Joint developmental trajectories of depression and post-traumatic stress disorder symptoms among Chinese children during COVID-19.

BACKGROUND: In early 2020, Chinese children started to demonstrate severe depression and post-traumatic stress disorder symptoms (PTSS) caused by lockdown and self-isolation (measures taken at the beginning of the COVID-19 pandemic). OBJECTIVES: Concerning the significant impact of the pandemic on children's physical and mental development, the study aimed to explore children's depression and PTSS during the COVID-19 pandemic and the protective effects of family resilience on the trajectories. METHODS: 883 children participated and completed three waves of online follow-up questionnaires. The latent growth mixture modeling (LGMM) analysis was used to explore the trajectories of children's depression and PTSS based on the individual approach. RESULTS: Two types of depression trajectories were identified and defined as the resilient group (83.01 %) and the recovery group (16.99 %); Two types of PTSS trajectories were identified and defined as the resilient group (71.12 %) and the recovery group (28.88 %); Two types of the joint trajectories of depression and PTSS were identified and defined as the resilient group (83.47 %) and the chronic group (16.53 %). The results indicated that maintaining a positive outlook (a dimension of family resilience) was the potential predictor of PTSS trajectories. CONCLUSION: The trajectories of depression and PTSS among Chinese children during the COVID-19 pandemic were heterogeneous, and there were similar evolving subtypes. Family resilience could be a critical protective factor for children and families.

Hurting myself to cope: Using network analysis to understand the association between perceived stigma and non-suicidal self-injury functions among men who have sex with men in China.

Prior studies have demonstrated that perceived stigma is robustly associated with risky and life-threatening behaviors, including non-suicidal self-injury (NSSI), among men who have sex with men (MSM). However, studies regarding the relationship between perceived stigma and NSSI are limited. The present study aimed to investigate the network structure of perceived stigma and NSSI functions, along with bridge nodes, to elucidate how they co-exist. A sample of 2610 Chinese MSM (mean age = 23.99, age range: 18-68 years) was recruited from an online survey platform. All participants completed a web-based survey with measures of perceived stigma and NSSI functions. Results indicated that 'negative attitudes towards homosexuality' and 'disappointment in gay son' were identified as the most central nodes in the perceived stigma network, whereas 'seeking attention' and 'influencing others to change' ranked highest on centrality in the NSSI network. Two bridge connections were exhibited within the combined perceived stigma and NSSI network model: 'unwelcoming in public' and 'avoiding unpleasant tasks' from perceived stigma and NSSI communities, respectively. This is among the first studies investigating the co-occurrence between perceived stigma and NSSI from the network approach. Our findings provide an empirically-based perspective on the importance of family- and community-based interventions, with potential clinical implications for reducing NSSI among sexual and gender minority groups.

Impact of enacted stigma on mental health, substance use, and HIV-related behaviors among sexual minority men in Zambia.

Sexual minority men (SMM) in Zambia face significant challenges including stigma, discrimination, and mental health issues, which further impact their HIV-related risk behaviors. This study aimed to investigate the associations between enacted stigma, substance abuse, HIV-related behaviors, and mental health (i.e., depression, anxiety, and post-traumatic stress disorder [PTSD] symptoms) among SMM in Zambia. SMM aged 18-35 years who reported having multiple and/or concurrent sexual partners or low and/or inconsistent condom use in the past three months were recruited from four districts in Zambia between February and November 2021. Participants completed an anonymous interviewer-administered survey. Key variables of interest were compared between participants with higher vs. lower levels of enacted stigma. Independent samples t-tests were used for continuous variables, and chi-squared tests were used for categorical variables. A total of 197 eligible SMM participated in the study (mean age = 24.41 years). Participants with a higher level of enacted stigma showed a higher level of anxiety symptoms (χ2 = 12.91, p ≤ .001), PTSD symptoms (χ2 = 7.13, p < .01), tobacco use (χ2 = 10.47, p < .01), cannabis use (χ2 = 5.90, p < .05), and a higher number of sexual partners (t = 1.99, p < .05) in the past three months. Stigma reduction interventions may help mitigate substance abuse, HIV-related behaviors, and adverse mental health outcomes among SMM in Zambia. Health care providers, especially psychiatric-mental health nurses, can incorporate strategies for recognizing and addressing stigma into their practice through training and integrate multiple resources to create an inclusive and non-judgmental environment for SMM to improve their well-being.

