Chinese Mental Health Research Articles

Assessing mental health professionals’ attitudes toward routine outcome monitoring across Eastern and Western cultures: an examination of invariance and latent mean differences†

Objective To investigate the attitudes of mental health professionals towards Routine Outcome Monitoring (ROM) in Eastern and Western cultures. Method Two samples of American (N = 455) and Chinese (N = 505) mental health professionals completed the prevalent Monitoring and Feedback Attitudes Scale (MFA). We tested the measure’s psychometric characteristics, measurement invariance, and latent mean difference across cultures. Results Confirmatory factor analysis (CFA) found a two-factor structure of the MFA within both cohorts. The MFA subscales showed excellent internal consistency in both the Chinese and American samples. The MFA demonstrated partial scalar invariance between the two cultural groups, supporting the comparison of latent means among Chinese and American professionals. Chinese professionals perceived greater harm from ROM than their American counterparts. Conclusions The findings show that the MFA is a valid tool to evaluate and compare the US and Chinese mental health professionals’ attitudes toward ROM, suggesting that the measure may be useful in both Eastern and Western cultures.

Depression, anxiety and suicidality among Chinese mental health professionals immediately after China's dynamic zero-COVID policy: A network perspective

BackgroundUsing network analysis, the interactions between mental health problems at the symptom level can be explored in depth. This study examined the network structure of depressive and anxiety symptoms and suicidality among mental health professionals after the end of China's Dynamic Zero-COVID Policy. MethodsA total of 10,647 mental health professionals were recruited nationwide from January to February 2023. Depression and anxiety were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively, while suicidality was defined by a ‘yes’ response to any of the standard questions regarding suicidal ideation (SI), suicide plan (SP) and suicide attempt (SA). Expected Influence (EI) and Bridge Expected Influence (bEI) were used as centrality indices in the symptom network to characterize the structure of the symptoms. ResultsThe prevalence of depression, anxiety, and suicidality were 45.99 %, 28.40 %, and 7.71 %, respectively. The network analysis identified GAD5 (“Restlessness”) as the most central symptom, followed by PHQ4 (“Fatigue”) and GAD7 (“Feeling afraid”). Additionally, PHQ6 (“Guilt”), GAD5 (“Restlessness”), and PHQ8 (“Motor disturbance”) were bridge nodes linking depressive and anxiety symptoms with suicidality. The flow network indicated that the strongest connections of S (“Suicidality”) was with PHQ6 ("Guilt"), GAD7 (“Feeling afraid”), and PHQ2 ("Sad mood"). ConclusionsDepression, anxiety, and suicidality among mental health professionals were highly prevalent after China's Dynamic Zero-COVID Policy ended. Effective measures should target central and bridge symptoms identified in this network model to address the mental health problems in those at-risk.

Dynamic risk factors of psychiatric readmission for major depressive disorder: A longitudinal study on patients treated with mono-antidepressant

In this comprehensive study, we sought to unravel the risk factors for recurrence in Major Depressive Disorder (MDD), uniquely focusing on patients undergoing mono-antidepressant treatment. By considering psychiatric readmission as a direct indicator of MDD recurrence, we meticulously analyzed the records of 1,456 inpatients from a Chinese mental health center from 2012 to 2020. Our follow-up periods, spanning 90, 180, and 365 days post-discharge, allowed for a nuanced understanding of the recurrence dynamics. We identified four critical risk factors: thyroid function (FT3 and TSH), high-density lipoprotein (HDL) levels, and region of residence. Notably, the study revealed an increasing risk of readmission associated with decreased FT3 and HDL over time, while elevated TSH and residing in another province 's impact diminished. The antidepressant type did not significantly alter readmission risks, providing a unique perspective on MDD management. This research contributes to the field by offering a deeper understanding of how demographic and biochemical factors influence the likelihood of MDD recurrence, guiding more effective treatment approaches.

