Search

This study utilized attachment theory to explore the functions of companion animals (pets) and the influence of secure human-pet bond on attachment security and emotion regulation among companion-animal guardians (pet owners) in Hong Kong. Hierarchical regression analyses were conducted exploring the relative influence of adult attachment and pet attachment on mental wellbeing, and the moderating effect of pet attachment on emotion regulation. Results revealed a consistent attachment pattern across human-human and human-pet bonds. A secure human-pet bond can act as a positive catalyst that exerts a moderating effect on emotion reappraisal. Treating pets as family members/friends helps pet owners receive the security that they lack in adult attachment. This study verified the role of pets as a “security supplement” (an additional supply of security) rather than a complete substitute for a human attachment figure. Implications for theory, service practice, and policy are discussed.

Purpose: This study compared Cognitive-Behavioral Therapy (CBT), Mindfulness-Based Cognitive Therapy (MBCT), and Activity-based Supportive Counselling (treatment-as-usual; TAU) for reducing delinquency, psychological risk factors, mental health symptoms, and improving the quality of life among at-risk youths in Hong Kong outreaching social services. Methods: In this quasi-experimental study, non-custodial youths with delinquency and mental health issues underwent eight sessions of CBT ( n = 24), MBCT ( n = 30), or TAU ( n = 61). Results: Dependent-sample t-test showed CBT reduced mental health symptoms and delinquency. TAU reduced mental health symptoms and improved quality of life. MBCT resulted in no significant change. Time x group ANCOVA underscored TAU in improving quality of life. Hierarchical linear regression showed decreases in delinquency and mental health symptoms mediated by decreases in psychological risk factors. Discussion: Results suggest that outreaching social service agencies in Hong Kong could enhance their intervention by augmenting the sports and leisure activities of TAU with structured CBT programs.

Depressive symptomatology is associated with caregiver burden and poor health outcomes among dementia caregivers. Scholars called for a paradigm shift to focus on positive aspects of caregiving, in particular, meaning making during the caregiving journey. This study draws on the meaning making model and a generation perspective to predict depression among dementia caregivers from two generations, including Baby Boomers who were born between 1946 and 1964 and Generation X who were born between 1965 and 1980, using a configuration approach. Data was collected in a two-wave longitudinal design, from December 2019 to March 2021 in Hong Kong. A fuzzy-set qualitative comparative analysis resulted in six configurations with an overall solution consistency and overall solution coverage of 0.867 and 0.488, respectively. These configurations consist of a different combination of conditions that predict high depressive symptomatology among dementia caregivers in two generations. Specifically, generation is related to five out of six configurations. This study is the first to predict depression among dementia caregivers using a meaning making model from a generation perspective. It advances the understanding of factors contributing to high depressive symptomatology among dementia caregivers from two generations, thus contributing to the future development of generation-responsive assessments, interventions, and policies.

Objectives: Effective prevention and intervention of Internet gaming disorder require the identification of risk and protective factors. This study aims to exhaustively review the risk and protective factors of Internet gaming disorder among Chinese people. Method: We searched for articles published from database inception to February 2020 in MEDLINE, PsycINFO, Embase, PubMed, Web of Science and two Chinese databases, CNKI and Wanfang Data. Studies were included in the meta-analysis if they addressed Internet gaming disorder, sampled people in China, presented correlational factors of Internet gaming disorder and reported the effect sizes for correlations. Reviewers independently selected the studies, assessed their validity and extracted the data. Pooled Pearson’s correlations were calculated using the random effects model. Result: In the meta-analysis, 153 studies covering 115,975 subjects were included. We identified 56 risk factors and 28 protective factors. Most risk factors strongly correlated with Internet gaming disorder fell into the category of maladaptive cognitions and motivations. Other factors that showed high effect sizes fell into various categories, including psychopathological characteristics, personality traits, cognition emotion regulation style and gaming-related factors. The only protective factor strongly correlated with Internet gaming disorder was self-control. We found that the factors related to the ‘environments’ show modest effect sizes compared to those related to the individual. The pooled effect sizes for most factors were not influenced by outliers and publication bias. Conclusion: Factors strongly correlated with Internet gaming disorder, especially maladaptive cognitions and motivations, are more likely to be proximal correlates of Internet gaming disorder and may be considered the focus of interventions. We encourage further empirical and experimental studies to examine the causal pathway and the treatment efficacy.

