Factor structure, measurement invariance, and psychometric properties of the Posttraumatic Cognitions Inventory (PTCI) and its brief version (PTCI-9) in Chinese adolescents and adults.

The Posttraumatic Cognitions Inventory (PTCI) is a widely used self-report tool to assess negative posttraumatic cognitions about self, world, and self-blame, but the factor structure remains controversial. Recently, a brief version of the PTCI with nine items (PTCI-9) loading onto three factors has been developed, and an excellent model fit was obtained. In this study, we examined the psychometric properties of the PTCI and PTCI-9 in a large sample of trauma-exposed Chinese adolescents (n = 1,451; mean age = 13.67 years, SD = 1.24) and adults (n = 924; mean age = 39.6 years, SD = 5.43). Confirmatory factor analysis indicated an acceptable model fit for the original PTCI but a better model fit for the PTCI-9. Furthermore, the configural, metric, and scalar invariances of the PTCI-9 were supported across age groups (adolescent and adult), gender (male and female), trauma exposure (direct and indirect), and types of traumatic events (interpersonal and noninterpersonal). The PTCI and PTCI-9 and their subscale scores showed adequate internal consistency reliability in adolescent and adult samples. The PTCI-9 also demonstrated good convergent validity, as demonstrated by statistically significant correlations with PTSD, depression, anxiety, and life satisfaction. Overall, the present study supports the Chinese PTCI and PTCI-9 as valid measures of negative cognitions in both adolescents and adults and makes meaningful comparisons of negative cognitions across gender, trauma exposure, and types of traumatic events. Notably, as a brief and valid tool, the PTCI-9 is suggested to be used in survey and longitudinal studies for adolescents and adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Longitudinal associations of menstrual characteristics with mental health problems among Chinese girls.

Cross-sectional studies indicate that menstrual problems are related to poorer mental health; however, longitudinal studies are limited. This longitudinal study aimed to determine whether baseline menstrual characteristics were risk factors for incident and persistent mental health problems. The study was conducted among Chinese adolescent girls. Menstrual characteristics including menarche, menstrual cycle and menstrual pain were assessed at baseline, whereas mental health problems including PTSD, depression, anxiety, ADHD, insomnia, psychotic-like experiences, non-suicidal self-injury, suicide ideation, suicide plan, and suicide attempt were assessed at baseline (n = 1039) and at the 1-year follow-up (n = 946) by self-administered, structured questionnaires. Multiple logistic regressions were performed to examine whether menstrual characteristics were associated with incident (e.g., PTSD at follow-up but not baseline) and persistent (e.g., PTSD at both time points) mental health problems. The results demonstrated that early menarche was related to persistence of psychotic-like experiences; irregular menstruation was associated with higher rates of incident anxiety and insomnia, and persistent depression, anxiety, ADHD, insomnia, non-suicidal self-injury, suicide ideation, and suicide plan; menstrual pain was associated with elevated rates of incident PTSD and depression, and persistent depression, insomnia, psychotic-like experiences, non-suicidal self-injury, suicidal ideation, suicide plan, and suicide attempt. In conclusion, irregular menstruation and menstrual pain specifically contributed to the development of emotional problems and insomnia, and were associated with maintenance of the most mental health problems in early adolescence. The long-term effects of menstrual problems on mental health need further study.

Childhood experiences and dissociation among high school students in China: Theoretical reexamination and clinical implications.

