Lifestyle factors, physical health, and life satisfaction under different changes in depressive symptoms among Chinese community-dwelling older adults: A longitudinal analysis.

BACKGROUND: The study aims to investigate the long-term impact of lifestyle-related factors and physical health on life satisfaction and depressive symptoms among Chinese community-dwelling older adults. METHODS: Using data from the China Health and Retirement Longitudinal Study (CHARLS), the analytic sample of this study included 1,068 older adults who had participated in the surveys in both 2011 and 2018. Multivariate regression was employed to analyze both cross-sectional and longitudinal relationships between lifestyle-related factors, physical health, and subjective well-being - specifically depressive symptoms and life satisfaction. Additionally, the model tested how these factors correlate with life satisfaction across different groups of depressive symptom changes among older adults, categorized as not at risk of depression, intermittent depression, and chronic depression. RESULTS: Multimorbidity was significantly related to baseline and follow-up depressive risk in older adults. Shorter sleep duration was associated with baseline depression risk. Current alcohol drinkers reported significantly more severe depressive symptoms than non-drinkers. At baseline, current smokers were more likely to have a lower degree of life satisfaction than nonsmokers. Among older adults with chronic depression at the 7-year follow-up, former smokers tended to have lower life satisfaction than nonsmokers. CONCLUSIONS: Our findings identified drinking alcohol and having a shorter sleep duration as modifiable lifestyle-related risk factors for late-life depression and smoking as a detrimental factor for life satisfaction in older Chinese adults. Multimorbidity was a significant predictor of more depressive symptoms. Our findings have implications for future psychosocial interventions that target the alleviation of depressive symptoms and the promotion of life satisfaction in older Chinese people based on their different long-term mental and physical health conditions.

An Intersectional Exploration of Outness, Encountered Discrimination and Violence, and Non-Suicidal Self-Injury among Asexual Youth across Gender Identities.

Current research on asexual youth is limited, especially in understanding the impact of their outness and the intersection of sexual orientation with gender minority identities. This study investigates the influence of outness on experiences of harassment, discrimination, violence, and the risk of non-suicidal self-injury (NSSI) among asexual youth, with a focus on those with transgender and non-binary identities. Data for this study were obtained from the 2021 Ace Community Survey, an international online survey designed to assess the needs and health status of the Ace community, targeting respondents aged 13 and older. The analysis involved a subsample of 5574 respondents aged 13 to 24 (mean age = 19.28), including 2361 cisgender (mean age = 19.65), 1,195 transgender (mean age = 18.80), and 2,018 non-binary individuals (mean age = 19.13). The results revealed that experienceds of sexual violence, verbal aggression, and physical harassment and bullying not only correlated with but also completely mediated the relationship between outness and NSSI. Asexual transgender youth experienced heightened levels of discrimination and NSSI but demonstrated notable resilience against the negative effects of identity disclosure, highlighting complex dynamics of vulnerability and protection within these communities.

Neighborhood deprivation and depressive symptoms in Chinese adolescents: Mediated by parenting styles and moderated by relative family status.

BACKGROUND: Previous research has shown that neighborhood and family have a crucial impact on adolescent mental health. However, limited research has been conducted on the intersection between neighborhood and family and the mechanisms behind its influence. This study investigates the direct and indirect associations between neighborhood deprivation and adolescent depressive symptoms through parental responsiveness and demandingness. The heterogeneity of neighborhood effects, varying across different relative family statuses, is also discussed. METHODS: Using a sample (n = 6775) from the two waves of the China Education Panel Survey, this study used moderated mediation analysis to analyze simultaneously the mediation roles of parental responsiveness and demandingness and the moderating effect of relative family status. RESULTS: Neighborhood deprivation (W1) was positively associated with adolescent depressive symptoms (W2). Parental responsiveness (W2) rather than demandingness (W2) partially mediated the relationship between neighborhood deprivation and adolescent depression. Additionally, relative family status moderated the direct relationship between neighborhood deprivation and depression and the indirect relationship through parental responsiveness. LIMITATIONS: First, Neighborhood deprivation in this study was self-reported. Second, relative family status was a single-item measure. Third, only family and neighborhood environments were discussed in this study. Finally, long-term changes in the mental health of adolescents in poor neighborhoods could not be captured in this study. CONCLUSIONS: The results highlight that neighborhood deprivation and relative family status can influence adolescent mental health individually and intersectively. This study also contributes to a more nuanced understanding of parenting styles in the Chinese context.