Purpose:Recent literature has pointed out the seriously unmet treatment needs of delinquent youth with mental health problems in Hong Kong. This study pioneers to systematically develop and evaluate the effectiveness of a structured low-intensity cognitive behavioral intervention (LICBI) to concurrently address mental health issues and delinquent behaviors among Hong Kong Chinese youth.Method:A quasi-experimental controlled design was adopted with three assessments at baseline, postintervention, and 6-week follow-up. One hundred and eighty participants were recruited to the LICBI and 123 to the control group.Results:Multilevel modeling analyses showed that the LICBI might be effective in improving mental health–related factors (impulsivity, self-esteem, negative emotions, and loneliness) and delinquent behaviors. A mediation analysis suggested that LICBI might reduce participants’ delinquent behaviors through reducing their impulsivity and enhancing their self-esteem.Discussion:The results provide preliminary evidence for the effectiveness of LICBI for Chinese delinquent youth in a community social service setting.

Purpose Hong Kong has experienced four waves of COVID-19 since the first case was confirmed in January 2020. Several studies have highlighted the psychological impacts of the outbreak in Hong Kong but have largely ignored the protective factors that contribute to resilience among vulnerable families. This study adopted an ecological resilience framework to explore the impact of this epidemic on members of families with youth with a delinquent tendency/mental health concerns and the ecological protective factors for these vulnerable families. Methods Random sampling based on a sampling frame provided by one of the largest local social service organizations in Hong Kong led to the recruitment of 407 respondents who were interviewed using a battery of standardized questionnaires. Results The results showed that 30.6% and 11.5% of respondents reported a moderate and a severe level of psychological distress, respectively, almost double the percentages reported in a previous study conducted in Hong Kong before the COVID-19 outbreak. Around 36.6% of respondents indicated they had encountered financial problems and almost 40% indicated aggravated financial circumstances since the outbreak. Hierarchical regression analysis revealed that financial stress was the strongest predictor of psychological distress. Structural equation modeling indicated that family support, indoor leisure activities and community resources significantly mediated the negative influence of COVID-19-related stressors on psychological distress of family members. Conclusion Family leisure activities, family support, community spirit and mutual help within the context of social-distancing restrictions may need to be promoted to benefit vulnerable families in Hong Kong under the COVID-19 epidemic.

Cultural sensitivity is missing in the widely researched construct of resilience. The assumption that resilience takes the same form in all cultures fails to acknowledge that culture shapes the interpretation and instantiation of resilience. Examining how suffering and adversity are perceived and dealt with in Chinese contexts, can identify cultural concepts related to resilience. In this paper, we examine the ways in which Confucianism, Buddhism, and Taoism, the three main belief systems that have influenced Chinese people's perception of the nature of life, can serve as sources of strength to individuals facing adversity. We summarise three culturally inflected elements of dealing with adversities and compare them with existing, widely researched notions of resilience. Taking a socio-ecological perspective to explore resilience, this paper proposes a multidimensional model that can improve understanding of culturally embedded resilience.

Purpose: Complex and widespread stigma exposes sexual minority people to disproportionate risks for adverse mental health. Intersectionality theory calls for consideration of the unique experiences of living with multiple forms of inequality. Yet, concerns remain regarding the extent to which intersectionality theory has been integrated into mental health interventions for sexual minority populations. This systematic review aims to assess the degree to which available mental health interventions account for intersecting forms of marginalization and to identify methods that facilitate the application of intersectionality. Methods: A search for peer-reviewed English language journal articles was conducted using PsycINFO and PubMed to locate reports of mental health interventions for sexual minority groups. A coding framework was designed to evaluate how interventions incorporated intersectionality theory. Results: Of 1877 potentially eligible articles, forty-three were included in the analysis. They were each classified as low, medium, or high with regard to intersectionality. Thirteen (30.2%) were rated as low on intersectionality for only recruiting a homogeneous group of participants in the interventions; 23 (53.4%) were classified as medium for including additional identities in recruitment without responding to possible intersectional disadvantages; 7 (16.3%) were rated as high with adequate consideration of the complex effects of intersecting positions. In addition, the review identified community-based participatory research as a common and instrumental method to ensure intersectionality. Conclusions: This review highlights the limitations of interventions for sexual minority people in addressing intersectionality. Guidelines are needed for clinical practice and evaluation to adequately incorporate intersectionality theory.

