Mindfulness group intervention improved self-compassion and resilience of children from single-parent families in Tibetan areas.

OBJECTIVE: The current study aimed to examine the effects of a mindfulness group intervention on self-compassion, psychological resilience, and mental health of children from single-parent families in Tibetan areas. METHODS: A total of 64 children from single-parent families in Tibetan areas were randomly allocated to a control group (n = 32) and an intervention group (n = 32). Participants in the control group received conventional education, while participants in the intervention group received 6-week mindfulness intervention in addition to the conventional education. Both groups completed the Five Facet Mindfulness Questionnaire (FFMQ), Self-compassion Scale (SCS), Resilience Scale for Chinese Adolescent (RSCA), and the Mental Health Test (MHT) before and after the intervention. RESULTS: After the intervention, the levels of mindfulness and self-compassion in the intervention group were significantly improved in relative to the control group. The positive cognition in the RSCA was significantly increased in the intervention group, whereas no significant change was observed in the control group. There was a trend towards lower self-blame in the MHT, but no significant impact of the intervention on the overall level of mental health was found. CONCLUSION: Results suggest that a 6-week mindfulness training effectively improve self-compassion and resilience of single-parent children. Thus, mindfulness training as a cost-effective approach can be arranged in the curriculum, which helps students develop high level of self-compassion and resilience. In addition, there may be a need to improve emotional control in order to improve mental health.

Validation of sociocultural attitudes towards appearance questionnaire and its associations with body-related outcomes and eating disorders among Chinese adolescents.

Introduction: The Sociocultural Attitudes Towards Appearance Questionnaire-4 Revised (SATAQ-4R) has been widely used in Western countries to link body appearance that is related to eating disorders and body dissatisfaction being commonly reported by adolescents. However, a comprehensive psychometric validation of the SATAQ-4R in Chinese adolescent samples is still lacking. To this end, the aim of the current study was to validate the gender-appropriate SATAQ-4R in a sample of Chinese adolescents, following by an investigation of its associations with body-related outcomes and eating disorder symptoms. Methods: Two gender-specific studies were conducted to examine the psychometric properties of the SATAQ-4R-Female and SATAQ-4R-Male respectively among adolescent girls (Study1, N=344, with 73 participants at retest) and boys (Study2, N=335, with 64 participants at retest). Confirmatory factor analysis was employed to examine the factor structure and their test-retest reliability, the internal consistency and convergent validity were subsequently examined. Results: For the SATAQ-4R-Females, the seven-factor model has a reasonable fit, with Chi-square =1112.769 (p < 0.001), CFI = 0.91, RMSEA = 0.071, SRMR = 0.067. For the SATAR-4R-Males, an acceptable seven-factor model with Chi-square = 982.92 (p<0.001), CFI = 0.91, RMSEA = 0.08, SRMR= 0.06 was observed. With respect to test-retest reliability, the internal consistency for 7 subscales was rated as good (Cronbach's alpha =0.74 to 0.95) among female adolescents, likewise the internal consistency of the seven subscales was also rated as good (Cronbach's alpha =0.70 to 0.96) among male participants. Good convergent validity was observed, reflected by associations of the subscales of the gender-specific SATAQ-4R with muscularity-related attitude, body image-acceptance, body appearance, perceived stress level, symptoms of eating disorder and self-esteem. Discussion: For women and men, the original 7-factor structure was validated among Chinese adolescents, internal reliability coefficients for the seven subscale scores were good and test-retest reliability was acceptable. Our results also confirmed the convergent validity of the two different gender-appropriate scales.

Validation of the 4-Item and 10-Item Uncertainty Stress Scale in a Community-Based Sample of Chinese Adults.

