Modern lifestyle risks associated with alcohol consumption and cigarette smoking in Ukraine.

Background: Substance uses confer huge risks for public health in modern society. This study aimed to evaluate current factors related to alcohol drinking and tobacco smoking in the republic of Ukraine. Methods: We distributed a questionnaire to healthy volunteers in four Ukrainian regions and collected 929 responses regarding demographic information, reasons for starting substance use, substance use family history, environmental factors, use pattern (internet, drinking or smoking), consequences of drinking, and insomnia. Linear regression and logistic regression analyses were performed to identify factors related to alcohol drinking and cigarette smoking. Results: Aging appeared to attenuate either drinking or smoking. To reduce school- or job-related stress, staying awake, peer pressure, friend-related issues, or to increase sexual desire and single parenting all would trigger drinking; male gender, family divorce, unhealthy diet and lack of awareness about harmful consequences were the main factors leading to smoking. Logistic regression suggested that education background, sleep problems, celebration events and lengthy internet work all could contribute to drinking. Conclusions: Various real-world factors related to substance uses were identified for the public of Ukraine. A validated instrument would help to identify risk factors in patients with substance use disorders.

Increased functional interaction within frontoparietal network during working memory task in major depressive disorder.

Abnormal fronto-parietal activation has been suggested as a neural underpinning of the working memory (WM) deficits in major depressive disorder (MDD). However, the potential interaction within the frontoparietal network during WM processing in MDD remains unclear. This study aimed to examine the role of abnormal functional interactions within frontoparietal network in the neuropathological mechanisms of WM deficits in MDD. A total of 40 MDD patients and 47 demographic matched healthy controls (HCs) were included. Functional magnetic resonance imaging and behavioral data were collected during numeric n-back tasks. The psychophysiological interaction and dynamic causal modelling methods were applied to investigate the connectivity within the frontoparietal network in MDD during n-back tasks. The psychophysiological interaction analysis revealed that MDD patients showed increased functional connectivity between the right inferior parietal lobule (IPL) and the right dorsolateral prefrontal cortex (dlPFC) compared with HCs during the 2-back task. The dynamic causal modelling analysis revealed that MDD patients had significantly increased forward modulation connectivity from the right IPL to the right dlPFC than HCs during the 2-back task. Partial correlation was used to calculate the relationship between connective parameters and psychological variables in the MDD group, which showed that the effective connectivity from right IPL to right dlPFC was correlated negatively with the sensitivity index d' of WM performances and positively with the depressive severity in MDD group. In conclusion, the abnormal functional and effective connectivity between frontal and parietal regions might contribute to explain the neuropathological mechanism of working memory deficits in major depressive disorder.

Childhood trauma is associated with elevated anhedonia and altered core reward circuitry in major depression patients and controls.

Childhood trauma (CT) is a well-established risk factor for major depressive disorder (MDD). However, the underlying mechanism linking CT and MDD remains not fully understood. The present study tested the hypothesis that CT have effects on specific types of anhedonia in depression via reward system. To do so, we evaluated different aspects of anhedonia and resting-state functional connectivity (FC) in reward system among 66 patients with MDD (44 with moderate-to-severe and 22 with no or low CT), and 57 healthy controls (HC; 23 with moderate-to-severe and 34 with no or low CT). Results showed that MDD patients with moderate-to-severe CT suffered more severe state anhedonic depression than patients with no or low level of CT. Individuals with moderate-to-severe CT, irrespective of MDD diagnosis, had elevated physical, social and anticipatory but not consummatory trait anhedonia, and demonstrated decreased left nucleus accumbens (NAcc)-right orbital frontal cortex (OFC) and left ventral caudate-left OFC connectivity compared to those with no or low exposure. Left NAcc-right OFC connectivity mediated relationship between CT and state anhedonia in MDD. The total altered ventral striatum (VS)-OFC connectivity mediated links between CT and physical trait anhedonia in HC. These findings highlight specific types of anhedonia and the core reward system as targets of CT. Blunted hedonic responses via decreased coupling within core reward system may be involved in the mechanism of depression following CT. Implications for clinical interventions are also discussed.

