recruited from the psychiatric daycare center at a hospital in Northern Taiwan. They were divided into two groups. The intervention group received a walking exercise intervention, while the control completed their daily courses at the psychiatric daycare center. The changes in both groups' physical fitness, BMI, waist-to-hip ratio, and depressive symptoms were monitored. Cardiorespiratory endurance significantly improved in the intervention group, attesting to the effectiveness of the walking exercise intervention. Their depression level significantly decreased across all measurement stages. The group walking exercise reduced sedentary behaviors and increased the participants' autonomous motivation, hip circumference, and cardiorespiratory fitness. Structured exercise programs may increase the patients' hippocampal neuroplasticity and reduce their depressive symptoms. The walking exercise intervention positively affected physiological traits, physical fitness, and mental health of the participants.

Validation of the English-language version of the Morningness-Eveningness-Stability-Scale-improved (MESSi), and comparison with a measure of sleep inertia.

The Morningness-Eveningness-Stability-Scale-improved (MESSi) assesses three components of circadian functioning: Morning Affect (time to fully awaken), Eveningness (orientation/preference for evening activity), and Distinctness (amplitude of diurnal variations in functioning). Following the original German version, translations of the MESSi (including Spanish, Turkish, and Chinese) have been validated, but validity evidence for the English-language version has been lacking. The current study tested the factor structure, internal consistency, and predicted correlations of the English-language MESSi. A sample of 600 adults from an online recruitment platform (aged 18-78, mean = 41.31, SD = 13.149) completed an online survey including the MESSi, reduced Morningness-Eveningness Questionnaire (rMEQ), Sleep Inertia Questionnaire (SIQ), and measures of personality and depressive symptoms. Exploratory factor analysis exactly reproduced the three-component structure of Morning Affect (MA), Eveningness, and Distinctness, with all items loading strongly on their respective component. Confirmatory factor analysis of this structure showed acceptable fit. The three subscales showed good internal consistency and replicated previously reported correlations with depressive symptoms, sleep inertia, sleep quality, and personality. Further factor analysis combining the items of the MESSi, rMEQ, and SIQ replicated a previously found seven-factor structure: Cognitive, Emotional, and Physiological sleep inertia (SI), Responses to SI (including one MA item); Duration of SI (one SIQ item, 3/5 MA items); Morningness-Eveningness (MESSi Eveningness items, plus 3/5 rMEQ items); Distinctness (5/5 MESSi items). In conclusion, the English-language MESSi shows sound psychometric properties, but Morning Affect may be more suitably characterised as a measure of sleep inertia duration, rather than morningness preference.

Mindfulness, work-family conflict, family-work conflict and depressive symptoms among nurses: A cross-sectional design.

BACKGROUND: Work and family role conflict is a common source of stressors that affect nurses, leading to negative outcomes on their mental health, such as depressive symptoms, which affect nurses' job performance and patients' health outcomes. Mindfulness positively affected mental health, but its role in the relationship between role conflict and depressive symptoms was not previously examined. PURPOSE: To examine the mediating role of mindfulness in the relationship between work-family conflict and family-work conflict with depressive symptoms among nurses. METHODS: A descriptive cross-sectional design was used to collect data from a sample of 188 nurses from two large referral hospitals in northern and central Jordan. Data analysis was performed using Pearson correlation and macro PROCESS. RESULTS: The mean score of depressive symptoms in our sample indicated that our sample is at risk for clinical depression. The bivariate correlation showed that depressive symptoms were significantly and negatively associated with work-family and family-work conflicts and significantly and positively associated with mindfulness. Both regression models explained 52% of the variance in depressive symptoms (F [6, 181] = 35.38, p < .001). The models also showed that mindfulness had a significant negative effect on depressive symptoms (t = -8.98, p < .001). The results of macro PROCESS indicated that mindfulness mediated the relationship between work-family conflict and family-work conflict with depressive symptoms. CONCLUSION: Nurses are exposed to a number of stressors in their work environment, including long work hours and frequent exposure to traumatic events. The current study showed that mindfulness might play a role in mediating the relationship between family-work conflict and family-work conflict with depressive symptoms. Nurses, nurse managers and policymakers can work with healthcare organizations to promote nurses' work quality by controlling risk factors, such as depressive symptoms, and implementing strategies to mitigate these risks.