Disparities in insecurity, social support, and family relationships in association with poor mental health among US adults during the COVID-19 pandemic.

The COVID-19 pandemic has had a significant impact on mental health. Identifying risk factors and susceptible subgroups will guide efforts to address mental health concerns during the pandemic and long-term management and monitoring after the pandemic. We aimed to examine associations of insecurity (concerns about food, health insurance, and/or money), social support, and change in family relationships with poor mental health and to explore disparities in these associations. An online survey was collected from 3952 US adults between May and August 2020. Symptoms of anxiety, depression, stress, and trauma-related disorders were assessed by the Generalized Anxiety Disorder 7-item scale, the Patient Health Questionnaire-9, the Perceived Stress Scale-4, and the Primary Care Post-Traumatic Stress Disorder Screen, respectively. Social support was measured by the Oslo Social Support Scale. Logistic regression was used and stratified analyses by age, race/ethnicity, and sex were performed. We found a higher prevalence of poor mental health among those who were younger, female, with lower socioeconomic status, and racial/ethnic minorities. Participants who were worried about money, health insurance, or food had higher odds of symptoms of anxiety (OR = 3.74, 95% CI: 3.06-4.56), depression (OR = 3.20, 95% CI: 2.67-3.84), stress (OR = 3.08, 95% CI: 2.67-3.57), and trauma-related disorders (OR = 2.93, 95% CI: 2.42-3.55) compared to those who were not. Compared to poor social support, moderate and strong social support was associated with lower odds of all four symptoms. Participants who had changes in relationships with parents, children, or significant others had worse mental health. Our findings identified groups at higher risk for poor mental health, which offers insights for implementing targeted interventions.

Suicide and non-suicide mortality and associated risk factors among suicide attempters: A 10-year follow-up of a large cohort in rural China.

Previous suicide attempt is a strong risk factor for subsequent suicide and other causes of mortality, but evidence from China is sparse. In this study, follow up face-to-face interviews were conducted with suicide attempters or a key informant, and any subsequent deaths were examined through local cause-of-death censoring databases to ascertain details surrounding the death. Competitive risk models and Cox proportional hazard regression models were used to ascertain significant risk factors of suicide, non-suicide and overall deaths following suicide attempt. Predictive nomograms were also constructed to predict the probability of suicide, non-suicide, and overall deaths. A total of 1103 suicide attempters were successfully interviewed with an average follow-up time of 7.48 (7.38-7.57) years. The cumulative rates of suicide at 1, 2, 3, 5 and 10 years were 0.27%, 0.63%, 0.91%, 1.56%, and 1.83%, respectively. Factors significantly associated with subsequent suicide were advancing age, history of suicide attempt, and mental disorders. Significant risk factors for non-suicide death included males, advancing age, and physical illness. Overall deaths during the follow-up period were associated with males, advancing age, physical illness, and mental disorders. Predictive models showed good ability with satisfactory C-indexes (between 0.77 and 0.86) and excellent calibration performance in predicting the varying causes of subsequent death among suicide attempters in rural China.

Characteristics and Risk Factors for Suicide in People with Schizophrenia in Comparison to Those without Schizophrenia.

BACKGROUND: Little research has been conducted that compares suicide cases with and without schizophrenia. The aim of the present study was to identify demographic, personal, social, relational, and psychological characteristics among suicides identified posthumously with schizophrenia compared to those without. METHODS: The DSM-IV was used to independently assess the presence of schizophrenia among suicide cases by two psychiatrists. Data on risk factors was collected through a psychological autopsy method, which included structured interviews of two informants for each suicide case (a family member and a close friend). Interview questions included demographic characteristics, suicide risk factors, the Beck Hopelessness Scale, Dickman's Impulsivity Inventory, the Spielberger State-Trait Anxiety Inventory, the Hamilton Depression Scale and the Duke Social Support Inventory. RESULTS: The prevalence of schizophrenia was 9.69% among suicide cases in this sample. The schizophrenia suicide group was more likely to be female, older, in poorer physical health, suffer from chronic disease, suffer other psychological disorders, and have a family history of psychological disorders compared to those not diagnosed schizophrenia. Other important risk factors included more frequent past suicide attempts, increased levels of depression and anxiety, lower levels of impulsivity, lower help seeking from friends, and lower social interaction social support. CONCLUSIONS: There is a notable link between schizophrenia and suicide in China. Identification of social, personal, relational, and psychological risk factors could beneficially guide attempts to improve future preventive measures against suicide among those with schizophrenia in China.

Psychological impact of mandatory COVID-19 quarantine on small business owners and self-employed in China.

