Association between Family Functioning, Child Emotional and Behavioral Problems, and Parental Stress during the COVID-19 Pandemic in Thailand.

The COVID-19 pandemic has had a huge impact on people of all ages, especially children. This is a cross-sectional study in Thailand to explore the emotional and behavioral problems of school-aged children and associated factors during the lockdown. An online survey was conducted with 942 parents of school-age children. Strengths and Difficulties Questionnaire (SDQ) scores showed that total difficulties and all subscale difficulties (hyperactivity, conduct problems, peer problems, and emotional problems) were increased, whereas prosocial behaviors were decreased in the pandemic period. The factors significantly associated with higher parental stress were higher emotional and peer problems after the COVID-19 outbreak, high family difficulty, and sleep problems. Sleep problems were associated with all children's difficulties, except prosocial behavior. High score in family difficulty subscale was associated with increased emotional problems, whereas poor family communication was associated with increased hyperactivity. Appetite change was negatively associated with parental stress and some children's difficulties. Higher household income, family time, physical activities, and recreational activities were associated with a decreased level of some difficulties and family functioning problems, but positively with an increase in the prosocial behavior of children. Additionally, higher screen time was associated with a higher level of hyperactivity, conduct problems, and poor family communication. This study demonstrated that Thai children were at high risk of developing mental health problems during the pandemic lockdown. We suggest that intervention to promote physical activities and reduce screen time is needed. Moreover, efficient monetary policy is urgently required. The limitations here include a recall bias with no baseline to compare and a potential selection bias due to parental selection and a webpage announcement.

Bullying Victimization Moderates the Association between Social Skills and Self-Esteem among Adolescents: A Cross-Sectional Study in International Schools.

Background. Bullying is a major school problem. Victims of bullying often experience low self-esteem, whereas social skills are positively associated with the level of self-esteem. This research examined whether the victim's condition impacted their social skills and self-esteem. Methods. International school students in Thailand aged 13 to 18 years old completed the Olweus bullying questionnaire, social capital questionnaire (SC), social skills questionnaire (SS), adolescent discrimination index (ADDI), and the Rosenberg self-esteem scale (RSES). Moderation analyses and visual presentations were carried out using IBM SPSS ver. 22 and PROCESS, ver. 4.0. Results. A total of 102 students participated (63% female). The mean age of the participants was 16.57 (SD = 1.42). The number of victims was 16 (15.7%), the mean (SD) for the SC, SS, ADDI, and RSES was 7.82 (2.37), 44.45 (9.40), 12.33 (9.82), and 27.85 (5.31), respectively. As predicted, those with high social skills reported greater self-esteem when they had never been bullied. The moderation effect was significant: B = 0.458, standard error = 0.203, 95% CI = -0.836 to -0.054. Additionally, the ADDI and SC were found to predict self-esteem. Conclusions. The significant moderation effect suggests the importance of identifying the victim's condition when the association between social skills and self-esteem is not observed (as expected) among school adolescents. A longitudinal study to confirm the causal relationship should be encouraged. Further research on providing appropriate interventions along with social skill training for the victim group is warranted.

Psychological Factors Influencing Achievement of Senior High School Students.

Numerous factors are proposed to affect high school students' academic achievement; however, these factors may not reveal all possible causal relationships. This study conducted path analysis to examine the direct and indirect effects of interpersonal relationships, life satisfaction, self-esteem, anxiety, and depression on the academic achievement of senior high school students. Two hundred and eighty-five students from five schools in Chiang Mai, Thailand, aged 14-19 years, were included for data analysis. The fit indices of all models were in agreement with the empirical data. Anxiety levels had a significantly positive direct effect on achievement, whereas depression had a negative direct effect on achievement. Additionally, self-esteem, life satisfaction, and interpersonal relationships had negative indirect effects on depression and anxiety. A program that stimulates the optimal and appropriate level of anxiety may be useful. An appropriate level of anxiety appeared positively related to academic achievement, but a high level of anxiety relatively influenced the incidence of depression. Thus, encouraging self-esteem, interpersonal relationships, and life satisfaction can promote academic ability and decrease the risk of depression. Further well-designed and large sample-size studies should be conducted to confirm these findings. The interplay of all studied factors may account for the variation in academic achievement, depression, and anxiety of 11.60%, 42.80%, and 17.60%, respectively.