BACKGROUND: Dissociation remains a controversial topic in terms of its prevalence, cross-cultural validity, and relationship with childhood trauma and adversities. AIMS: This study investigated the prevalence of dissociative symptoms and probable dissociative disorders among Chinese high school students and tested the trauma model of dissociation. METHODS: A total of N = 1,720 high school students completed standardized measures of positive and adverse childhood experiences (PCEs and ACEs), dissociation, depression, and anxiety. RESULTS: The prevalence rates of dissociative symptoms and (probable) DSM-5 dissociative disorders (DDs) were 11.2% and 6.9%, respectively. Dissociation was a reliable construct (ICC = .682 to .752, p < .001) and was moderately correlated with general psychopathology (r = .424 with depressive symptoms, r = .423 with anxiety symptoms). Participants with a probable DD reported more ACEs, fewer PCEs, and more mental health symptoms than those without a probable DD. ACEs were significantly associated with dissociative symptoms (ß = .107, p < .001) even after controlling for age, depressive, and anxiety symptoms. PCEs moderated the relationship between ACEs and dissociative symptoms. CONCLUSIONS: This is the first report of the prevalence of dissociative symptoms and probable DSM-5 DDs among nonclinical children. We provide cross-cultural evidence that dissociation is a reliable and valid clinical phenomenon associated with psychopathology in children across cultures. The findings partly support the trauma model of dissociation. This study contributes to the limited literature on dissociation in children. It also offers empirical data to facilitate the ongoing controversy about (childhood) trauma and dissociation. Our findings imply that dissociation is cross-culturally associated with childhood adversities, but trauma is not the only, sufficient cause. Theoretical and clinical implications are discussed.

Clinical correlates of irritability, anger, hostility, and aggression in posttraumatic stress disorder.

OBJECTIVE: Although irritability, anger, and aggression are diagnostic symptoms of posttraumatic stress disorder (PTSD), their clinical significance and associations with psychopathology remain unclear. METHOD: In a sample of community adults with probable PTSD (n = 151), we measured irritability, physical aggression, verbal aggression, anger, and hostility with the Brief Irritability Test and the Brief Aggression Questionnaire. Participants' psychopathology, including depression, attention deficit and hyperactivity disorder (ADHD), psychotic-like experiences, insomnia, as well as suicidal behaviors were also assessed. RESULTS: Correlation analysis showed that irritability and anger were modestly related to all PTSD dimensions; physical aggression was related to avoidance, negative alterations in cognitions and mood (NACM), and hyperarousal; hostility was related to reexperiencing, NACM, and hyperarousal; while verbal aggression was not significantly related to any PTSD dimensions. After adjustment for trauma exposure and PTSD symptoms, irritability was associated with almost all psychopathology and suicidal behaviors, however, anger, hostility, and aggression were sparsely related to some psychopathology or suicidal behaviors. Particularly, anger was only related to ADHD and insomnia. Latent profile analysis based on PTSD, irritability, anger, hostility, and aggression indicated two discrete subgroups: the high severity group (33.8%) and the low severity group (66.2%), with high severity group reporting higher rates of comorbidity and suicidal behaviors. CONCLUSIONS: The findings support irritability, aggression, anger, and hostility as separate constructs; moreover, irritability, anger, and aggression should be independently measured in PTSD. Our findings also suggest the significance of irritability as a separate hallmark of PTSD and the need to incorporate PTSD dimensions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prevalence, Clinical Features, and Psychological Characteristics of Dissociative Subtype of Posttraumatic Stress Disorder in Chinese Prisoners.

This study aimed to examine prevalence, clinical symptoms, and psychological characteristics of D-PTSD in a sample of Chinese prisoners with probable PTSD. A total of 1458 male prisoners were recruited from a large prison in Guangdong, China. Participants completed self-administrated questionnaires that assessed PTSD and dissociative symptoms, psychopathology, emotion regulation, emotional expressivity, social pleasure, traumatic events, and social support. According to DSM-5 criteria, participants were classified into four groups: D-PTSD, PTSD only, derealization/depersonalization (DD) only, and neither. The proportions of D-PTSD, PTSD only, DD only and neither were 2.5%, 4.7%, 2.4%, and 92.2%, respectively. PTSD symptoms and emotion regulation difficulties were distinguishing for the four groups: PTSD symptoms declined gradually in the order of D-PTSD, PTSD only, DD only, and neither, while emotion regulation difficulties declined in an order from D-PTSD, DD only, and PTSD only to neither, all ps < .001. D-PTSD and DD only had higher depressive and dissociative symptoms than PTSD only and the neither groups, all ps < .001. D-PTSD also had more borderline personality symptoms, emotion regulation difficulties, and more negative emotional expressivity than PTSD only and DD only, all ps < .05. Logistic regressions indicated that D-PTSD reported lower social support compared to PTSD only (OR = 0.95, p < .01), DD only (OR = 0.96, p < .05) and neither (OR = 0.93, p < .001). D-PTSD is common in probable PTSD in prisoners and is associated with complex clinical presentations as well as emotional processing. Social support is an important protective factor of D-PTSD.

