Multiple types of victimization or poly-victimization (PV) can occur simultaneously during childhood, resulting in outcomes that are detrimental and difficult to reverse. Very few studies have focused on PV in Chinese adolescents. The present study is based on information collected from a stratified cluster sample of 1,561 females and 1,594 males aged 12-18 years living in Shandong Province, China. A self-administered questionnaire was used to assess background information, the Juvenile Victimization Questionnaire was used to measure the extent of victimization and PV, the Screen for Child Anxiety Related Emotional Disorders was used to measure anxiety levels, and a Depression Self-rating Scale for Children was used to ascertain depression. A majority of the study sample (66.2%) had experienced at least one form of victimization over the past year. Prevalence of PV was 16.9%, and was significantly higher among males (21.1%) than females (12.5%). Younger ages, one-child families, and lower socioeconomic status were positively associated with PV. Logistic regression analysis indicated that smoking, alcohol consumption, exposure to pornography, and anxiety- and depression-like symptoms were risk factors of PV. Results of this study highlight the need for further exploration of factors related to the PV of Chinese adolescents.

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The study examines the similarities and differences between China and the United States with regard to rape myths. We assessed the individual level of rape myth acceptance among Chinese university students by adapting and translating a widely used measure of rape myth endorsement in the United States, the Illinois Rape Myth Acceptance (IRMA) scale. We assessed whether the IRMA scale would be an appropriate assessment of attitudes toward rape among young adults in China. The sample consisted of 975 Chinese university students enrolled in seven Chinese universities. We used explorative factor analysis to examine the factor structure of the Chinese translation of the IRMA scale. Results suggest that the IRMA scale requires some modification to be employed with young adults in China. Our analyses indicate that 20 items should be deleted, and a five-factor model is generated. We discuss relevant similarities and differences in the factor structure and item loadings between the Chinese Rape Myth Acceptance (CRMA) and the IRMA scales. A revised version of the IRMA, the CRMA, can be used as a resource in rape prevention services and rape victim support services. Future research in China that employs CRMA will allow researchers to examine whether individual's response to rape myth acceptance can predict rape potential and judgments of victim blaming and community members' acceptance of marital rape.

Child maltreatment is a public health problem worldwide, and China is no exception. However, the pattern of child maltreatment remains unknown, including whether the gender of children and their parents has an impact on the occurrence of maltreatment. This study aims at examining the rates and frequency of child maltreatment, including physical abuse, psychological abuse and neglect perpetrated by mothers and fathers. We also test whether the interaction between parents' gender and their child's gender affects the occurrence of child maltreatment in China. 997 children from the China Jintan Child Cohort Study participated in the present study and reported their maltreatment experience perpetrated by their mothers and fathers using the questionnaire, Parent-Child Conflict Tactics Scale (CTSPC_CA). Generalized linear model analyses show that boys were more likely than girls to report physical abuse, and, in particular, boys were more likely than girls to be physically abused by their fathers. On the other hand, mothers were more likely than fathers to exhibit psychological aggression and use corporal punishment for both boys and girls. There was no difference based on the child's or parent's gender in the occurrence of neglect. The findings present empirical evidence that enhances the understanding of the pattern of child maltreatment in China, provide implications for social workers and health professionals to identify children at risk of child maltreatment, and shed light on future research studies.

Objective The association between iron and neurocognition remains underexplored in adolescents, and the neurocognitive effects of low and high iron levels have yet to be established. The aim of this study was to investigate the relationships of low and high iron levels with neurocognitive domains in early adolescents. Method The sample comprised 428 adolescents (12.0 ± 0.4 years) from Jintan, China. Serum iron concentrations were analyzed from venous blood samples and classified into low, normal, and high levels according to the clinical reference range 75–175 μg/dl. Neurocognition was measured by the Penn Computerized Neurocognitive Battery and Wechsler Intelligence Scale. Generalized linear regression was used to analyze relationships. Results Prevalence rates of iron deficiency, normal iron, and high iron were 13.8%, 76.4%, and 9.8%, respectively. Compared with normal levels, iron deficiency was associated with slower performance in tasks that measured abstraction and mental flexibility (β = 107.5, p = .03) and spatial processing ability (β = 917.2, p = .04). High serum iron was associated with less accuracy in the spatial processing ability task (β = −2.2, p = .03) and a longer reaction time in the task assessing abstraction and mental flexibility (β = 702.8, p = .046) compared to normal levels. Conclusion Both iron deficiency and high iron levels contribute to reduced neurocognitive performance in a domain-specific manner in early adolescents. The dual burden of iron under- and overnutrition should be incorporated into future interventions for improving brain development and cognitive function in adolescents, especially in a Chinese context.