Trust, discrimination and preference for shared decision-making in adolescents diagnosed with depression: Implications from Chinese mental health professionals

BackgroundWhile evidence suggests that the attitudes of healthcare providers toward medical decision-making in adolescents diagnosed with depression merit exploration, research on their preferences for Shared Decision-Making (SDM) and the factors affecting these preferences remains limited. ObjectiveTo investigate Chinese mental health professionals’ (MHPs) preferences for SDM in adolescents with depression and identify the relationships between their preference for SDM and trust and discrimination. MethodsA cross-sectional design was used in this study. Clinical Decision-making Style-Staff (CDMS-S) was applied to evaluate their preferences for SDM. Physician Trust in the Patient Scale (PTPS) was utilised to assess their trust in consumers. Social Distance Scale to Mental Illness (SDSMI) was utilised to measure their discrimination against people with mental illness. ResultsA total of 581 MHPs were identified in China. MHPs rated their preference for participation in decision making (PD) as shared (1.89 ± 0.472), information (IN) as moderate (2.62 ± 0.682), and family involvement (FI) as high (3.13 ± 0.840). The preferences for three decision topics ranked from the highest to the lowest score were working-related decision (2.35 ± 0.681), general preferences in decision (1.82 ± 0.581) and medication-related decision (1.74 ± 0.826). The mean score of PTPS and SDSMI were 34.71 (SD=9.709) and 15.17 (SD=4.299), respectively. Logistic regression indicated that the preference for PD was associated with discrimination; the preference for IN was associated with trust, discrimination and SDM-related training experience; and the preference for FI was associated with both trust and discrimination. ConclusionsWhile MHPs generally exhibit a favourable attitude toward SDM, this positivity is not universally observed across all contexts. There remains room for improvement in the willingness to co-develop medication regimens and share health information. Rational recognition of depression, and building trusting and friendly therapeutic relationships are key to promoting MHPs’ preferences for SDM. Practical valueMHPs' preferences for SDM have a significant impact on SDM implementation, which will be promoted by implementing SDM-related training.

Prevalence and network structure of post-traumatic stress symptoms and their association with suicidality among Chinese mental health professionals immediately following the end of China’s Dynamic Zero-COVID Policy: a national survey

Studies on post-traumatic stress symptoms (PTSS) among mental health professionals (MHPs) are limited, particularly since restrictions due to coronavirus disease (COVID-19) have been lifted such as the recent termination of China’s Dynamic Zero-COVID Policy. The current study filled this gap by exploring the prevalence, correlates, and network structure of PTSS as well as its association with suicidality from a network analysis perspective. A cross-sectional, national survey was conducted using a convenience sampling method on MHPs between January 22 and February 10, 2023. PTSS were assessed using the Post-Traumatic Stress Disorder Checklist-Civilian version, while suicidality was assessed using standardized questions related to ideation, plans, and attempts. Univariate and multivariate analyses examined correlates of PTSS. Network analysis explored the structure of PTSS and suicidality. The centrality index of “Expected influence” was used to identify the most central symptoms in the network, reflecting the relative importance of each node in the network. The “flow” function was adopted to identify specific symptoms that were directly associated with suicidality. A total of 10,647 MHPs were included. The overall rates of PTSS and suicidality were 6.7% (n = 715; 95% CI = 6.2–7.2%) and 7.7% (n = 821; 95% CI = 7.2–8.2%), respectively. Being married (OR = 1.523; P < 0.001), quarantine experience (OR = 1.288; P < 0.001), suicidality (OR = 3.750; P < 0.001) and more severe depressive symptoms (OR = 1.229; P < 0.001) were correlates of more PTSS. Additionally, higher economic status (e.g., good vs. poor: OR = 0.324; P = 0.001) and health status (e.g., good vs. poor: OR = 0.456; P < 0.001) were correlates of reduced PTSS. PCL6 (“Avoiding thoughts”; EI = 1.189), PCL7 (“Avoiding reminders”; EI = 1.157), and PCL11 (“Feeling emotionally numb”; EI = 1.074) had the highest centrality, while PCL12 (“Negative belief”), PCL 16 (“Hypervigilance”) and PCL 14 (“Irritability”) had the strongest direct, positive associations with suicidality. A high prevalence of lingering PTSS was found among MHPs immediately after China’s “Dynamic Zero-COVID Policy” was terminated. Avoidance and hyper-arousal symptoms should be monitored among at-risk MHPs after the COVID-19 pandemic and serve as potential targets for the prevention and treatment of PTSS in this population.

