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While the cross-sectional relationship between internet gaming disorder (IGD) and depression is well-established, whether IGD predicts future depression remains debated, and the underlying mechanisms are not fully understood. This large-scale, three-wave longitudinal study aimed to clarify the predictive role of IGD in depression and explore the mediating effects of resilience and sleep distress.
Methods
A cohort of 41,215 middle school students from Zigong City was assessed at three time points: November 2021 (T1), November 2022 (T2) and November 2023 (T3). IGD, depression, sleep distress and resilience were measured using standardized questionnaires. Multiple logistic regression was used to examine the associations between baseline IGD and both concurrent and subsequent depression. Mediation analyses were conducted with T1 IGD as the predictor, T2 sleep distress and resilience as serial mediators and T3 depression as the outcome. To test the robustness of the findings, a series of sensitivity analyses were performed. Additionally, sex differences in the mediation pathways were explored.
Results
(1) IGD was independently associated with depression at baseline (T1: adjusted odds ratio [AOR] = 4.76, 95% confidence interval [CI]: 3.79–5.98, p < 0.001), 1 year later (T2: AOR = 1.42, 95% CI: 1.16–1.74, p < 0.001) and 2 years later (T3: AOR = 1.24, 95% CI: 1.01–1.53, p = 0.042); (2) A serial multiple mediation effect of sleep distress and resilience was identified in the relationship between IGD and depression. The mediation ratio was 60.7% in the unadjusted model and 33.3% in the fully adjusted model, accounting for baseline depression, sleep distress, resilience and other covariates. The robustness of our findings was supported by various sensitivity analyses; and (3) Sex differences were observed in the mediating roles of sleep distress and resilience, with the mediation ratio being higher in boys compared to girls.
Conclusions
IGD is a significant predictor of depression in adolescents, with resilience and sleep distress serving as key mediators. Early identification and targeted interventions for IGD may help prevent depression. Intervention strategies should prioritize enhancing resilience and improving sleep quality, particularly among boys at risk.
Major depressive disorder (MDD) is the leading cause of disability globally, with moderate heritability and well-established socio-environmental risk factors. Genetic studies have been mostly restricted to European settings, with polygenic scores (PGS) demonstrating low portability across diverse global populations.
Methods
This study examines genetic architecture, polygenic prediction, and socio-environmental correlates of MDD in a family-based sample of 10 032 individuals from Nepal with array genotyping data. We used genome-based restricted maximum likelihood to estimate heritability, applied S-LDXR to estimate the cross-ancestry genetic correlation between Nepalese and European samples, and modeled PGS trained on a GWAS meta-analysis of European and East Asian ancestry samples.
Results
We estimated the narrow-sense heritability of lifetime MDD in Nepal to be 0.26 (95% CI 0.18–0.34, p = 8.5 × 10−6). Our analysis was underpowered to estimate the cross-ancestry genetic correlation (rg = 0.26, 95% CI −0.29 to 0.81). MDD risk was associated with higher age (beta = 0.071, 95% CI 0.06–0.08), female sex (beta = 0.160, 95% CI 0.15–0.17), and childhood exposure to potentially traumatic events (beta = 0.050, 95% CI 0.03–0.07), while neither the depression PGS (beta = 0.004, 95% CI −0.004 to 0.01) or its interaction with childhood trauma (beta = 0.007, 95% CI −0.01 to 0.03) were strongly associated with MDD.
Conclusions
Estimates of lifetime MDD heritability in this Nepalese sample were similar to previous European ancestry samples, but PGS trained on European data did not predict MDD in this sample. This may be due to differences in ancestry-linked causal variants, differences in depression phenotyping between the training and target data, or setting-specific environmental factors that modulate genetic effects. Additional research among under-represented global populations will ensure equitable translation of genomic findings.
To examine the effectiveness of Self-Help Plus (SH+) as an intervention for alleviating stress levels and mental health problems among healthcare workers.