Purpose: The objectives of this study were to examine the psychometric properties of the Uncertainty Stress Scale (USS) and to compare the usefulness of two versions of the scale (USS-4 and USS-10) among a large community-based sample of Chinese adults. Participants and Methods: The Uncertainty Stress Scale was validated in 904 community residents (mean age: 32.71 ± 10.99; male: 41.7%) through an online survey conducted in February 2020. Psychometric properties of reliability (Cronbach's alpha), construct validity (confirmatory factor analysis), and criterion validity (correlation and ROC curve analyses) were evaluated using established benchmarks. To validate the USS, we used the Chinese version of the Perceived Stress Scale (CPSS). In addition, sensitivity, specificity, and suitable cutoff values of the two versions of USS were determined. Results: Both versions of the USS had high internal consistency (USS-10: 0.941; USS-4: 0.851). Confirmatory factor analyses supported a one-factor structure for both measures. Both USS-4 and USS-10 scores were significantly positively correlated with CPSS scores, indicating acceptable criterion validity. Conclusion: The findings of the current study confirmed that the psychometric properties of two Chinese versions of USS are acceptable. Furthermore, the 4-item USS was as effective as the 10-item USS for the measurement of uncertainty stress in our community-based sample of Chinese adults suggesting that the USS-4 is a time-efficient alternative to the USS-10 which can be used when the circumstances require a time-efficient instrument (eg, in epidemiological studies with a large test battery).

Association of social support with negative emotions among Chinese adolescents during Omicron-related lockdown of Shenzhen City: The roles of rumination and sleep quality.

Objective: Adolescents are likely to suffer from negative emotions such as depression and anxiety due to the rapid development of biological, cognitive and social changes. Previous studies have indicated possible risk (rumination) and protective (good social support and high sleep quality) factors for depression and anxiety among this age group. The present study is the first to investigate the association between social support and negative emotions during the Outbreak of Omicron variant, on this basis, to further determine the mediating role of rumination and sleep quality on this link. Method: A total of 1,065 Chinese middle- and high-school students (51.5% female, M age = 13.80, SD = 1.20) completed a psychosocial battery, including the Social Support Rating Scale (SSRS), the Pittsburgh Sleep Quality Index (PSQI), the Ruminative Responses Scale (RRS), the Depression Anxiety Stress Scale (DASS). Serial multiple mediation analysis was conducted using PROCESS macro based on SPSS. Results: Social support, rumination, and sleep quality were significantly negatively correlated with negative emotional states (Ps < 0.05). Further, rumination and sleep quality were found to partially mediate the relationship between social support and negative emotional states. Conclusions: For early detection and prevention of depression and anxiety, providing sufficient social support is necessary for adolescents, because rumination and sleep problems are reported during stressful periods, such as the COVID-19 pandemic.

Research on Mask-Wearing Detection Algorithm Based on Improved YOLOv5.

COVID-19 is highly contagious, and proper wearing of a mask can hinder the spread of the virus. However, complex factors in natural scenes, including occlusion, dense, and small-scale targets, frequently lead to target misdetection and missed detection. To address these issues, this paper proposes a YOLOv5-based mask-wearing detection algorithm, YOLOv5-CBD. Firstly, the Coordinate Attention mechanism is introduced into the feature fusion process to stress critical features and decrease the impact of redundant features after feature fusion. Then, the original feature pyramid network module in the feature fusion module was replaced with a weighted bidirectional feature pyramid network to achieve efficient bidirectional cross-scale connectivity and weighted feature fusion. Finally, we combined Distance Intersection over Union with Non-Maximum Suppression to improve the missed detection of overlapping targets. Experiments show that the average detection accuracy of the YOLOv5-CBD model is 96.7%-an improvement of 2.1% compared to the baseline model (YOLOv5).

Do Global Adolescents With Food Insecurity Feel Lonely?