A massive home-quarantine took place in China due to the novel coronavirus in the end of 2019. The purpose of the present study was to explore the potential mental health impact of this forced quarantine and widespread shutdown among small business owners and the self-employed. A semi-structured interview was employed among 14 participants from three different cities in China. Grounded Theory was employed to analyze the data using Nvivo11 plus. Based on a qualitative analysis, 9 categories of responses emerged to describe the experience and actions of participants towards the quarantine: enjoyment of life, emotional disturbance, hope, comparisons to others, social support, patriotism, making changes, and obedience. Further analysis suggested that the mental state of participants was either positive or negative depending on enjoyment of life, loss, emotional disturbance, and hope, and that these were impacted by intervening conditions (national measures, social support, patriotism), personal strategies (exercising, studying, comparisons to others), and personal consequences (making change, obedience). Rather than observing a linear pattern of negative outcomes, mental state was found to be variable in that positive outcomes were experienced earlier in the quarantine (making connections with family), negative states were encountered midway through the quarantine (fear of financial loss, anxiety), and more positive mental states (hope) emerged towards the end of the quarantine depending on intervening conditions, personal strategies, and consequences. It can be concluded that the nature of the impact of mandatory quarantine in China among small business owners and the self-employed is complex and depends on a variety of personal and situational factors.

Physical Illnesses and Medically Serious Suicide Attempts in Rural China.

Background: Physical illness is a strong correlate of suicidal behavior. However, its impact on attempted suicide in rural China is under-studied. Aims: This study was designed to assess the influence of physical illness on risk of suicide attempts and to identify distinguishing characteristics among medically serious suicide attempters with physical illnesses from those without. Method: Participants were medically serious suicide attempters identified through hospital emergency rooms (n = 659) as well as age- and gender-matched community controls (n = 659) from Shandong Province, China. Face-to-face interviews with the respondents were conducted with a semistructured protocol that included sociodemographic and psychological measures. Results: Physical illness was a significant risk factor for medically serious suicide attempts (OR = 1.739, 95% CI = 1.182-2.560). Older age was a significant risk factor, while female gender, no religion, and non-peasant occupations were significant protective factors for suicide attempts with physical illness. Limitations: Samples from only one province may not completely represent all serious suicide attempters in China. Furthermore, we did not assess the severity and the degree to which their physical illness limited the functioning of the individual. Conclusion: Physical illness is an important risk factor for suicide attempts in rural China. More efforts are needed to specifically target older people, males, those with religious beliefs, and peasant workers with physical illness.

Negative life events as triggers on suicide attempt in rural China: a case-crossover study.

This study aims to investigate the potential triggering of negative life events (NLEs) on suicide attempt in rural China. A case-crossover design was used to study 1200 suicide attempters aged 15-70 years. NLEs were assessed by a modification of Paykel's Interview for Recent Life Events. NLEs had significant triggering effects on the day of and month of suicide attempt. Marriage/love, family/home, and friend/relationship were the types of NLEs found to trigger suicide attempt when occurring on the day and month of suicide attempt. Specifically, increased risk of suicide attempt was associated with quarreling with a partner or family member on the day and month of suicide attempt. Being disappointed in a love affair, fighting with a partner, family poverty and loss of face during the month of attempts were linked to increase odds of suicide attempt. Further, when month of suicide attempt was assigned as the case period, the impact of NLEs on suicide attempt was greater among those who were younger and without mental disorders. These findings provide knowledge of the triggering of NLEs on suicide attempt, especially among the young and those without mental disorders. Further, family conflicts should be a greater focus of attention in suicide prevention.

Psychological strains, depressive symptoms, and suicidal ideation among medical and non-medical staff in urban china.

BACKGROUND: The Strain Theory of Suicide has been tested and well supported regarding rural people who show risk of suicide. Studies on the impact of psychological strains on psychopathologies and suicidality in urban environments in China have been lacking. AIMS: This study was designed to further examine the associations between psychological strains, depressive symptoms, and suicidal ideation in two separate urban samples of adults in China. METHODS: One sample consisted of randomly selected medical employees of a large hospital (n = 1012), and a second sample included heterogeneous office employees (n = 1052). A self-administered questionnaire was used to collect demographics, psychological strains, social support, depressive symptoms, and suicidal ideation. RESULTS: Depressive symptoms were associated with longer work hours, less social support, value strain, aspiration strain and coping strain among medical staff, and were linked to longer work hours, less social support, aspiration strain and coping strain among non-medical staff. Suicide ideation was associated with longer work hours, coping strain, and depression among medical staff, and was linked to longer work hours, gender, religion, value strain and depression among non-medical staff. CONCLUSIONS: Both depressive symptoms and suicidal ideation were associated with psychological strains among Chinese urban professionals. Reduction of psychological strain is necessary to help maintain proper mental health and to ensure optimal performance at work.

The role of family absolute and relative income in suicide among Chinese rural young adults: mediation effects of social support and coping strain.

