Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool.

OBJECTIVE: Alexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use. METHOD: As part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator. RESULTS: The current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher). CONCLUSION: These results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects. PLAIN LANGUAGE TITLE: Does difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?

In a recent study we recruited participants who were concerned with both their alcohol use and low mood. We provided two different online interventions. Half of the participants received an intervention designed for both concerns and half received an intervention that addressed only depression. We hypothesized that receiving the combined intervention for both concerns would result in greater benefits, however, our results indicated no apparent difference. This analysis uses the same data, but investigated the influences of alexithymia on the effectiveness of the interventions. Alexithymia is defined as having difficulty identifying/describing emotions and/or thinking more about external events than internal feelings. It commonly co-occurs with depression and with hazardous alcohol use and can increase the challenge of supporting individuals with these co-occurring concerns. The results of this analysis showed support for our original hypothesis that participants who received the intervention that addressed both their mood and alcohol concerns had lower depression scores 6-months later, but only among individuals who also had alexithymia scores above 60.5. Taking alexithymia severity into consideration during treatment planning may help optimize the effectiveness of interventions. These results show merit for future research to consider alexithymia as a variable that could potentially impact outcomes among individuals with co-occurring depression and hazardous alcohol use.

The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: a moderated mediation analysis of the role of psychological distress and family resilience.

BACKGROUND: The caregiver burden frequently experienced by family members tending to advanced cancer patients significantly impacts their psychological well-being and quality of life (QoL). Although family resilience might function as a mitigating factor in this relationship, its specific role remains to be elucidated. This study aims to probe the mediating effect of psychological distress on the relationship between caregiver burden and QoL, as well as the moderating effect of family resilience. METHODS: A cross-sectional study was conducted between June 2020 and March 2021 in five tertiary hospitals in China. Data were collected on caregiver burden, family resilience, psychological distress (including anxiety and depression), and QoL. Moderated mediation analysis was performed. RESULTS: Data analysis included 290 caregivers. It confirmed the mediating role of psychological distress in the caregiver burden-QoL relationship (P < 0.001). Both overall family resilience and the specific dimension of family communication and problem-solving (FCPS) demonstrated significant moderating effects on the "psychological distress/anxiety-QoL" paths (P < 0.05). The utilization of social and economic resources (USER) significantly moderated the association between depression and QoL (P < 0.05). CONCLUSIONS: The study corroborates psychological distress's mediation between caregiver burden and QoL and family resilience's moderation between psychological distress and QoL. It underscores the need for minimizing psychological distress and bolstering family resilience among caregivers of advanced cancer patients. Accordingly, interventions should be tailored, inclusive of psychological assistance and promotion of family resilience, particularly focusing on FCPS and USER, to augment the caregivers' well-being and QoL.

Mediation of metabolic syndrome in the association between long-term exposure to particulate matter and incident cardiovascular disease: Evidence from a population-based cohort in Chengdu.

BACKGROUND: Particulate matter (PM) exposure has been linked with cardiovascular disease (CVD) and metabolic syndrome (MetS), the latter characterized by concurrent multiple metabolic disorders. As a result, the mechanisms assumption from PM to CVD through MetS have emerged, thus requiring further epidemiological evidence. This cohort study aimed to assess whether MetS mediates the associations of PM with CVD risk. METHODS: This study included 14,195 participants from the Chengdu cohort of the China Multi-Ethnic Cohort (CMEC) study in 2018. The primary outcome of incident CVD diagnoses was identified using matched hospital records from the Health Information Center of Sichuan Province. Residence-specific levels of PM with aerodynamic diameters of ≤ 1 µm (PM1), ≤ 2.5 µm (PM2.5), and ≤ 10 µm (PM10) were estimated by spatiotemporal models. Causal mediation analyses were applied to evaluate the indirect effect of MetS. RESULTS: Increased exposure levels to PM were significantly associated with MetS and CVD. Mediation analyses indicated that the associations between PM exposure and CVD were mediated by MetS, with the proportion of multiple mediations being 19.3%, 12.1%, and 13.5% for PM1, PM2.5, and PM10, respectively. Further moderated mediation analyses suggested that male, overweight individuals, alcohol drinkers, and those suffering from indoor air pollution may experience more significant adverse effects from PM exposure on CVD via MetS than others. CONCLUSIONS: Our findings suggest that MetS partially mediates the association between long-term exposure to PM and CVD. These mediation effects appear to be amplified by demographic characteristics and unhealthy lifestyles.