As a proxy measure of socioeconomic status, food insecurity is understudied in mental health-related research. This study aimed to explore the association between food insecurity and loneliness in adolescents. Using cross-sectional data from the Global Student Health Survey (GSHS), 164,993 adolescent participants were included in this study. Food insecurity, loneliness, and other covariates were assessed by self-reported questionnaire. Multivariable logistics regression considering complex survey was used to explore the association between food insecurity and loneliness. The prevalence of loneliness was 10.8% in adolescents. With higher levels of food insecurity, the prevalence of loneliness in general increased, but "most of the time" was the most frequently reported item in terms of food insecurity. Adolescents who reported severe food insecurity had significantly greater odds for loneliness: (1) being most of the time [odd ratio (OR) = 2.54, 95% CI = 2.13-3.02]; (2) always hungry (OR = 1.97, 95% CI = 1.55-2.51). Of all the 53 countries, adolescents from 39 countries reported significantly higher prevalence of loneliness when exposed to food insecurity. The pooled OR was 1.74 (1.60-1.89) with a negligible heterogeneity (higher I-squared was 34.2%). Adolescents with food insecurity were more likely to be exposed to be lonely. Eliminating socioeconomic disparities in adolescents might be a good approach to promote mental health in adolescents. Future studies are encouraged to utilize longitudinal studies to confirm or negate our study findings.

Relationship between adverse childhood experiences and anxiety symptoms among Chinese adolescents: The role of self-compassion and social support.

Previous studies have revealed that adverse childhood experiences (ACEs) create a significant and lasting effect of increased anxiety. However, few studies have examined the mediating and moderating mechanisms underlying this relation. The present study aimed to explore the mediating role of self-compassion and moderating role of social support in ACEs-anxiety relationship among Chinese adolescents. In this cross-sectional study, 1,764 middle school students completed questionnaires measuring their levels of ACEs, anxiety, self-compassion (SC), and social support. Correlations of variables were computed using Pearson's r. Mediation and moderated mediation models were tested using PROCESS macro with the regression bootstrapping method. After covariates (age and gender) were controlled, results showed that: (1) ACEs were positively associated with anxiety symptoms; (2) self-compassion partially mediated the ACEs-anxiety association; (3) both ACEs-anxiety and SC-anxiety relationships were moderated by social support. Specifically, social support was associated with lower anxiety, particularly among students with fewer ACEs or lower level of self-compassion. Reducing possible adversities existing in environment may help to reduce risk of anxiety for adolescents. Cultivating self-compassion is crucial for adolescents' mental health, since it may play a role in ACEs-anxiety relationship. Social support would operate as a buffer to ACEs in the relation with anxiety, under the circumstances of mild adversities, and a promoter to self-compassion in the relation with anxiety, under the circumstances of low self-compassion.

Psychometric Evaluation of the Fear of COVID-19 Scale Among Chinese Population.

Fear is a negative emotional reaction to or persistent worry over an imminent public health event like COVID-19. The COVID-Fear Scale was developed in many countries, but not in China. The current study aims to examine the psychometric properties of Chinese version of the Fear of COVID-19 Scale. Translation into Chinese and back-translation into English were conducted firstly. Item analysis and exploratory factor analysis were conducted in Sample 1, followed by validity tests in Sample 2. Likely, test-retest reliability was conducted in sample 3. A bifactor structure of Chinese version of FCV-19S with a general fear factor and two orthogonal group factors with fear thoughts and physical response was confirmed. Besides, it has good internal consistency reliability (α = .92), composite reliability (CR = .92), and validity correlation validity. The results of the present study confirmed that the Chinese version of FCV-19S has good psychometric properties in the Chinese communities. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-020-00441-7.

Posttraumatic Stress Symptoms Among Chinese College Students During the COVID-19 Pandemic: A Longitudinal Study.

A longitudinal assessment of the prevalence of posttraumatic stress symptoms (PTSS) and risk factors is indispensable for further prevention and/or treatment. The longitudinal web-based survey enrolled 1,164 college students in China. Measured at two time points (February and August 2020), PTSS, demographic information, adverse childhood experiences (ACEs), resilience and self-compassion information were collected to explicate the prevalence and predictors of PTSS concurrently and over time. Results showed that although PTSS generally declined throughout the 6 months after the outbreak of COVID-19, the prevalence remained relatively high. Resilience and self-compassion negatively predicted PTSS concurrently and longitudinally. While subjective family socioeconomic status (SES) and ACEs at Wave 1 did not predict PTSS under COVID-19 at Wave 1, but both significantly predicted PTSS at Wave 2. Findings implicate potential targets for detecting and intervening on symptoms of trauma in this vulnerable population.