Methods
This was a prospective, two-arm, unblinded, parallel-designed randomised controlled trial. Participants were recruited at all levels of medical facilities within all municipal districts of Guangzhou. Eligible participants were adult healthcare workers experiencing psychological stress (10-item Perceived Stress Scale scores of ≥15) but without serious mental health problems or active suicidal ideation. A self-help psychological intervention developed by the World Health Organization in alleviating psychological stress and preventing the development of mental health problems. The primary outcome was psychological stress, assessed at the 3-month follow-up. Secondary outcomes were depression symptoms, anxiety symptoms, insomnia, positive affect (PA) and self-kindness assessed at the 3-month follow-up.
Results
Between November 2021 and April 2022, 270 participants were enrolled and randomly assigned to either SH+ (n = 135) or the control group (n = 135). The SH+ group had significantly lower stress at the 3-month follow-up (b = −1.23, 95% CI = −2.36, −0.10, p = 0.033) compared to the control group. The interaction effect indicated that the intervention effect in reducing stress differed over time (b = −0.89, 95% CI = −1.50, −0.27, p = 0.005). Analysis of the secondary outcomes suggested that SH+ led to statistically significant improvements in most of the secondary outcomes, including depression, insomnia, PA and self-kindness.
Conclusions
This is the first known randomised controlled trial ever conducted to improve stress and mental health problems among healthcare workers experiencing psychological stress in a low-resource setting. SH+ was found to be an effective strategy for alleviating psychological stress and reducing symptoms of common mental problems. SH+ has the potential to be scaled-up as a public health strategy to reduce the burden of mental health problems in healthcare workers exposed to high levels of stress.
Sensory differences and anxiety disorders are highly prevalent in autistic individuals with and without ADHD. Studies have shown that sensory differences and anxiety are associated and that intolerance of uncertainty (IU) plays an important role in this relationship. However, it is unclear as to how different levels of the sensory processing pathway (i.e., perceptual, affective, or behavioral) contribute. Here, we used psychophysics to assess how alterations in tactile perception contribute to questionnaire measures of sensory reactivity, IU, and anxiety. Thirty-eight autistic children (aged 8-12 years; 27 with co-occurring ADHD) were included. Consistent with previous findings, mediation analyses showed that child-reported IU fully mediated an association between parent-reported sensory reactivity and parent-reported anxiety and that anxiety partially mediated an association between sensory reactivity and IU. Of the vibrotactile thresholds, only simultaneous frequency discrimination (SFD) thresholds correlated with sensory reactivity. Interestingly, we found that sensory reactivity fully mediated an association between SFD threshold and anxiety, and between SFD threshold and IU. Taken together, those findings suggest a mechanistic pathway whereby tactile perceptual alterations contribute to sensory reactivity at the affective level, leading in turn to increased IU and anxiety. This stepwise association can inform potential interventions for IU and anxiety in autism.
Background: Machine learning (ML) methods hold promise in allowing early detection of dementia. We performed a systematic review to assess the quality of published evidence for using ML methods applied to drawing tests of cognition, and to describe the accuracy of the methods. Methods: Embase, Medline, and Cochrane Central Library databases were searched for potential studies up to December 8, 2018 by four independent reviewers. Included articles satisfied the following criteria: 1) use of ML on 2) a drawing test in order to 3) assess cognition. The quality of evidence was then assessed using GRADE methodology. Results: The initial search yielded 4620 citations. Of these, 64 were eligible for full text review. 18 articles then met inclusion criteria. Median AUC across all models was 0.765, with certain ML algorithms performing better in terms of AUC or diagnostic accuracy. However, based on GRADE, the quality of evidence was deemed very low. Conclusions: ML has been applied by several groups to drawing tests of cognition. The quality of evidence is currently too low to make recommendations on their use. Future work must focus on improving reporting, and using standard algorithms and larger, more diverse datasets to improve comparability and generalizability.
Maternal migraine may contribute to mental heath problems in offspring but empirical evidence has been available only for bipolar disorders. Our objective was to examine the association between maternal migraine and the risk of any and specific psychiatric disorders in offspring.
Methods
This population-based cohort study used individual-level linked Danish national health registers. Participants were all live-born singletons in Denmark during 1978–2012 (n = 2 069 785). Follow-up began at birth and continued until the onset of a psychiatric disorder, death, emigration or 31 December 2016, whichever came first. Cox proportional hazards model was employed to calculate the hazard ratios (HRs) of psychiatric disorders.
