Background: Direct exposure to natural disasters and related losses are associated with post-traumatic stress disorder (PTSD). It is less clear whether indirect media exposure is associated with PTSD.Objective: This study investigated key exposure-related risk factors for PTSD and examined the effect of media exposure on the prevalence of disaster-related PTSD.Method: Typhoon Hato directly hit Macao on 23 August 2017. It was one of the most serious natural disasters ever to strike southern China. One month after the event, 1876 Chinese university students in Macao were recruited into a cross-sectional study (mean age 20.01 years, SD = 2.63; 66.2% female). Self-reported typhoon exposure, media use and exposure to disaster-related content, and PTSD symptoms were collected using an electronic survey. Univariable analyses assessed associations between risk factors and PTSD, which were then included in a series of multivariable logistic regressions.Results: The prevalence of PTSD was 5.1%. Adjusted models demonstrated that being male (vs female) [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI) 1.07–2.63], home damage (aOR = 2.86, 95% CI 1.71–4.78), witnessing people injured (aOR = 2.33, 95% CI 1.36–4.00), and almost drowning during the storm (aOR = 8.99, 95% CI 1.92–41.99) were associated with PTSD. After adjusting for direct exposure, indirect exposure to disaster-related social media content, including information related to drowning victims (aOR = 1.29, 95% CI 1.00–1.67) and residents’ emotional reactions (aOR = 1.98, 95% CI 1.44–2.72), was associated with PTSD. Viewing more information about the storm itself (aOR = 0.37, 95% CI 0.28–0.49) and images of heroic acts (aOR = 0.72, 95% CI 0.55–0.94) were significantly associated with lower odds of PTSD.Conclusion: These findings add to the literature demonstrating that some types of media use and certain media content following a natural disaster are associated with PTSD.
Background: Chinese young adults experience barriers to mental health treatment, including the lack of treatment providers and stigma around treatment seeking. Evidence-based digital mental health interventions are promising and scalable alternatives to face-to-face treatment for this population, but lack rigorous evidence to support scale-up in China.Aim: The study was a feasibility study for a large-scale RCT of Step-by-Step, a behavioral activation-based, mental health intervention to address depression and anxiety symptoms in Chinese young adults. It sought to assess feasibility of recruitment and of delivery of Step-by-Step in a University setting, to assess acceptability of the intervention, and to examine potential effectiveness.Method: An uncontrolled, feasibility trial was conducted to assess the feasibility and acceptability of Chinese Step-by-Step for Chinese University students with elevated depressive symptoms (PHQ-9 scores at or above 10) in Macao, China. Data was collected at two different time points (i.e., baseline and 8-weeks after baseline), administered via questionnaires embedded in an interventional mobile application. Participation rate and dropout rate were measured. Depressive and anxiety symptom severity, well-being, and self-defined stress were assessed. Satisfaction with the program was assessed using qualitative interviews.Results: A total of 173 students were screened, 22.0% (n = 38) were eligible, and 63.2% of them (n = 24) started the intervention. The dropout rate by post-test was 45.8%. Results from completers showed that Step-by-Step was potentially effective in reducing depressive and anxiety symptom severity, and self-defined stress. Students were generally satisfied with the program, but also offered suggestions for continued improvement. Qualitative feedback was reported within the RE-AIM framework, covering recruitment, effectiveness, adoption, implementation, and maintenance. Amendments to the program were made according to the feedback (e.g., adding notification for new session, modify the time zone).Conclusion: A minimally guided Step-by-Step protocol and the study procedure were successfully pilot tested for use for Chinese University students. The intervention was acceptable and no adverse events were reported. The results support the potential effectiveness and feasibility of a large-scale evaluation of the program.
The Career Adapt-Abilities Scale (CAAS) is a widely used measure to assess career adaptability. The initial design covered four areas — concern, control, curiosity, and confidence. Recent research validated a 12-item version of the scale (CAAS-SF) and a five-factor version that includes the additional factor of cooperation (CAAS-5). The study reported here developed and validated a brief 15-item Chinese version of Career Adapt-Abilities Scale (CAAS-5-SF) to include five factors. Based on data obtained in Macao from a sample of 326 university graduates who had gained employment, it was found that the scale has good factor structure and internal consistency. Significant correlations between CAAS-5-SF and career success, as well as between cooperation subscale and social capital, provided evidence for convergent validity of the instrument and the cooperation subscale respectively. It was also found that CAAS-5-SF and CAAS-5 were strongly associated in their subscales and overall scale. Results suggested that CAAS-5-SF is a suitable alternative to CAAS-5 for research and practice purposes with Chinese speakers. Implications for research and practice are discussed.
Despite the increasing research attention being paid to gaming disorder globally, a screening tool developed specifically for the Chinese population is still lacking. This study aims to address this gap by constructing a screening tool to assess Internet gaming disorder (IGD) symptomology, defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), among Chinese gamers. Based on expert interviews and consultations, a focus group of gamers, a background literature review, and the IGD criteria proposed by the DSM-5, we developed the Chinese Internet Gaming Disorder Checklist (C-IGDC). This study evaluated its dimensional structure, reliability, validity, and screening efficacy with 464 Chinese past-year gamers (53% female; mean age = 19.84). The two-level structure of the 27-item C-IGDC showed a satisfactory model fit, acceptable reliability, as well as good validity via expected associations with Internet addiction, gameplay frequency, and depressive symptoms. The optimal screening cutoff score (≥20) was proposed to detect probable IGD cases. The C-IGDC is the first DSM-5-based, multidimensional IGD screening tool designed specifically for Chinese gamers. Further evaluation of the C-IGDC in epidemiological studies and clinical settings is recommended.
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