Evacuation- and hurricane-related experiences, emotional distress, and their associations with mothers' health risk behaviors.

The purpose of this study was to examine the prevalence of posttraumatic stress symptoms (PTSS) in patients with renal cell carcinoma (RCC), the associations and co-occurrence between PTSS, depressive, and other cancer-related symptoms and the ability of a single-item distress question to identify patients with PTSS. Patients with stage I-IV RCC completed assessments of depressive symptoms (Center for Epidemiologic Studies Depression Scale), PTSS (Impact of Event Scale), cancer-related symptoms (MD Anderson Symptom Inventory), fatigue (Brief Fatigue Inventory), and sleep disturbance (Pittsburgh Sleep Quality Index). We used the distress item on the MD Anderson Symptom Inventory as a distress screener and general linear model analyses to test study hypotheses. Of the 287 patients (29% stage IV; 42% female; mean age = 58 years), 46% (n = 131) reported psychiatric symptoms with 15% (n = 44) reporting comorbid clinical levels of depressive symptoms and PTSS, 24% (n = 70) PTSS alone, and 6% (n = 17) depressive symptoms alone. Controlling for age, gender, and stage, patients with comorbid depressive symptoms and PTSS reported more cancer-related symptoms (p < 0.0001), fatigue (p < 0.0001), and sleep disturbance (p = 0.0003) than those with PTSS alone and more cancer-related symptoms (p = 0.002) and fatigue (p = 0.09) than those with depressive symptoms alone. Sensitivity analyses revealed that 26.9% of negative cases on the distress item fell within the clinical range of the Impact of Event Scale and 9.3% of negative cases met caseness on the Center for Epidemiologic Studies Depression Scale. Posttraumatic stress symptoms occurred both independently and comorbid with depressive symptoms in patients with RCC. PTSS were correlated with overall cancer symptom burden. Single-item distress screening was less sensitive in detecting PTSS than depressive symptoms. Therefore, additional screening strategies are required in the clinical setting.

Six-year changes of posttraumatic stress symptoms and depressive symptoms among Chinese earthquake survivors: A network analysis

The interplay between acute post-traumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19 emergency: A multicenter study comparing regions with increasing pandemic incidence

Adolescents frequently experience symptoms of mental disorders (SOMD) and engage in health risk behaviors (HRB), both of which significantly contribute to global disability and mortality. Despite this, data on these issues remain limited in low- and middle-income countries (LMICs), including Vietnam. This study aims to estimate the prevalence of SOMD and HRB and examine their associations among high school students in Vietnam. A cross-sectional survey was conducted with 3,025 students from four high schools and four continuing education centers across Ho Chi Minh City. Participants completed a self-administered questionnaire capturing demographic information, HRB (using the YBRS scale), and SOMD (using the DASS-21 screening scale). SOMD assessments focused on symptoms of depression, anxiety, and stress rather than clinical diagnoses, while HRB covered substance use, risk-taking, physical fighting, suicidal ideation, unsafe sexual behaviors, unhealthy diet, physical inactivity, and sleep deprivation. Of the 2,631 students included in the analysis, prevalence rates were 42.6% for symptoms of depression, 50.3% for symptoms of anxiety, and 31.1% for symptoms of stress. Engagement in HRB varied widely, from 4.0% for unsafe sexual behaviors to 79.9% for physical inactivity, with 91.6% reporting involvement in multiple HRB. Students experiencing SOMD were significantly more likely to engage in HRB compared to those without SOMD, with odds ratios ranging from 1.24 to 4.64. SOMD and HRB represent dual and interrelated challenges among Vietnamese adolescents, underscored by their high prevalence. These findings emphasize the critical need for integrated interventions addressing both mental health symptoms and health risk behaviors, especially in resource-constrained LMIC settings.

Are posttraumatic stress and depressive symptoms pathways to smoking relapse after a natural disaster?