Exploring the Longitudinal Influence of Perceived Social Support, HIV Stigma, and Future Orientation on Depressive Symptoms Among People Living with HIV in China.

Prior studies demonstrated that perceived social support is negatively associated with behavioral and mental health problems among people living with HIV (PLWH). However, longitudinal data regarding the associations between perceived social support, internalized HIV stigma, future orientation, and depressive symptoms are limited. The current study aimed to investigate the possible indirect relationship between these variables using four-wave follow-up data (6-month intervals) from a sample of 1,098 Chinese PLWH (Mage = 38.63, SD = 9.20, age range: 18-60 years; 63.9% men). All participants were asked to complete an adapted version of Perceived Social Support Scale, Internalized HIV Stigma Scale, Optimism About the Future Scale, and Center of Epidemiological Studies Depression Scale. Results indicated that perceived social support at baseline was negatively related to depressive symptoms at wave 4. Internalized HIV stigma at wave 2 and future orientation at wave 3 indirectly affected the linkage between perceived social support at baseline and depressive symptoms serially over time. This study highlights the essential role of perceived social support in alleviating depressive symptoms among PLWH, and underscores the complex interplay in which internalized HIV stigma and future orientation serially mediated the relationship between perceived social support and depressive symptoms. These findings suggest the need for integrated interventions to enhance social support, address HIV-related stigma, and promote positive future orientation, which could potentially alleviate depressive symptoms and promote mental well-being among PLWH.

How Does Anticipated HIV Stigma Affect Medication Adherence? A Longitudinal Path Analysis Model.

Prior research has documented that anticipated HIV stigma may play an important predictive role in medication adherence among people living with HIV (PLWH). However, longitudinal data on the mechanisms underlying this linkage are scarce. The current study aimed to explore the longitudinal mediation association among anticipated HIV stigma, medication adherence support, HIV self-management, and medication adherence. A four-wave sample consisting of 1,098 Chinese PLWH (Mage = 38.63, SD = 9.20; 63.9% male) with a six-month interval was used in the current study. Participants were asked to complete self-report questionnaires. A path analysis model was analyzed. Results indicate that anticipated HIV stigma at baseline was positively related to medication adherence at Time 4 (T4). Medication adherence support at Time 2 (T2) and HIV self-management at Time 3 (T3) serially mediated the anticipated HIV stigma at Time 1 (T1) and medication adherence at T4. These findings provide critical insights into the mediating roles of medication adherence support and HIV self-management in the relationship between anticipated HIV stigma and medication adherence over time. Such an understanding has important implications for the development of tailored interventions and public health strategies aimed at improving medication adherence among PLWH in the context of HIV-related stigma.

Longitudinal Association Between Posttraumatic Stress Symptoms and Depression Symptoms Among Chinese Adolescents During COVID-19: Evidence from Network Perspective.

Although there are an increasing number of studies that have explored the mental health consequences of COVID-19 focusing on revealing risk factors, the longitudinal research examining the potential mechanism of the co-occurrence of posttraumatic stress symptoms (PTSS) and depression symptoms among adolescents were scarce. The present study identified the important comorbidity symptoms and explored longitudinal relationship of PTSS and depression symptoms from the network perspective. A two-wave investigation (4 months interval; T1 and T2) was conducted with a sample of 1225 Chinese adolescents. Cross-sectional network and cross-lagged panel network (CLPN) analyses were adopted. Results showed that comorbidity symptoms consisted of both overlapping and non-overlapping symptoms, including "Future foreshortening" at T1 and T2 from PTSS, and "Hard to get started" at T1 and "Not sleep well" at T2 from depression symptoms. Strong longitudinal pathways appeared from all PTSS to depression symptoms, among which the pathway from "Difficulty concentrating" to "Hard to get started" was the strongest. These findings suggest that the possible comorbidity between PTSS and depression symptoms is caused by their independent and related structures, and their longitudinal association. Clinical intervention for these symptoms may alleviate adolescents' psychological problems in the aftermath of traumatic events.

Longitudinal Analysis of the Relationship Between Internalized HIV Stigma, Perceived Social Support, Resilience, and Depressive Symptoms Among People Living with HIV in China: A Four-Wave Model.