Associations of childhood neglect, difficulties in emotion regulation, and psychological distresses to COVID-19 pandemic: An intergenerational analysis.

BACKGROUND: Although individuals' psychological responses to trauma are varied, significant associations between parental and offspring's reactions have been documented among trauma-exposed families. Common susceptible factors originated from intergenerational transmission may be underlying mechanisms of this phenomenon. OBJECTIVE: This study aimed to investigate the intergenerational transmission of depression and anxiety during early outbreak of COVID-19 and further examined whether the transmission of child neglect and difficulties in emotion regulation (ER) was associated with the transmission of psychological distresses. METHODS: Self-reported questionnaires of depression, anxiety, COVID-19 related worries, difficulties in ER, physical and emotional neglect suffered in childhood were completed by 2011 Chinese parent - offspring dyads. Path analysis was used to examine hypothesized relationships. RESULTS: The proportions of physical neglect and emotional neglect were 31.2% and 16.9% respectively among parents, while 28.6% and 20.8% respectively among offspring. There were remarkably similar in response patterns between parents and offspring. Parents' COVID-19 related worries, depression and anxiety levels were significantly associated with offspring's COVID-19 related worries, depression and anxiety. Difficulties in ER not only impacted psychological distresses directly, but also mediated the relationships between childhood neglect and psychological distresses among both parents and offspring. Difficulties in ER and childhood neglect, as important risk factors, were modestly transmitted from parent to offspring. CONCLUSIONS: Family members shared a certain degree of similarity in psychological reactions to trauma. Transmitted susceptible factors from parents to offspring may contribute to this similarity. Family therapy may be suitable for family members exposed to the same traumatic events.

The associations of parental COVID-19 related worries, lifestyles, and insomnia with child insomnia during the COVID-19 outbreak.

The impacts of the Coronavirus Disease 2019 (COVID-19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID-19 pandemic on insomnia in both adults and children, and to explore whether parental COVID-19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent-child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID-19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID-19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID-19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID-19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.

The transmission of psychological distress and lifestyles from parents to children during COVID-19.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak had rapidly become a global health threat, and its impact on the mental health was transmitted among different populations, especially from parents to children. The study aimed to investigate Chinese parents' influence on their children, in terms of mental health and lifestyles (screen time and physical exercise), during the COVID-19. METHODS: Self-reported online questionnaires of depression, anxiety, COVID-19 related worries, physical exercise, and screen time were completed by 3471 Chinese children and one of their parents (1514 fathers and 1957 mothers), during the COVID-19 epidemic in February 2020. Path analysis was used to examine the extent of transmission of psychological distress and whether lifestyles tied to transmission. RESULTS: During the quarantine, Chinese parents' depression and anxiety both positively predicted their children's depression and anxiety; parents' COVID-19 related worries, physical exercise and screen time separately had positive effects on children's COVID-19 related worries, physical exercise and screen time; parents' depression and anxiety were positively influenced by their COVID-19 related worries, self-quarantine and quarantine of family members, relatives or friends; children's depression and anxiety positively predicted their non-suicidal self-injury and suicide ideation. Bootstrap analyses showed that parents' COVID-19 related worries and lifestyles increased children's depression and anxiety via children's COVID-19 related worries and lifestyles, as well as parents' depression and anxiety. CONCLUSIONS: When families face to public events, parents' psychological distress and lifestyles are related to children's psychological stress and lifestyles. Interventions of parents' psychological distress and lifestyles would improve family resilience.

