Relationships between dispositional mindfulness, self-acceptance, perceived stress, and psychological symptoms in advanced gastrointestinal cancer patients.

OBJECTIVE: Previous studies have shown that dispositional mindfulness is associated with less psychological symptoms in cancer patients. The present study investigated how dispositional mindfulness is related to psychological symptoms in advanced gastrointestinal cancer patients by considering the roles of self-acceptance and perceived stress. METHODS: A total of 176 patients with advanced gastrointestinal cancer were recruited to complete a series of questionnaires including Mindfulness Attention Awareness Scale, Self-acceptance Questionnaire, Chinese Perceived Stress Scale, and General Health Questionnaire. RESULTS: Results showed that the proposed model fitted the data very well (χ2  = 7.564, df = 7, P = .364, χ2 /df = 1.094, Goodness of Fit Index (GFI) = 0.986, Comparative Fit Index (CFI) = 0.998, Tucker Lewis Index (TLI) = 0.995, Root Mean Square Error of Approximation (RMSEA) = 0.023). Further analyses revealed that, self-acceptance and perceived stress mediated the relation between dispositional mindfulness and psychological symptoms (indirect effect = -0.052, 95% confidence interval = -0.087 ~ -0.024), while self-acceptance also mediated the relation between dispositional mindfulness and perceived stress (indirect effect = -0.154, 95% confidence interval = -0.261 ~ -0.079). CONCLUSIONS: Self-acceptance and perceived stress played critical roles in the relation between dispositional mindfulness and psychological symptoms. Limitations, clinical implications, and directions for future research were discussed.

A consideration of hoarding disorder symptoms in China.

BACKGROUND: Hoarding disorder is rarely examined in populations of non-European and/or non-Euro-American descent, especially in East Asian nations like China. Across two studies, the current investigation sets out to examine the psychometric properties of a Chinese version of a widely used measure of hoarding symptoms-the Savings Inventory Revised (SIR)-and to explore the nature of hoarding beliefs compared to a separate US sample. PROCEDURES: For the first study, 1828 college students in China completed a Mandarin translation of the SIR and measures of anxiety, depression, and obsessive-compulsive disorder. For the second study, 303 students from China and 87 students from the US completed the SIR and a novel hoarding beliefs questionnaire. FINDINGS: In the first study, the Chinese-version of the SIR demonstrated convergent and discriminant validity, as well as internal reliability and preliminary construct validity. However, evidence of temporal stability was modest and requires further investigation. In the second study, the Chinese sample endorsed greater hoarding symptoms and hoarding beliefs compared to the US sample, although only themes of usefulness and wastefulness were associated with hoarding in the Chinese samples, whereas a wider range of beliefs was linked with hoarding in the US sample. In addition, the factor structure of the SIR from the first study did not replicate in second study, suggesting that construct validity of the Chinese SIR may require further corroboration. CONCLUSIONS: The current study established preliminary evidence for the reliability and validity of the Chinese SIR, although future research is needed to confirm its temporal stability and factor structure. Hoarding beliefs in China may be centered on themes of usefulness and wastefulness compared to more heterogeneous themes in the West, suggesting differential manifestations of hoarding tendencies in cultures of non-European and/or non-Euro-American descent.

Relationship between autistic traits and hoarding in a large non-clinical Chinese sample: mediating effect of anxiety and depression.

Researchers and clinical practitioners have found that hoarding appears in many autism patients and that most of these patients show high anxiety and depression. There is no consensus on the relationship between autistic traits and hoarding, and little research concerning the role of negative emotions. This study investigated the relationship between autistic traits and hoarding in a large non-clinical Chinese sample. Participants were 3,229 university students (M age = 20.5 yr., SD = 1.6; 1,839 men) who were recruited in classroom. They completed measures of hoarding, autistic symptomology, anxiety, and depression: specifically the Saving Inventory-Revised, the Autism-Spectrum Quotient, the Zung Self-Rating Anxiety Scale, and The Center for Epidemiological Studies Depression Scale. Mediating effects of anxiety and depression in the correlation between autistic traits and hoarding were also explored. There was a weak but significant correlation between autistic traits and hoarding. Significant mediating effects of anxiety and depression were observed. Hoarding in people with high autistic traits could be influenced by anxiety and depression.

The effects of psychosocial interventions on geriatric depression in the mainland of China: A systematic review and meta-analysis.