Intersecting self-stigma among young Chinese men who have sex with men living with HIV/AIDS: A grounded theory study.

Young men in China who have sex with men (MSM) are disproportionately infected with HIV. While scholars have drawn attention to the intersecting stigma against individuals with multiple stigmatized identities, little is known about how HIV-positive MSM navigate stigmatized identities and cope with intersecting self-stigma. This qualitative study explored how young Chinese MSM living with HIV/AIDS respond to their stigmatized identities and developed a typological framework to elucidate their experiences of intersecting self-stigma in the Chinese context. Between August and October 2020, semistructured interviews were conducted online with 24 young Chinese MSM living with HIV/AIDS aged 18-30. Guided by the analytic strategies of constructivist grounded theory, initial, focused, and theoretical coding were employed to analyze the data. Four profiles around the experience of intersecting self-stigma emerged. The first profile described participants self-stigmatizing their MSM identity more than their HIV/AIDS identity; the second profile captured those who reported stronger HIV/AIDS self-stigma. The third and fourth profiles were characterized by those who either self-stigmatized or accepted both intersecting identities, respectively. This study contributes to understanding the intricate nuances of the responses of Chinese HIV-positive MSM to their MSM identity and HIV-positive status in China's social and institutional contexts. Theoretical, policy, and practice implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objectification and ambiguity of body image in women with Polycystic Ovary Syndrome: A mixed-method study.

BACKGROUND: The manifestations of Polycystic Ovary Syndrome (PCOS), including acne, hirsutism, obesity, uncertain fertility, etc., can make women anxious, worried, or even depressed with their appearance and body. However, little relevant research has been conducted in the Chinese context. This mixed-method study aimed to understand how women with PCOS in China perceive their bodies and to examine the association between body image and depression. METHODS: First, 101 PCOS patients participated in a survey using the Body Surveillance subscale of the Objectified Body Consciousness Scale, the Short-form Mishel Uncertainty in Illness Scale, the Appearance Anxiety Scale, and the Beck Depression Inventory-II, which measured participants' self-objectification, illness ambiguity, appearance anxiety, and depression, respectively. Second, fifteen women joined face-to-face semi-structured in-depth interviews, investigating their illness ambiguity, objectified experience, and behaviors to pursue beauty. RESULTS: Results indicated a high level of self-objectification, illness ambiguity, appearance anxiety, and depression among women with PCOS in China and supported the significant associations among the outcomes. Qualitative findings presented a body image of the precarious body, indiscernible identity, and distraught mind. LIMITATIONS: A convenient sampling method was used. The generalization of the study results needs further validation. Future longitudinal studies are necessary to clarify the causal relationships among outcomes. CONCLUSIONS: This study presented women's body image with PCOS and found the negative impact of body image on their depression levels. This study was of both theoretical and practical significance. Appropriate mind-body therapies were suggested for them.

Effects of Same-Sex Marriage Legalization for Sexual Minority Men in Taiwan: Findings From a Prospective Study.

Objective: On May 24, 2019, same-sex marriage (SSM) was legalized in Taiwan. Increasing research in western countries has yielded longitudinal evidence about the psychosocial benefits of SSM for sexual minority individuals, but they have rarely included sexual minority-specific measures or considered participants' relationship status. This study aimed to examine the short-term effects associated with the legalization of SSM for gay and bisexual men in Taiwan. Methods: A panel sample of 731 gay and 132 bisexual men participated in baseline (May 2019) and follow-up (October 2020) online surveys to report their depressive symptoms, distal sexual minority stress, internalized homophobia, and outness status. Results: The results demonstrated significant reductions in depressive symptoms and distal sexual minority stress along with increased rates of coming out to friends, family, and parents. These changes were similar for partnered and un-partnered individuals. Fixed-effect regression analysis indicated that the decline in distal sexual minority stress and internalized homophobia contributed to the decline in depressive symptoms. Conclusion: This study preliminarily supports the positive effects of SSM in promoting sexual minority men's mental health and disclosure in Taiwan.

Sexual Minority Stress, Adverse Childhood Experiences, and Obesity Among Gay Men in Taiwan: Findings from a Panel Study.