The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM.

BACKGROUND: The association between mode of delivery (MOD) and parent-infant-bonding has only been studied in mothers and findings have been inconclusive. The aim of this study was to prospectively investigate how MOD relates to postpartum parent-infant-bonding in both mothers and fathers and whether these associations are mediated by birth experience. METHODS: This study is part of the prospective cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Our sample comprised N = 1,780 participants who completed quantitative questionnaires during pregnancy as well as 8 weeks and 14 months postpartum. MOD was dummy coded, contrasting spontaneous vaginal delivery against vaginal delivery induced by drugs, operative vaginal delivery, planned, and unplanned cesarean section. Parent-infant bonding and birth experience were assessed using validated scales. A moderated mediation analysis based on ordinary least square (OLS) regression and bootstrapped estimates was conducted, considering relevant confounding variables. RESULTS: Compared to spontaneous vaginal delivery, all categories of MOD predicted more negative birth experiences in both parents. A more positive birth experience predicted stronger parent-infant-bonding at 8 weeks, but not at 14 months postpartum. Mothers who delivered via cesarean section (planned or unplanned) reported stronger parent-infant-bonding at 8 weeks and 14 months postpartum. In fathers, only unplanned cesarean section was associated with stronger parent-infant-bonding at 8 weeks postpartum. At 8 weeks postpartum, birth experience mediated the association between a vaginal delivery induced by drugs and a planned cesarean section and mother-infant-bonding and between a vaginal delivery induced by drugs, an operative vaginal delivery, and planned cesarean section and father-infant-bonding. At 14 months postpartum, birth experience mediated the association between a vaginal delivery induced by drugs, operative vaginal delivery, and planned cesarean section and parent-infant-bonding in both parents. CONCLUSIONS: The results emphasize the importance of the birth experience for parent-infant-bonding in both mothers and fathers. Further research should address the mechanisms by which parents with an unplanned cesarean section establish stronger parent-infant-bonding compared to parents whose baby was delivered via spontaneous vaginal delivery, despite their overall more negative birth experiences.

Work immersion and perceived stress among clinical nurses: a latent profile analysis and moderated mediation analysis.

BACKGROUND: Exploration of the relationship between individual work immersion and perceived stress is critical for clinical nurses' effective psychological interventions and human resource management, as well as to alleviate nursing staff shortages. In order to further dissect the influencing factors of perceived stress among nursing staff, our study introduces the concepts of perfectionism and social connectedness to analyze the specific pathways that influence perceived stress in terms of an individual's intrinsic and external personality traits. This study provides relevant recommendations for the development of stress management measures for nursing staff. METHODS: This was a cross-sectional survey. 993 registered clinical nurses were included from four hospitals in Guangzhou through a convenience sampling method. Clinical nurses' work immersion, perceived stress, perfectionism, and social connectedness were investigated using questionnaires based on latent profile analysis. The relationships between variables were analyzed using t-tests, analysis of variance, Pearson's correlation analysis, latent profile analysis, and moderated mediation analysis. RESULTS: The results showed that (1) general influences on nurses' perceived stress included only child, labor relationship, labor allowance, and family support; (2) nurses' work immersion contained four subgroups: lowest (12.6%), medium-low (39.8%), medium-high (39.9%), and highest (7.7%); (3) positive and negative perfectionism played a mediating role between the association of work immersion and perceived stress; (4) social connectedness played a moderating role in the mediation model of perceived stress. CONCLUSIONS: Work immersion, perfectionism, and social connectedness have an important impact on clinical nurses' perceived stress. Nursing managers or leaders should pay attention to the differences of individual work immersion status, adopt reasonable stress management strategies, accurately identify positive perfectionist groups and strengthen the relationship between groups, so as to ensure the quality of nursing care, and reduce nursing turnover and alleviate the problem of staff shortage.