BACKGROUND: The effectiveness of psychosocial interventions for geriatric depression across different treatment settings, regions, and comorbidities in China remains unclear. Therefore, we systematically reviewed studies geared towards reducing geriatric depression in China. METHODS: Nine databases in Chinese or English from database were searched from inception through June 2024. Randomized controlled trials investigating psychosocial interventions on older adults with depression in China were included. The primary outcome was post-intervention depression measured by self-report instruments. Random-effect model was used to pool the overall effect size Hedge's g. RESULTS: In 99 studies with a total of 9369 older adults with depression, psychosocial interventions were effective compared with control conditions (Hedges' g: -1·48 [95 % CI: -1·83 to -1·13]). Comorbidity with physical disease significantly affect the pooled effect size (without comorbidity: Hedges' g = -1.19, 95 % CI: -1.42 to -0.95; with comorbidity: Hedges' g = -2.06, 95 % CI: -2.97 to -1.14; p = 0.062), and heterogeneity was substantial (without comorbidity, I2 = 91·3 %, 95 % CI: 89·5 % to 92·7 %; with comorbidity, I2 = 94·3 %, 95 % CI: 93·1 % to 95·4 %). The quality of evidence according to the GRADE criteria was generally moderate. LIMITATIONS: Significant heterogeneity among the studies reviewed was unavoidable, and the possible publication bias could lead to overestimation of the result. CONCLUSION: Psychosocial interventions are significantly effective for treating geriatric depression in China regardless of the setting, region, or therapeutic orientation. Policies should support the development and implementation of psychosocial interventions in China, especially in community settings, to reduce disease burden.

Social anxiety and bullying victimization: A three-level meta-analysis of cross-sectional and longitudinal studies.

BACKGROUND: Numerous studies have explored the association between social anxiety and bullying victimization. However, inconsistency are found regarding the strength and the direction of this relationship. Moreover, it remains unclear how different subtypes of bullying victimization associate with social anxiety. OBJECTIVE: The purpose of this study was to conduct a meta-analysis to systematically investigate the cross-sectional and longitudinal relationships between social anxiety and bullying victimization. PARTICIPANTS AND SETTING: Individuals experiencing social anxiety and bullying victimization. METHODS: The present study employed three-level random effects model to combine the correlation coefficients r to indicate the strength of the cross-sectional association between social anxiety and bullying victimization. Cross-lagged regressions were utilized to examine the prospective relationship between both variables. RESULTS: A total of 133 cross-sectional studies reporting 220 effect sizes were included in the meta-analysis, and the results showed a significant moderate association between social anxiety and bullying victimization (r = 0.268, 95 % CI [0.244, 0.292]). Nineteen longitudinal studies were also identified, revealing that social anxiety at Time 1 significantly predicted bullying victimization at Time 2 (ß = 0.067, 95 % CI [0.038, 0.096]). However, bullying victimization did not significantly predict subsequent social anxiety (ß = 0.012, 95 % CI [-0.026, 0.049]). Subgroup analyses revealed that social anxiety had the strongest association with relational victimization (r = 0.382, 95 % CI [0.335, 0.430]), followed by reputational victimization (r = 0.254, 95 % CI [-0.171, 0.337]), physical victimization (r = 0.226, 95 % CI [0.144, 0.308]) and overt victimization (r = 0.202, 95 % CI [0.146, 0.257]). Social anxiety was significantly more associated with traditional bullying victimization (r = 0.281, 95 % CI [0.233, 0.328]) than cyberbullying victimization (r = 0.177, 95 % CI [0.137, 0.218]; p < 0.001). CONCLUSIONS: Social anxiety was found to be moderately associated with and prospectively predict bullying victimization. Future research and interventions could focus on reducing social anxiety to prevent bullying victimization.

Sources of Social Support, Self-Esteem and Psychological Distress among Chinese Lesbian, Gay and Bisexual People.

Objective: Minority stressors are associated with increased psychological distress, and social support is considered as a significant protective factor to mitigate the psychological distress in LGB individuals. In China, LGB individuals suffer additional pressure from society and family, but only a few studies have explored the effect of social support on the psychological distress of Chinese LGB individuals and the mechanism underlying the association. The current study aimed to examine the mediating role of self-esteem in the relationship between three sources of social support (from family, friends, and others) and psychological distress in Chinese LGB individuals. Methods: 227 LGB individuals (M age = 25.9 years; SD = 5.6) who were voluntarily recruited by a combination of snowballing and targeted sampling strategies. Path analysis was used to test the associations between variables. Results: Results indicated that 31.3% of LGB individuals had a high level of psychological distress. The results showed that social support from family, friends, and others was associated with higher levels of self-esteem and lower levels of psychological distress. Only the mediating effect of self-esteem was found between friend support and psychological distress. Conclusions: This study demonstrated that friend support might be a protective factor against psychological distress in Chinese LGB individuals, and more friend support could potentially relieve psychological distress by building higher self-esteem. These results highlight the importance of fostering friend support in the group of Chinese LGB individuals.

