Health care barriers and perceived mental health among adults in Canada during the COVID-19 pandemic: a population-based cross-sectional study. / Obstacles en matière de soins de santé et santé mentale perçue chez les adultes au Canada pendant la pandémie de COVID-19 : étude transversale fondée sur la population.

INTRODUCTION: The perceived mental health of individuals in Canada who faced health care barriers during the COVID-19 pandemic is underexplored. METHODS: We analyzed data collected March to June 2021 from adults who reported needing health care services within the past 12 months in the Survey on Access to Health Care and Pharmaceuticals during the Pandemic. Unadjusted and adjusted logistic regression analyses examined the associations between health care barriers (appointment scheduling problems, delaying contacting health care) and high self-rated mental health and perceived worsening mental health compared to before the pandemic, overall and stratified by gender, age group, number of chronic health conditions and household income tertile. RESULTS: Individuals who experienced pandemic-related appointment changes or had appointments not yet scheduled were less likely to have high self-rated mental health (aOR = 0.81 and 0.64, respectively) and more likely to have perceived worsening mental health (aOR = 1.50 and 1.94, respectively) than those with no scheduling problems. Adults who delayed contacting health care for pandemic-related reasons (e.g. fear of infection) or other reasons were less likely to have high self-rated mental health (aOR = 0.52 and 0.45, respectively) and more likely to have perceived worsening mental health (aOR = 2.31 and 2.43, respectively) than those who did not delay. Delaying contacting health care for pandemic-related reasons was associated with less favourable perceived mental health in all subgroups, while the association between perceived mental health and pandemic-related appointment changes was significant in some groups. CONCLUSION: Health care barriers during the pandemic were associated with less favourable perceived mental health. These findings could inform health care resource allocation and public health messaging.

Validating the Children's Intrinsic Needs Satisfaction Scale in the 2019 Canadian Health Survey on Children and Youth.

Background: The Public Health Agency of Canada monitors the psychological and social well-being of Canadian youth using the Children's Intrinsic Needs Satisfaction Scale (CINSS). Validation analyses of the CINSS have been conducted, but not in the 2019 Canadian Health Survey on Children and Youth (CHSCY), a more recent and representative national survey with a different sampling frame, collection method and other measured outcomes. This study tested the validity of the CINSS in the 2019 CHSCY. Data and methods: Data were collected in all provinces and territories from February 11 to August 2, 2019. The CINSS was administered to respondents aged 12 to 17 years and was designed to assess relatedness, autonomy and competence at home, at school and with friends. Descriptive statistics for CINSS items and subscales were obtained. Confirmatory factor analysis (CFA) was conducted to test how well a correlated traits correlated uniqueness (CTCU) model fit the CINSS data. Associations with mental health and other psychosocial variables were examined. Results: In general, items within the CINSS were correlated in expected ways, and support was found for a CTCU model in the CFA. While response distributions on the CINSS items were skewed, the CINSS subscales had acceptable internal consistency and were associated with self-rated mental health, happiness, life satisfaction, perceived stress, bullying victimization and behaviour problems in line with expectations. Interpretation: This study supports the validity of the CINSS. Inclusion of the CINSS in future youth health surveys would allow for continued public health surveillance of the psychological and social well-being of youth in Canada.

Social isolation, loneliness and positive mental health among older adults in Canada during the COVID-19 pandemic. / Isolement social, solitude et santé mentale positive chez les aînés au Canada pendant la pandémie de COVID-19.

INTRODUCTION: Social isolation and loneliness are associated with poorer mental health among older adults. However, less is known about how these experiences are independently associated with positive mental health (PMH) during the COVID-19 pandemic. METHODS: We analyzed data from the 2020 and 2021 cycles of the Survey on COVID-19 and Mental Health to provide estimates of social isolation (i.e. living alone), loneliness and PMH outcomes (i.e. high self-rated mental health, high community belonging, mean life satisfaction) in the overall older adult population (i.e. 65+ years) and across sociodemographic groups. We also conducted logistic and linear regressions to separately and simultaneously examine how social isolation and loneliness are associated with PMH. RESULTS: Nearly 3 in 10 older adults reported living alone, and over a third reported feelings of loneliness due to the pandemic. When examined separately, living alone and loneliness were each associated with lower PMH. When assessed simultaneously, loneliness remained a significant independent factor associated with all three PMH outcomes (overall and across all sociodemographic groups), but living alone was only a significant factor for high community belonging in the overall population, for males and for those aged 65 to 74 years. CONCLUSION: Overall, social isolation and loneliness were associated with poorer wellbeing among older adults in Canada during the pandemic. Loneliness remained a significant factor related to all PMH outcomes after adjusting for social isolation, but not vice versa. The findings highlight the need to appropriately identify and support lonely older adults during (and beyond) the pandemic.