Prevalence and Associated Factors of Problematic Smartphone Use During the COVID-19 Pandemic: A Bangladeshi Study.

BACKGROUND: Problematic smartphone use (PSU) has been increasing hastily in recent decades, and it has become inseparable during the COVID-19 pandemic, especially among the students who are at risk of problematic smartphone use. Therefore, the present study aimed to investigate the prevalence and associated factors of PSU during the COVID-19 pandemic among the Bangladeshi students. METHODS: A total of 601 Bangladeshi students were recruited through an online-based cross-sectional survey that was conducted between October 7 and November 2, 2020. The survey collected information related to socio-demographics, behavioral health, internet use behaviors, depression, anxiety, and PSU. Independent samples t-test and one-way ANOVA were performed to present the relationship between the studied variables and PSU. Multiple linear regression analysis was also used for investigating the explanatory power of the predictive models for PSU. RESULTS: Surprisingly, about 86.9% of the students scored to be problematic smartphone users (≥21 out of a total 36 based on the Smartphone Application-Based Addiction Scale). In addition, medical students, engaging in a relationship, performing less physical activity, longer duration of internet use, some sorts of internet use purpose (eg, messaging, watching videos, using social media), depression, and anxiety were significantly associated with higher scores of PSU. After adjusting all the studied variables, the final model explained a 31.3% variance predicting PSU. CONCLUSION: The present study is one of the first approaches to assess the prevalence of PSU among the Bangladeshi students during the COVID-19 pandemic, whereas the addiction level was superfluous (and this may be due to more online engagement related to the pandemic). Thus, the study recommended strategies or policies related to the students' risk-reducing and healthy use of smartphones.

Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity / Problemas de salud mental en adolescentes chinos durante el COVID-19: importancia de la nutrición y la actividad física

Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19. Method: Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety. Results: The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms. Conclusions: These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents’ mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise. (AU)

Los problemas de salud mental son comunes en adolescentes y están influenciados por eventos estresantes. Se evaluó prevalencia y correlatos de síntomas de insomnio, depresión y ansiedad en adolescentes chinos durante el COVID-19. Método: En mayo de 2020 se realizó un estudio transversal (N = 1.794 adolescentes, edad media = 15,26) mediante una encuesta en línea para recopilar datos sociodemográficos, miedo relacionado con COVID-19, nutrición, actividad física (AF) y síntomas de insomnio, depresión y ansiedad. Resultados: La prevalencia de síntomas de insomnio, depresión y ansiedad fue del 37,80%, 48,20% y 36,70%, respectivamente. Modelos lineales generalizados revelaron que mujeres, niños abandonados y estudiantes con más miedo al COVID-19 tendían a informar síntomas de insomnio, depresión y ansiedad simultaneamente. Después de ajustar los factores sociodemográficos y el miedo al COVID-19, mejor estado nutricional y AF moderadamente activa se asociaron con niveles más bajos de síntomas de depresión y ansiedad, mientras que AF muy activa se asoció con niveles más bajos de insomnio, síntomas depresivos y de ansiedad. Conclusiones: Se debe prestar más atención a la salud psicológica de los adolescentes mientras se combate el COVID-19. Para promover su salud mental, los educadores deben ayudarles a desarrollar un estilo de vida saludable con una dieta equilibrada y ejercicio regular. (AU)

The relationship between childhood adversities and complex posttraumatic stress symptoms: a multiple mediation model.