Insecure attachment and maladaptive emotion regulation mediating the relationship between childhood trauma and borderline personality features.

BACKGROUND: Previous studies suggested that childhood trauma is an important etiologic factor for the development of borderline personality disorder (BPD). Moreover, insecure attachment and maladaptive emotion regulation (ER) might be related to childhood trauma and BPD. This study was aimed to explore the relationships among childhood trauma, insecure attachment, maladaptive ER, and BPD features. METHODS: A cohort of 637 patients with psychological disorders completed a series of psychometric instruments such as the Personality Diagnostic Questionnaire-4+ (PDQ-4+), the 23-Item Borderline Symptom List, the Childhood Trauma Questionnaire, the Attachment Style Questionnaire, and the Cognitive Emotion Regulation Questionnaire. The path analyses were conducted to investigate the experience-driven model that whether insecure attachment and maladaptive ER could mediate the relationship between childhood trauma and BPD features. The random forest regression was performed to select variables that contribute significantly to BPD features, which variables would be incorporated into the data-driven model to further confirm the experience-driven model. RESULTS: Both the experience-driven model and the data-driven model verified that there were three significant mediation pathways (childhood trauma → insecure attachment/maladaptive ER → BPD features, childhood trauma → insecure attachment → maladaptive ER → BPD features; all p < .05), and the most weighted mediation pathway by which childhood trauma influencing the BPD features was through insecure attachment and then through maladaptive ER (weighted 53.16%). CONCLUSION: The influence of childhood trauma on BPD features was mainly mediated by the combination of insecure attachment and maladaptive emotion regulation.

Factor structure and measurement invariance of the Chinese version of the Center for Epidemiological Studies Depression (CES-D) scale among undergraduates and clinical patients.

BACKGROUND: The Center for Epidemiologic Studies Depression scale (CESD) was widely used for screening of depressive symptoms. The purpose of the current study was to investigate the factor structure and measurement invariance of the CESD across genders and groups in a sample of Chinese undergraduates and clinical patients. METHODS: Participants included 3093 undergraduates from the Hunan province and 336 patients from psychological clinics. The structure of the CESD scale was analyzed by confirmatory factor analysis (CFA). Multiple sets of CFAs were used to test measurement invariance across genders among undergraduates and clinical patients. Internal consistency reliability was also evaluated. RESULTS: The five-factor model achieved satisfactory fit (in the undergraduate sample: WLSMVχ2 = 1662.385, df = 160, CFI = 0.973, TLI = 0.968, RMSEA = 0.055; in the clinical patients: WLSMVχ2 = 502.089, df = 160, CFI = 0.962, TLI = 0.955, RMSEA = 0.072). The measurement invariance of the five-factor model across genders was supported fully assuming different degrees of invariance. The CESD also showed acceptable internal consistency. CONCLUSION: Due to its sound structure and measurement invariance, the five-factor model of the CESD is best suited for testing in Chinese mainland college students and clinical patients.

Psychometric properties of the 10-item ruminative response scale in Chinese university students.

BACKGROUND: Rumination increases vulnerability to depression, exacerbates and perpetuates negative moods. This study was aimed to examine the psychometric properties of the Chinese version of the 10-item Ruminative Response Scale (RRS-10) in a large undergraduate sample. METHODS: A sample of 5,236 university students finished the RRS and the Center for Epidemiological Studies Depression Scale (CES-D). Confirmatory Factor Analysis (CFA) was performed to examine the two-factor structure and the measurement equivalence of the RRS-10 across gender. The internal consistency, test-retest reliability, correlations among RRS, RRS-10 and CES-D were also explored. In addition, gender difference on rumination and the relationship between rumination and depression were further investigated. RESULTS: The two-factor model of RRS-10 fit the data reasonably and had acceptable internal consistency and test-retest reliability in Chinese undergraduates sample. And the measurement equivalence of the RRS-10 was acceptable across gender in Chinese university students. Findings in respect of latent means and manifest means revealed non-significant gender difference in RRS-10. Besides, participants with high-level rumination had more depressive symptoms than those with low-level rumination. CONCLUSIONS: The Chinese version of the RRS-10 showed good psychometric properties and was measurement invariant across gender in undergraduates.