Results
Maternal migraine was associated with a 26% increased risk of any psychiatric disorders in offspring [HR, 1.26; 95% confidence interval (CI), 1.22–1.30]. Increased rates of psychiatric disorders were seen in all age groups from childhood to early adulthood. Increased rates were also observed for most of the specific psychiatric disorders, in particular, mood disorders (HR, 1.53; 95% CI, 1.39–1.67), neurotic, stress-related and somatoform disorders (HR, 1.44; 95% CI, 1.37–1.52) and specific personality disorders (HR, 1.47; 95% CI, 1.27–1.70), but not for intellectual disability (HR, 0.84; 95% CI, 0.71–1.00) or eating disorders (HR, 1.10; 95% CI, 0.93–1.29). The highest risk was seen in the offspring of mothers with migraine and comorbid psychiatric disorders (HR, 2.13; 95% CI, 1.99–2.28).
Conclusions
Maternal migraine was associated with increased risks of a broad spectrum of psychiatric disorders in offspring. Given the high prevalence of migraine, our findings highlight the importance of better management of maternal migraine at childbearing ages for early prevention of psychiatric disorders in offspring.
Cross-cultural research is burgeoning. Behavioral and social sciences such as psychology, sociology, management, marketing, and political science witness a steady increase in cross-cultural studies. For example, during the last decades, there has been a consistently increasing number of psychological studies on cross-cultural similarities and differences (Boer, Hanke, & He, 2018; Smith, Harb, Lonner, & Van de Vijver, 2001; Van de Vijver & Lonner, 1995). The increased interest is undoubtedly inspired by various factors, such as the opening of previously sealed international borders, large migration streams, globalization of the economic market, international tourism, increased cross-cultural communications, and technological innovations such as new means of telecommunication.
In the previous chapters, typical problems and pitfalls of cross-cultural research were discussed and solutions proposed. The current chapter briefly integrates the major methodological issues into eight statements. Each statement is followed by an explanation. The last section is devoted to our view on the future of cross-cultural research.
This chapter contains a description of the sampling of cultures, design, data analysis, and major strengths and weaknesses of the eight types of cross-cultural studies described in Chapter 2: structure- and level-oriented psychological differences studies; structure- and level-oriented generalizability studies; structure- and level-oriented contextual linkage exploration studies; and structure- and level-oriented contextual linkage validation studies. The structure- and level-oriented studies differ primarily in the analyses employed, so their presentation is integrated. A schematic overview is given in Table 5.1.
This book addresses the methodological features of cross-cultural research. The common characteristic of such studies is their comparative nature, which involves the comparison of at least two cultural populations. Many studies involve different nation states, in sociology (e.g., Inglehart & Welzel, 2010; Van Deth, Montero, & Westholm, 2007), education (e.g., Arnove, Torres, & Franz, 2012; Van de Werfhorst & Mijs, 2010), political sciences (e.g., Coffé & Bolzendahl, 2010; Poguntke & Webb, 2007), management (e.g., House et al., 2004), and psychology (e.g., Schmitt, Allik, McCrae, & Benet-Martínez, 2007). However, comparative studies can also involve different ethnic groups from a single country such as the comparison of ethnic groups in the United States (e.g., Trinidad, Pérez-Stable, White, Emery, & Messer, 2011) and in Europe (Phalet & Kosic, 2006).
Two closely related concepts play an essential role in cross-cultural comparisons, namely equivalence and bias (Poortinga, 1989; Van de Vijver, 2015). There is no consensual definition of either concept in the cross-cultural literature. Johnson (1998) identified more than fifty types of definitions of equivalence, addressing dissimilar features, such as constructs, methodology, language, and context. All definitions refer to some aspect that is shared across cultures or to a qualitative or quantitative procedure to establish the shared features. A review of bias approaches would probably show a comparable variety.
Four procedures for sampling cultures can be discerned (cf. Boehnke, Lietz, Schreier, & Wilhelm, 2011). In convenience sampling, researchers select a culture simply because of considerations of convenience. These considerations can derive from various sources; researchers may be from that culture, are acquainted with collaborators from that culture, or happen to stay there for a period of time. The choice of culture is not related to the theoretical questions raised and is often haphazard. Studies adopting this sampling scheme often fall into the category of psychological differences studies.