The Association Between Morningness-Eveningness Preference, Depression, Anxiety and Insomnia Among Chinese Textile Workers With or Without Shift Work.

Objective: Circadian preference and mental health disorders are closely related to insomnia. This study aimed to evaluate insomnia symptoms in textile factory workers with different work schedules, and to investigate the association between insomnia, morningness-eveningness preference, anxiety, and depression. Methods: A total of 3,883 textile workers were assessed using the 3-items of Pittsburg Sleep Quality Index, Composite Scale of Morningness, Beck Anxiety Inventory, Center for Epidemiologic Studies-Depression Scale, and socio-demographic questionnaires. Results: The prevalence rate of insomnia in textile workers was 16.7% (N = 646), with 49.8% (N = 322) were shift workers. Among shift workers (N = 1,833), 9.5% had difficulty initiating sleep, and almost 9.0% suffered from early morning awakening, a rate significantly higher than among daytime workers. Logistics regressions revealed that work schedule was insignificantly associated with insomnia. Depression (OR = 1.034, 95% CI = 1.022-1.046) and anxiety (OR = 1.031, 95% CI = 1.018-1.043) positively predicted insomnia, whereas morningness preference (OR = 0.977, 95% CI = 0.960-0.995) decreased the likelihood of insomnia. Furthermore, mediation analysis showed that both anxiety and depression independently mediated the association between circadian preferences and insomnia in textile workers with or without shift work. Conclusion: This study highlighted the insomnia, depression, and anxiety of textile factory workers in a Chinese textile factory. To improve insomnia symptoms, interventions to promote morningness circadian preference and reduce depressive and anxious symptoms among workers are encouraged.

Shift work disorder and related influential factors among shift workers in China.

BACKGROUND: Shift work may cause insomnia and sleepiness in individuals. The present study aimed to exam shift work disorder (SWD), and to investigate their associations with individual characteristics. METHODS: A total of 1833 shift workers were assessed using the Pittsburg Sleep Quality Index, Epworth Sleepiness Scale (ESS), Composite Scale of Morningness (CSM), Circadian Type Inventory (CTI), Center for Epidemiologic Studies-Depression Scale (CES-D), Beck Anxiety Inventory (BAI) and other self-compiled socio-demographic questionnaires. RESULTS: In the current sample, 17.1% shift workers have experienced insomnia symptoms, 20.9% were tested for daytime sleepiness, and 19.9% were categorized as having SWD. Logistics regressions revealed that history of mental disorders (OR = 2.04, 95% CI = 1.30-3.21), chronic physical illness (OR = 1.53, 95% CI = 1.17-1.99), CES-D scores (OR = 1.03, 95% CI = 1.02-1.05), BAI scores (OR = 1.04, 95% CI = 1.03-1.06), languid/vigorous tendencies (OR = 1.06, 95% CI = 1.03-1.10) were positively associated with the onset of SWD, while morningness (OR = 0.97, 95% CI = 0.94-0.99) decreased the odds of SWD onset. CONCLUSIONS: These findings suggested that attention should be drawn to individuals with mental and chronic diseases in when scheduling work shifts. While SWD and its associates should be considered when providing psychological services to shift workers.

Prevalences of and correlations between childhood trauma and depressive symptoms, anxiety symptoms, and suicidal behavior among institutionalized adolescents in Vietnam.

OBJECTIVES: We investigated the prevalence rates of childhood trauma, depressive symptoms, anxiety symptoms and suicidal behaviors among Vietnamese adolescents and compared the differences between institutionalized adolescents (IAs) and noninstitutionalized adolescents (NIAs). In addition, we examined the multidimensional associations between childhood trauma and psychopathology among IAs. METHODS: Five hundred forty-six participants were recruited into two groups (IAs and NIAs) matched by age, sex and grade. They completed a childhood trauma questionnaire, depression scale, anxiety scale, and 3 suicide-related questions. The chi-squared test and logistic regressions were performed. RESULTS: The prevalences of anxiety symptoms and suicide attempts among IAs was higher than that among NIAs (25.6 % vs 14.7 %, p = 0.001 and 8.1 vs 3.7, p = 0.03, respectively), while the prevalences of other psychopathologies did not differ significantly. In the IA group, high prevalences of victimization through physical abuse (22.3 %), emotional neglect (57.9 %), and physical neglect (72.9 %) were found, and 58.6 % of the participants had experienced more than one type of trauma. These figures were significantly higher in IAs than in NIAs. Depression and suicidal ideation were more strongly correlated with emotional abuse and neglect than other types of maltreatment, while anxiety, suicide planning and suicide attempts were more strongly correlated with physical abuse. IAs who experienced more than two categories of trauma or greater intensity of trauma were more susceptible to developing depression, anxiety, and suicidal behaviors. CONCLUSIONS: Childhood trauma was multidimensionally associated with adverse psychological outcomes. We suggest that various aspects of childhood trauma, as well as psychopathologies, must be routinely assessed.