Development and psychometric evaluation of the Chinese mental health support scale

ABSTRACT Objective To culturally adapt a self-report measure of mental health first aid behaviours, the Mental Health Support Scale (MHSS), into Chinese. Method The MHSS has two versions that measure either Intended support, or Provided support, and is applicable to a range of mental health problems. The MHSS was adapted for consistency with Chinese mental health first aid guidelines, forward- and back-translated, and pre-tested with 19 adult residents of mainland China to check the scale was understandable, acceptable and clear. The psychometric properties of the final translation were evaluated with a convenience sample of 406 Chinese adults. Participants completed both versions of the Chinese MHSS: the Chinese MHSS Intended, which measures help a respondent intended to provide if a person close to them developed a mental health problem or crisis, and the Chinese MHSS Provided if they had supported a person with a mental health problem, as well as measures of stigma and mental health literacy. Results The Chinese MHSS Intended comprised two factors: Recommended Actions with 17 items and Not Recommended Actions with 5 items. The Chinese MHSS Provided comprised 10 items in a single factor. Scales demonstrated excellent internal consistency and there was evidence in support of validity, particularly for the Chinese MHSS Intended. Discussion These preliminary results suggest the Chinese MHSS has acceptable psychometric properties. Future research should examine the responsiveness of the scales to MHFA training.

Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey.

China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective. A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function." A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048). This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

Stigma and emotional distress in Chinese mental health professionals: Moderating role of cognitive fusion.

Stigma and emotional distress in Chinese mental health professionals: Moderating role of cognitive fusion.

Chinese Personality Traits and Mental Health: A Meta-Analysis.

This meta-analysis aimed to synthesize the evidence on the relationship between Chinese personality traits and mental health. Through literature search and screening, a total of 70 original articles and 72 independent samples with a total of 65,133 participants were included. The results showed that: (1) Chinese mental health was significantly correlated with three dimensions of personality: psychoticism, neuroticism, and extraversion (correlation coefficients were 0.234, 0.438, and -0.101, respectively); (2) each factor of mental health was significantly positively correlated with psychoticism and neuroticism; only the factor of interpersonal sensitivity was significantly negatively correlated with extraversion; (3) subject type has a significant moderating effect on the relationship between mental health and neuroticism and extraversion, but has no significant moderating effect on the relationship between mental health and psychoticism; (4) publication type does not play a moderating role in the relationship between mental health and the three personality dimensions. This meta-analysis confirmed that personality traits have a significant predictive effect on mental health in Chinese people. However, the relationship between personality and mental health varied considerably across dimensions and groups.

Culture matters: Chinese mental health professionals’ fear of losing face in routine outcome monitoring

Objective: The culturally salient fear of losing face might influence Chinese therapists’ attitudes toward and use of routine outcome monitoring (ROM). We tested a model wherein self-face concern is associated with ROM use by way of attitudes toward ROM, and whether this process is weakened when therapists report high counseling self-efficacy and perspective-taking. Method: A national sample of Chinese mental health professionals (N = 371) completed questionnaires on their fear of losing face, attitudes toward ROM, ROM use, counseling self-efficacy, and perspective-taking. Results: Regression-based analyses showed that fear of losing face was linked to greater negative attitudes toward ROM and lower ROM use. Greater negative attitudes mediated the relationship between fear of losing face and ROM use. However, neither counseling self-efficacy nor perspective-taking mitigated the relationship between self-face concern and ROM use; instead, they exacerbated this relationship through different paths. In the mediated pathway, counseling self-efficacy in coping with clients with difficult problems interacted with self-face concern to predict negative attitudes toward ROM. Perspective-taking served as a moderator that exacerbated the direct relationship between self-face concern and ROM use. Conclusions: Findings suggest the importance of considering culturally salient factors in implementing ROM in China and other non-Western contexts.