Background: There is a growing research literature on complex posttraumatic stress disorder (CPTSD), yet studies that focused on Chinese populations are still limited. Accumulating evidence showed that adverse childhood experiences (ACEs) are associated with a higher likelihood of CPTSD symptoms, but potential mediating roles of self-kindness and self-judgement on the ACEs-CPTSD relationship remain understudied. Objective: The purpose of this study was to first examine the relationship between ACEs and CPTSD among Chinese college students, and then to test the mediating role of self-kindness and self-judgement on the ACEs-CPTSD relationship. Method: The study included 1361 college students for an online survey in May 2020. Demographic variables (e.g. age, gender, having sibling[s] or not, residence, family structure, and subjective socioeconomic status), ACEs, self-compassion (self-kindness and self-judgement subscales), and CPTSD symptoms were assessed. After controlling for demographic variables, a series of structural equation models tested the mediation hypothesis: indirect effects of self-kindness and self-judgement on the relationship between ACEs and CPTSD symptom. Results: ACEs of College students were positively associated with more severe CPTSD symptoms (posttraumatic stress disorder and disturbances in self-organization symptoms). Furthermore, these direct pathways were mediated by decreased self-kindness and increased self-judgement. Conclusions: Findings have substantial theoretical and treatment implications, including the two critical targets (i.e. lowering self-judgement and raising self-kindness) when treating complex PTSD.

Antecedentes: existe una creciente literatura de investigación sobre el trastorno de estrés postraumático complejo (TEPT-C), sin embargo, los estudios centrados en la población China aún son limitados. La evidencia acumulada mostró que las experiencias adversas de la infancia (ACEs en sus siglas en inglés) están asociadas con una mayor probabilidad de síntomas de TEPT-C, pero los posibles roles mediadores de la bondad hacia uno mismo y auto- juicio propio en la relación ACE-TEPT-C siguen siendo poco estudiados.Objetivo: El propósito de este estudio fue examinar primero la relación entre ACE y TEPT-C entre estudiantes universitarios chinos, y luego probar el papel mediador de la bondad y el auto-juicio en la relación ACE-TEPT-C.Método: El estudio incluyó a 1361 estudiantes universitarios para una encuesta en línea en mayo del 2020. Variables demográficas (por ejemplo, edad, sexo, tener hermanos o no, residencia, estructura familiar y estatus socioeconómico subjetivo), ACE, autocompasión (subescalas de auto-bondad y auto-juicio), y se evaluaron los síntomas de TEPT-C. Después de controlar las variables demográficas, una serie de modelos de ecuaciones estructurales probaron la hipótesis de la mediación: los efectos indirectos de la bondad personal y el auto-juicio sobre la relación entre los ACE y los síntomas de TEPT-C.Resultados: Las ACEs de los estudiantes universitarios se asociaron positivamente con síntomas de TEPT-C más graves (trastorno de estrés postraumático y alteraciones en los síntomas de autoorganización). Además, estas vías directas fueron mediadas por una disminución de la bondad hacia uno mismo y un mayor auto-juicio.Conclusiones: Los hallazgos tienen implicaciones teóricas y de tratamiento sustanciales, incluidos los dos objetivos críticos (es decir, reducir el auto-juicio y aumentar la bondad hacia uno mismo) al tratar el TEPT complejo.

How Has the COVID-19 Pandemic Changed BMI Status and Physical Activity - Its Associations with Mental Health Conditions, Suicidality: An Exploratory Study.

BACKGROUND: The COVID-19 pandemic has psycho-socially impacted people of all age groups. The consequences related to this crisis may increase the suicide mortality rate as reported in prior pandemics. Although many studies have been conducted identifying suicidal behavior attributing factors, there is a lack of knowledge on the associations of body mass index (BMI) and physical activities, their changes, and suicidal behavior, which were explored herein for the first time. METHODS: An online-based, cross-sectional study was carried out with a total of 324 Bangladeshi people (mean age = 26.99 ± 8.17 years). The measures included questions on socio-demographics, health-related variables, physical activities-related variables, and mental health problems (eg, depression, anxiety and suicidal behavior). RESULTS: About 41.0% and 29.3% of the participants reported being depressed and anxious, respectively, whereas suicidal behavior after the pandemic's inception was found to be 6.5%. Although the role of BMI status either prior to or during the pandemic in mental health conditions was not statistically significant, the changes of BMI status were (that is, those with decreasing BMI status compared to no change in BMI status were at greater risk of depression and anxiety, which was followed by increasing BMI status). Besides having no outside space for exercise and performing more physical activities prior to the pandemic were reported to increase anxiety levels, but no significant associations between changes in physical exercise frequency and other mental health problems were observed. CONCLUSION: In summary, the present findings showed that people with either decreased or increased BMI status after the inception of the pandemic were at greater risk of mental instabilities, which is a concern which should be considered when adopting any preventive approaches.

Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity.

Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19. METHOD: Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety. RESULTS: The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms. CONCLUSIONS: These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise.

Los problemas de salud mental son comunes en adolescentes y están influenciados por eventos estresantes. Se evaluó prevalencia y correlatos de síntomas de insomnio, depresión y ansiedad en adolescentes chinos durante el COVID-19. Método: En mayo de 2020 se realizó un estudio transversal (N = 1.794 adolescentes, edad media = 15,26) mediante una encuesta en línea para recopilar datos sociodemográficos, miedo relacionado con COVID-19, nutrición, actividad física (AF) y síntomas de insomnio, depresión y ansiedad. Resultados: La prevalencia de síntomas de insomnio, depresión y ansiedad fue del 37,80%, 48,20% y 36,70%, respectivamente. Modelos lineales generalizados revelaron que mujeres, niños abandonados y estudiantes con más miedo al COVID-19 tendían a informar síntomas de insomnio, depresión y ansiedad simultaneamente. Después de ajustar los factores sociodemográficos y el miedo al COVID-19, mejor estado nutricional y AF moderadamente activa se asociaron con niveles más bajos de síntomas de depresión y ansiedad, mientras que AF muy activa se asoció con niveles más bajos de insomnio, síntomas depresivos y de ansiedad. Conclusiones: Se debe prestar más atención a la salud psicológica de los adolescentes mientras se combate el COVID-19. Para promover su salud mental, los educadores deben ayudarles a desarrollar un estilo de vida saludable con una dieta equilibrada y ejercicio regular.

Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries / Desplazamientos escolares activos reducen intentos de suicidio de jóvenes de países con ingresos bajos y medios

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts. (AU)

Objetivo: Se exploró la asociación entre desplazamientos escolares activos (AST, por sus siglas en inglés) e intentos de suicidio entre adolescentes en países de ingresos bajos y medios. Método: Se utilizaron datos de la Global School-based Health Survey, que incluyó a 127.097 adolescentes de 13 a 17 años de 34 países de ingresos bajos y medios. Se utilizó una encuesta autoinformada para recopilar datos sobre AST e intentos de suicidio, así como otras variables. Se realizó una regresión logística multivariable para evaluar la asociación entre AST e intentos de suicidio. Se realizó un metanálisis con efectos aleatorios para identificar la diferencia en la asociación entre AST e intentos de suicidio. Resultados: La prevalencia de AST fue del 37% y la prevalencia de intentos de suicidio fue del 11,60%. Los adolescentes que participaron en AST tenían menos probabilidades de tener intentos de suicidio independientemente del sexo. El análisis por países indicó una gran inconsistencia en la asociación entre AST e intento de suicidio. Conclusiones: AST parece ser un factor protector para reducir los intentos de suicidio entre adolescentes. Sin embargo, la asociación entre AST e intentos de suicidio varió mucho entre países. Estudios futuros deberían confirmar la asociación entre AST e intentos de suicidio. (AU)

Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries.

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.