Web-based cognitive behavior therapy for chronic pain patients with aberrant drug-related behavior: How did it work and for whom?

This study explored mediating pathways, moderating factors, and moderated mediation effects of a web-based, cognitive behavioral therapy (CBT) intervention for chronic pain patients with aberrant drug-related behavior (ADRB). In a 2-arm RCT, patients with chronic pain who screened positive for ADRB received treatment-as-usual (TAU, n = 55) or TAU plus a 12-week, web-based CBT intervention (n = 55). Assessments were conducted at weeks 4, 8, and 12, and at 1- and 3-months post intervention. Web-CBT significantly reduced pain catastrophizing, which, in turn, reduced pain interference and pain severity via a pathway of pain catastrophizing. Web-CBT also significantly reduced ADRB both directly and indirectly by reducing pain catastrophizing. For pain interference and pain severity, web-CBT was more effective than TAU for younger patients (≤ age 50). For pain severity, web-CBT was more effective for both younger patients (≤ age 50), and those with a lifetime substance use disorder. Findings suggest that web-CBT's positive impact on pain outcomes and ADRB are mediated by its effect on pain catastrophizing, and its treatment effects may be most robust for younger patients and those with histories of substance dependence.

Do temporal changes in vegetation structure additional to time since fire predict changes in bird occurrence?

Fire is a major ecological process in ecosystems globally. Its impacts on fauna can be both direct (e.g., mortality) and indirect (e.g., altered habitat), resulting in population recovery being driven by several possible mechanisms. Separating direct from indirect impacts of fire on faunal population recovery can be valuable in guiding management of biodiversity in fire-prone environments. However, resolving the influence of direct and indirect processes remains a key challenge because many processes affecting fauna can change concomitantly with time since fire. We explore the mechanisms influencing bird response to fire by posing the question, can temporal changes in vegetation structure predict changes in bird occurrence on sites, and can these be separated from other temporal changes using the surrogate of time since fire? We conducted a 12-yr study of bird and vegetation responses to fire at 124 sites across six vegetation classes in Booderee National Park, Australia. Approximately half of these sites, established in 2002, were burned by a large (>3000 ha) wildfire in 2003. To disentangle collinear effects of temporal changes in vegetation and direct demographic effects on population recovery that are subsumed by time since fire, we incorporated both longitudinal and cross-sectional vegetation effects in addition to time since fire within logistic structural equation models. We identified temporal changes in vegetation structure and richness of plant and bird species that characterized burned and unburned sites in all vegetation classes. For nine bird species, a significant component of the year trend was driven by temporal trends in one of three vegetation variables (number of understory or midstory plant species, or midstory cover). By contrast, we could not separate temporal effects between time since fire and vegetation attributes for bird species richness, reporting rate, and the occurrence of 11 other bird species. Our findings help identify species for which indirect effects of vegetation dominate recovery and thus may benefit from vegetation management where conservation actions are required and, conversely, those species for which direct effects of time since fire drive recovery, where simply leaving a system to recover following the last disturbance will be sufficient.

Unlocking the link between temporomandibular disorders and suicide ideation in pre-orthodontic patients: A moderated mediation model of depression and anxiety.