This study evaluated the effectiveness of a culturally attuned group cognitive-behavior therapy (CBT) intervention for Chinese adolescents at risk for anxiety disorders in Hong Kong and the additive effects of parental involvement. A randomized controlled design was adopted. Assessments were gathered at pre- and posttreatment, and 6-month follow-up. Participants (N = 136) were randomly assigned to (a) CBT plus parental involvement (CBT-PI) (n = 46), (b) CBT (n = 45), and (c) social activity (n = 45) conditions. Data were analyzed according to the intention-to-treat principle using multilevel modeling. The CBT-PI condition showed a greater reduction in physical injury fears compared with the CBT condition. The current findings suggest that involving parents in CBT for Chinese adolescents with anxiety problems may provide a small improvement in treatment efficacy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Universal prevention is a practical approach to preventing depressive symptoms in adolescents, but barriers might reduce its effectiveness. This study explored possible barriers to universal prevention of depressive symptoms in Chinese adolescents. We interviewed thirteen adolescents who participated in the program. Thematic analysis was used to analyse the data. The results revealed three categories of barriers. The first category was participants' maladaptive coping strategies and beliefs about negative emotions. They tended to use avoidance coping, did not believe that negative emotions can be regulated, and had an unrealistic wish for a quick fix. The second category originated from the prevention contents. The complexity of the psychological techniques and the lack of proficiency among the participants were important barriers. The third category was the setting of the psychological course. Participants were reluctant to invest cognitive effort in the psychological course. The large-size class also made it challenging to have an in-depth exploration into emotions and thoughts. Our study added to the existing literature by providing more knowledge of barriers to universal prevention. Future research and practice need to adequately address these barriers so that universal prevention can be conducted more effectively.

Background The objective of the study is to systematically estimate the effect size of psychosocial risk factors for depressive symptoms among adolescents in secondary schools in mainland China. Method A literature search was conducted in both English and Chinese databases. This meta-analysis used a random-effects model to estimate the effect size. Results Fifteen psychosocial risk factors were identified in a total of 164 articles. The results revealed the absolute value of effect size ranging from 0.16 to 0.43. Among them, poor parent–child communication (r = 0.43), negative life events (r = 0.40), academic pressure (r = 0.40), abuse (r = 0.33), poor family functioning (r = 0.33), bullying (r = 0.32), and poor family cohesion (r = 0.32) were associated with depression with a medium to large effect. Moderator analysis shows that grade, study quality, mean age, and gender were significant moderators of at least one factor for depression. Limitations Limitations included the heterogeneity which is largely unexplained, and the inability to investigate the interactions of different factors and to determine the direction of causal relationships between psychosocial factors and depression in the present meta-analysis. Conclusions This study suggests that family-related factors and school-related factors may be significantly associated with depressive symptoms in Chinese secondary school students. Further research is needed to develop effective strategies to modify these factors in depression prevention programmes.

Purpose: Chinese international students have been widely reported to lack recognition of their psychological problems and to delay treatment until their symptoms become rather disabling. The present study pioneered to evaluate the effectiveness of Mental Health First Aid (MHFA) training in improving mental health knowledge among Chinese-speaking international tertiary students. Method: A quasi-experimental design was adopted, whereby 202 Chinese-speaking international students in Melbourne were assigned to the MHFA condition or a control condition. All participants completed a standardized questionnaire before, at the end, and 3 months after training. Data were analyzed using multilevel modeling. Results: The findings demonstrated that MHFA training might be effective in improving participants’ knowledge of mental disorders (i.e., recognition of symptoms, belief in helpful treatments, and understanding the biogenetic and psychosocial causes) and reducing stigma. Conclusions: The MHFA program has the potential to enhance mental health knowledge and promote help-seeking among Chinese-speaking international students.

Objectives:This study aims to test the effectiveness of a culturally attuned cognitive behavioral intervention (CBI) in promoting mental health and quality of life (QOL) among Chinese international students in Hong Kong.Method:A waitlist control designed was adopted. Sixty-five Chinese international students in a university in Hong Kong were assigned to experimental groups and control groups. The intervention consisted of eight weekly 3-hr sessions. All the participants were assessed preintervention, postintervention, and at a 3-month follow-up.Results:Participants in the experimental group showed a significant and continuous increase in mental health and overall QOL compared to those in the control group. Changes of dysfunctional attitudes mediated the effect of CBI on mental health and QOL.Conclusion:The current culturally attuned CBI may be useful in improving mental health and QOL among Chinese international students in Hong Kong.