What factors are predictive of benefit finding in women treated for non-metastatic breast cancer? A prospective study.

OBJECTIVE: Patients with breast cancer are able to gain psychological benefits from cancer diagnosis and treatment, such as a greater purpose of life and closer relationships, termed as 'benefit finding' (BF). The objective of this study was to determine the effects of sociodemographic, pathological, and psychological variables on BF in women with non-metastatic breast cancer. METHODS: A total of 404 patients with breast cancer were recruited to complete a demographic survey, a Chinese version of the Benefit Finding Scale, the Optimism-pessimism Scale, the Multidimensional Scale of Perceived Social Support, and the Cognitive Emotion Regulation Questionnaire during the first week after the confirmation of the diagnosis (T1). All participants finished the Chinese version of the Benefit Finding Scale again 6 weeks after diagnosis (T2). RESULTS: Age and education of patients, perceived social support from family, acceptance, positive reappraisal, and the baseline level of BF exhibited a positive prediction on BF. Education, pessimism, and perceived social support from family had a positive prediction and perceived social support from friends and refocus on planning had a negative prediction on the family relationship of BF. Education, perceived social support from family and friends, and the baseline level of BF had a positive prediction on the acceptance of BF. CONCLUSIONS: Perceived social support and cognitive emotion regulation strategies employed in response to breast cancer are important contributing factors to BF in women with breast cancer. In order to improve the longer-term adaptation of patients, benefit finding, either directly or via cognitive emotion regulation strategies, could be targeted for intervention.

Cognitive emotion regulation: characteristics and effect on quality of life in women with breast cancer.

BACKGROUND: In recent decades, researchers and clinicians have sought to determine how to improve the quality of life (QOL) of women with breast cancer. Previous research has shown that many women have particular behavioral coping styles, which are important determinants of QOL. As behavior is closely associated with cognition, these patients may also have particular cognitive coping styles. However, the cognitive coping characteristics and their effects on QOL in women with breast cancer remain unclear. Thus, this study aimed to characterize cognitive coping styles among women with breast cancer and explore the effects of cognitive emotion regulation strategies on QOL. METHODS: The Chinese version of the Cognitive Emotion Regulation Questionnaire was used to assess cognitive coping strategies in 665 women newly diagnosed with breast cancer and 662 healthy women. QOL of patients was assessed using the Functional Assessment of Cancer Therapy for Breast Cancer Scale. Independent-samples t-tests were performed to investigate group differences in reporting of cognitive coping strategies. Multiple regression analyses were performed to examine the effects of cognitive coping strategies on QOL in patients after controlling for sociodemographic and medical variables. RESULTS: Compared with control subjects, patients reported less frequent use of self-blame, rumination, positive refocusing, refocusing on planning, positive reappraisal, and blaming others, and more frequent use of acceptance and catastrophizing (all p < 0.01). The three strongest predictors of group membership were catastrophizing (B = -0.35), acceptance (B = -0.29), and positive reappraisal (B = 0.23). All nine coping strategies were significantly correlated with QOL in patients (all p < 0.05). After controlling for sociodemographic and medical variables, self-blame, rumination, and catastrophizing negatively affected QOL (all p < 0.05), whereas acceptance and positive reappraisal had positive effects (all p < 0.01). CONCLUSIONS: Compared with healthy women, women newly diagnosed with breast cancer use catastrophizing and acceptance more frequently, and positive reappraisal, self-blame, rumination, positive refocusing, refocusing on planning, and blaming others less frequently. Catastrophizing, rumination, and self-blame may be not conducive to QOL of women with breast cancer and acceptance and positive reappraisal may be useful.