BACKGROUND: Temporomandibular disorders (TMD) are a series of musculoskeletal diseases with high prevalence. A few studies have reported the correlation between TMD and suicide ideation (SI). However, the underlying mechanism of the relationship lacks in-depth exploration. METHODS: A cross-sectional study was conducted among 954 pre-orthodontic patients. TMD assessment was based on the quintessential five TMD symptoms (5Ts) questionnaire. Anxiety, depression and pain catastrophizing was evaluated by Seven-item Generalized Anxiety Disorder Scale (GAD-7), Nine-item Patient Health Questionnaire (PHQ-9), and Pain Catastrophizing Scale (PCS), respectively. Correlational and moderated mediated analysis was preformed to demonstrate the relationship between TMD and SI. RESULTS: In pre-orthodontic patients, 31.87 % reported having TMD symptoms and 6.50 % declared SI during the past two weeks. The SI prevalence was 10.53 % in participants with TMD and 4.62 % in those without TMD. Intra-articular TMD, rather than pain-related TMD were especially related with SI. Individuals with TMD had higher risk to SI (rs = 0.112, adjusted OR = 2.213, p < 0.001). The effect of TMD on SI was fully mediated through depression (ß = 0.445, 95 % CI = [0.326, 0.563]). Anxiety exerted a negative moderating effect on the depression-SI relation (ß = -0.033, 95 % CI = [-0.047, -0.019]). LIMITATIONS: This study was a single-centered and cross-sectional survey. The data collection relied on self-reporting methods. CONCLUSIONS: A positive link between TMD and SI was disclosed. The effect of TMD on SI was fully mediated through depression with anxiety as a negative moderator.

The Effect of Health Literacy on Disease Management Self-Efficacy in Chronic Disease Patients: The Mediating Effects of Social Support and the Moderating Effects of Illness Perception.

Purpose: To test a hypothetical pathway model to estimate the links between health literacy, social support, illness perception, and disease management self-efficacy. Methods: This cross-sectional study, conducted from June to October 2022, involved the recruitment of 210 patients with chronic diseases at two primary care facilities. Participants completed the Health Literacy Management Scale, Self-Efficacy for Managing Chronic Disease 6-Item Scale, Social Support Rating Scale and Brief Illness Perception Questionnaire. We used the PROCESS macro for R to determine the hypothetical pathway model. Results: The direct effect of health literacy on self-efficacy was significant (ß=0.1792, 95% CI: 0.0940-0.2644), and social support played a partial mediating role between health literacy and self-efficacy (ES=0.0761, 95% CI: 0.0398-0.1204). Illness perception moderated the relationship between social support and self-efficacy (ß=-0.0153, 95% CI: -0.0268- -0.0039). Conclusion: Proposed a conceptual model including the mediating effect of social support and the moderating effect of illness perception, which helps to clarify the underlying mechanisms between health literacy and self-efficacy.

How COVID-19 prevention burnout impacts emotional symptoms among Chinese college students: A moderated mediation model.

The current study investigated the relationship between COVID-19 prevention burnout and emotional symptoms (depression and anxiety) among 1,837 Chinese college students and the underlying mechanisms. Results from moderated mediation analysis revealed that the association between COVID-19 prevention burnout and emotional symptoms was mediated by psychological inflexibility (ß = 0.20, 95%CI = [0.10, 0.19]). Also, COVID-19 prevention burnout's direct and indirect effects on emotional symptoms were more substantial for students with high susceptibility to emotional contagion than those with low susceptibility. These findings contribute to understanding how COVID-19 prevention burnout relates to emotional symptoms and provide a new perspective for interventions promoting students' psychological flexibility, particularly those with higher susceptibility to emotional contagion.

Association between non-restorative sleep and psychotic-like experiences among Chinese college students: A latent profile and moderated mediation analysis.

BACKGROUND: Non-restorative sleep (NRS) is a core symptom of insomnia that has considerable consequences for daily life. However, the association between NRS and psychotic-like experiences (PLEs) remains unclear. The current study was designed to explore the relationship between NRS and PLEs as well as the mediation/moderation role of rumination and resilience among college students in China. METHODS: 3060 college students were recruited from two universities in South China from September 21st to October 26th, 2022. Non-restorative Sleep Scale, 8-item Positive Subscale of the Community Assessment of Psychic Experiences, Ruminative Response Scale, and 10-item Connor-Davidson Resilience Scale were administered. Latent profile analysis and moderated mediation analysis were performed. RESULTS: 11.3 % participants reported frequent PLEs in the past one month. Three profiles of rumination were identified and named as "low rumination" group (27.7 %), "medium rumination" group (55.3 %), and "high rumination" group (16.9 %). NRS directly predicted PLEs, and rumination played a significant mediation role between NRS and PLEs. Resilience significantly moderated the association between NRS and rumination as well as the association between NRS and PLEs. CONCLUSIONS: NRS, rumination and resilience are important predictors to PLEs. Strategies on increasing restorative sleep, decreasing rumination, and enhancing resilience are of great significance in the prevention of PLEs.