Social support and prolonged grief disorder symptoms in parents who lost their only child from urban and rural China.

OBJECTIVE: The one-child policy has existed in China for more than 30 years. It brought benefits to the country's economic development and reduced the magnitude of the population within a short period. However, it has led to the emergence of a significant number of parents who have lost their only child, referred to as shiduers (). This study explored the symptoms of prolonged grief disorder (PGD) among shiduers and their relationship with the social support shiduers received after they lost the child, specifically accounting for the disparity between rural and urban areas. METHOD: In total, 405 participants were recruited with a mean age of 60.37 years (SD = 7.78). Around 68.75% were female, and 58.66% were urban shiduers. They were asked to complete a series of self-reported questionnaires, including demographic information, the Social Support Rate Scale, and the Prolonged Grief-13. RESULTS: First, 29.63% of the participants (N = 120) fulfilled the International Classification of Diseases (11th rev.) diagnostic criteria for PGD symptoms; second, PGD symptoms of shiduers were negatively related to social support, including objective support, subjective support, and the availability of support; and third, urban/rural location moderated the effect of objective support on the PGD symptoms of shiduers, but not the effect of subjective support on PGD symptoms. Furthermore, the simple-slope tests indicated that the shiduers in rural areas benefited most from objective support. CONCLUSIONS: The present results revealed high rates of PGD symptoms in Chinese shiduers, and our findings highlight the important role of urban/rural location in the relationship between social support and PGD symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mental contamination among people in China: A replication of a moral manipulation experiment.

BACKGROUND AND OBJECTIVES: Mental contamination can be evoked by thoughts, images, and memories without having physically contacted any contaminants. Although several experiments have investigated the mechanism of mental contamination, none has been conducted in the Chinese socio-cultural context. Considering the potential cultural-sensitivity of mental contamination we replicated Elliott and Radomsky's experiment (2009) to examine whether an imagined immoral act would prompt mental contamination among female university students in China. METHODS: We assigned participants (n = 148) to 4 conditions in which they listened to an audio recording asking them to imagine that they had (a) shared a consensual kiss with a moral man, (b) shared a consensual kiss with an immoral man, (c) received a non-consensual kiss from a moral man, (d) or received a non-consensual kiss from an immoral man. Afterwards, they completed questionnaires, and their personal hygiene behaviours were recorded. RESULTS: As in the precedent study, participants who imagined a non-consensual kiss reported greater feelings of mental contamination than ones who imagined a consensual kiss. Unlike in that study, however, imagining a consensual kiss from a moral man also aroused strong mental contamination. LIMITATIONS: It remains unclear which aspect of immoral acts (information or behaviour) weigh more in evoking mental contamination. CONCLUSIONS: The results suggest that imagining sexually immoral acts can evoke feelings of mental contamination among people in China. Nevertheless, cultural beliefs and attitude towards sexuality may play a role of causing the discrepancies.

Explaining the Efficacy of an Internet-Based Behavioral Activation Intervention for Major Depression: A Mechanistic Study of a Randomized-Controlled Trial.

Background: Behavioral activation is an effective treatment for depression that is theorized to facilitate structured increases in enjoyable activities that increase opportunities for contact with positive reinforcement; to date, however, only few mechanistic studies focused on a standalone intervention. Method: Interventions using internet-based behavioral activation or psychoeducation were compared based on data from a randomized-controlled trial of 313 patients with major depressive disorder. Activation level and depression were measured fortnightly (baseline, Weeks 2, 4, 6, 8, 10), using the Patient Health Questionnaire-9 and the Behavioral Activation for Depression Scale-Short Form, respectively. Analysis was performed to determine if a change in activation level mediated treatment efficacy. Results: Latent growth modeling showed that internet-based behavioral activation treatment significantly reduced depressive symptoms from baseline to the end of treatment (standardized coefficient = -.13, p = .017) by increasing the rate of growth in the activation level (mediated effect estimate = -.17, 95% CI [-.27, -.07]. Results from mixed effects and simplex models showed that it took 4 weeks before mediation occurred (i.e., a significant change in activation that led to a reduction in depressive symptoms). Conclusion: Activation level likely mediated the therapeutic effect of behavioral activation on depression in our intervention. This finding may be of significant value to clinicians and depressed individuals who should anticipate a 4-week window before seeing a prominent change in activation level and a 6-week window before depressive symptomatology reduces. Future research must consolidate our findings on how behavioral activation works and when mediation occurs.

