A national survey of pandemic fear and cyberchondria after ending zero-COVID policy: The chain mediating role of alexithymia and psychological distress.

BACKGROUND: More than half the domestic population in China were infected with COVID-19 in two months after ending "zero-infection policy", which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism. METHODS: A cross-sectional sample of frontline nurses (N = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis. RESULTS: When other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (b = 0.58, 95%CI [0.56, 0.60], p < .001). The chain mediation model suggested that both alexithymia and psychological distress were mediating factors between pandemic fear and cyberchondria. CONCLUSIONS: The higher the perceived fear, the greater the cyberchondria, which suggests that reducing fear about the pandemic and providing adequate support could reduce the incidence of cyberchondria. As alexithymia and psychological distress may be transdiagnostic mechanisms between fear and cyberchondria, targeted interventions focused on expression dysregulation and emotional identification could be useful.

Predictive effects of organizational justice on job satisfaction in bus drivers: the moderating effects of role overload and proactive personality.

BACKGROUND: There have been few longitudinal studies on Chinese bus drivers and the individual differences in the relationships between organizational justice and job satisfaction. This study examined the organizational justice and job satisfaction in bus drivers and the individual differences in this relationship. METHODS: A two-wave longitudinal study design was employed. A first survey was conducted on 513 Chinese bus drivers in October 2021 that collected socio-demographic information and asked about their perceptions of organizational fairness. A second survey was conducted six months later that asked about role overload and job satisfaction and assessed their proactive personality type. An effect model was then used to explore the moderating effects of role overload and proactive personality type on the relationships between organizational justice and job satisfaction. RESULTS: Both procedural and interactive justice predicted the bus drivers' job satisfaction. Proactive personalities and role overload were found to enhance this relationship. CONCLUSIONS: Organizations could benefit from screening at the recruitment stage for drivers with highly proactive personalities. Relevant training for drivers with low proactive personalities could partially improve employee job satisfaction. When viewed from a Chinese collectivist cultural frame, role overload could reflect trust and a sense of belonging, which could enhance job satisfaction. Finally, to improve employee job satisfaction, organizations need to ensure procedural and interactive justice.

Life cycle environmental impact assessment of natural gas distributed energy system.

Natural gas distributed energy is recognized as a pivotal means to enhance energy efficiency and mitigate carbon dioxide emissions through localized energy cascading. Positioned as a key option for advancing the Sustainable Development Goals, this system optimizes energy utilization near end-users. While maximizing energy efficiency, it is imperative to address potential environmental challenges. A thorough, comprehensive environmental assessment, facilitated by the life cycle assessment method, proves instrumental in meeting this standard. Employing this method enables an intuitive grasp of the environmental strengths and weaknesses inherent in natural gas distributed energy within the power structure. This insight serves as a foundation for informed project decision-making, fostering the growth of the industry. We selected six environmental impact assessment categories based on the CML 2001 method, and conducted the life cycle analysis across four stages. China's inaugural natural gas distributed energy demonstration project was chosen as a model case, and an environmental impact assessment inventory was established, utilizing survey data and literature for comprehensive data collection and analysis. Results from case testing yield environmental impact assessment outcomes, with a specific sensitivity analysis for stages with notable environmental impact factors. The study underscores that the operation phase has the highest environmental impact, comprising 78.37% of the total combined environmental impact, followed by the fuel production phase. Comparative analyses with coal-fired and conventional natural gas power generation, based on dimensionless literature data, reveal that abiotic resources depletion potential is the primary contributor to the environmental impact of 1 kWh of electricity product, constituting 52.76% of the total impact value, followed by global warming potential. Concrete strategies have been outlined for decision-making in both the operational and planning phases of natural gas distributed energy projects. The strengthening of policies is pinpointed towards grid connection and scale expansion.

Factors Affecting Purchase Intention of Hanfu: Considering Product Identification, Cultural Motivation, and Perceived Authenticity.