Purpose: Obesity is linked to personal behaviors and external stressors. Despite emerging evidence that sexual minority stress (SMS) and adverse childhood experiences (ACEs) are associated with the risk of obesity, little is known about their independent and interactive effects on sexual minority men. This study investigated these relationships using panel data. Methods: Self-identified gay and bisexual adult men in Taiwan were recruited through Facebook advertisements to complete an online questionnaire. This study reports only on data from the gay subsample (n = 731, mean age = 28.05 years, standard deviation = 5.75 years) as the bisexual subsample (n = 132) was insufficient for comparative statistical analysis. Over two time points, respondents reported their body weight and height, experiences with SMS, and ACEs on an online survey platform. Data analysis was conducted using multiple logistic regression to determine the individual and interactive effects of the ACE score, ACE components, and SMS on the odds for obesity. Results: Almost 16% of the respondents met the criterion for obesity (body-mass index ≥27). In the adjusted models, neither SMS nor ACEs had significant associations with the likelihood of obesity. Only the interaction term of SMS and childhood sexual abuse was significant, indicating that victims of sexual abuse have an increased likelihood of obesity that SMS may intensify. Conclusions: This study shows that gay men who experience childhood sexual abuse and SMS accumulatively faced an increased risk of obesity. Healthy weight promotion for these men should address these stressors.

Self-stigma Among Children Living with Atopic Dermatitis in Hong Kong: a Qualitative Study.

BACKGROUND: Stigma has been recently identified as a crucial factor associated with the psychosocial burden of those who have chronic skin diseases. The self-stigma experiences of children living with atopic dermatitis (AD) have yet to be fully investigated, and questions of how these children respond to public stigma and how AD symptoms further affect their self-stigma experiences remain unresolved. The current qualitative study aimed to (1) describe the main manifestations of self-stigma in children living with AD; (2) investigate factors that might influence their self-stigma experiences; and (3) explore the potential mechanisms underlying the impacts of AD on their psychosocial well-being from the self-stigma perspective. METHODS: We performed a secondary analysis of the qualitative literal transcription data which were collected earlier by using the participatory, drawing-based qualitative interviews with 17 children aged 8-12 who were diagnosed with severe or moderate AD. RESULTS: The qualitative findings indicated that the visible and invisible symptoms of AD and its management exerted unique influences on self-stigma in children living with AD, which manifested in cognitive, affective, and behavioral aspects and ultimately affected their psychosocial well-being. CONCLUSIONS: Findings of this study allowed us to advocate for eliminating public stigma of people with skin diseases and propose recommendations for helping children living with AD relieve their self-stigma.

Intersecting Stigma and HIV/AIDS Community Participation Among Young Chinese Men Who Have Sex with Men Living with HIV.

Community participation is vital for the recovery and empowerment of men who have sex with men (MSM) living with HIV. Intersectionality also provides an important lens that inequalities operate in an intersectional manner and pose compound challenges to the lives of minority individuals. However, the association between intersecting stigma toward HIV-positive MSM and their community participation is underexplored. The study drew on a sample of young Chinese MSM living with HIV from a community-based online survey that recruited respondents using nonprobability purposive sampling (n = 1004). Structural equation modeling was performed to investigate the associations among perceived stigma against sexual minorities and people living with HIV, HIV-related self-stigma, and HIV/AIDS community participation. The indirect effect of self-stigma and the statistical interaction between perceived homosexual stigma and perceived HIV-related stigma were further examined. Results show that total direct effect was significant [B (SE) = 0.859 (0.233); confidence interval (95% CI) = 0.402-1.316]. Perceived HIV-related stigma was positively correlated with HIV/AIDS community participation, while HIV-related self-stigma was negatively correlated. The mediating role of HIV-related self-stigma was significant in both types of perceived stigma [total indirect effect: B (SE) = -0.935 (0.175); 95% CI = -1.277 to -0.593]. The interaction effect was also significant and negative [B (SE) = -0.117 (0.056), p < 0.001], showing that perceived homosexual stigma could offset the effect of perceived HIV-related stigma on HIV-related self-stigma. The findings illustrate how intersecting stigma is involved in HIV-related self-stigma and community participation and highlight the importance of applying an intersectionality perspective to investigate stigma toward MSM living with HIV and their community participation.

Perceived academic stress and depressive symptoms among Chinese adolescents: A moderated mediation analysis of overweight status.