Objetivo: Se exploró la asociación entre desplazamientos escolares activos (AST, por sus siglas en inglés) e intentos de suicidio entre adolescentes en países de ingresos bajos y medios. Método: Se utilizaron datos de la Global School-based Health Survey, que incluyó a 127.097 adolescentes de 13 a 17 años de 34 países de ingresos bajos y medios. Se utilizó una encuesta autoinformada para recopilar datos sobre AST e intentos de suicidio, así como otras variables. Se realizó una regresión logística multivariable para evaluar la asociación entre AST e intentos de suicidio. Se realizó un metanálisis con efectos aleatorios para identificar la diferencia en la asociación entre AST e intentos de suicidio. Resultados: La prevalencia de AST fue del 37% y la prevalencia de intentos de suicidio fue del 11,60%. Los adolescentes que participaron en AST tenían menos probabilidades de tener intentos de suicidio independientemente del sexo. El análisis por países indicó una gran inconsistencia en la asociación entre AST e intento de suicidio. Conclusiones: AST parece ser un factor protector para reducir los intentos de suicidio entre adolescentes. Sin embargo, la asociación entre AST e intentos de suicidio varió mucho entre países. Estudios futuros deberían confirmar la asociación entre AST e intentos de suicidio.

Comparison of Prevalence and Risk Factors of PTSS Between Chinese Patients With Depression and Non-depressed Controls During COVID-19 Outbreak.

Background: COVID-19 pandemic is a traumatic event all over the world, and may lead to post-traumatic stress symptom (PTSS) in different population who are under the threat of novel corona virus. Therefore, the aim of our study was to compare the prevalence and risk factors of PTSS between Chinese patients with depression and non-depressed controls during the COVID-19 outbreak. Methods: 437 depressed patients and 2,940 non-depressed controls were enrolled in this cross-sectional study between February 14 and May 9, 2020.The Impact of Events Scale-Revised (IES-R), Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the psychological status of all the participants. Results: The prevalence of PTSS (IES-R ≥ 33) in depressed patients (45.08%) was higher than that in non-depressed controls (5.31%). Patients with depression were 16 times more likely to suffer from PTSS than those without depression. Correlation analyses showed that the IES-R total score was positively correlated with SDS, SAS, and PSQI scores in both depressed and non-depressed groups (Bonferroni corrected all p < 0.001). Multiple linear regression analysis showed that SAS score, and PSQI score were independently associated with IES-R total score in both depression and non-depression groups. In depressed patients, education level and duration of media exposure to COVID-19 were positively associated with PTSS, while in the non-depressed group, subjects who were married, in the 31-50 year group or with higher SDS score were more likely to develop PTSS. Conclusions: These results indicate that the prevalence rate of PTSS in patients with depression is very higher than that in subjects without depression. PTSS are associated with a number of socio-demographic and clinical variables.

Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity / Problemas de salud mental en adolescentes chinos durante el COVID-19: importancia de la nutrición y la actividad física

BACKGROUND/OBJECTIVE: Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19. METHOD: Cross-sectional study (N = 1794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety. RESULTS: The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms. CONCLUSIONS: These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise

ANTECEDENTES/OBJETIVO: Los problemas de salud mental son comunes en adolescentes y están influenciados por eventos estresantes. Se evaluó prevalencia y correlatos de síntomas de insomnio, depresión y ansiedad en adolescentes chinos durante el COVID-19. MÉTODO: En mayo de 2020 se realizó un estudio transversal (N = 1.794 adolescentes, edad media = 1526) mediante una encuesta en línea para recopilar datos sociodemográficos, miedo relacionado con COVID-19, nutrición, actividad física (AF) y síntomas de insomnio, depresión y ansiedad. RESULTADOS: La prevalencia de síntomas de insomnio, depresión y ansiedad fue del 3780%, 4820% y 3670%, respectivamente. Modelos lineales generalizados revelaron que mujeres, niños abandonados y estudiantes con más miedo al COVID-19 tendían a informar síntomas de insomnio, depresión y ansiedad simultaneamente. Después de ajustar los factores sociodemográficos y el miedo al COVID-19, mejor estado nutricional y AF moderadamente activa se asociaron con niveles más bajos de síntomas de depresión y ansiedad, mientras que AF muy activa se asoció con niveles más bajos de insomnio, síntomas depresivos y de ansiedad. CONCLUSIONES. Se debe prestar más atención a la salud psicológica de los adolescentes mientras se combate el COVID-19. Para promover su salud mental, los educadores deben ayudarles a desarrollar un estilo de vida saludable con una dieta equilibrada y ejercicio regular

Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic.