With the trend of national cultural confidence and the growing appreciation for aesthetic diversity, traditional apparel from different countries or regions has become a driving force in the clothing industry. Hanfu, an emerging trend that industrializes traditional culture, has garnered increasing attention from consumers. Thus, with the objective of exploring the psychological antecedents of Hanfu consumers' purchase intentions from the perspectives of product identification, cultural motivation, and consumers' perceived authenticity, the present study was empirically conducted with a sample of 823 respondents. Partial least squares-structural equation modeling (PLS-SEM) was employed to examine the proposed research model. The results demonstrate that consumers' identification with Hanfu and cultural motivation positively influence object-based and existential authenticity, as well as purchase intention. Furthermore, the mediating effect of perceived object-based authenticity is confirmed, indicating its significance in shaping consumers' purchase intentions, while the mediating effect of existential authenticity is found to be insignificant. Research findings could contribute to the understanding of the psychological mechanisms driving consumers' purchase intentions towards traditional clothing and highlight the importance of consumers' perceived object-based authenticity in the market of traditional cultural clothing.

[Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial].

OBJECTIVE: To observe the short-term efficacy, long-term efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: Forty-two patients with CP/CPPS were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases). The patients in the acupuncture group were treated with acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6); the needling depth of Zhongliao (BL 33) and Huiyang (BL 35) was 60 to 80 mm, while Shenshu (BL 23) and Sanyinjiao (SP 6) was directly punctured of 30 mm. The patients in the sham acupuncture group were treated with acupuncture at non-acupoints, including points 2 cm next to Shenshu (BL 23), Zhongliao (BL 33) and Huiyang (BL 35), and the midpoint of the connecting line between the spleen meridian and the kidney meridian. All the non-acupoints were treated with directly puncture of 2 to 3 mm. The needles were left for 30 min in both groups, once every other day in the first four weeks, three times a week, and twice a week in the next four weeks, totally 20 treatments. Before treatment, after treatment and in follow-up of 24 weeks after treatment completion, the National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) score and urinary flow rate were observed in both groups; the clinical efficacy and safety were evaluated. RESULTS: Compared with those before treatment, the pain and discomfort scores, urination symptoms scores, quality of life scores and total scores of NIH-CPSI in both groups were reduced after treatment in the two groups (P<0.01), while each item score and total score of NIH-CPSI in the acupuncture group were reduced in follow-up (P<0.01, P<0.05). After treatment and in follow-up, each item score and total score of NIH-CPSI in the acupuncture group were lower than those in the sham acupuncture group (P<0.05, P<0.01). After treatment, the maximum and average urinary flow rates in the acupuncture group were higher than those before treatment (P<0.05), and the average urinary flow rate in the acupuncture group was higher than that in the sham acupuncture group (P<0.05). The total effective rate was 75.0% (15/20) in the acupuncture group, which was higher than 42.9% (9/21) in the sham acupuncture group (P<0.05). No significant adverse reactions were observed in the two groups, and there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSION: Acupuncture could effectively alleviate the clinical symptoms, improve quality of life, and has a sustained, safe and reliable therapeutic effect in patients with CP/CPPS.

Bullying victimization and internalizing and externalizing problems in school-aged children: The mediating role of sleep disturbance and the moderating role of parental attachment.

BACKGROUND: Studies have shown that bullying victimization may be related to internalizing and externalizing problems; however, the mechanism underlying this relationship remains unknown. This study explored the mediating role of sleep disturbance and the moderating role of parental attachment. METHODS: A total of 1543 Chinese primary school students (M age = 8.92 years, SD1.7 years; range, 6-12) completed bullying victimization, sleep disturbance, and parental attachment measures, and provided information on their parents' occupations. The parents or guardians (n = 1995) also completed ratings on their children's internalizing and externalizing problems. RESULTS: It was found that bullying victimization directly affected internalizing and externalizing problems and also influenced sleep disturbance. Regardless of the parent's socioeconomic status, parental attachment was found to moderate the relationship between bullying victimization and internalizing problems. CONCLUSIONS: These findings contribute to understanding the partial mediating mechanism of sleep disturbance in the association between bullying victimization and internalizing and externalizing problems. The protective role of parental attachment proved central to preventing internalizing problems in bullied children. Intervention programs that enhance parental attachment and improve sleep quality could assist in mitigating the impact of bullying victimization on internalizing or externalizing problems.

A bi-level optimized approach for promoting the mixed treatment of municipal sludge and food waste.