Corporate sustainable development performance through top management team's transactive memory system and organizational resilience: A moderated mediation analysis.

Addressing the measurement of corporate sustainable development performance (SDP) in economic, social, and environmental dimensions is a pressing global challenge. This study investigates the intrinsic impact mechanisms of the top management team's transactive memory system (TMT TMS) on SDP within Chinese manufacturing firms. It extends the analysis by introducing opportunity alertness (OA) as a moderating variable and organizational resilience (OR) as a mediating variable. Notably, OA was found to have a moderating mediation effect on the TMT TMS-OR-SDP pathway. Data from 294 executives was collected through non-probability convenience sampling. Initially, exploratory factor analysis was conducted utilizing SPSS; confirmatory factor analysis was performed with the aid of AMOS. Additionally, hierarchical regression and the SPSS PROCESS macro were employed to test the hypothesized models and paths of influence. The results illuminate the positive impact of TMT TMS on SDP through the enhancement of OR, a relationship further strengthened by OA. This study adds to the theoretical understanding and offers practical insights for optimizing TMT TMS and OA to achieve corporate sustainable development.

Exploring the moderating effects of SIRT1 and gene polymorphisms rs7895833 on the relationship between hemoglobin levels and physical frailty in elderly adults with comorbid chronic diseases: A moderated mediation analysis.

Background: Relationship age, hemoglobin, and physical frailty have all been investigated in older people with more than one chronic disease. There has been little analysis of the relationship between hemoglobin, age, physical frailty, plasma levels of Sirtuin1 (SIRT1), and the gene polymorphism (SNP) rs7895833 A>G. The goal of this study was to find out how SIRT1 level, SNP rs7895833, hemoglobin, age, and physical frailty (frail score) are related in older Indonesian adults with comorbid chronic diseases. Methods: This was an observational study. Demographic and clinical data were retrieved from the electronic health records of Universitas Sumatera Utara Hospital, Medan, Indonesia. Physical frailty, SIRT1 level, and SNP rs7895833 were measured using an appropriate and valid method. Purposive sampling was used to determine the eligibility of 132 elderly adults from November 2022 to February 2023. Results: The indirect effect of hemoglobin on the frail score (FS) through age was negative and significant, according to a conditional mediation analysis (ß=-0.0731; p=0.023). Meanwhile, the direct effect of hemoglobin on the FS was negative and not significant (ß=0.1632; p=0.052). According to the conditional moderated mediation analysis, the size of the direct effect of age on FS was increased by genotype AG-GG and SIRT1 level (ß low=0.2647; p=0.002, ß middle=0.2956; p<0.001, and ß high=0.319; p<0.001). The size of the conditional indirect effect of Hemoglobin on FS through age was negative and significantly increased by SNP genotype AG-GG and SIRT1 level (ß low=-0.0647; p=0.032, ß middle=-0.0723; p=0.024, and ß high=-0.078; p=0.02). Conclusions: Higher plasma levels of SIRT1 and the SNP genotype AG-GG may both contribute to physical frailty in the elderly population. Hemoglobin levels in the blood fall with age, which can negatively impact older persons who already have chronic diseases. However, the interactions between these factors are intricate, requiring more study to completely understand the processes underlying development.

The impact of eye gaze on social interactions of females in virtual reality: The mediating role of the uncanniness of avatars and the moderating role of task type.