The relationship between three types of child maltreatment, including physical abuse, emotional abuse and neglect, and childhood behavior problems in Mainland China, has not been systematically examined. This meta-analysis reviewed findings from 42 studies conducted in 98,749 children in Mainland China and analyzed the pooled effect sizes of the associations between child maltreatment and childhood behavior problems, heterogeneity in study findings, and publication bias. In addition, this study explored cross-study similarities/differences by comparing the pooled estimates with findings from five existing meta-analyses. Equivalent small-to-moderate effect sizes emerged in the relationships between the three types of maltreatment and child externalizing and internalizing behaviors, except that emotional abuse related more to internalizing than externalizing behaviors. Considerable heterogeneity exists among the 42 studies. Weak evidence suggests that child gender and reporter of emotional abuse may moderate the strengths of the relationships between child maltreatment and behavior problems. No indication of publication bias emerged. Cross-study comparisons show that the pooled effect sizes in this meta-analysis are about equal to those reported in the five meta-analyses conducted in child and adult populations across the world. Findings urge relevant agencies in Mainland China to build an effective child protection system to prevent child maltreatment.

STUDY QUESTION What is the effect of two guided self-administered interventions on psychological distress in women undergoing IVF or ICSI? SUMMARY ANSWER A brief mindfulness intervention significantly reduced depression and improved sleep quality, while the gratitude journal intervention showed no significant effect on any outcome variables. WHAT IS KNOWN ALREADY Mindfulness and gratitude journal interventions have been found to be beneficial in reducing negative affect and improving well-being. However, there are very few mental health professionals who implement such interventions in low- and middle-income countries. Therefore, two guided self-administered interventions for women with infertility were designed to help them cope with their psychological distress. STUDY DESIGN, SIZE, DURATION A three-armed, randomized controlled trial was designed to evaluate the mindfulness and gratitude journal interventions for women undergoing IVF/ICSI. Between May 2016 and November 2017, at the reproductive center in a public hospital, 234 women were randomly assigned to the brief mindfulness group (BMG, n = 78), gratitude journal group (GJG, n = 78) or control group (CG, n = 78). The inclusion criteria were being a woman undergoing her first cycle of IVF, having at least junior middle school education and having no biological or adopted children. PARTICIPANTS/MATERIALS, SETTING, METHODS Female infertility patients (n = 346) were approached, and 112 did not meet the inclusion criteria. All three randomized groups completed questionnaires on the day of down-regulation (T1), the day before embryo(s) transfer (T2), and 3 days before the pregnancy test (T3). The BMG completed four sessions and listened to a 20-minute audio daily, including guided mindfulness breathing and body scan. The GJG completed four sessions and wrote three gratitude journals daily. The CG received routine care. A generalized estimating equation was used in an intention-to-treat analysis. The primary outcome was depression. Secondary outcomes were anxiety, sleep quality, infertility-related stress, mindfulness and gratitude. MAIN RESULTS AND THE ROLE OF CHANCE Participants of the BMG showed decreased depression (mean difference (MD) = −1.69, [−3.01, −0.37], d = 0.44) and improved sleep quality (MD = −1.24, [−1.95, −0.39], d = 0.43) compared to the CG, but the effect was not significant for anxiety, Fertility Problem Inventory totals, mindfulness, gratitude scores or pregnancy rates. The BMG showed a significant reduction in depression and improvement in sleep quality between T1 and T2, a continuous significant reduction between T1 and T3 and no reduction between T2 and T3. There were no significant effects on any of the variables for the GJG. LIMITATIONS, REASONS FOR CAUTION The inclusion criteria may result in bias because some participants with low education were excluded and only women with infertility were included. A low compliance rate occurred in the gratitude journals group. Moreover, men were not included in this study. Further research should consider including spouses of the target population. WIDER IMPLICATIONS OF THE FINDINGS The brief mindfulness intervention was beneficial in decreasing depression and improving sleep quality. Implementation of guided self-administered mindfulness could make the psychological counseling service more accessible for patients with infertility in resource-poor settings. The efficiency and feasibility of the gratitude journal intervention needs to be investigated further. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the National Social Science Foundation (17BSH054). The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER ChiCTR-IOR-16008452. TRIAL REGISTRATION DATE 9 May 2016 DATE OF FIRST PATIENT’S ENROLMENT 15 May 2016.

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