Benefit finding predicts depressive and anxious symptoms in women with breast cancer.

PURPOSE: The aims of this study were to examine the psychometric properties of Chinese version of the Benefit Finding Scale (BFS-C) and to evaluate the effect of benefit finding on depressive and anxious symptoms in Chinese women with breast cancer. METHODS: The English version of the Benefit Finding Scale was translated and back-translated prior to its administration. At the baseline assessment (T1), 658 women with breast cancer completed a demographic form, BFS-C, and Hospital Anxiety and Depression Scale (HAD). Then, 4 weeks later (T2), all the participants finished HAD again, and the BFS-C was re-administered to 100 patients who were randomly selected from the total sample. RESULTS: The BFS-C exhibited moderate internal consistency and test-retest reliability. Five factors were extracted by principal component analysis: personal growth, worldview, family relationship, social relationship, and acceptance, and confirmatory factor analyses supported this five-factor model. Regression analyses showed that more benefit finding at T1 could predict less depressive and anxious symptoms at T2, accounting for 21.1 % and 15.3 % of variance, respectively. More worldview, family relationship, social relationship, and acceptance at T1 were associated with less depressive symptoms at T2, and more personal growth, worldview, family relationship, and acceptance at T1 were associated with less anxious symptoms at T2. CONCLUSIONS: BFS-C is of good reliability and validity, and appropriate for assessing benefit finding in women with breast cancer. Worldview, family relationship, and acceptance are important contributing factors to depressive and anxious symptoms, which may be beneficial for women with breast cancer.

Serotonin transporter gene polymorphism (5-HTTLPR) L allele interacts with stress to increase anxiety symptoms in Chinese adolescents: a multiwave longitudinal study.

BACKGROUND: Previous studies of the interaction between a functional polymorphism in the serotonin transporter gene-linked promoter region (5-HTTLPR) and stress in anxiety-related phenotypes have produced inconsistent results. The aim of the current study was to examine the effect of the 5-HTTLPR × stress interaction on anxiety symptoms in Chinese adolescents. METHODS: A total of 651 healthy adolescents [323 females and 328 males; age 14-17 (mean = 16.27, standard deviation = 0.77)] participated in this study. At the initial assessment, participants completed self-report measures assessing anxiety symptoms, depressive symptoms and stressful life events. Additionally, anxiety symptoms and stressful life events were assessed once every 3 months for the subsequent 9 months. A hierarchical linear model (HLM) was used to investigate the 5-HTTLPR × stress interaction. RESULTS: The HLM indicated no main effect of 5-HTTLPR on anxiety symptoms. Significant 5-HTTLPR × stress interaction effect in predicting anxiety symptoms was found. Specifically, individuals with the 5-HTTLPR L allele exhibited more anxiety symptoms related to stressful life events. CONCLUSIONS: The association between stress and anxiety symptoms is moderated by 5-HTTLPR. The 5-HTTLPR L allele increases individuals' vulnerability to anxiety under stress situations.

Emotional suppression and depressive symptoms in women newly diagnosed with early breast cancer.