Depression is one of the most common mental health problems among people living with HIV (PLWH). However, the longitudinal psychological mechanism underlying the link of internalized HIV stigma and depressive symptoms remains a research gap. This study attempted to articulate how and to what extent perceived social support and resilience mediate the longitudinal associations between internalized HIV stigma and depressive symptoms. A sample consisting of 1,098 Chinese PLWH (Mage = 38.63, SD = 9.20; 63.9% male) with a six-month interval and four waves of follow-up was used in the current study. Participants were asked to complete self-report questionnaires. The associations among main study variables were examined via a complete longitudinal mediation approach. Results indicated that the linkage between internalized HIV stigma at T1 and depressive symptoms at T4 was serially mediated by perceived social support at T2 and resilience at T3, and perceived social support at T2 and depressive symptoms at T3 serially mediated the relationship between resilience at T1 and internalized HIV stigma at T4. Depressive symptoms at a previous time point consistently predicted the levels of internalized HIV stigma at subsequent time points. The study highlights the complex interplay between internalized HIV stigma, mental health problems, and protective factors in a longitudinal context. The findings suggest the need to incorporate interventions aimed at enhancing social support and resilience in mental health programs for PLWH, as these factors may interrupt the pathway from internalized HIV stigma to depressive symptoms and potentially improve the overall psychological well-being of this population.

Psychological Mechanisms of Internalized HIV Stigma Affect Sleep Impairment among People Living with HIV in China: A follow-up Study.

Prior studies have demonstrated that HIV-related stigma (e.g., internalized HIV stigma) is detrimental to the physical and mental health (e.g., sleep impairment and depressive symptoms) of people living with HIV (PLWH). However, follow-up data are limited regarding the longitudinal relationships between internalized HIV stigma, future orientation, self-esteem, depressive symptoms, and sleep impairment. The present study attempted to examine a mediation model involving these variables among Chinese PLWH. A two-wave follow-up design (6 months intervals) was employed in a final sample of 1,140 Chinese PLWH (Mage = 41.63, SD = 9.29, age range: 21-67 years; 64.6% men). Participants completed Internalized HIV Stigma Scale, Optimism About the Future Scale, Rosenberg Self-Esteem Scale, Center of Epidemiological Studies Depression Scale, and an adapted version of Pittsburgh Sleep Quality Index. Results revealed that internalized HIV stigma at baseline had a significant direct relationship with sleep impairment over time, and a significant indirect relationship with increased sleep impairment over time via future orientation and depressive symptoms. Furthermore, the linkage between internalized HIV stigma and sleep impairment was serially mediated via self-esteem and depressive symptoms. This study highlights the deleterious effects of internalized HIV stigma on the physical and psychological health of PLWH. The findings suggest that interventions targeting internalized HIV stigma and related factors such as future orientation, self-esteem, and depressive symptoms may facilitate improvements in sleep quality and overall well-being among PLWH.

Is teacher violence a form of betrayal trauma? Relationship with mental health problems among young adults.

BACKGROUND: Childhood trauma is one of the most preventable risk factors for mental health problems. Considering the substantial amount of time that young people spend in school during their early years, it is important to understand the potential impacts of teachers' behaviors on students' mental health. OBJECTIVES: This study examined the relationship between exposure to teacher violence and mental health problems. PARTICIPANTS AND SETTING: An international sample of young adults aged 18 to 24 (N = 283). METHODS: Participants completed self-report measures of childhood trauma, exposure to teacher violence, depressive symptoms, post-traumatic stress, and alcohol misuse. RESULTS: Exposure to teacher violence could be reliably and validly measured using the Teacher Violence Scale (TVS). Current mental health problems - including depressive symptoms, post-traumatic stress, and alcohol misuse - were associated with exposure to teacher violence during high school years, but not with childhood non-betrayal trauma. CONCLUSIONS: Our findings expand the application of the betrayal trauma theory to school settings and point to the importance of preventing and managing teacher violence. It is important to provide more support and training to teachers and enhance monitoring measures in schools. More research on the prevalence and correlates of exposure to teacher violence is needed. We also provided first evidence supporting the reliability and validity of the English version of the TVS to facilitate future research.

Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model.

Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (Mage = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms.

Associations Between Internalized and Anticipated HIV Stigma and Depression Symptoms Among People Living with HIV in China: A four-wave Longitudinal Model.