The mixed treatment of municipal sludge and food waste can generate renewable energy, solve the environmental and economic challenges caused by this waste, and has attracted significant research attention. Using environmentally friendly anaerobic co-digestion of municipal sludge and food waste can improve the effects of anaerobic mono-digestion and produce more biogas. However, as the municipal sludge and food waste managers are different, balancing the interests of both managers is needed to encourage anaerobic co-digestion development. By fully considering the interests of the local authority, the waste water treatment plants, and the food waste anaerobic digestion treatment plants, this paper developed a bi-level optimization approach based on Stackelberg equilibrium theory to resolve the conflicts between the different stakeholders, in which uncertain parameters were used to describe the uncertainties. The proposed model was then applied to a real case in Chongqing, China, to test its practicality, and scenario analyses under different policy parameter values were conducted to provide guidance for local authorities, waste water treatment plants, and food waste treatment plants. The proposed approach was found to provide balanced strategies for all three stakeholders, increase the renewable energy output of municipal sludge and food waste treatment 14.2 times, and reduce carbon emissions by 50%, thereby protecting the environment and achieving a circular economy.

Physical-cyber-human framework-based resilience evaluation toward urban power system: Case study from China.

Because the increased frequency, intensity, and duration of extreme weather events have significantly challenged power systems, there has been an increased interest in resilient power systems. This article establishes a multicriteria resilience evaluation framework for urban power systems from a physical-cyber-human system perspective, in which the two principal elements responsible for power system function degradation are described, the three major domains comprising urban power systems are explained, four core capacities that positively contribute to power system resilience are proposed, and 15 (11 objective and four subjective) power system resilience evaluation indicators are identified. Fuzzy hesitant judgment and a Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) aggregation method are employed to minimize the expert divergence and maximize the group consensus. A validation method is designed and a comparison with commonly applied performance-based and attributes-based evaluation methods is conducted. The applicability of the evaluation framework is verified using data from four Chinese municipalities: Shanghai, Beijing, Chongqing, and Tianjin. It was found that Shanghai's resilience was the best, and Chongqing's physical resistance disadvantages would result in the greatest difficulties in coping with extreme event disturbances. Physical, cyber, and human domain resilience enhancement strategies are given for different cities separately. This study provides a practical tool to evaluate, compare, and enhance power system resilience for governments and public utilities.

Association between hospital characteristics and 30-day mortality of patients hospitalized for acute myocardial infarction in Sichuan, China.

OBJECTIVE: Because acute myocardial infarction (AMI) is a major cause of death, China faces the challenge of improving its quality of care. This study provides context-specific evidence of association between 30-day mortality and hospital characteristics in China to extend the understanding of hospitalized AMI patients. METHODS: We conducted a retrospective cohort study of 67,619 hospitalized AMI patients at 372 tertiary and secondary hospitals in Sichuan, China, between January 1, 2018 and December 31, 2020. Using a hierarchical logistic regression model to control risk factors, we explored relationships among 30-day mortality, hospital level, AMI volume, and percutaneous coronary intervention (PCI) timeliness. Locally weighted scatterplot smoothing was used to observe the trends of 30-day mortality with increased AMI volume and PCI timeliness. RESULTS: After risk factor adjustment, the 30-day mortality model demonstrated that a lower hospital level and smaller AMI volume were associated with higher 30-day mortality (medium-volume: OR = 1.511, 95% CI (1.195, 1.910); small-volume: OR = 1.636, 95% CI (1.277, 2.096); other tertiary: OR = 1.190, 95% CI (1.037, 1.365); secondary: OR = 1.524, 95% CI (1.289, 1.800)). Similarly, 30-day mortality was higher for patients at hospitals with a low PCI timeliness (low timeliness: OR = 1.318, 95% CI (1.079, 1.610)). Scatterplot smoothing showed hospital 30-day mortality first reduced quickly and gradually stabilized with increased AMI volume and PCI timeliness. CONCLUSION: Patients admitted to tertiary grade A hospitals, large-volume hospitals, and high- or medium-timeliness hospitals were more likely to survive at 30 days. Policymakers should focus on improving the outcomes at hospitals without these characteristics.

Is It Necessary to Launch a School-Based Financial Literacy Curriculum? Evidence From China.