BACKGROUND: Patients with breast cancer usually present varying levels of depressive symptoms. Emotional suppression, as a coping style, refers to an individual's ability to consciously control expression of negative emotions. Thus, emotional suppression is an important psychological factor related to depressive symptoms in patients with breast cancer. It has long been considered that compared to European and American women, Chinese women are more likely to ascribe to norms of negative emotion control for smooth social interaction. However, there is paucity of research focusing on emotional suppression among Chinese women with breast cancer. Thus the aims of the current study were (1) to investigate the incidence of depressive symptoms in women newly diagnosed with early breast cancer in Mainland China, and (2) to examine the relationships between emotional suppression and depressive symptoms in these patients. METHODS: The Center for Epidemiological Studies Depression Scale (CES-D), the Beck Anxiety Inventory (BAI) and the Chinese version of the Courtauld Emotional Control Scale (CECS) were used to assess the level of depressive symptoms, anxiety symptoms and emotional suppression respectively in 247 women with early breast cancer and 362 healthy women. Analyses of variance were conducted to investigate group differences on depressive symptoms and emotional suppression. Bivariate correlations and Hierarchical regression analyses were performed to examine the effect of emotional suppression on depressive symptoms in participants after controlling the impact of group membership and anxiety level. RESULTS: (1) The incidence rates of clinical and severe depressive symptoms in patients were 36.4 and 36.0 % respectively. (2) Patients scored significantly higher than healthy women on CECS. (3) The scores on CECS were significantly associated with the total CES-D scores in all participants; Anger suppression significantly predicted the total CES-D scores. CONCLUSIONS: The majority of women newly diagnosed with early breast cancer reported clinical or severe depressive symptoms. As well, these patients presented a controlled emotion coping style. Emotional suppression was associated with the level of depressive symptoms in women newly diagnosed with breast cancer. Anger suppression might play a unique role in the depressive symptoms among women newly diagnosed with breast cancer.

Neurological soft signs in adolescents with borderline personality traits.

OBJECTIVE: This study investigated the prevalence and severity of neurological soft signs (NSS), and their relationships with borderline personality (BP) traits in adolescents. METHODS: Eighty-nine adolescents with BP traits (BP-trait group), and 89 adolescents without traits of any personality disorder (control group), were recruited in China. BP traits were diagnosed by the BPD subscale of the Personality Diagnostic Questionnaire for the DSM-IV (PDQ-4+). The soft sign subscales of the Cambridge Neurological Inventory were administered to all participants. The group differences in prevalence of soft signs and in NSS scores were analyzed, as well as the associations between the NSS scale and borderline personality traits. RESULTS: Five soft signs were significantly more frequent in adolescents with BP traits. A total of 59.6% of adolescents with BP traits exhibited at least 1 NSS, whereas only 34.8% of adolescents without BP traits did (p < 0.01). A total of 42.7% of adolescents in the BP-trait group exhibited at least 2 NSS, while only 16.9% of adolescents without BP traits did (p < 0.001). Moreover, adolescents with BP traits showed more sensory integration, disinhibition, total neurological soft signs, left-side soft signs, and right-side soft signs, than adolescents without BP traits. Sensory integration and disinhibition were positively associated with BP traits. CONCLUSION: These findings suggest that adolescents with BP traits may have a nonfocal abnormality of the central nervous system.

Cognitive emotion regulation strategies as predictors of depressive symptoms in women newly diagnosed with breast cancer.

OBJECTIVE: This study aimed to determine the effects of cognitive emotion regulation strategies on depressive symptoms in women with breast cancer. METHODS: Five hundred and nine women with breast cancer completed a demographic survey, the Chinese version of Cognitive Emotion Regulation Questionnaire (CERQ-C), and the Center for Epidemiological Studies Depression Scale (CES-D) at the initial assessment (T1). One month later (T2), 504 patients completed the CES-D. Patients were assigned to four groups: H-H (CES-D scores ≥16 at both timepoints), H-L (CES-D score ≥16 at T1, <16 at T2), L-H (CES-D score <16 at T1, ≥16 at T2) and L-L (CES-D scores <16 at both timepoints). RESULTS: Over 80% patients had mild or no depressive symptoms at both timepoints. There were significant group differences in cognitive emotion regulation strategies. CERQ-C subscale scores for adaptive strategies were higher, and scores for maladaptive strategies were lower among patients in L-L and H-L groups than among those in H-H group. Hierarchical regression analyses showed that cognitive emotion regulation strategies at T1 differentiated depressive symptoms at T2, accounting for 56.5% of variance after controlling for sociodemographic and biological variables and baseline levels of depression. Greater acceptance, positive refocusing, and positive reappraisal at T1 were associated with fewer depressive symptoms at T2. CONCLUSIONS: Cognitive emotion regulation strategies accounted for considerable variance in depressive symptom scores 1 month later. The strategies of acceptance, positive refocusing, and positive reappraisal may be beneficial for women with breast cancer. Intervention studies are needed to confirm if these associations are causal.