Relations between social withdrawal subtypes and socio-emotional adjustment among Chinese children and early adolescents.

The aim of the present study was to compare the relations between subtypes of social withdrawal and socio-emotional adjustment in Chinese children and early adolescents. Participants included 571 children (Mage  = 9.62 years) and 345 adolescents Mage  = 12.12 years) in mainland China. Social withdrawal subtypes (i.e., shyness, unsociability, social avoidance) and indices of socio-emotional adjustment were assessed via self-reports, peer nominations, and teacher ratings. Shyness tended to be more strongly associated with emotional maladjustment in early adolescence, whereas unsociability was more strongly associated with socio-emotional difficulties in childhood. For social avoidance, associations with indices of negative adjustment (i.e., social anxiety, emotional symptoms, peer problems) were stronger in childhood, however, associations with indices of positive adjustment (i.e., life satisfaction, well-being) were stronger in early adolescence.

Self-rated mental health, community belonging, life satisfaction and perceived change in mental health among adults during the second and third waves of the COVID-19 pandemic in Canada. / Santé mentale autoévaluée, sentiment d'appartenance à la communauté, satisfaction à l'égard de la vie et changement perçu en matière de santé mentale chez les adultes pendant la deuxième et la troisième vagues de la pandémie de COVID-19 au Canada.

Findings from the 2020 Survey on COVID-19 and Mental Health (SCMH) suggested that the positive mental health of adults in Canada was lower during the second wave of the pandemic (fall 2020) than in 2019. With 2021 SCMH data from winter/spring 2021, we find in the current study that average life satisfaction and the prevalence of high self-rated mental health, high community belonging and perceptions of stable/improved mental health were even lower during the third wave of the pandemic as compared to the second wave in the overall adult population and in most sociodemographic groups.

Fewer adults in Canada reported high self-rated mental health in winter/spring 2021 (51.5%) compared to fall 2020 (59.9%). Fewer adults reported high community belonging in winter/spring 2021 (57.3%) compared to fall 2020 (63.7%). Rated from 0 (very dissatisfied) to 10 (very satisfied), average life satisfaction was lower in winter/spring 2021 (6.9) compared to fall 2020 (7.2). Fewer adults in winter/spring 2021 (58.1%) compared to fall 2020 (66.5%) reported that their mental health was better or about the same compared to before the COVID-19 pandemic.

Le nombre d'adultes au Canada ayant fait état d'un niveau élevé de santé mentale autoévaluée s'est révélé moindre à l'hiver et au printemps 2021 (51,5 %) par rapport à l'automne 2020 (59,9 %). Le nombre d'adultes ayant fait état d'un fort sentiment d'appartenance à la communauté s'est révélé moindre à l'hiver et au printemps 2021 (57,3 %) par rapport à l'automne 2020 (63,7 %). Notée de 0 (très insatisfait) à 10 (très satisfait), la satisfaction moyenne à l'égard de la vie s'est révélée plus faible à l'hiver et au printemps 2021 (6,9) qu'elle ne l'était à l'automne 2020 (7,2). Le nombre d'adultes qui ont déclaré que leur santé mentale était meilleure ou à peu près la même qu'avant la pandémie de COVID-19 était moindre à l'hiver et au printemps 2021 (58,1 %) par rapport à l'automne 2020 (66,5 %).

Longitudinal Relations between Rejection Sensitivity and Adjustment in Chinese Children: Moderating Effect of Emotion Regulation.

The goal of the present study was to examine the moderating effect of emotion regulation in the longitudinal relations between rejection sensitivity and indices of adjustment among Chinese children. Participants were N = 590 children (Mage= 11.25 years, SD = 1.33) attending public elementary and middle schools in Shanghai, P.R. China. Measures of anxious rejection sensitivity and socio-emotional functioning were collected via self-reports and peer nominations. Among the results, rejection sensitivity significantly predicted higher levels of later internalizing problems. Moreover, emotion regulation significantly moderated (i.e. buffering effect) the relations between rejection sensitivity and later peer and emotional difficulties. The current findings suggest that rejection sensitivity poses developmental risk over time, but emotion regulation may serve as a protective factor for Chinese youth. Results are discussed in terms of the implications of rejection sensitivity and emotion regulation in Chinese culture.