To identify the associations among posttraumatic stress, depressive and obsessive-compulsive symptoms (OCS) in outpatients with psychological trauma and to examine the mediating effect of social provision. Psychologically traumatized patients simultaneously experience depressive and OCS. Social provision may mediate multiple symptoms differently compared with social support. Cross-sectional and correlational study. Data were collected between August 2016-May 2017. Psychiatric outpatients (N=151) completed a structured questionnaire consisting of the Korean versions of the Social Provision Scale, Beck Depression Inventory-II, Maudsley Obsessional-Compulsive Inventory and Impact of Event Scale-Revised. Structural equation modelling was used to examine the recursive association among the three symptoms and the mediation of social provision. There was a recursive association between posttraumatic stress symptoms (PTSS) and depressive symptoms, which were simultaneously associated with OCS with a one-way direction. OCS and social provision partially mediated these identified associations among three symptoms. Our findings provide insight into the complex associations of multiple symptoms experienced by traumatized outpatients and the partial mediation of social provision. Psychiatric and mental health professionals may enhance social functioning and interpersonal interactions based on social provision components used for helping traumatized patients with obsessive-compulsive and depressive symptoms. There was a recursive association between PTSS and depressive symptoms that were simultaneously associated with OCS with a one-way direction. Social provision functions as a partial mediator when working with OCS. Mental health nurses can develop social provision interventions for depressive symptoms for traumatized outpatients with OCS.

As global climate change intensifies, the frequency and intensity of extreme weather events continue to increase, and their impact on economic and social operations is gradually becoming more significant. The growing income inequality is an important challenge faced by countries worldwide, so the impact of extreme weather events on it is worth further study. Based on the cross-national panel data from 1990 to 2022 across 104 countries, this paper tests the impact and mechanism of extreme weather events on income inequality. The study finds that extreme weather events significantly increase income inequality, which remains the same under a series of robustness tests. Consistent with theoretical analysis, the mechanism test indicates that extreme weather events expand income inequality by reducing macroeconomic stability, hindering the market-oriented development of financial structures, and inhibiting the rationalization level of industrial structure. Further heterogeneity tests reveal that the effect of extreme weather events on income inequality is more pronounced in countries characterized by poorer economic development levels, lower insurance coverage, weaker government effectiveness, and non-OECD membership status. It is also found that extreme temperature has the most prominent impact among the four types of extreme weather events. This study provides valuable insights for understanding the impact of extreme weather events on income inequality, as well as practical guidance for mitigating the effects of climate change.

To examine the relationship between health-risk behaviors and depressive symptoms among college students, and explore the mediating role of plasma IL-10 level in the relationship between the two. Freshman students in two universities in Hefei City, Anhui Province and Shangrao City, Jiangxi Province were recruited between April and May 2019, and follow-up investigation was conducted 6 months later. Health risk behaviors were measured based on the Young Risk Behavior Surveillance System(YRBSS) questionnaire, and depressive symptoms was evaluated by using the Depression Anxiety Stress Scale(DASS-21) among college students at baseline and 6 months follow-up survey. Plasma interleukin-10(IL-10) level was measured at baseline. Univariate analysis was used to compare the correlation between health risk behaviors and depressive symptoms among college students. Binary Logistic regression analyzed the relationship between health risk behaviors, IL-10 and depressive symptoms. The mediation model was used to explore the mediating role of IL-10 levels in the association between health risk behaviors and depressive symptoms. At baseline, boys reported a higher rate of depressive symptoms than that of girls(χ~2=6.33, P=0.01); higher rates of depressive symptoms were observed in students who were from a family with a low perceived economic status(χ~2=7.31, P=0.03)or in poor health(χ~2=6.71, P=0.04). Participants who reported low physical activity(χ~2=19.09, P&lt;0.01), smoking(χ~2=7.03, P&lt;0.01), and poor sleep quality(χ~2=68.78, P&lt;0.01)at baseline were more likely to experience depressive symptoms. Multiple health-risk behaviors at baseline were positively correlated with depressive symptoms among college students. After adjusting gender, self-reported family economy and self-rated health, the regression model showed that plasma IL-10 at baseline was negatively associated with the prevalence of depressive symptoms(OR=0.36, 95% CI 0.18-0.72) and the incidence of depressive symptoms after 6 months(OR=0.20, 95% CI 0.08-0.49). Structural equation model showed that health-risk behaviors was negatively correlated to IL-10 level(β=-0.13, SE=0.04), IL-10 negatively predicted depressive symptoms at follow-up(β=-0.09, SE=0.04), and IL-10 play a mediating role between health risk behavior and depressive symptoms. Health risk behaviors are positively correlated with depressive symptoms among college students. Plasma IL-10 level at baseline was negatively associated with the incidence of depressive symptoms after 6 months, and IL-10 level at baseline has a partial mediating effect between baseline health risk behavior clustering and depressive symptoms at follow-up.