As starting university is a critical independence milestone for many young people, it would also be the best time to provide them with some financial education (FE). Although there have been many initiatives aimed at enhancing individual financial literacy (FL) and/or financial decision-making, meta-analyses have shown that the effectiveness of FE has been mixed. This study examined the driving forces behind the decision by college students to enroll in a targeted financial literacy curriculum (FLC) and the impact of this attendance on their FL. An endogenous switching model (ESM) was employed to account for the heterogeneity in the decision to attend or not attend the FLC and to counteract any unobservable characteristics. It was found that students with higher self-perceived FL did not prefer to attend the FLC; however, for others, FLC attendance was found to significantly boost their FL in areas such as financial knowledge (FK), financial attitude (FA), and financial behavior (FB), especially for the non-attendees under the counterfactual framework. These "non-attendees" were observed to have some characteristics (e.g., prior knowledge) that made them more financially literate regardless of attendance; however, if they had attended the FLC, they would have gained a greater FL than the attendees. As the FL of the attendees would have been much lower if they had not attended, the FLC appeared to be particularly important for the attendees, which strengthened the case for making the FLC a compulsory part of a general college education.

Prospective examination of adolescent emotional intelligence and post-traumatic growth during and after COVID-19 lockdown.

OBJECTIVES: While there have been some studies examining the post-traumatic growth (PTG) responses to the COVID-19 pandemic, few have been longitudinal studies exploring the changes over time or examining the underlying psychological PTG mechanisms. This study examined whether baseline perceived emotional intelligence (EI) predicted PTG through self-esteem and emotional regulation (ER) in a five-month follow-up study conducted on Chinese adolescents during the COVID-19 pandemic. METHODS: Validated measures were completed by 2090 participants, which assessed both the perceived EI and the PTG 1 month after a nationwide lockdown in China, with 1609 of these participating in the follow-up five months later. Structural equation models (SEM) were then used to explore the paths between the variables. RESULTS: As hypothesized, the follow-up survey found that the baseline perceived EI predicted PTG, ER, and self-esteem outcomes. The SEM analyses also revealed that self-esteem and ER significantly mediated the association between EI and PTG. LIMITATIONS: Studies of three or more waves may be more suitable for longitudinal mediation analyses. Self-assessment reports may have subjective effects. CONCLUSIONS: It was concluded that perceived EI might improve PTG in adolescents following the COVID-19 pandemic, and self-esteem and ER program training could be helpful in promoting PTG.

Incorporating a constructed wetland system into a water pollution emissions permit system: a case study from the Chaohu watershed, China.

Water pollution emissions permit systems (WPEPS) and constructed wetland systems (CWS) are widely but independently used to balance regional economic development and ecosystem health. In this paper, a watershed scale framework that incorporates a CWS into a WPEPS is proposed for regional economic and ecosystem health sustainability. A strategy that integrates three allocation principles: per capita emissions, economic utility, and water quality contributions, is established for the initial CWS-incorporated WPEPS emissions permit allocations. To quantitatively verify the effectiveness of the CWS-incorporated WPEPS, a bi-level optimization model is formulated, in which fuzzy random variables are employed to describe the system uncertainties. The model is then applied to a practical case in the Chaohu watershed, China, to assess the effects of changing watershed management targets, from which practical insights are obtained on the initial emissions permit allocation strategies and the CWS coordination effects. It has proved that the integrated watershed management of the CWS-incorporated WPEPS is more able to rationally allocate the limited water pollution emissions permits and better balance the Chaohu watershed economic development to ensure ecological health sustainability. The CWS-incorporated WPEPS model under uncertainty can be used to guide local governments when formulating their sustainable watershed management strategies.

Psychotic-like experiences in Chinese children and adolescents: The effect of earthquake exposure, maltreatment and negative life events.