The introduction of the Metaverse and the rise of social virtual reality platforms such as VRChat has led to increased communication and collaboration in virtual reality. As interactions in social virtual reality take place through avatars, the behaviour, and in particular the eye gaze of an avatar can have an impact on the user experience. However, it is still unclear which features of the user experience are most influenced. Therefore, this study used data from 44 female participants to investigate how avatar gaze behaviour (static eyes vs. real-time tracked eyes) affects their perceived quality of communication and the amount of one-sided eye contact participants make during a communicative or collaborative task in virtual reality. In addition, the study investigated the mediating role of perceived avatar "uncanniness" (i.e., the finding that humanoid objects that imperfectly resemble real people evoke feelings of discomfort) in this relationship and the moderation effect of two multi-user scenarios (collaboration vs. communication). The results showed that uncanniness directly affected the perceived quality of communication. However, it did not significantly mediate the relationship between avatar eye gaze behaviour and the quality of communication or the amount of one-sided eye contact. Finally, there were no significant differences in user experience between the two scenarios. From this, we can conclude that the uncanniness of an avatar being interacted with in VR is not enough to hinder communication and collaboration in an immersive medium. And even if an avatar is perceived as uncanny, normative communication cues such as eye contact are still present. Notably, due to sample availability, the results of this study are based on a female-only sample. Thus, future research can benefit from exploring the outlined effects in a more gender-balanced sample.

The relationship between university students' goal orientation and academic achievement. The mediating role of motivational components and the moderating role of achievement emotions.

The present study aims to expand the understanding of the role played by achievement emotions in the learning process and academic achievement of university students. We investigated how achievement emotions moderate the direct and indirect associations between mastery and performance goal orientation and academic achievement. Also, we used as mediators the motivational components from Pintrich and De Groot's theoretical framework of motivation and learning strategies. 274 Romanian university students (Mage = 20.23, 84.7% women) participated in the study. Moderated mediation analyses indicated that self-efficacy was the only significant mediator, and this relationship was moderated by hope, pride and hopelessness. In addition, the links between mastery and performance approach goals and motivational components are stronger when the positive emotions are higher and the negative ones are lower. Mastery avoidance goals were linked with high scores of motivational components at higher levels of negative and lower levels of positive achievement emotions, whereas the association of avoidance goals with motivational components was moderated by two positive emotions (pride and enjoyment). The patterns derived from the moderating role of achievement emotions in the relationships between goal orientation, motivational components and academic achievement, alongside several inconsistent results and implications in theory and education, are discussed.

Role of Workplace Spirituality, Empathic Concern and Organizational Politics in Employee Wellbeing: A Study on Police Personnel.

Employee wellbeing as a central aspect of organizational growth has been widely regarded and accepted. Therefore, a considerable growth in the number of researches focusing on employee wellbeing has been comprehended in recent years. Employee wellbeing characterizes the individual's own cognitive interpretation of his/her life at work. The present study made an attempt to examine how workplace spirituality, empathic concern and organizational politics influences employee wellbeing. It was hypothesized that empathic concern mediates the relationship between workplace spirituality and employee wellbeing while organizational politics act as a moderator in this relationship. A survey was conducted on 253 employees working in Uttar Pradesh Police department (Uttar Pradesh, India). The results obtained revealed that workplace spirituality, empathic concern and employee wellbeing carries a positive association among them whereas these variables were found to be negatively correlated with organizational politics. Results also depicted that empathic concern significantly mediates between workplace spirituality and employee wellbeing. Further, moderated mediation analysis confirmed employee wellbeing as a function of workplace spirituality, empathic concern and organizational politics. The present study has put forward several practical implications for business practitioners and research directions for academicians, emphasizing upon the need to investigate the comprehensive impact of employee wellbeing in organization and the society as a whole.

Examining the Relationship of Information and Communication Technologies Use and Reading Literacy: A Moderated-Mediation Analysis of Metacognition Across Information and Communication Technologies Use Intensity.