Factors that influence family-focused practice in Chinese mental health workers: A cross-sectional survey.

Family-focused practice has become an emerging paradigm in mental health services. However, little is known about family-focused practice and associated factors in Chinese mental health workers. To examine family-focused practice and associated factors in Chinese mental health workers. A cross-sectional survey was conducted in a convenience sample of mental health workers (n = 515) in Beijing, China. The Family-Focused Mental Health Practice Questionnaire was used to measure family-focused practice, as well as worker, workplace and client factors that might influence family-focused practice. Multiple linear regression analysis was performed to investigate the factors associated with family-focused practice. On average, the participants exhibited a moderate level of engagement in family-focused practice. The factors that most significantly influenced family-focused practice in Chinese mental health workers were skill and knowledge, worker confidence and time and workload. Moreover, psychiatrists were found to engage more in family-focused practice than psychiatric nurses, and community mental health workers were more active in family-focused practice than hospital-based ones. This study provided important data concerning family-focused practice and associated factors in Chinese mental health workers. The varying level of Chinese mental health workers to engage in family-focused practice has advocacy, training, research and organizational implications for mental health services in China and elsewhere.

Validation of the Cooper–Norcross Inventory of Preferences (C-NIP) in Chinese lay clients and mental health professionals: Factor structure, measurement invariance, and scale differences.

The Cooper-Norcross Inventory of Preferences (C-NIP) is one of the most widely used measures of psychotherapy preferences. However, its psychometric properties have not been examined in non-Western samples. Research on disparities between the preferences of mental health professionals and their clients is also limited. We evaluated the C-NIP's psychometric properties and measurement invariance in Chinese lay clients and mental health professionals and evaluated the latent mean differences between clients' and professionals' scores on the C-NIP's four scales (preference for therapist vs. client directiveness, emotional intensity vs. emotional reserve, past vs. present orientation, and warm support vs. focused challenge). This cross-sectional investigation involved 301 lay clients and 856 mental health professionals who completed the Chinese version of the C-NIP. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to examine the factor structure of the C-NIP. ESEM provided stronger evidence than CFA for the four-factor model in both samples. The four scales had adequate internal consistency in both the lay clients (αs = .68-.89) and the mental health professionals (αs = .70-.80). Partial scalar invariance was established across these two populations. Chinese mental health professionals preferred less therapist directiveness, past orientation, and warm support-but more emotional intensity-than Chinese lay clients (ds = 0.25-0.90). Culture-specific cutoff values (norms) to identify strong therapy preferences were established. This study supports the application of the C-NIP to non-Western populations and suggests that discrepancies between the preferences of lay clients and mental health professionals are a cross-cultural phenomenon. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Research On The Influence Of Constructivism On Current Mental Health From The Perspective Of Mental Health Management

Psychoeducation, treatment, support, and advocacy are a few procedures in mental health education that show an effective learning process. Students who lack access to educational opportunities are negatively affected by the lack of health education. To give the greatest benefits, the Chinese mental health education sector must develop the educational process utilising constructivism theory. It also has to create a supportive educational curriculum system in Chinese universities to enhance the educational environment. Constructivism is a learning theory that encourages students to take an active part in the learning process and to create an understanding of it. This knowledge helps students take in information and reflect on their learning experiences. It is also noted that the study concentrates on the primary research approach that will be helpful to evaluate the implications of mental health in Chinese college students.