AIM: Psychotic-like experiences (PLEs) are common in adolescents who have experienced or are experiencing trauma. However, the potential relationships between exposure to a major earthquake, negative life events or maltreatment and PLEs in Chinese adolescents are poorly understood. Therefore, this study explored the prevalence of PLEs and the psychosocial correlates in adolescent earthquake survivors. METHODS: A total of 6132 adolescents from 11 primary and high schools in the areas most severely affected by the Ya'an earthquake completed questionnaires on earthquake exposure, maltreatment, negative life events and PLEs, which included paranoid ideation and psychoticism. RESULTS: It was found that earthquake exposure significantly contributed to the PLEs, child maltreatment explained a significant amount of the PLE variances, emotional abuse had the most important PLE role and negative life events also explained a large amount of the PLE variances, of which interpersonal difficulties and academic pressure had the greatest effects. CONCLUSIONS: Interventions should seek to reduce parental emotional abuse, reduce academic performance pressure, improve interpersonal skills and resolve interpersonal difficulties, and specific interventions should target children and adolescents exposed to the earthquake to prevent PLEs, schizophrenia or other mental illnesses arising from multiple traumas.

Post-traumatic growth among 5195 adolescents at 8.5 years after exposure to the Wenchuan earthquake: Roles of post-traumatic stress disorder and self-esteem.

We evaluated the level of post-traumatic growth in a large sample of Chinese adolescent earthquake survivors (n = 5195) and relationships among self-esteem, post-traumatic stress disorder, and post-traumatic growth. This cross-sectional study indicated that the prevalence of post-traumatic growth among adolescent survivors was 14.8 percent. Post-traumatic growth was independently associated with self-esteem, severity of exposures, and avoidance facets of post-traumatic stress disorder. Post-traumatic stress disorder was found to be partially mediated by self-esteem on post-traumatic growth; and post-traumatic stress disorder was also a mediator between earthquake exposure and post-traumatic growth. This study suggests that future longitudinal research and clinical practice should test whether promoting self-esteem can enhance post-traumatic stress disorder treatment.

Leader-follower optimized approach for carbon-economy equilibrium in the municipal solid waste (MSW) incineration industry.

Municipal solid waste (MSW) incineration contributes significantly to carbon emissions, and has become a serious problem in China, which has seen an exponential rise in waste over the last twenty years due to rapid urbanization and the associated consumer economy growth. To tackle this issue, this paper develops a leader-follower optimized approach for economic and environmental equilibrium in incineration power plants that includes a carbon allowance allocation scheme (IPP-CAAS) under combustion and pollutant limitations. In the leader-follower (bi-level) game, the regional authority on the upper level determines the carbon allocations and environmental targets and the IPPs on the lower level develop schemes to maximize revenue under the upper-level restrictions. By employing uncertain parameters for the carbon and power conversion fluctuations, the approach is able to more accurately depict the industry characteristics of waste incineration process in this carbon-economy balance problem. The robustness and practicality of the proposed methodology was then validated through a case study. Scenario analysis under different political parameters indicates that the proposed methodology can assist the authorities to achieve carbon-economy trade-off and under serious carbon-control situations, encourage the IPPs to reduce their blended coal ratios, and invest in low-carbon incineration technology. Managerial insights on further industrial developments are also given for the authority and relevant practitioners.

The role of alexithymia in the mental health problems of home-quarantined university students during the COVID-19 pandemic in China.

OBJECTIVE: While it is well known that mental health problems are common consequences of deadly pandemics, the association with alexithymia is less clear. This study examined this association in an evaluation of home-quarantined university students during the 2019/2020 COVID-19 pandemic in China. METHODS: In total, 2501 home-quarantined students from six southwest Chinese universities completed the following questionnaires: the 20-item Toronto Alexithymia Scale (TAS-20), the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Patients Health Questionnaire-9 (PHQ-9), after which structural equation modeling (SEM) and mediation analyses were employed to extract and evaluate the possible associations. RESULTS: It was found that participants with probable depression or PTSD also reported more severe alexithymia features, such as difficulties in identifying feelings (DIF) or describing feelings (DDF). Alexithymia was also found to partially mediate the effect of number of exposures on mental health problems. CONCLUSION: These results suggested that implementing strategies to assist young people identify and deal with their own emotions and those of others could prevent or mitigate the mental health problems associated with deadly pandemic events. However, future longitudinal studies are needed to examine the specific involvement of DIF or DDF in people with mental health problems.

Germacrone Induces Apoptosis as Well as Protective Autophagy in Human Prostate Cancer Cells.