Predictors of the initiation of shift work disorder among Chinese intern nurses: a prospective study.

AIM: Individual vulnerability to shift work disorder (SWD) varies. The aim of the present study was to verify the individual characteristics that predicted SWD onset by following Chinese intern nurses who at baseline had not worked rotating or night shifts. METHODS: A total of 706 Chinese first-year intern female nurses aged 16-24 years were recruited. At baseline (T0), they reported demographic characteristics, insomnia symptoms and excessive sleepiness, trait neuroticism, sleep reactivity, morningness, and circadian flexibility and languidity. At the three-month (T1) and six-month (T2) follow-up, the SWD status was determined based on significant sleep disturbance and/or excessive sleepiness in the context of working a rotating shift schedule. RESULTS AND CONCLUSIONS: The prevalence rates of SWD were 35.2% at T1 and 37.7% at T2. Two bivariate logistics regressions revealed that morningness (odds ratio [OR] = 1.31, 95% confidence interval [CI] = 1.09-1.58, T1; OR = 1.36, 95% CI = 1.12-1.65, T2), languidity (OR = 1.56, 95% CI = 1.28-1.90, T1), and sleep reactivity (OR = 1.29, 95% CI = 1.07-1.57, T1; OR = 1.31, 95% CI = 1.07-1.61, T2) predicted the onset of SWD, while flexibility (OR = 0.75, 95% CI = 0.62-0.90, T1) decreased the odds of SWD onset. By comparing nurses with SWD and nurses without SWD across all six months, morningness (OR = 1.58, 95% CI = 1.20-2.07), sleep reactivity (OR = 1.54, 95% CI = 1.16-2.04), languidity (OR = 1.70, 95% CI = 1.30-2.22), and flexibility (OR = 0.70, 95% CI = 0.54-0.90) showed significant effects on persistent SWD.

Emotional exhaustion and sleep-related worry as serial mediators between sleep disturbance and depressive symptoms in student nurses: A longitudinal analysis.

OBJECTIVE: The multi-wave longitudinal study was to explore the underlying mechanisms between sleep disturbance and depressive symptoms for up to 9.5 months among student nurses and to examine whether emotional exhaustion and sleep-related worry could be the mediators. METHODS: 856 student nurses aged 15-24 years (mean age = 17.8 years; all female) were recruited from a nursing school. Participants reported demographic variables (age, sibling, location, health condition, family monthly income and parents' marital quality) at baseline (Time1), Body Mass Index, weekly exercise, sleep disturbance and depressive symptoms at 3-month into internship (Time2), emotional exhaustion and sleep-related worry at 6-month into internship (Time3), and depressive symptoms at 9.5-month follow-up (Time4). Mediation analyses with bootstrapping were conducted to investigate the mediating role of emotional exhaustion and sleep-related worry in the relationship between sleep disturbance and depressive symptoms. RESULTS: Adjusted analyses suggested that the direct effect of sleep disturbance on depressive symptoms was not significant (ß = 0.026, SE = 0.069, p = .71). Mediation analyses revealed two significant indirect effects between Time2 sleep disturbance and Time4 depressive symptoms with the mediating effect of emotional exhaustion (ß = 0.019, SE = 0.009, BC95%CI [0.0036,0.0405]) and sleep-related worry (ß = 0.016, SE = 0.008, BC95%CI [0.0026,0.0337]) respectively. When testing serial multiple mediation, the specific indirect effect of sleep disturbance on depressive symptoms through both emotional exhaustion and sleep-related worry was significant (ß = 0.005, SE = 0.003, BC95%CI [0.0004,0.0123]). CONCLUSIONS: Emotional exhaustion and sleep-related worry were positively associated with sleep disturbance and depressive symptoms.