This study tested an ecological model of resilience that illustrated the influence of COVID-19-related stressors (i.e., social and health stressors) and various socio-ecological factors at microsystem (i.e., parent-child conflicts and couple relationship) and exo-system levels (i.e., the utilization of community resources) on family functioning among Chinese families during COVID-19. An anonymous telephone survey was conducted using random sampling method. The sample contained 322 respondents who were co-habiting with their child(ren) and their partner. Hierarchical regression analysis and structural equation modelling were used to examine the differential impacts of various levels of factors and the model that were proposed. Results showed that 13.2% of the households were categorized as at-risk of poorer family functioning. Couple relationship and stressors significantly accounted for much of the variance in family functioning. While stressors had a significant direct effect on family functioning, couple relationship, but not parent-child conflicts or utilization of community resources, significantly mediated and moderated the impact of stressors on family functioning. The findings highlighted the impacts of both individual and ecological factors on family functioning under COVID-19. Importantly, cultural and contextual factors should be considered when adopting ecological model of resilience to examine family functioning in diverse cultural groups.

The role of parental behavioural control in influencing developmental outcomes of children and adolescents has been inconsistently delineated in the literature. The present study aims to examine the relationships among parental behavioural control, academic self-efficacy, anxieties and academic achievement of young Chinese children in Hong Kong, paying particular attention to understanding the role of academic self-efficacy and anxieties in influencing the relationship between parental behavioural control and children’s academic achievement. Two hundred and thirty-five parents of junior elementary school students completed a battery of standardised questionnaires. Results interestingly documented an inconsistent mediation effect for both academic self-efficacy and social anxiety. In essence, parental control indeed had a significant positive influence on academic achievement among Chinese junior primary school students in Hong Kong. Nevertheless, parental behavioural control at the same time decreased academic self-efficacy and induced social anxiety feelings, which in turn led to a lower level of academic achievement. Given that a greater parental behavioural control is inherently culturally accepted in Chinese communities, such findings shed light on that enhancing academic self-efficacy and reducing social anxiety are potential mechanisms through which parents could facilitate growth and development in their children. The results could also lessen the “guilt and blame” that are unnecessarily placed on some Chinese parents.

Background Based on the cognitive theory, anxiety arising from the awareness of death and dying may activate dysfunctional attitudes, which may then reduce quality of life. This study examined the interdependence and the mediating role of dysfunctional attitudes on the relationship between death anxiety and quality of life among patients with lung cancer and their caregivers. Methods From March 2016 to April 2017, 173 pairs of patients and their caregivers enrolled in a randomized controlled trial of psychosocial support. Using the baseline data, actor-partner interdependence modeling was used to analyze the relationships among death anxiety, dysfunctional attitudes, and quality of life. Results In patients, death anxiety was related to dependency (β = .51) and self-control (β = -.37); achievement (β = -.21) and self-control (β = .34) were related to quality of life. Among caregivers, death anxiety was related to all 3 dysfunctional attitudes of their own (βs = .23 to.32); dependency (β = -.22) was associated with quality of life. Caregiver quality of life was also associated with patient self-control (β = .22) and achievement (β = -.18). Patient self-control mediated the links between patient death anxiety with both patient and caregiver quality of life. The relationship between death anxiety and quality of life was mediated by dependency in caregivers. Discussion Death anxiety influences dysfunctional attitudes and quality of life of both patients and caregivers. Our results support the relevance of dysfunctional attitudes in understanding the impact of death anxiety and underscore the need for parallel psychosocial interventions.

Objectives: This study endeavors to advance the current literature by examining the gender differences in the caregiving experiences and the stress-buffering role of positive aspects of caregiving (PAC) among Chinese spousal caregivers of frail elders in Hong Kong. Method: Forty-nine husband caregivers and 121 wife caregivers of frail elders in Hong Kong (N = 170) responded to the Positive Aspects of Caregiving (PAC) scale, the Zarit Burden Interview (ZBI), the 21-item Depression, Anxiety, and Stress Scales (DASS-21), and demographic questions. These spousal caregivers were diverse in age, and their care receivers were diverse in terms of age and health condition. Results: As predicted, there were significant gender differences in the moderating effects of PAC on the relationships of caregiving burden to depression, anxiety, and overall psychological distress. While PAC significantly buffered the effects of caregiving burden on depression, anxiety, and overall psychological distress for wife caregivers, the moderating effects of PAC were not significant for husband caregivers. Unexpectedly, wife caregivers reported lower PAC, higher caregiving burden, and higher psychological distress. Conclusion: As these findings suggest that PAC is lower but more beneficial for Chinese wife caregivers than Chinese husband caregivers, helping professionals are recommended to use strengths-based interventions that target PAC when working with Chinese wife caregivers.