Previous research has documented that HIV-related stigma (e.g., internalized and anticipated stigma) is detrimental to the mental health of people living with HIV (PLWH). However, longitudinal data on the bidirectional relationship between HIV-related stigma and depression symptoms are limited. The purpose of this study was to examine the bidirectional association among internalized and anticipated HIV stigma and depression symptoms among Chinese PLWH. A four-wave longitudinal design (6 months intervals) was employed among 1,111 Chinese PLWH (Mage = 38.58, SD = 9.16, age range: 18-60 years; 64.1% men). The bidirectional model was examined using a random-intercept cross-lagged panel model (RI-CLPM), which evaluated the within- and between-person effects of study variables. At the within-person level, results indicated that depression symptoms at T2 mediated the linkage between internalized HIV stigma at T1 and anticipated HIV stigma at T3, and that anticipated HIV stigma at both T2 and T3 mediated the relationship between depression symptoms at the previous time point and internalized HIV stigma at the subsequent time point. Furthermore, a bidirectional association was found between anticipated HIV stigma and depression symptoms across four waves. At the between-person level, internalized and anticipated HIV stigma were significantly associated with depression symptoms. This study highlights the complex interplay between different forms of HIV-related stigma and mental health problems among PLWH and underscores the importance of considering the bidirectional relationship between the development of psychopathology and stigmatization process in clinical practice.

Association between psychological capital and depressive symptoms during COVID-19: The mediating role of perceived social support and the moderating effect of employment pressure.

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic affects individuals' mental health that can result in fear of getting COVID-19 infection and depression. Prior research has demonstrated that both psychological capital and perceived social support are related to the severity of depression. Yet no study explored the direction of associations between these factors. This undermines the validity of psychological capital as a basis for health interventions. Methods: This study aimed to explore the association between psychological capital, perceived social support, employment pressure, and depressive symptoms during COVID-19. A cross-sectional design was employed in a sample of 708 Chinese senior medical students who were asked to complete an online questionnaire survey. Results: Results indicated that psychological capital negatively predicts depressive symptoms (ß = -0.55, p < 0.001); perceived social support plays a mediating role in the impact of psychological capital on depressive symptoms (indirect = -0.11, SE = 0.02, p < 0.001, 95%CI [-0.16, -0.07]), and these associations were moderated by employment pressure. Medical students with high employment pressure, the negative impact of psychological capital on depressive symptoms was statistically significant (ß = -0.37, SE = 0.05, p < 0.001, 95% CI [-0.046, -0.27]); when the perceived employment pressure was low, the negative effect of psychological capital on depressive symptoms, although significant, was stronger (ß = -0.49, SE = 0.04, p < 0.001, 95% CI [-0.57, -0.40]). Discussion: The current study highlights that it is of great significance to address Chinese medical students' employment pressure and improve their mental health during the COVID-19 epidemic.

Association Among Negative Life Events, Sense of Security, and Depressive Symptoms in Chinese Adolescents After the 2013 Ya'an Earthquake.

OBJECTIVE: About a fourth of Chinese adolescents developed clinically significant depressive symptoms following a disaster. However, little is known about whether and how post-trauma negative life events and a sense of security are associated with depressive symptoms in this population. This study examined the psychological experiences of Chinese young people who had experienced the 2013 Ya'an earthquake in Sichuan, China. METHODS: This cross-sectional study was conducted in 2019. A total of 693 Chinese middle school students completed a questionnaire that measured their level of depressive symptoms, trauma exposure, stressful life events, and sense of security. RESULTS: Results of hierarchical multiple-regression analyses showed that the level of life stress from stressful life events was positively associated with the level of depressive symptoms (ß = 0.416, P < 0.001) and the level of the sense of security was negatively associated with the level of depressive symptoms (ß = -0.352, P < 0.001) when analysis controlled for age, gender, and trauma exposure. CONCLUSIONS: These findings highlight the importance of considering the influence of life stressors and the sense of security in devising measures and strategies for the prevention of the manifestation of depression among young people, particularly those who were exposed to disasters.

Symptoms of internet gaming disorder and depression in Chinese adolescents: A network analysis.

The current study aimed to investigate comorbidity among symptoms of depression and internet gaming disorder (IGD) utilizing symptom network analysis in a sample of Chinese adolescents. A total of 1,362 Chinese adolescents (Mean age = 15.19 ± 1.67; range 13-21; 39.79% female, 56.02% male, 4.19% not disclosed) were recruited from 11 local secondary schools between June and July 2020. Symptoms of depression and IGD were assessed by the 7-item DASS-21 depression subscale and the 9-item Internet Gaming Disorder Scale. We conducted network analysis to estimate network models and the most central symptoms of depression and IGD and computed a combined network model of both depression and IGD symptoms to find bridge symptoms and illustrate the comorbidity between depression and IGD. We found that feeling 'Worthless', 'Meaningless', and 'Down-hearted' were identified as the most central symptoms of depression, whereas 'Preoccupation' and 'Tolerance' were the two most central symptoms of IGD. The bridge symptoms in the combined network model were 'Gaming for escape or mood relief' from the IGD cluster and 'No initiative' and 'Down-hearted" from the depression cluster. The current study was the first to investigate the relationship between depression and IGD symptoms among adolescents utilizing a symptom network perspective. Also, it highlighted key bridge symptoms in understanding how IGD and depression contribute to each other.