Reliability and Validity of Chinese Version of the Perceived Competence Scale for Disaster Mental Health Workforce: A Cross-Sectional Study.

This study aimed to translate the English version of the Perceived Competence Scale for Disaster Mental Health Workforce (PCS-DMHW) into Chinese, and to test its reliability and validity in Chinese mental health workers. With the consent of Professor Choi, Keimyung University, Korea, and the authorization of the scale, the English version of PCS-DMHW was translated, retranslated and culturally debugged to form the Chinese version of PCS-DMHW. The general information questionnaire and the Chinese version of PCS-DMHW scale were used to investigate 706 mental health workforce from 9 tertiary hospitals in Sichuan province in China from March 24, 2020 to April 14, 2020. The Cronbach's α coefficient was used to evaluate the internal consistency reliability of the scale, and the test-retest correlation coefficient r was used to evaluate the test-retest reliability of the scale. The content validity indexes (CVI) and exploratory factor analysis (EFA) was used separately for evaluating the content validity and structure validity of the scale. The Cronbach's α coefficient of the Chinese version of PCS-DMHW total scale, individual competences and organizational competences subscale was 0.978, 0.956, and 0.964, respectively. The test-retest reliability of the total scale, individual competences and organizational competences subscale was 0.949, 0.932 and 0.927, respectively. The item-level CVI of all scale were ranged from 0.833-1.000, the scale-level CVI (S-CVI)/universal agreement of the total scale, individual competences and organizational competences subscale was 0.833, 0.875, and 0.857, respectively, and the S-CVI/average was 0.972, 0.979, and 0.976, respectively. EFA showed that two principal components were extracted from the subscale of individual competences and organizational competences. The Chinese version of PCS-DMHW has good reliability and validity, and can be widely used in China.

Factors associated with the mental health status of pregnant women in China: A latent class analysis.

Prenatal mental health is a neglected public health issue that places pregnant women at a higher risk for mental disorders. The purpose of this study was to investigate the influencing factors of prenatal mental disorders and provide a scientific basis to guide and promote the mental health of pregnant women. The study sample comprised 973 women in their first pregnancy, who were in their second trimester and third trimester, who underwent obstetric outpatient checkups at the Maternal and Child Health Hospital in Huai'an, who were recruited in the survey that was conducted from July to December 2017. The Chinese mental health scale (CMHS) was used to assess the mental health of pregnant women. The present study uses the chi-square test to compare the rates of class with different demographic variables, a latent class analysis to identify psychological symptoms, and multiple logistic regression analysis to examine whether the demographics predicted class membership. The chi-square test results showed that participants who reported feeling different in the perinatal period (χ2 = 6.35, P = 0.04), having marital satisfaction (χ2 = 15.8, P < 0.001), with an in-law relationship (χ2 = 29.43, P < 0.001), with a friend relationship (χ2 = 24.81, P < 0.001), with basic diseases (χ2 = 8.04, P = 0.02), and taking birth control pills (χ2 = 8.97, P = 0.01) have different probabilities of being classified. Three latent classes were identified: the high symptoms group (6.89%), the moderate symptoms group (20.56%), and the low symptoms group (72.56%). Pregnant women in the third trimester [odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.04-3.25, P = 0.04], with a poor in-law relationship (OR = 2.82, 95% CI:1.45-5.51, P = 0.002), with a bad friend relationship (OR = 3.17, 95% CI: 1.31-7.71, P = 0.01), and who had basic diseases (OR = 1.70, 95% CI: 1.00-2.90, P = 0.04) tended to be classified under the high symptoms group than under the low symptoms group. Pregnant women with a bad friend relationship (OR = 2.15, 95% CI: 1.08-4.28, P = 0.03) and taking birth control pills (OR = 1.51, 95% CI: 1.08-2.11, P = 0.02) were more likely to be placed under the moderate symptoms group than under the low symptoms group. A pregnant woman's mental health status factors include feeling different in the perinatal period, those with marital satisfaction, those with an in-law relationship, those with a friend relationship, those with basic diseases, and those taking birth control pills. To ensure a smooth progress of pregnancy and promote the physical and mental health of pregnant women, psychological screening and psychological intervention measures should be strengthened.