The Smiley Activation Programme (SAP) is a home-based intervention that is targeted to reduce depressive symptoms in elderly Hong Kong Chinese. The SAP includes eight social worker’s home visits an...

Very few clinical cognitive-behavioural intervention (CBI) studies were conducted with the Chinese gamblers. There is a lack of attention paid to intervening in negative emotions that may also adversely affect PGs in current CBI treatment modality. This study is the first attempt to systematically and rigorously evaluate both the short-term and longer-term effects of a culturally-attuned CBI group treatment with an emotion regulation component for a group of Chinese PGs in Hong Kong. A quasi-experimental matched-pairs design was adopted and 84 participants were allocated to the CBI (N = 42) and social activity groups (N = 42). There are 3 assessment points in the study: baseline at recruitment, post-intervention at the end of CBI and social activity groups, and at 6-month follow-up. When compared to the social activity group and after controlling for general group effects, there were significantly greater decreases in the severity of gambling, gambling-related cognitions (i.e. interpretive bias), negative psychological states (i.e. stress) and money spent on gambling in the past month in the CBI group between pre- and post-intervention and between pre-intervention and 6-month follow-up. Results also indicated that both reduction in gambling-related cognitions and negative psychological states could mediate the treatment effect of the CBI on the reduction of problematic gambling behaviours. The culturally attuned integrated CBI group treatment with an emotional regulation component appeared to be effective in treating Chinese problem gamblers in Hong Kong and the effects could be sustained at 6-month follow-up.

Purpose: Hope and meaning in life are essential components of personal growth and happiness. Built on the recovery model, this study attempted to evaluate the effects of a recovery-oriented cognitive–behavior approach (CBA) in enhancing hope and meaning in life among a group of people with severe mental illness in Hong Kong. Method: A matched-pair comparison approach was adopted. Twenty-seven experimental group participants received recovery-oriented CBA, while 25 participants received standard counseling services. Assessments were administered at preintervention and at 6 and 12 months of intervention. Results: Repeated measures analyses of covariance indicated that the recovery-oriented CBA was more effective than the control condition in improving the mental health recovery process (basic functioning, finding new potentials, and spirituality) and a sense of hope (planning in achieving goals). Conclusion: Given these initial positive results, more vigorous studies and refinement of this recovery-oriented CBA are needed to ascertain the effectiveness of this combined intervention approach.

Gambling-related cognitions and negative psychological states have been proposed as major factors in the initiation and maintenance of problem gambling (PG). While there are a substantial number of studies supporting the role of cognitive dysfunctions in the initiation and maintenance of PG, very few empirical studies have explored the specific role of negative psychological states in influencing PG behaviours. In addition, very few studies have examined the interaction effects of cognitive dysfunctions and negative psychological states in exerting influence on PG behaviours. Therefore, the present study aims to examine the main and interaction effects of gambling-related cognitions and psychological states on the gambling severity among a group of problem gamblers in Hong Kong. A cross-sectional research design was adopted. A purposive sample of 177 problem gamblers who sought treatment from a social service organization in Hong Kong completed a battery of standardised questionnaires. While gambling-related cognitions were found to exert significant effects on gambling severity, negative psychological states (i.e. stress) significantly moderated the relationship between gambling cognitions and gambling severity. In essence, those participants who reported a higher level of stress had more stable and serious gambling problems than those who reported a lower level of stress irrespective of the level of gambling-related cognitions. The findings of the moderating role of negative emotions in the relationship between cognitive distortions and severity of gambling provide insight towards developing an integrated intervention model which includes both cognitive-behavioural and emotion regulation strategies in helping people with PG.