The Association between Physical Activity, Self-Compassion, and Mental Well-Being after COVID-19: In the Exercise and Self-Esteem Model Revised with Self-Compassion (EXSEM-SC) Perspective.

During the great life-altering challenges brought by Coronavirus 2019, school closures and lack of access to exercise and social interactions may have increased students' negative emotions. The current research acts as a follow-up study to the development of the EXSEM-SC, using the Repeated Measures Panel Analysis Framework (RMPAF) to examine the stability of the model in revealing the relationship between physical activity, self-compassion, and mental well-being among Hong Kong adolescents. It is also aimed at examining the changes in physical activity, self-compassion, and mental well-being among Hong Kong adolescents between, before, and after the peak of COVID-19 using the EXSEM-SC Model. The RMPAF has involved 572 (60% Female, Mage = 13.63, SD =1.31) Hong Kong secondary school students. Furthermore, using the abductive qualitative approach, a total of 25 (Mage = 14.84, SD = 1.40) students were involved in the in-depth interviews to further investigate the relationships within the EXSEM-SC. The quantitative results showed that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs, as well as satisfying model construct consistency. Moreover, it showed no significant differences in the level of physical activity, self-compassion, and mental well-being during and after the peak of COVID-19. The qualitative results demonstrated two new categories within the EXSEM-SC variables, which are personality traits and injuries experiences. With the stability of the EXSEM-SC model among adolescents, it is expected that the physical activity intervention, which is based on the EXSEM-SC model, could also aim at easing Hong Kong adolescent's mental health issues. In addition, in terms of generating a long-term impact among students, the physical activity and self-compassionate intervention should be promoted among schools. However, the quantitative properties of the two new categories in the qualitative outcomes should be involved in future investigation.

Bridging internalized HIV stigma and depressive symptoms among people living with HIV in China during the COVID-19 pandemic: a network analysis.

Previous research has documented that HIV-related stigma may be a significant trigger of mental health problems among people living with HIV (PLWH). However, less is known about how internalized HIV stigma is linked to depressive symptoms among PLWH during the COVID-19 pandemic. The current study sought to explore the network structure of internalized HIV stigma and depressive symptoms, along with bridge nodes, to elucidate how they co-exist. Participants were 1,197 Chinese PLWH (64.3% male, Mage = 41.52, SD = 9.20) who completed the measurements of internalized HIV stigma and depressive symptoms during the early phase of the COVID-19 outbreak (May 2020). Results revealed that "ashamed of having HIV" was identified as the most central nodes in the internalized HIV stigma network, whereas "mind wandered during tasks" ranked highest on centrality in the depressive symptoms network. Two bridge connections were exhibited within the combined internalized HIV stigma and depressive symptoms network model: "inferiority due to HIV" and "gloomy feelings" from internalized HIV stigma and depressive symptoms communities, respectively. This study is one of the first to examine the co-occurrence of internalized HIV stigma and depressive symptoms in the context of the COVID-19 pandemic using a network approach. These findings have potential clinical implications for mitigating depressive symptoms in populations facing socioeconomic disadvantage and vulnerability.

Chinese adolescents' depression, anxiety, and family mutuality before and after COVID-19 lockdowns: Longitudinal cross-lagged relations.

Objective: This study aimed to investigate the longitudinal cross-lagged association between family mutuality, depression, and anxiety among Chinese adolescents before and after the COVID-19 lockdown in 2020. Background: Limited attention has been paid to the longitudinal links between family mutuality, depression, and anxiety in the context of the COVID-19 pandemic. Method: We used self-administered questionnaires to collect data from three high schools and two middle schools in Chengdu City at two time points: Time 1 (T1), December 23, 2019-January 13, 2020; Time 2 (T2), June 16-July 8, 2020. The sample consisted of 7,958 participants who completed two wave surveys before and after the COVID-19 lockdown. We analyzed the data using cross-lagged structural equation modeling. Results: The longitudinal cross-lagged model showed family mutuality at T1 significantly predicted depression, anxiety, and family mutuality at T2. We observed a decreasing prevalence of depression and anxiety after the COVID-19 lockdown. Conclusion: Family mutuality plays an important role in mitigating long-term mental health disorders, such as depression and anxiety. More family-centered psychological interventions could be developed to alleviate mental health disorders during lockdowns. Implications: Improving family mutuality (e.g., mutual support, interaction, and caring among family members) could be beneficial for reducing mental health disorders among Chinese adolescents during the COVID-19 pandemic.