Using Baidu Index to Understand the Public Concern of Children's Mental Health in Mainland China in the Context of COVID-19 Epidemic

This study aims to understand the temporal and spatial characteristics of public concern for "children's mental health" in China in the context of the COVID-19 epidemic. Baidu Index is a research tool to collect and analyze massive data on Chinese netizens' behaviors. Using Baidu Index as the research tool, this paper analyzes the trend and distribution of Chinese netizens' attention to "children's mental health" from December 1st, 2019 to March 20th, 2022 from three aspects of trend research, demand map, and crowd portrait. The study found that since the outbreak of COVID- 19, the search trend of "children's mental health" has shown a cyclical change, peaking in May and valley around the Spring Festival and National Day, and stable in other periods. "Mental health", "handwritten newspaper on mental health" and "youth mental health" are the most popular buzzwords among the public. The groups concerned with "children's mental health" is mainly distributed in Guangdong, Jiangsu, Beijing, and the majority are women between 30 and 39 years old. Meanwhile, search trends for "mental health" are like that for "children's mental health." The factors influencing the search volume change of "children's mental health" include Chinese traditional holidays, Spring Festival, National Day, Chinese Mental Health Day, and policies and instructions on children's mental health issued by the PRC Ministry of Education. The public would like to know about "mental health", "handwritten newspaper on mental health" and "adolescent mental health".

Mental health professionals views and the impact of COVID-19 pandemic on implementing digital mental health in China: A nationwide survey study

BackgroundUsing digital health technologies (DHTs) to deliver and augment healthcare is an innovative way to solve common challenges that the mental healthcare setting faces. Despite China's rapid development of DHT, a comprehensive understanding of staff views of DHTs is lacking, which limited the evidence to support implementation strategies. In the current study, we aim to: (i) investigate staff attitudes towards digital technology for mental health problems in China; (ii) explore staff's views on the facilitators and barriers regarding uptake and adoption of digital technology in mental health services in China; and (iii) understand how the COVID-19 pandemic has changed staff views on digital mental health. MethodsAn online survey was conducted to explore staff attitudes towards implementing DHTs in China. Descriptive statistics were conducted to summarise quantitative data. Free-text data were analysed using qualitative content analysis. Results1270 mental health professionals completed the survey. Respondents reported low levels of knowledge of DHTs and moderate levels of accessibility of DHTs in their hospitals. Respondents expressed positive attitudes towards DHTs and demonstrated moderate levels of perceived feasibility and acceptability of implementing DHTs in clinical services. As expected, respondents reported that the COVID-19 pandemic caused significant impacts on their clinical services, and almost all respondents deemed DHTs useful for services provision during the pandemic and were willing to apply such technologies in clinical services after the pandemic. ConclusionsDespite the Chinese mental health staff expressed positive attitudes towards implementing DHTs in clinical practice, most of the staff lacked sufficient knowledge to provide such services. These findings highlight the need to develop implementation strategies such as training programmes and dissemination of research evidence to support the translation of research.

Psychometric Evaluation of the Cooper-Norcross Inventory of Preferences-Therapist Version.

The Cooper-Norcross Inventory of Preferences (C-NIP) is a commonly used and psychometrically validated measure of client preferences in therapy. However, the C-NIP version for therapists (C-NIP-T) has not yet been validated. This study aimed to develop a Chinese version of the C-NIP-T and test its factor structure, reliability, and concurrent validity. A national sample of 1,054 Chinese mental health professionals completed the C-NIP-T and provided relevant demographic information. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to examine the factor structure of the C-NIP-T. ESEM provided stronger evidence than CFA for the hypothesized four-factor model. Internal consistency coefficients (Cronbach's α) of the four subscales ranged between .60 and .76. Full or partial scalar invariance was established across therapists' therapeutic orientations, gender, personal therapy, and clinical experience. There were significant differences in subscale scores among therapists who identified as cognitive/cognitive-behavioral, psychoanalytic/psychodynamic, and humanistic/client-centered, supporting the concurrent validity of the C-NIP-T. The C-NIP-T is a psychometrically sound measure that can be used to assess therapists' preferences about therapy.