Psychological factors for the onset of depression: a meta-analysis of prospective studies.

OBJECTIVES: A comprehensive overview of the evidence for factors derived from leading psychological theories of the onset of major depressive disorder (MDD) that underpin psychological interventions is scarce . We aimed to systematically investigate the prospective evidence for factors derived from the behavioural, cognitive, diathesis-stress, psychodynamic and personality-based theories for the first onset of MDD. DESIGN: Systematic review and meta-analysis. METHODS: Databases PubMed, PsycINFO, Cochrane and Embase and published articles were systematically searched from inception up to August 2019. Prospective, longitudinal studies that investigated theory-derived factors before the first onset of MDD, established by a clinical interview, were included. Screening, selection and data extraction of articles were conducted by two screeners. The Grading of Recommendations Assessment, Development and Evaluation criteria were used to estimate level of confidence and risk of bias. Meta-analysis was conducted using random-effects models and mixed-method subgroup analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: Effect size of a factor predicting the onset of MDD (OR, risk ratio or HR). RESULTS: From 42 133 original records published to August 2019, 26 studies met the inclusion criteria. Data were only available for the cognitive (n=6585) and personality-based (n=14 394) theories. Factors derived from cognitive theories and personality-based theories were related to increased odds of MDD onset (pooled OR=2.12, 95% CI: 1.12 to 4.00; pooled OR=2.43, 95% CI: 1.41 to 4.19). Publication bias and considerable heterogeneity were observed. CONCLUSION: There is some evidence that factors derived from cognitive and personality-based theories indeed predict the onset of MDD (ie, dysfunctional attitudes and negative emotionality). There were no studies that prospectively studied factors derived from psychodynamic theories and not enough studies to examine the robust evidence for behavioural and diathesis-stress theories. Overall, the prospective evidence for psychological factors of MDD is limited, and more research on the leading psychological theories is needed. PROSPERO REGISTRATION NUMBER: CRD42017073975.

Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis.

BACKGROUND: The effectiveness of digital psychological interventions in low-income and middle-income countries (LMICs) remains unclear. We aimed to systematically investigate the available evidence for digital psychological interventions in reducing mental health problems in LMICs. METHODS: In this systematic review and meta-analysis, we searched PubMed, PsycINFO, Embase, and Cochrane databases for articles published in English from database inception to March 9, 2020. We included randomised controlled trials investigating digital psychological interventions in individuals with mental health problems in LMICs. We extracted data on demographics, inclusion and exclusion criteria, details of the intervention, including the setting, digital delivery method, control group conditions, number of sessions, therapeutic orientation (eg, cognitive therapy or behaviour therapy), presence or absence of guidance, and length of follow-up, and statistical information to calculate effect sizes. If a study reported insufficient data to calculate effect sizes, the corresponding authors were contacted to provide data that could be aggregated. We did random-effects meta-analyses, and calculated the standardised mean difference in scores of digital psychological interventions versus control conditions (Hedges'g). Quality of evidence was assessed by use of the Grading of Recommendations Assessment, Development, and Evaluation approach. The primary outcome was post-intervention mental health problems, as measured by self-reporting instruments or clinical interviews. This study is registered with PROSPERO, CRD42019137755. FINDINGS: We identified 22 eligible studies that were included in the meta-analysis. The included studies involved a total of 4104 participants (2351 who received a digital psychological intervention and 1753 who were in the control group), and mainly focused on young adults (mean age of the study population was 20-35 years) with depression or substance misuse. The results showed that digital psychological interventions are moderately effective when compared with control interventions (Hedges'g 0·60 [95% CI 0·45-0·75]; Hedges'g with treatment as usual subgroup for comparison 0·54 [0·35-0·73]). Heterogeneity between studies was substantial (I2=74% [95% CI 60-83]). There was no evidence of publication bias, and the quality of evidence according to the GRADE criteria was generally high. INTERPRETATION: Digital psychological interventions, which have been mostly studied in individuals with depression and substance misuse, are superior to control conditions, including usual care, and are moderately effective in LMICs. However, the considerable heterogeneity observed in our analysis highlights the need for more studies to be done, with standardised implementation of digital psychological intervention programmes to improve their reproducibility and efficiency. Digital psychological interventions should be considered for regions where usual care for mental health problems is minimal or absent. FUNDING: None. TRANSLATIONS: For the Persian, Chinese, Hindi, Portuguese, Bahasa, Turkish, Romanian, Spanish and Thai translations of the abstract see Supplementary Materials section.