Adverse Childhood Experiences (ACEs) and Internalizing Mental Health, Pain, and Quality of Life in Youth With Chronic Pain: A Longitudinal Examination

Few longitudinal studies have focused on mental health problems among adolescents after earthquakes. We investigated changes in post-traumatic stress symptoms (PTSS) and depressive symptoms from 18 to 31 months after the 2015 earthquake in Nepal and explored potential risk factors associated with the change in psychiatric symptoms. This study comprised of 515 adolescents, aged 11–17 years from two earthquake-affected areas, one severely affected than the other. The psychiatric symptoms were assessed using the standardized Child Post-traumatic Stress Disorder Scale and the Depression Self-Rating Scale. No significant change was observed in the prevalence of PTSS and depressive symptoms from 18 to 31 months after the earthquake. Living in severely affected area and exposure to trauma after the earthquake were associated with adolescents who developed chronic or delayed PTSS and depressive symptoms. The study findings highlight the need for disaster preparedness and early interventions that strengthen support at various levels.

The coronavirus disease 2019 (COVID-19) pandemic had direct effects on population health through infection and morbidity, as well as indirect effects on population mental health. We estimated the network structure of post-traumatic stress symptoms (PTSS) and depressive symptoms throughout the pandemic in Korea and aimed to identify the most central and bridging symptoms. Participants aged 30-64 years completed mental health surveys across 3 phases of the COVID-19 pandemic: March 2020 (n=1,925), February-March 2021 (n=1,754), and December 2021-January 2022 (n=1,595). Using PTSS and depressive symptom data, we conducted network analyses, and the primary measures of symptom importance (centrality) were expected influence and bridge expected influence. In the comorbidity network, although the most central symptoms fluctuated over the course of the pandemic, sleep problems were consistently identified as the most influential bridge symptoms throughout. The symptom network structure differed between the subacute and chronic phases of the pandemic. We found evidence of changes in the network structure of PTSS and depressive symptoms, even as sleep problems retained a consistent role as a bridging symptom. Although overall network structures varied across phases of the pandemic, the bridging role of sleep-related symptoms remained consistently strong, suggesting that sleep problems may represent a general and enduring mechanism underlying PTSS-depression comorbidity. During future pandemics, prompt screening for sleep problems may help prevent the development of comorbidity between PTSS and depressive symptoms.