Factors influencing attitudes toward cyber-counseling among China's Generation Z: A structural equation model.

Information technology developments have combined traditional face-to-face counseling with online- or cyber-counseling. As digital natives, Generation Z has easy access to cyber-counseling. However, their attitudes toward cyber-counseling remain unknown. This study explored these attitudes and relevant influencing factors among 1216 Chinese adolescents using self-report questionnaires. Descriptive analyses and structural equation modeling were used for data analysis. The model explained 27.7 % of the total variance, attitudes toward psychological help was the most influential, followed by attitudes toward the Internet and perceived behavioral control. The model was effective in explaining attitudes toward cyber-counseling, emphasizing the influence of attitudes toward psychological help.

Gaming to cope: Applying network analysis to understand the relationship between posttraumatic stress symptoms and internet gaming disorder symptoms among disaster-exposed Chinese young adults.

Research has demonstrated that posttraumatic stress disorder (PTSD) is associated with internet-related problematic behaviors. However, studies have not explored the linkage between PTSD symptoms and internet gaming disorder (IGD) symptoms. The current study aimed to investigate the relationship between posttraumatic stress symptoms (PTSS) and IGD symptoms via network analysis. We conducted a cross-sectional study with 341 Chinese young adults directly exposed to a typhoon and examined the network structure of PTSS and IGD symptoms, along with bridge symptoms, to elucidate how they co-occur. Results indicated that 'avoiding external reminders' and 'anhedonia' were identified as the most central symptoms in the PTSD network, whereas 'preoccupation,' 'gaming despite harms', and 'loss of control' ranked highest on centrality in the IGD network. Two bridge symptoms emerged within the combined PTSD and IGD network model: 'concentration difficulties' and 'conflict due to gaming' from among the PTSS and IGD symptoms, respectively. These findings reveal novel associations between PTSS and IGD symptoms and provide an empirically-based hypothesis for how these two disorders may co-occur among individuals exposed to natural disasters.

Mental Disorders and Emotional Competence Among Chinese Adolescents Before and During COVID-19 Pandemic: A Longitudinal Mediation Model.

Background: The outbreak of the COVID-19 pandemic has had a profound influence on the mental health and well-being of individuals across the globe. Emotional competence, defined as one's ability to recognize, understand, and manage their emotions, has been found linked with mental health problems (e.g., depression and anxiety) in previous studies. However, there is limited knowledge about the direction of the association between these factors among populations exposed to COVID-19. This study examined the possible mediation relationships between depression, anxiety, emotional competence, and COVID-19 exposure among Chinese adolescents. Methods: Responses from 7,958 Chinese adolescents who had previously taken part in a two-wave study before (December 23, 2019-January 13, 2020) and during COVID-19 (June 16, 2020-July 8, 2020) were analyzed (51.67% males, mean age = 11.74, SD = 2.15). Structural equation modeling with three covariates (i.e., age, gender, and ethnicity) was used to test the longitudinal mediation relationships between COVID-19 exposure and depression, anxiety via emotional competence. Results: Results indicated that the prevalence of depression (38.67 to 36.74%) and anxiety (13.02 to 12.77%) decreased from Time 1 to Time 2. The T2 emotional competence significantly mediated the relationship between T2 COVID-19 exposure and T2 anxiety (indirect effect [95% CI] = 0.011 [0.004-0.019], p < 0.05). T2 emotional competence also significantly mediated the relationship between T2 COVID-19 exposure and T2 depression (indirect effect [95% CI] = 0.013 [0.005-0.022], p < 0.05). The results indicated that T2 emotional competence had a significant and negative influence on T2 anxiety (ß = -0.266, SE = 0.005, p < 0.001), and T2 depression (ß = -0.326, SE = 0.029, p < 0.001). Conclusions: This longitudinal research study demonstrated the crucial role of emotional competence in influencing the severity of long-term mental health problems, and suggested that emotional competence interventions can be conducted to improve mental well-being among Chinese adolescents exposed to COVID-19.