The relationships between screen time and mental health problems among Chinese adults.

BACKGROUND: This study aimed to examine the specific relationships between screen time and various mental health problems among community-dwelling adults in China. METHODS: Self-reports of weekday and weekend screen time (TV, computer use and cell phone/tablet use), symptoms of PTSD, depression, and ADHD, and psychotic-like experiences (PLEs) were completed by 7121 Chinese adults. Logistic regression was used to examine specific relationships between screen time and mental health problems with demographics, physical activity, drinking, smoking, and sleep duration as covariates. RESULTS: On weekdays, the participants spending at least 3 h on watching TV, computer use and cell phone/tablet use respectively accounted for 6.8%, 15.9% and 45.9%. On weekends, the proportions were 15.5%, 12.1% and 50.0%. Computer use on weekends was associated with higher risk of PTSD (OR = 1.81); cell phone/tablet use on weekdays and weekends was related to increased depression (OR = 1.38, OR = 1.28, respectively), while only computer use on weekends was related to depression (OR = 1.33); cell phone/tablet use both on weekdays and weekends was also connected to ADHD (OR = 1.56, OR = 1.48, respectively); on weekdays and weekends, more time TV viewing (OR = 1.76-1.79, OR = 1.46-1.71, respectively) and less cell phone/tablet use (OR = 0.66, OR = 0.65, respectively) were associated with higher numbers of PLEs. CONCLUSIONS: The relationships between different types of screen time and mental health problems are variant. Future longitudinal studies should subdivide screen time on the basis of content and explore the specific causal relationship between screen time and mental health problems.

The validity and reliability of benevolent childhood experiences scale in Chinese community adults.

Background: Several studies have indicated that positive childhood experiences (PCEs) might have important protective effects on adulthood mental health. However, the instruments to assess PCEs are scarce. Objective: In this study, we assessed the validity and reliability of the Benevolent Childhood Experiences (BCEs) scale, a new instrument of PCEs, in a large sample of Chinese adults. Furthermore, we examined associations of PCEs with symptoms of posttraumatic stress disorder (PTSD) and depression, as well as, prosocial behaviours across different levels of trauma. Method: Participants were 6929 adults (33% male; mean age 38.04 years, SD = 7.81, ranging from 18 to 81.) recruited from Jiangxi and Hunan provinces in China. Self-administrated questionnaires were used to measure PCEs, childhood trauma, lifetime trauma, PTSD, depression, and prosocial behaviours. Multiple linear regression models were conducted to examine the interdependent and interactive effects of PCEs, lifetime trauma, childhood trauma on symptoms of PTSD and depression and prosocial behaviours. Results: In the current sample, the Cronbach's α of the BCEs scale was 0.70. PCEs were not related to lifetime trauma, while modestly associated with childhood trauma, demonstrating excellent discriminant validity. PCEs were negatively correlated with severity of PTSD and depression, while positively correlated with prosocial behaviours, indicating good predictive validity. PCEs, lifetime trauma and childhood trauma were independently associated with severity of PTSD and depression and prosocial behaviours. Moreover, the interaction of PCEs and lifetime trauma negatively predicted severity of PTSD and depression, while the interaction of PCEs and childhood trauma negatively predicted prosocial behaviours. PCEs had a protective effect on PTSD and depression in high level of lifetime trauma, and showed a reduced positive effect on prosocial behaviours in high level of childhood trauma. Conclusions: The Chinese BCEs scale is a reliable and valid instrument. PCEs can buffer adversity and foster positive outcomes in adulthood.