The psychometric properties of the Cognitive-Somatic Anxiety Questionnaire in Chinese undergraduate students and clinical patients.

BACKGROUND: The present study was conducted to develop a Chinese version of the 14-item Cognitive-Somatic Anxiety Questionnaire (CSAQ) and examine its psychometric properties. METHODS: The original English version of the CSAQ was first translated into Chinese and then backtranslated and modified until cross-language equivalence was established. This version was then completed by 2168 undergraduate students and 289 clinical patients with mental disorder in China. The Mood and Anxiety Symptoms Questionnaire (MASQ) was also administered to students. Confirmatory factor analysis was performed to examine the two-factor construct, and the CSAQ's internal consistency, test-retest reliability, and concurrent and discriminant validity were also evaluated. RESULTS: The two-factor model (cognitive and somatic) of the CSAQ was confirmed, and the scale showed an adequate model fit in the student and clinical samples. The CSAQ showed adequate internal consistency (student sample: Cronbach's α=0.82, mean inter-item correlation coefficient=0.25; clinical sample: Cronbach's α=0.81, mean inter-item correlation coefficient=0.23) and good stability (2-week test-retest reliability in student sample, 0.84). The coefficient of correlation between CSAQ and overall anxious symptoms MASQ scores among students was 0.64. CONCLUSIONS: The Chinese version of the CSAQ is a promising instrument for reliable and valid measurement of anxiety in Chinese populations.

Health-related quality of life and influencing factors among rural left-behind wives in Liuyang, China.

BACKGROUND: In China, the number of left-behind wives in rural areas has reached 47 million. Left-behind wives might have more psychological stress and lower life quality. This study was to examine the health-related quality of life and influencing social and cognitive factors in a sample of left-behind wives in rural areas of China. METHODS: The demographic data questionnaire, the Short Form 36 Health Survey Scale, Center for Epidemiological Studies Depression Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Perceived Stress Scale were completed by a sample of 1,893 left-behind wives and 969 non-left-behind wives. RESULTS: Left-behind wives had lower scores on physical component summary (PCS), mental component summary (MCS) , and all the eight subscales of the SF-36 than non-left-behind wives (P < 0.05), especially on the role limitations due to emotional problems (RE) and on MCS. Compared to non-left-behind wives, left-behind wives scored higher in depression, stress, and passive coping styles, and scored significantly lower in social support and active coping styles. Logistic regression analysis showed that the status of being left behind, age, education years, monthly income, employment, physical health status, active coping styles, and depression were influencing factors on the PCS of rural women, whereas the status of being left behind, monthly income, physical health status, sense of marriage security, stress, social support, passive coping styles, and depression were influencing factors on the MCS of rural women. CONCLUSIONS: Left-behind wives scored lower on health-related quality of life than non-left-behind wives. Low health-related quality of life was associated with left behind status, older age, less education, low monthly income, unemployment, bad physical health status, passive coping styles, low social support, high level of stress, and high depression.

Associations between physical inactivity and sedentary behaviors among adolescents in 10 cities in China.