Psychological interventions for depression in Chinese university students: A systematic review and meta-analysis.

BACKGROUND: University students in China are vulnerable to depression with a high estimated prevalence. It is currently unknown which types of psychological interventions are being delivered to treat depression in this population and whether they are effective. Therefore, a systematic review was conducted to address this issue. METHODS: We searched records in English and Chinese databases up to January 2019. RESULTS: From 2,739 records, we identified 39 randomized controlled trails (RCTs) and 54 non-RCTs. A range of psychological interventions were identified including cognitive behaviour therapy, interpersonal therapy, and local interventions. Hedge's g pooled effect size of 23 comparisons from 21 RCTs (N =858) compared to a control group (N = 802) was 1.08 (95% CI: 0.72 to 1.45). Heterogeneity was moderate with I2 = 47 (95%CI: 14 to 68). Type of control group was significantly associated with the effect size (p =0.039). Comparisons between the intervention condition and the 'no intervention' condition yielded a higher effect size (Hedges' g =1.38, 95% CI: 0.89 to 1.87) than comparisons between the intervention condition and the 'usual care/control' condition (Hedges' g = 0.56, 95% CI 0.08 to 1.05). No other significant differences based on the study characteristics were observed. LIMITATIONS: Publication bias and quality of inclusions. CONCLUSIONS: Collectively, there is evidence that psychological interventions for depression in Chinese university students are effective as compared to control groups, although the effects merit further examination by research of higher quality. Innovations in treatment delivery could facilitate wider dissemination of evidence-based interventions.

Psychological theories of depressive relapse and recurrence: A systematic review and meta-analysis of prospective studies.

Psychological factors hypothesized to account for relapse of major depressive disorder (MDD) roughly originate from five main theories: Cognitive, diathesis-stress, behavioural, psychodynamic, and personality-based. In a meta-analysis we investigated prospective, longitudinal evidence for these leading psychological theories and their factors in relation to depressive relapse. Included studies needed to establish history of MDD and prospective depressive relapse through a clinical interview, have a longitudinal and prospective design, and measure at least one theory-derived factor before relapse. We identified 66 eligible articles out of 43,586 records published up to November 2018. Pooled odds ratios (OR) indicated a significant relationship between the cognitive, behavioural, and personality-based theories and depressive relapse (cognitive: k = 17, OR = 1.24, 95% CI = 1.10-1.40; behavioural, k = 8, OR = 1.15, 95% CI = 1.05-1.25; personality: k = 12, OR = 1.26, 95% CI = 1.02-1.54), but not for the psychodynamic theories (k = 4, OR = 1.29, 95% CI = 0.83-1.99). Pooled hazard ratios of the theories were not significant. There were no articles identified for the diathesis-stress theories. To conclude, there is a restricted number of prospective studies, and some evidence that the cognitive, behavioural, and personality-based theories indeed partially account for depressive relapse.

Psychometric properties of the Chinese version of the Affective Style Questionnaire and its role as a moderator of the relationship between stress and negative affect.

The Affective Style Questionnaire is a self-report instrument for assessing affective style. Study 1 investigated the psychometric properties of the Chinese Affective Style Questionnaire in a sample of 459 Chinese participants. The confirmatory factor analysis supported a three-factor structure. Study 1 indicated that the Chinese Affective Style Questionnaire can be used as a simple, reliable, and valid scale for measuring individual differences in affective style. Study 2 examined the moderating role of different affective styles in the relationship between stress and negative affect. Concealing and tolerating moderated the relationship between stress and anxiety, and adjusting moderated the relationship between stress and depression.

Growing in times of grief: attachment modulates bereaved adults' posttraumatic growth after losing a family member to cancer.

This study explored whether attachment moderated the relationship between grief and posttraumatic growth. A total of 240 Chinese adults who have lost a family member to cancer reported on their grief (Prolonged Grief Questionnaire-13; PG-13), posttraumatic growth (Posttraumatic Growth Inventory; PTGI) and attachment (Experiences in Close Relationships; ECR). The results suggested that bereaved individuals who scored high on attachment anxiety showed a substantial and positive relationship between grief and posttraumatic growth, while their less anxiously attached counterparts showed no such association. Attachment avoidance was not significantly related to the association between grief and posttraumatic growth. Findings indicated that individuals high in attachment anxiety have the potential to benefit and gain from the process of adapting to the loss. The implications of the results for relevant research and grief counseling were discussed.