Coronavirus disease 2019 pandemic pointed out significant mental symptoms of frontline healthcare workers (HCWs). We aimed to estimate the prevalence and comorbidity of post-traumatic stress symptoms (PTSS), depression and anxiety symptoms in HCWs from Fangcang shelter hospitals during the pandemic. Demographic information, post-traumatic stress disorder checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7) were obtained online based on stratified random sampling design during April 2022, with 284 eligible responses. Hierarchical regression analyses were applied to investigate independent variables associated with psychological status outcomes (PHQ-9, GAD-7 and PCL-5), and the network analyses were applied to explore the comorbidity using all items of PCL-5, PHQ-9 and GAD-7. (1) 10.56%, 13.03% and 8.10% of HCWs reported PTSS, depression and anxiety symptoms. Fifty-three (18.66%) HCWs experienced at least one mental health disorder, among which 26.42-37.74% HCWs had comorbidity of two or three mental disorders; (2) several influence factors of mental health were identified, including medical professions, working hours, contacted patients (p < 0.05); (3) prominent bridge symptoms between PTSS and depression were sleep problems, suicide ideation, concentration difficulties and recklessness. Comorbidity between PTSS and anxiety was thought to mainly stem from negative affect, such as afraid, anxious, annoyed and worrying. Depressed mood and worry might be good targets during treatment of comorbidity of depression and anxiety. Our data suggest mild level of PTSS, depression and anxiety symptoms among HCWs during the pandemic and might give novel insights into assessment and intervention of comorbidity.

Exploring the Impact of Racism on Black Youth: A Multidimensional Examination of Discriminatory Experiences Across Place and Time

Rescue workers face frequent occupational trauma, increasing their risk for posttraumatic stress symptoms (PTSS), depression, and suicidal ideation. However, pathways linking trauma to suicidality remain poorly understood. This study investigated these mechanisms by testing a serial mediation model. From a larger survey of Swiss rescue workers, participants reporting suicidal ideation (n = 44) were matched by age, sex, and profession with a control group without suicidal ideation (n = 44). Symptomatology was assessed using validated questionnaires such as the Posttraumatic Stress Scale-10 (PTSS-10) for posttraumatic stress and the Brief Symptom Inventory (BSI) for depressive symptoms. Structural Equation Modeling (SEM) was employed to test a serial two-mediator model: Trauma Exposure - PTSS - Depressive Symptoms - Suicidal Ideation. Participants with suicidal ideation had significantly higher levels of trauma, PTSS, and depressive symptoms. SEM confirmed an excellent model fit (χ² = 1.925, CFI=1.000, RMSEA <.001) and a full mediation effect: trauma exposure was associated with PTSS, which in turn related to depressive symptoms, which were subsequently linked to suicidal ideation. The specific serial indirect pathway was significant (B=0.143, p = .011), while the direct path from trauma to suicidal ideation was non-significant. The model explained 69.4% of the variance in suicidal ideation. The findings suggest a developmental pathway in which trauma exposure is associated with suicidal ideation through the sequential roles of PTSS and depressive symptoms. Consequently, suicide prevention for rescue workers should prioritize the management of post-traumatic and depressive symptoms to potentially disrupt this symptomatic progression.

Posttraumatic stress symptoms (PTSS) have been associated with increased somatic symptom expression. Sleep concerns have been associated with PTSS and somatic symptoms. Previous research suggests that sleep affects multiple domains of functioning including comorbid psychological and physical health concerns. The current study examines whether perceived sleep quality or sleep efficiency/duration may be mediating the relationship between PTSS and somatic symptoms in a trauma-exposed sample. The sample consisted of 864 students, recruited from a large Midwestern university and compensated with research participation credit. Data were collected online over approximately 39 months (October 2015 through January 2019), and the pertinent scales examined in this study included Pittsburgh Sleep Quality Index, Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, and Screening for Somatoform Symptoms-7. Of the 864 students, 668 participants identified as female (77.3%) and 540 identified as non-Hispanic White (62.5%), with an overall average age of 23.14 years (SD = 6.64). Mediation analyses indicated that the overall model examining global sleep quality complaints as a mechanism of the relationship between PTSS and somatic symptoms was significant, F(3, 860) = 193.97, R² = .40, p < .001, and that perceived sleep quality was found to be the only significant specific mediator (indirect effect = .21). Although females reported greater somatic severity, PTSS, and sleep concerns, models were significant, even after examining the influence of gender. Global sleep complaints are associated with both PTSS and somatic symptoms. Perceived sleep quality specifically mediated the relationship between PTSS and somatic symptoms, highlighting a potential intervention for improving physical health consequences in trauma-exposed individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).