Antecedentes: Varios estudios han indicado que las experiencias positivas en la infancia (PCEs) podrían tener efectos protectores importantes sobre la salud mental en la edad adulta. Sin embargo, los instrumentos para evaluar PCEs son escasos.Objetivo: En este estudio, evaluamos la validez y confiabilidad de la escala de Experiencias Benévolas de la Infancia (BCE en sus siglas en inglés), un nuevo instrumento de PCEs, en una muestra grande de adultos chinos. Además, examinamos asociaciones de PCEs con síntomas de trastorno de estrés postraumático (TEPT) y depresión, así como comportamientos prosociales en diferentes niveles de trauma.Método: Los participantes fueron 6929 adultos (33% hombres; edad media 38,04 años, DE = 7,81, con un rango de 18 a 81) reclutados en las provincias de Jiangxi y Hunan en China. Se utilizaron cuestionarios autoadministrados para medir PCEs, trauma infantil, trauma a lo largo de la vida, TEPT y depresión, y comportamientos prosociales. Se realizaron modelos de regresión lineal múltiples para examinar los efectos interdependientes e interactivos de los PCEs, el trauma a lo largo de la vida, el trauma infantil sobre los síntomas del TEPT y la depresión y las conductas prosociales.Resultados: En esta muestra, el α de Cronbach de la escala BCE fue de 0,70. Los PCEs no se relacionaron con el trauma a lo largo de la vida, aunque se asociaron modestamente con el trauma infantil, demostrando una excelente validez discriminante. Los PCEs se correlacionaron negativamente con la gravedad del TEPT y depresión, mientras que se correlacionaron positivamente con las conductas prosociales, lo que indica una buena validez predictiva. Los PCEs, el trauma a lo largo de la vida y el trauma infantil se asociaron de forma independiente con la gravedad del TEPT y la depresión y las conductas prosociales. Además, la interacción de los PCEs y el trauma de por vida predijo negativamente la gravedad del TEPT y la depresión, mientras que la interacción de los PCE y el trauma infantil predijo negativamente las conductas prosociales. Los PCEs tuvieron un efecto protector para el TEPT y la depresión en un nivel alto de trauma a lo largo de la vida, y mostraron un efecto positivo reducido sobre las conductas prosociales en un nivel alto de trauma infantil.Conclusiones: La escala de BCE de China es un instrumento válido y confiable. Los PCEs pueden amortiguar la adversidad y fomentar resultados positivos en la edad adulta.

Associations of substance abuse histories and gambling addiction history with post-traumatic stress symptoms and depressive symptoms among Chinese prisoners.

Background: Although there are over two million prisoners in China, few studies have reported the prevalence and correlates of mental health problems in this population. Objective: This study investigated the prevalence rates of trauma exposure, post-traumatic stress disorder (PTSD) and depression among Chinese male prisoners and further examined the associations of substance abuse histories and gambling addiction history with PTSD and depressive symptoms. Method: Participants were 1,484 male prisoners (mean age 35.44 years, sd = 9.66) recruited from a large prison in Guangdong, China. Self-administered standardized questionnaires were used to assess trauma exposure, histories of substance abuse and perceived gambling addiction, social supports, childhood trauma, PTSD and depression. Criminal background information was extracted from jail record. Linear regressions were performed to examine the correlates of PTSD and depressive symptoms. Results: Of these participants, 78.8% had experienced at least one trauma exposure, 26.7% had drug addiction, 85.5% had smoked cigarettes, 70.8% had used alcohol and 21.4% had gambling addiction before incarceration. The prevalence rates of PTSD and depression were 7.1% and 28.8%, respectively. Trauma exposure was significantly associated with PTSD and depressive symptoms, but not substance abuse histories and gambling history except for drinking. Histories of drinking and perceived gambling addiction were significantly related to PTSD and depressive symptoms after adjustment of demographics, criminal background, health status, social supports, childhood trauma and lifetime traumatic exposure. Conclusions: Trauma exposure, PTSD and depression are common among prisoners. Furthermore, this study for the first time demonstrates a significant relationship between gambling addiction history and PTSD.