Sad, Scared, or Rejected? A Short-Term Longitudinal Study of the Predictors of Social Avoidance in Chinese Children.

The goal of the present study was to empirically examine different conceptual mechanisms previously postulated to underlie the development of social avoidance in childhood. Participants were N = 601 children (321 boys, 280 girls) attending elementary schools (Mage = 10.21 years) and middle schools (Mage = 12.77 years) in Shanghai, P.R. China. Measures of motivations for social withdrawal (shyness, unsociability, social avoidance) and socio-emotional adjustment were collected using self-reports and peer nominations at two time-points separated by 9 months. Results from cross-lagged panel analyses indicated that: (1) social avoidance and symptoms of social anxiety were not reciprocally related over time; (2) Time 1 social avoidance predicted incremental change in Time 2 peer problems (whereas Time 1 peer problems did not predict incremental change in Time 2 social avoidance); and (3) Time 1 symptoms of depression significantly predicted incremental change in Time 2 social avoidance (whereas Time 1 social avoidance did not predict incremental change in Time 2 symptoms of depression). These results provide evidence in support of depressive symptoms (but not symptoms of social anxiety or peer problems) as a salient predictor of social avoidance. Results are discussed in terms of the development and implications of social avoidance in Chinese culture.

Young children's preference for solitary play: Implications for socio-emotional and school adjustment.

The purpose of this study was to provide additional psychometric support for the Preference for Solitary Play Interview (PSPI) and to examine the associations between self-reported preference for solitary play and indices of adjustment in early childhood. Participants were N = 340 children attending kindergarten and grade 1. Children completed the PSPI, and teachers provided assessments of children's socio-emotional and school adjustment. In support of the validity of the PSPI, preference for solitary play was positively associated with asocial behaviours. Further, preference for solitary play displayed an indirect (but not direct) association with peer exclusion via asocial behaviours. Findings are discussed in terms of the social and behavioural implications of preference for solitary play in early childhood. Statement of contribution What is already known on this subject? Children who spend more time alone are at increased risk of adjustment difficulties. However, some individuals desire to spend time alone because of an appreciation for solitude. A preference for solitude is not associated with negative adjustment in adults and older youth. What does this study add? This study is among the first to examine self-reported preference for solitary in early childhood. Preference for solitude may not be related to emotional or school difficulties in young children. However, a heightened display of solitary behaviours may still evoke negative responses from peers.

Maternal Agreeableness Moderates Associations Between Young Children's Emotion Dysregulation and Socioemotional Functioning at School.

The goal of this study was to explore associations among maternal agreeableness, child temperament (i.e., emotion dysregulation), and children's social adjustment at school. Participants were 146 children in kindergarten and Grade 1 (76 girls; Mage = 67.78 months, SD = 10.81 months). Mothers provided ratings of their own agreeableness and their child's temperament, and teachers assessed indices of children's socioemotional functioning at school. Among the results, maternal agreeableness moderated associations between child dysregulation and aspects of adjustment at school. Specifically, at higher levels of maternal agreeableness, the relations between child dysregulation and both anxiety with peers and their prosocial behavior were attenuated. Overall, the results suggest that maternal agreeableness may serve as a protective factor for dysregulated children. Implications for research and practice are discussed.

Examining the Implications of Social Anxiety in a Community Sample of Mainland Chinese Children.

OBJECTIVE: The purpose of this study was to examine the implications of social anxiety symptoms in a community sample of elementary school children in mainland China. METHOD: Participants were N = 576 children (309 boys, 267 girls; mean age = 11.52 years, standard deviation = 1.21) attending public elementary schools in Shanghai, People's Republic of China. Multisource assessments included child self-reports, teacher ratings, and school records. RESULTS: Confirmatory factor analyses replicated the previously established 3-factor solution for the Social Anxiety Scale for Children-Revised. Social anxiety symptoms were associated with indices of internalizing problems, peer difficulties, and poorer school adjustment. CONCLUSION: Results are discussed in terms of the implications of social avoidance as a particularly maladaptive component of social anxiety in the collectivistic society of China.