BACKGROUND: Studies in western countries have revealed that excessive sedentary behavior is a major risk factor for physical inactivity in adolescents. This study was performed to investigate the association between sedentary behavior and physical inactivity in Chinese adolescents using a large-scale cross-sectional survey design. METHODS: This study was part of the 2011 Chinese Youth Risk Behavior Survey. Between March and September 2011, 10,214 11-18-year-olds were recruited for survey participation in 18 schools in 10 cities in China. Demographic and socioeconomic characteristics, and the prevalences of physical inactivity and sedentary behaviors, were examined. Correlations between sedentary behavior and physical inactivity were analyzed using baseline logistic regression. RESULTS: Among the final 9,901 students, physical inactivity (~80%) and sedentary behaviors (television viewing, 43%; computer use, 30.2%) were prevalent. More male than female students reported sedentary behaviors (television viewing > 2 h: 5.5% vs. 3.9%; computer use > 2 h: 7.2% vs. 3.5%; both p < 0.05), but more males were physically active than females (25.1% vs.14.6%; p < 0.05). Television viewing was associated with lower odds of no physical activity (No PA) in males [0-2 h: adjusted odds ratio (AOR) = 0.81, 95% confidence interval (CI) = 0.68-0.96; >4 h: OR = 0.34, 95% CI = 0.18-0.64], but not in females. A similar pattern between insufficient physical activity and >4 h TV viewing (AOR = 0.42, 95% CI = 0.23-0.76) and >4 h computer use (AOR = 0.49, 95% CI = 0.30-0.78) was observed in males. In females, 0-2 h daily computer use was associated with higher odds of physical inactivity (No PA: AOR = 1.42, 95% CI = 1.10-1.82; Insufficient PA: AOR = 1.58, 95% CI = 1.24-2.01), while TV viewing was not associated with No PA or Insufficient PA. The probability of physical inactivity significantly increased with grade and decreased with socioeconomic status. CONCLUSIONS: Physical inactivity and sedentary behaviors were prevalent in Chinese adolescents. Further support, including parental guidance and the provision of publicly accessible facilities, is necessary to encourage Chinese youths to engage sufficiently in physical activities.

Screening cluster A and cluster B personality disorders in Chinese high school students.

BACKGROUND: Personality disorders (PDs) during adolescence may, in addition to increasing risk for violent behaviors and suicide, also increase risk for elevated PD traits in adulthood. The aim of this study was to explore the prevalence of Cluster A and Cluster B PD traits and their relationships to demographic variables in Chinese high school students. METHODS: A cohort of 3,552 students from eight high schools completed the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and MacArthur Scale of Subjective Social Status-youth version (SSSy) questionnaires. RESULTS: Boys scored higher than girls on the paranoid, schizotypal, antisocial, and narcissistic PDs. Freshmen and sophomores scored higher than juniors on schizoid, borderline, and antisocial PDs. Children in single-child families scored higher than nonsingletons on the paranoid and antisocial PDs. Students from single-parent households scored higher than students from double-parent households on the schizotypal and antisocial PDs, and students with remarried parents scored higher than students from double-parent households on the borderline and antisocial PDs. Students who had low perception of social status in the society ladder scored higher than those with a high perceived status on the schizoid and borderline PDs, but scored lower on the histrionic PD; students with a low subjective social status in the school community ladder scored higher scores than those with a high perceived status on the paranoid, schizoid, borderline, and antisocial PDs, but scored lower on the histrionic PD. CONCLUSIONS: Gender, grade, family structure, and subjective social status may affect the development of PDs. Longitudinal studies and studies of the full scope of PDs are needed to fully elucidate the impact of demographic variables on PD prevalence rates in adolescence and adulthood.

Interaction between a serotonin transporter gene promoter region polymorphism and stress predicts depressive symptoms in Chinese adolescents: a multi-wave longitudinal study.