BACKGROUND: Germacrone, a natural product isolated from the traditional Chinese medicine Rhizoma Curcuma, has been reported to exhibit antitumor activities in vitro. To further understand the antitumor mechanism of germacrone, we investigated the growth inhibitory effect of germacrone on the human prostate cancer cell lines PC-3 (androgen independent) and 22RV1 (androgen dependent). MATERIALS AND METHODS: Prostate cancer cells were cultured with different concentrations of germacrone, and cell viability was measured by MTT assay. The levels of proteins were measured by Western blotting. Cell apoptosis was assessed by flow cytometry. Images of autophagy-related protein staining were captured by fluorescence microscopy. Autophagic flux was assessed by detecting the LC3B-II level. RESULTS: Our results indicated that germacrone treatment significantly inhibited cell proliferation by inducing apoptosis in a dose-dependent manner, with IC50 values of 259 µM for PC-3 cells and 396.9 µM for 22RV1 cells. Germacrone-treated cells also exhibited induction of autophagy, as evidenced by elevated LC3B-II protein expression levels and punctuate patterns. Additionally, an autophagy inhibitor enhanced the growth inhibitory effect of germacrone. Moreover, the phosphorylation of Akt and mTOR was inhibited in germacrone-treated prostate cancer cells. CONCLUSION: Germacrone induced apoptosis and autophagy in prostate cancer cells by inhibiting the Akt/mTOR signaling pathway. Germacrone treatment also led to the activation of protective autophagy. These findings suggest that germacrone may potentially contribute to the development of a new therapeutic agent for prostate cancer treatment.

Prevalence and correlates of PTSD and depressive symptoms one month after the outbreak of the COVID-19 epidemic in a sample of home-quarantined Chinese university students.

BACKGROUND: When COVID-19 emerged in China in late 2019, most citizens were home-quarantined to prevent the spread of the virus. This study explored the prevalence of post-traumatic stress disorder (PTSD) and depression in a sample of home-quarantined college students to identify the psychological distress risk factors. METHOD: The PTSD and depressive symptoms in the 2485 participants from 6 universities were investigated using online survey versions of the PTSD Checklist Civilian Version and the 9-question Patient Health Questionnaires (PHQ-9), and data on sleep durations, exposure, home-quarantine time and socio-demographic variables were also collected. RESULTS: The PTSD and depression prevalence were found to be 2.7% and 9.0%. Subjectively, feeling extreme fear was the most significant risk factor for psychological distress, followed by short sleep durations, being in their graduating year (4th year) and living in severely afflicted areas. Sleep durations was a mediator between exposures and mental health problems. CONCLUSIONS: The results suggested that the psychological consequences of the COVID-19 could be serious. Psychological interventions that reduce fear and improve sleep durations need to be made available to the home-quarantined university students, and graduating students and those in the worst-hit areas should be given priority focus.

Impact of earthquake exposure, family adversity and peer problems on anxiety-related emotional disorders in adolescent survivors three years after the Ya'an earthquake.

BACKGROUND: Traumatic experiences often give rise to an increased risk of anxiety problems in adolescents. This study investigated the anxiety prevalence in adolescent earthquake survivors and the effect of secondary stressors such as bullying, poverty, or being "left behind" by parents working in the cities. METHODS: This cross-sectional study was conducted three years after the 2013 Ya'an (China) earthquake on 6,132 adolescents aged 9 to 18 years from 11 public schools in three severely earthquake affected counties. The participants completed self-report questionnaires that assessed anxiety, earthquake exposure, poverty level, left-behind duration and bullying. RESULTS: Separation anxiety (38.7%) and panic symptoms (32.2%) were found to be the primary contributors to anxiety in this adolescent sample. The regression and structural equation modeling indicated that adolescents who had suffered from high earthquake exposure, peer bullying, being left-behind, or poverty were more likely to report problems in all anxiety subcategories, with females reporting more anxiety symptoms than males. The likelihood of all anxiety disorders except separation anxiety was found to increase with age. CONCLUSIONS: This study highlighted the need for post-disaster interventions aimed at minimizing post-earthquake adversity such as peer bullying and specialized psychological services that target subgroups that might be more susceptible to anxiety-related emotional problems. The results could be used to identify possible markers for anxiety problems in children who had not experienced any major traumas.