Workforce situation of the Chinese mental health care system: results from a cross-sectional study

BackgroundHigh-quality mental health services can improve outcomes for people with mental health problems and abate the burden of mental disorders. We sought to identify the challenges the country’s mental health system currently faces and the human resource situation related to psychological services and to provide recommendations on how the mental health workforce situation could be addressed in China.MethodsThis study used a cross-sectional survey design. A web-based questionnaire approach and a convenience sampling method were adopted. It was carried out from September 2020 to January 2021 in China, and we finally included 3824 participants in the analysis. Descriptive statistical analysis of the characteristics of the study sample was performed. The risk factors for competence in psychological counseling/psychotherapy were assessed using multiple linear regression analysis.ResultsWorkforce related to psychotherapy is scarce in China, especially in Western China and community mental health sectors. Psychiatrists (39.1%) and nurses (38.9%) were the main service providers of psychotherapy in psychiatric hospitals, and clinical psychologists (6.9%) and counsellors (5.0%) were seriously scarce in mental health care sectors. A total of 74.2% of respondents had no systematic psychological training, and 68.4 and 69.2% of them had no self-experience and professional supervision, respectively. Compared with clinical psychologists and counselors, psychiatrists and nurses had less training. Systematic psychological training (β = − 0.88), self-experience (β = − 0.59) and professional supervision (β = − 1.26) significantly influenced psychotherapy capacity (P<0.001).ConclusionsSustained effort will be required to provide a high-quality, equitably distributed psychotherapy workforce in China, despite challenges for community mental health sectors and western China being likely to continue for some time. Because mental illness is implicated in so many burgeoning social ills, addressing this shortfall could have wide-ranging benefits.

Validation of the International Trauma Questionnaire—Child and Adolescent Version (ITQ-CA) in a Chinese mental health service seeking adolescent sample

BackgroundThe International Trauma Questionnaire—Child and Adolescent version (ITQ-CA) is a self-report measure that assesses posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on the diagnostic formulation of the 11th version of the International Classification of Diseases (ICD-11). This study aimed to provide a Chinese translation and psychometric evaluation of the ITQ-CA using a sample of mental-health service seeking adolescents in Mainland China.MethodsThe ITQ-CA was translated and back-translated from English to simplified Chinese and finalized with consensus from an expert panel. Adolescents ages 12–17 were recruited via convenience sampling from an outpatient psychiatric clinic in Mainland China. Participants completed the ITQ-CA; measures of four criterion variables (depression, anxiety, stress, adverse childhood experiences); and the PTSD Checklist for DSM-5 (PCL-5). Construct validity, concurrent validity, and comparison of PTSD caseness between ICD-11 and DSM-5 measures were assessed.ResultsThe final sample consisted of 111 Chinese adolescents (78% female; mean age of 15.23), all diagnosed with a major depressive disorder. Confirmatory factor analysis indicated the two-factor second-order model provided optimal fit. All criterion variables were positively and significant correlated with the six ITQ-CA symptom cluster summed scores. In the present sample, 69 participants (62.16%) met symptom criteria for ICD-PTSD or CPTSD using the ITQ-CA, and 73 participants (65.77%) met caseness for DSM-5 PTSD using the PCL-5. Rates of PTSD symptom cluster endorsement and caseness deriving from both diagnostic systems were comparable. ConclusionsThe Chinese ITQ-CA has acceptable psychometric properties and confers additional benefits in identifying complex presentations of trauma-related responses in younger people seeking mental health services.