The use of information and communication technologies (ICT) is increasingly becoming prevalent among students, both at home and school. While inconsistent results were found for student ICT use and reading literacy, this study attempted to explain these ambiguous links with the moderation of ICT use intensity and mediation of metacognition. Three moderated mediation models for each type of ICT use (at home for entertainment activities and for schoolwork, as well as at school) were analyzed using a Hong Kong sample taken from the Programme for International Student Assessment (PISA) 2018 data pertaining to 5180 15-year-old students from 152 schools. A dynamic effect pattern was found for the links of all ICT use types and reading literacy with the increasing intensity of ICT use, which begins with a positive effect followed by a decrease to less positive, then turns to fluctuating negative and finally ends up with a stable negative effect. But the dominant effect varies across ICT use intensity, which result in different overall effects of three ICT use types. In addition, all three aspects of metacognition showed a profound negative mediation on links of intensive and excessive ICT use with reading literacy, and a less positive mediation for limited ICT use. The metacognition of assessing credibility showed a more important role than summarizing, which was followed by understanding and remembering. In light of the findings, the study recommended that more metacognitive scaffolds should be developed for students with intensive or excessive ICT use, so as to alleviate the side effects of ICT use on their reading literacy.

Self-Efficacy and Professional Identity Among Freshmen Nursing Students: A Latent Profile and Moderated Mediation Analysis.

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students (FNSs) from the Be Resilient to Nursing Career (BRNC) program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest (15.6%), Med-low (45.0%), Med-high (32.7%), and Highest (6.7%). The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies.

Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model.

Introduction: Prenatal psychological distress is prevalent during pregnancy. This study aimed to estimate the associations among fear of childbirth, resilience and psychological distress. Methods: A total of 1,060 Chinese pregnant women were enrolled from Be Resilient to Postpartum Depression (ChiCTR2100048465) and the following instruments were administered to them: Childbirth Attitudes Questionnaire, Connor-Davidson Resilience Scale, Perceived Social Support Scale, General Self-Efficacy Scale, Adverse Childhood Experience scale and Hospital Anxiety and Depression Scale. A dominance, a response surface analysis and a moderated mediation analysis were performed. Results: In terms of psychological distress, resilience and fear of childbirth could explain 41.6% (0.148/0.356) and 33.1% (0.118/0.356), respectively. Pregnant women with high resilience-low fear of childbirth had significantly lower levels of psychological distress than those with low resilience-high fear of childbirth. The indirect effects of fear of childbirth on psychological distress through resilience was significantly (B = 0.054, 95% CI 0.038 to 0.070). The interactions between fear of childbirth and adverse childhood experiences (ß = 0.114, 95% CI -0.002 to 0.231, p = 0.054) and between resilience and adverse childhood experiences (ß = -0.118, 95% CI -0.222 to -0.012, p < 0.05) were significant. Conclusion: Resilience, fear of childbirth and adverse childhood experiences may be three important factors to psychological distress in Chinese pregnant women.

Bullying victimization and depressive symptoms in Chinese adolescents: A moderated mediation model of self-esteem and friendship intimacy.

BACKGROUND: Depression is a major mental disorder and poses a serious threat to public health. Bullying victimization is identified as one of the major risk factors for depression in adolescence. Understanding the mechanism that explain why bullying victimization leads to depression, and identifying protective factors that could alleviate the negative effects of bullying victimization are pivotal to developing effective intervention programs. METHODS: A sample of Chinese adolescents in junior high schools (N = 458, 50.58 % girls, M age = 11.63 years at T1) was followed for three years. The data on depression, bullying victimization, self-esteem, and friendship intimacy were collected from adolescents' self-report. RESULTS: After controlling related variables, T1 bullying victimization positively predicted T3 depressive symptoms. T2 self-esteem mediated the link between T1 bullying victimization and T3 depressive symptoms when T1 friendship intimacy was low. More specifically, only for youth who reported low friendship intimacy, bullying victimization would lead to a lower level of self-esteem, which in turn, was associated with a higher level of depression. LIMITATIONS: The study only considered the roles of self-esteem as the mediator and friendship intimacy as the moderator. All measures were based on self-report. CONCLUSIONS: The results highlighted the role of friendship intimacy and self-esteem in the longitudinal relation between bullying victimization and depressive symptoms. The results suggest that intervention programs aiming at reducing victimized adolescents' depressive symptoms should consider the buffering effect of friendship intimacy.