Stress and associated factors with received and needed support in medical students during COVID-19 pandemic: a multicenter study.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic is a global health crisis that has impacted daily life due to the policies created to contain the outbreak. Recent studies showed that medical students, a high-stress population, experienced deteriorated mental well-being during the pandemic. The aim of the present study was to assess stress and the need for support among Thai medical students during the COVID-19 pandemic, as a multicenter study. METHODS: The present study was a cross-sectional questionnaire-based study which collected data from second through sixth year medical students. Data was collected during the pandemic from multiple medical schools spanning all six regions of Thailand. Questionnaires included: demographic data; the Thai version of the Perceived Stress Scale-10 (T-PSS-10) assessing stress level and the sources of stress; and the received supports from medical schools, the satisfaction with the supports, and the further necessary needs. RESULTS: There were 1,395 medical students who responded to the questionnaires. Mean T-PSS-10 score was 17.8. Most of the sources of stress were related to the changing of teaching and evaluation system. Students residing in larger medical schools were significantly more satisfied with received support and tended to gain greater support than those in medium and small sized schools. Stress-relieving activities arrangement was considered the most sought after additional support by students. CONCLUSION: Medical student stress levels were higher during the pandemic compared to pre-pandemic levels. Stress relieving activities, availability and access to mental health resources, and other strategies to reduce stress among medical students are urgently needed.

Helpful family climate moderates the relationship between perceived family support of ADHD symptoms and depression: a conditional process model.

BACKGROUND: Symptoms of attention deficit hyperactivity disorder (ADHD) are commonly comorbid with depression This study aimed to examine the relationship between ADHD symptoms and depression through perceived family support and to explore whether the magnitude of the relationship depended on the type of family climate of medical students. METHODS: This cross-sectional study was conducted among 124 first year medical students in Thailand. Participants completed questionnaires on ADHD symptoms, depression, perceived family support, and 9 types of family climate. The questionnaires included the Adult ADHD Self-Report Scale Screener, Patient Health Questionnaire-9, and revised Thai Multidimensional Scale of Perceived Social Support. Mediational analysis was adopted to examine the mediating role of perceived family support in the relationship between ADHD symptoms and depression, while moderation analysis was applied to examine the extent of the relationship depending on family climate. RESULTS: The relationship between ADHD symptoms and depression was moderate. Perceived family support partially mediated this relationship after controlling for age and sex. Among the types of family climate, only helpful family climate was a significant moderator of perceived family support and depression. The moderated mediation model increased the variance in depression from 17% by the mediation model to 21%. However, follow-up conditional mediational analysis showed that the indirect effect of ADHD symptoms on depression via perceived family support was not significant and that this effect did not vary linearly as a function of helpful family climate. CONCLUSION: The findings of the study revealed that poor family support might be one risk of developing depression in the context of ADHD symptoms. Further study on providing intervention concerning family support among those with ADHD symptoms should be warranted. In addition, a study on helpful family climate in a larger sample size, in other populations, and in a longitudinal fashion for a more robust conclusion is encouraged.

Bordetella pertussis CyaA-RTX subdomain requires calcium ions for structural stability against proteolytic degradation.

Previously, the 126-kDa Bordetella pertussis CyaA pore-forming (CyaA-PF) domain expressed in Escherichia coli was shown to retain its hemolytic activity. Here, a 100-kDa RTX (Repeat-in-ToXin) subcloned fragment (CyaA-RTX) containing a number of putative calcium-binding repeats was further investigated. The recombinant CyaA-RTX protein, although expressed as a soluble form in a protease-deficient E. coli strain BL21(DE3)pLysS, was found to be highly sensitive to proteolytic degradation. Interestingly, the addition of calcium ions in a millimolar range into the CyaA-RTX preparation significantly prevented the degradation. Moreover, levels of proteolytic degradation were dependent on calcium concentrations, implying an important role for calcium-binding sites in the RTX subdomain for structural stability. Homology-based modeling of the repetitive blocks in the CyaA-RTX subdomain supports that this calcium-bound protein folds into a parallel ß-roll structure with calcium ions acting as a structural stabilizing bridge.