PURPOSE: This study aimed to investigate associations of physical activity time (PAT) and sitting time (ST) independently and jointly with insomnia, depressive and anxiety symptoms among Chinese adolescents in the context of COVID-19. METHODS: A cross-sectional study including 965 adolescents (mean age = 15.26, SD = 0.46) was conducted in May 2020. PAT, ST and the symptoms of insomnia, depression and anxiety were assessed with the International Physical Activity Questionnaire Short Form, the Youth Self-Rating Insomnia Scales, the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder scale via an online survey platform. Logistic regression was used to analyze the association between COVID-19-related fear, PAT, ST and combinations of PAT and ST with insomnia, depressive and anxiety symptoms. RESULTS: COVID-19-related fear was associated with higher odds of insomnia, depressive and anxiety symptoms. PAT was associated with lower odds of insomnia and depressive symptoms, while ST was associated with higher odds of these three symptoms. After combining PAT and ST, the group with both low PAT and high ST was set as the referent. For insomnia, groups with low ST reported significantly lower odds of symptoms. For depression, groups with high PAT and/or low ST reported lower odds of symptoms. Regarding anxiety, only the group with both high PAT and low ST reported lower odds of symptoms. Generally, group with both high PAT and low ST reported lower odds of the three symptoms than the referent. CONCLUSION: COVID-19-related fear was a risk factor for developing insomnia, depressive and anxiety symptoms among Chinese adolescents. Fortunately, moving more and sitting less were good for sleep and mental health in Chinese adolescents during the pandemic. Educators should help adolescents to be more physically active in their daily life in the primary prevention of adolescent insomnia, depression and anxiety.

Depression is Associated with Moderate-Intensity Physical Activity Among College Students During the COVID-19 Pandemic: Differs by Activity Level, Gender and Gender Role.

PURPOSE: The novel coronavirus disease (COVID-19) pandemic and associated restrictive measures have implications for depressive symptoms (henceforth depression) of young people and risk may be associated with their reduced physical activity (PA) level. Therefore, we aimed to examine the association between depressive symptoms and PA among college students with different gender and gender role (masculinity traits and femininity traits) during the COVID-19 pandemic. PARTICIPANTS AND METHODS: Cross-sectional study included 628 healthy college students from nineteen different locations. The Center for Epidemiological Studies Depression Scales (CES-D), the International Physical Activity Questionnaire - Short Form (IPAQ-SF), and the 50-item Chinese Sex-Role Inventory (CSRI-50) were used to measure depressive symptoms, PA continuous (weekly metabolic equivalent minutes, MET-minutes/week) and categorical indicators (activity level category) and gender role, respectively. The statistical analyses were used in partial correlation analysis, t-test, one-way ANOVA, moderation model tests, and linear regression model tests. RESULTS: Total of 34.72% participants had clinically relevant depression (16, CES-D scale). Total of 58.6% participants were classified as a "low" activity level for spending less time on PA. Depression significantly negatively correlated with MET-minutes/week in moderate-intensity PA but not vigorous and walking scores. Of note, the depression-PA association was only moderated by the "low" activity level group in terms of categorical scores across gender groups. Participants with higher masculinity traits were less likely to have depression among all participants. Moreover, more recovered cases and fewer deaths could also predict the lower depression risk in the "high" activity level group. CONCLUSION: Moderate-intensity PA is beneficial for reducing depression risk among college students at a low activity level. College students with fewer masculinity traits (regardless of gender) are highly vulnerable to depression during the outbreak of COVID-19. Effective control of the COVID-19 pandemic seems critical to alleviating the burden of mental disorders of the public including depression.