BACKGROUND: Previous research has indicated the association of perceived stress with mental health problems. In China, Confucian collectivism and an exam-centered culture encourage parents to have high educational expectations that impose great pressure on their children's learning. However, limited research has focused on adolescents' perceptions of the negative consequences of academic stress stemming from their parents' educational expectations. This study addressed this research gap by examining the direct effect of adolescents' perceptions of academic stress on their depressive symptoms and the indirect effects of both parent-child communication and interaction. We further explored the pathway differences between overweight and non-overweight adolescents. METHODS: By using a sample (n = 6,566) from the first two waves of the China Education Panel Survey, moderated mediation analysis was performed to simultaneously analyze the mediating roles of parent-children communication and parent-children interaction and the moderating role of adolescent overweight status. RESULTS: Adolescents' perceived academic stress (W1) was positively associated with their depressive symptoms (W2). This association was partially mediated by both parent-child communication (W1) and parent-child interaction (W1). Moreover, adolescent overweight status significantly moderated the paths between the adolescents' perceived academic stress and their depressive symptoms, between their perceived academic stress and parent-child interaction, and the indirect relationship via parent-child interaction. LIMITATIONS: Some measurement biases including self-reported, unverified, and single-item measures, alongside not considering all variations in controlled variables should be noted. CONCLUSION: The study's findings identify the significant roles of parent-child communication and parent-children interaction in contemporary China and indicate overweight adolescents' susceptibility to stress.

"Strong Together": Minority Stress, Internalized Homophobia, Relationship Satisfaction, and Depressive Symptoms among Taiwanese Young Gay Men.

Taiwan's legalization of same-sex marriage affords legal status for romantic relationships between sexual minority individuals. Yet, little is known about the role of intimate relationships in the experiences of minority stress and mental health among gay men. This study tested a model where internalized homophobia mediated the association between distal minority stress and depressive symptoms and relationship satisfaction was posited as a moderator. Data came from a sample (n = 557) of Taiwanese young gay men who were in a romantic relationship. Respondents completed the scales of distal minority stress, internalized homophobia, relationship satisfaction, and depressive symptoms. Mediation and moderation analyses were performed on the macro PROCESS. The Johnson-Neyman (J-N) technique was used to interpret the moderating effect of relationship satisfaction. Results show that both distal minority stress and internalized homophobia were positively associated with depressive symptoms. Internalized homophobia partially mediated the association between distal minority stress and depressive symptoms. Relationship satisfaction had a moderating effect. The effect of distal minority stress was lower among those who reported high satisfaction in their current romantic relationship. This study suggested that a satisfying relationship provides protection for gay men's mental health. Clinicians should attend to relationship issues when working with sexual minority clients.

Mediator of school belongingness and moderator of migration status in the relationship between peer victimization and depression among Chinese children: A multi-group structural equation modeling approach.

Peer victimization is a widespread threat to children's mental health. However, existing literature has yet to thoroughly investigate the mediators and moderators underlying the link between peer victimization and depression of Chinese children. Using a sample of school-aged children recruited through a multi-stage cluster random sampling in Southwest China (N = 1322), this study examined the mediating role of school belongingness between overt/relational victimization and children's depressive symptoms. In order to test the moderator of migration status, multi-group structural equation modeling (SEM) was adopted to investigate whether the paths in the mediation model were significantly different across migrant and non-migrant groups. Results indicated that overt and relational victimization had a direct impact on depression. School belongingness mediated the link between overt victimization and depression, but not the link between relational victimization and depression. Furthermore, migration status moderated the direct associations between peer victimization and depression. Specifically, the effect of overt victimization on depression was significant for migrant children but not for local children. By contrast, the effect of relational victimization on depression was significant for local children but not for migrant children. The contributions and implications of this study were discussed.

Family social capital mediates the effect of poverty on children's anxiety and depression.

This study aims to examine how family social capital mediates the relationship between poverty and children's anxiety and depression in mainland China. Data were collected with multistage cluster random sampling method in Xiushui City in mainland China. The sample comprised 1,314 school-aged children (Grades 4-9). Data included children's basic demographics, internalizing symptoms, and parenting process. Structural equation modeling was used to test the hypothesized model. The results demonstrated a good fit for the sample. The overall model explained 12.7% and 16.1% of the variance for children's anxiety and depression, respectively. Poverty had a significantly direct effect on children's anxiety and depression, and family social capital could partially mediate the influence of poverty on children's internalizing symptoms. Family social capital plays an important mediating role between poverty and children's mental health. Our findings provide strong evidence for social work intervention. Family social capital is essential for parent-child interactions, especially in underprivileged families.