BACKGROUND: The serotonin transporter (5-HTT) gene may play an important role in the onset and development of mental disorders. Past studies have tested whether a functional polymorphism in the 5-HTT gene linked promoter region (5-HTTLPR) moderated the association between stress and depressive symptoms, but the results of these studies were inconsistent. Thus, the aim of the current study was to examine the interaction between 5-HTTLPR and stress that predict depressive symptoms in Chinese adolescents. METHODS: A total of 252 healthy adolescents (131 females and 121 males, aged from 14 to 18, mean = 16.00, standard deviation = 0.60) participated in this study. During the initial assessment, all participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Adolescent Life Events Questionnaire (ALEQ) and were genotyped for the 5-HTTLPR polymorphism. Participants subsequently completed CES-D and ALEQ once every three months during the subsequent 24 months. A multilevel model was used to investigate the 5-HTTLPR × stress interaction in predicting depressive symptoms. RESULTS: The results indicated no main effect of 5-HTTLPR and a significant 5-HTTLPR × stress interaction in females only. Females with at least one 5-HTTLPR S allele exhibited more depressive symptoms under stressful situations. No significant 5-HTTLPR × stress interaction was found in males. CONCLUSIONS: In Chinese adolescents, there are gender differences on the interaction between 5-HTTLPR and stress that predict depressive symptoms. The association between stress and depressive symptoms is moderated by 5-HTTLPR in Chinese female adolescents.

Correlates of poor insight: A comparative fMRI and sMRI study in obsessive-compulsive disorder and schizo-obsessive disorder.

BACKGROUND: Despite the several researches on the correlates of insight in psychosis, less is known regarding the specificity of disease diagnosis on the relationship between insight and the correlates. The current study sought to explore the effects of insight and disease diagnosis on those in patients with obsessive-compulsive disorder (OCD) and patients with schizo-obsessive disorder (SOD). METHODS: We evaluated clinical symptoms and neurocognitions among 111 patients (including 41 OCD with good insight, 40 OCD with poor insight, 14 SOD with good insight and 16 SOD with poor insight. Gray matter volume and spontaneous neural activity were also examined by analyzing the voxel-based morphometry and amplitude of low frequency fluctuation (ALFF), respectively. RESULTS: Interactive effects of insight and diagnosis was found on working memory and the gray matter volume in right superior and middle temporal gyrus. Main effect of insight was found on working and visual memory, compulsion and obsession, and ALFF in right middle and superior occipital cortex. Main effect of diagnosis was found on severity of compulsion, relative verbal IQ, executive function, verbal and visual memory, working memory and ALFF in precuneus, medial superior frontal gyrus, anterior cingulate and paracingulate gyri, and inferior parietal, postcentral gyrus, paracentral lobule. CONCLUSIONS: As a common feature in mental disorders, insight has its own special influence on neurocognition and possible structural/functional alterations in brain, and the influence is partly dependent of disease diagnosis.

Application of Cognitive Emotion Regulation Questionnaire in Chinese Community Elderly.

Background: The present study investigated the applicability of the Cognitive Emotion Regulation Questionnaire (CERQ) in the Chinese community elderly and explored the influence of cognitive emotion regulation strategies on late-life depression. Methods: A total of 367 community elderly aged 60-94 were deemed eligible and completed CERQ, the Perceived Stress Scale-10, the Geriatric Depression Questionnaire-15, and the State Anxiety Inventory. Confirmatory factor analysis was adopted to verify the 9-factor structure of CERQ. Cronbach's α coefficient, Ω coefficient and split-half reliability were used to test the internal consistency of CERQ. Pearson correlations among scores of CERQ and other scales were calculated to examine its convergent validity. In addition, a structural equation model was used to further examine the effect of cognitive emotion regulation strategies on the association between perceived stress and late-life depression. Results: All the fitting indexes of CERQ's 9-factor model met the criterion (χ 2/df= 2.26, CFI= 0.916, TLI= 0.904, RMSEA= 0.052). For the total score of CERQ, the Cronbach's α coefficient and Ω coefficient were both 0.90, and the split-half reliability was 0.74. For the nine subscales, the α coefficients ranged from 0.66 to 0.88, and the Ω coefficients ranged from 0.69 to 0.88. Significant positive correlations were found between the maladaptive dimension of CERQ and other scales (all p < 0.001). The maladaptive emotion regulation strategies indirectly affected the effect of perceived stress on late-life depression (effect size was 21.57%). Conclusion: With good reliability and factor validity, the CERQ showed good applicability in the Chinese elderly population. The influence of perceived stress on depression in the elderly was mediated by maladaptive emotion regulation strategies.