BACKGROUND: suicide is a major public health issue in China. However, research on the impact of absolute and relative economic stats on suicide is scarce among the Chinese population, particularly rural young adults. Using a case-control psychological autopsy study design, we aimed to investigate the effect of family absolute and relative income on suicide among Chinese rural young adults and to further explore the potential mediating mechanism under these associations. METHOD: the information of 393 suicide cases and 416 community living controls were collected for this study. A Binary Choice Model was used to analyze the association between family absolute and relative income and suicide risk, as well as potential mediating factors for these associations. RESULTS: a much stronger association was found between relative income and suicide than between absolute income and suicide. Social support was a dominant mediator for the association between family relative income and suicide among both female and male young adults. Coping strain emerged as a mediating factor within the link between absolute income and suicide for males. CONCLUSIONS: public health interventions to reduce suicide should pay more attention to relative income in addition to absolute income as potential targets for intervention, and how social support and coping strain act as mediating factors.

Are women in China sexist toward other women? A study of Chinese college students.

This study assessed the extent to which social sexism affects Chinese women's perception and evaluation of other women's performance. A sample of 100 college women was selected in a top university in Beijing, China, and was asked to read six scholastic essays and then evaluate the quality of the essays and competence of the authors. Male and female names were randomly assigned as authors of the essays, and the respondents were blind to the arrangement. Results showed that the essays assumed to be written by male authors did not receive higher scores than those assumed to be written by female authors on quality or competence items. Sexism is not marked among these highly educated young women.

Personal predictors of spectator aggression at little league baseball games.

Parents from two baseball leagues completed questionnaires regarding their likelihood of engaging in various aggressive behaviors (yelling, swearing, shoving, fighting, humiliating) toward targets at youth baseball games (other spectators, umpires, coaches, other players, their child). Overall, the likelihood of all forms of aggression was very low, particularly physical aggression and swearing. Hierarchical entry stepwise regressions were calculated to determine predictors of yelling and humiliating using demographics, trait aggression, anger, hostility, and vengeance as predictors. Parents with greater hostility reported a greater likelihood of humiliating a child's teammate, while those with elevated trait anger reported a greater likelihood of yelling at other spectators. Finally, parents with a more vengeful attitude reported a greater likelihood of humiliating umpires.

The impact of visual perspective and anger on the actor-observer bias among automobile drivers.

OBJECTIVE: The present study was designed to examine the combined impact of the Actor-Observer Bias and driver anger on attributions of other drivers. METHODS: Participants watched a simulated driving sequence in which a car swerved in front of a truck in near collision. Half viewed from the perspective of the offending motorist while the other half viewed from the perspective of a trailing motorist. Participants then rated the general riskiness of the offending motorist and the responsibility of the victim driver. RESULTS: Findings support the visual perspective explanation of the Actor-Observer Bias in that attributions within a single event differed based on the random assignment of visual perspective. However, the nature of the attributions interacted with the level of anger experienced over the incident. Those viewing as a trailing motorist provided greater riskiness ratings for the offending motorist than did those viewing from the perspective of the offending motorist, but only when scoring/rating high on personal feelings of anger regarding the observed incident. CONCLUSION: The present study demonstrates that personal factors and common cognitive biases can influence how events in the traffic environment are perceived, and the subsequent judgments made of other drivers following negative events.

The effects of fatal vision goggles on drinking and driving intentions in college students.

The present study was designed to examine the effectiveness of Fatal Vision Goggles in reducing intentions to drink and drive. Participants performed a field sobriety task and drove in a traffic simulator while wearing the goggles. A regression analysis was performed in order to predict changes in intentions to drink and drive, using typical drinking patterns, perceived likelihood of getting into a collision when drinking and driving, self efficacy, and driving independence as predictor variables. Results showed that drinking and driving intentions were reduced following the use of Fatal Vision Goggles among those that typically drink more during outings, among those that believe the likelihood of collisions when drinking and driving are greater, and among those less likely to drive to achieve independence and autonomy. These results indicate that Fatal Vision Goggles can be an effective tool in altering drinking and driving attitudes among drivers with specific attitudinal and personal characteristics.

Age and vengeance as predictors of mild driver aggression.

The present study examined the influence of driver age and vengeance on mild aggression among drivers with at least 5 years experience. Mild aggression decreased with age among low vengeance drivers and changed little across age groups among moderately vengeful drivers. However, mild driver aggression actually increased with age among highly vengeful drivers. Results are interpreted in terms of the aggressive nature of an enduring vengeful attitude.

The relationship between driver aggression, violence, and vengeance.

A distinction is made between mild driver aggression and driver violence as unique constructs that differ mainly in frequency of occurrence and severity of outcome. Drivers completed questionnaires assessing the likelihood of engaging in mild driver aggression, the frequency of past driver violence, driving vengeance, and willful violations. Violence was predicted by the interaction of mild aggression and vengeance, such that violence was greater among aggressive drivers, but only for those with elevated levels of vengeance. Driver violence was also predicted by the interaction of mild aggression and violations. Specifically, violence was greater among aggressive drivers reporting traffic violations. The present findings suggest that mild driver aggression and driver violence are linked within a small group of drivers that hold other dangerous driving attitudes and behaviors as part of their typical driving repertoire.