Antecedentes: Aunque hay más de dos millones de presos en China, pocos estudios han informado la prevalencia y los correlatos de los problemas de salud mental en esta población.Objetivo: Este estudio investigó las tasas de prevalencia de exposición al trauma, trastorno de estrés postraumático (TEPT) y depresión entre prisioneros chinos masculinos y examinó más a fondo las asociaciones de los antecedentes de abuso de sustancias y el historial de ludopatía con el TEPT y los síntomas depresivos.Método: Los participantes fueron 1484 prisioneros varones (edad media 35,44 años, dt = 9,66) reclutados en una gran prisión de Guangdong, China. Se utilizaron cuestionarios estandarizados autoadministrados para evaluar la exposición al trauma, los antecedentes de abuso de sustancias y la percepción de adicción al juego, los apoyos sociales, el trauma infantil, el trastorno de estrés postraumático y la depresión. La información de antecedentes penales se extrajo del registro de la cárcel. Se realizaron regresiones lineales para examinar las correlaciones del TEPT y los síntomas depresivos.Resultados: De estos participantes, el 78,8% había experimentado al menos una exposición a un trauma, el 26,7% tenía adicción a las drogas, el 85,5% había fumado cigarrillos, el 70,8% había consumido alcohol y el 21,4% tenía ludopatía antes del encarcelamiento. Las tasas de prevalencia de trastorno de estrés postraumático y depresión fueron de 7,1% y 28,8%, respectivamente. La exposición al trauma se asoció significativamente con el trastorno de estrés postraumático y los síntomas depresivos, pero no con los antecedentes de abuso de sustancias y los antecedentes de juego, excepto por el alcohol. Las historias de adicción al alcohol y al juego se relacionaron significativamente con el trastorno de estrés postraumático y los síntomas depresivos después del ajuste por datos demográficos, antecedentes penales, el estado de salud, los apoyos sociales, el trauma infantil y la exposición al trauma a lo largo de la vida.Conclusiones: La exposición a trauma, el trastorno de estrés postraumático y la depresión son comunes entre los presos. Además, este estudio demuestra por primera vez una relación significativa entre el historial de ludopatía y el trastorno de estrés postraumático.

Associations of positive and adverse childhood experiences and adulthood insomnia in a community sample of Chinese adults.

STUDY OBJECTIVES: Research has documented that adverse childhood experiences (ACEs) are associated with increased adult sleep disturbances, little is known about whether positive childhood experiences (PCEs) influence sleep health in adulthood. This study aimed to examine the associations of ACEs and PCEs with adulthood insomnia, as well as the extent to which PTSD and depressive symptoms mediated these associations. METHODS: A sample of 7245 adults in China (male 32.7%; mean age 38.09 years, SD = 7.84, range from 18 to 81) completed self-report questionnaires to assess ACEs, PCEs, PTSD and depressive symptoms. Multiple linear regressions were used to examine the independent and interaction effects of ACEs and PCEs on insomnia. Path analyses were performed to examine the direct and indirect effects of ACEs and PCEs on insomnia. RESULTS: After adjustment of demographics, ACEs (ß = 0.11, p < 0.001) and PCEs (ß = -0.09, p < 0.001) were both independently associated with adulthood insomnia, while the relationship between PCEs and insomnia was weakened but still significant among participants with high levels of ACEs. After controlling for demographics, PTSD and depressive symptoms partially mediated the overall effect of PCEs on insomnia, and fully mediated the relationship between ACEs and insomnia. CONCLUSIONS: These data demonstrate that both positive and adverse childhood experiences influence adulthood insomnia. The findings highlight the importance of joint assessment of PCEs and ACEs to prevent and intervene insomnia. Optimizing the early childhood environment may help to foster healthy sleep throughout the life course.