Improvements in parenting skills do not necessarily lead to improvements in child and parent outcomes for children with attention deficit and hyperactivity disorder (ADHD). Cognitive factors such as parental cognitions and parenting self-efficacy may influence such outcomes. Clinical research on the effects of cognitive-behaviour therapy (CBT) on parental cognitions, parenting self-efficacy and mental health in Chinese parents of children with ADHD is lacking. This quasi-experimental study intended to assess the effects of a culturally attuned group CBT treatment on the mental health and quality of life of Chinese parents aged 26–58 years, with children with ADHD in Hong Kong. Participants in the experimental group received group CBT and standard treatment and their counterparts in the control group received standard treatment. Primary outcome variables of mental health and quality of life and process variables including parenting stress, parenting efficacy and dysfunctional attitudes were measured at baseline, post-treatment and 3-month follow-up. Data were analysed using 2 × 3 ANCOVAs, Cohen’s d statistics and multiple mediation analyses. Group by time interactions were found for most outcome variables. Effect size statistics indicated that group CBT had small to moderate effects on most outcome variables at post-treatment and follow-up assessments. The effect of CBT on mental health was mediated by the reduction in parenting stress and the effect of CBT on quality of life was mediated by the reductions in parenting stress and dysfunctional attitudes. Given its potential benefit, it is worth considering incorporating this group CBT programme into interventions for Chinese parents with ADHD children.

The study adopted a randomized controlled trial to compare the effect of culturally compatible psychosocial interventions on multiple aspects of quality of life (QoL) for family caregivers of lung cancer patients. 157 Chinese informal caregivers of lung cancer patients were recruited together with the family members for whom they were providing care, and randomly assigned to either integrative body-mind-spirit intervention (I-BMS) or cognitive behavioral therapy (CBT). Patient-caregiver dyads attended the same arm of intervention in separate groups for 8 weeks. Assessments of generic QoL, anxiety, depression, perceived stress, insomnia, and caregiving burden were measured before intervention (T0), within 1-week (T1), 8-week (T2), and 16-week (T3) post-intervention. Adopting the intention-to-treat analysis, family caregivers in receipt of both I-BMS and CBT exhibited a statistically significant improvement in generic QoL immediately following intervention and at follow-up assessments, with moderate effect size. Improvement of insomnia was found at T1 for both modes, which deteriorated at follow-up; both modes reduced anxiety and perceived stress at follow-up. No intervention effect was observed in depression and domains of caregiving burden. There was no significant interaction effect between intervention type and time. No main or interaction effect between sample background variables and intervention type was found to predict symptomatic changes at T1 and T3. Culturally attuned I-BMS and CBT exhibited equivalent effectiveness in improving psychological distress and generic QoL for family caregivers of lung cancer patients. To improve the evaluation of outcomes, future study could benefit from incorporating a usual care control.

Objectives: This study evaluated a culturally attuned cognitive–behavior intervention for reducing impulsivity and delinquency-related attitudes and behaviors among Chinese delinquent youth in Hong Kong. Methods: A quasi-experimental design was adopted. Twenty participants received CBI, and 20 received routine counseling for a period of 12 months. All participants filled out a standardized questionnaire before the intervention and at 6 and 12 months of intervention. Results: A series of 2 × 3 analyses of variance were used to examine the Time × Group Effects of the two groups of participants. Results suggested, when compared to the control group, the participants in the experimental group showed greater and continuous positive changes in overall impulsivity, nonplanning impulsivity, cognitive impulsivity, and overall delinquency, with effect sizes showing moderate to large magnitude of change. Conclusion: This culturally attuned CBI program may be a useful inclusion in the outreaching social services for Chinese delinquent youth in Hong Kong.

Background The construct of self-determination has received considerable attention in the international field of intellectual disabilities (ID). Recently, there has been a rapid development of this construct in Chinese societies including Hong Kong. However, there is no locally validated instrument to measure self-determination in people with ID. This article explains the validation process of the AIR Self-Determination Scale – Chinese version (AIR SDS-C) adapted from the 24-item AIR Self-Determination Scale, developed by Wolman and his colleagues, which is used in school setting. Methods People with mild/moderate ID aged 15 years or above were recruited from special schools and social services units in different regions of Hong Kong. Factor analysis and reliability tests were conducted. Results Data for a total of 356 participants were used for the analysis. A confirmatory factor analysis was performed to test the factorial construct, and Mplus 7.0 was used for the analysis. The factor structure proposed in the original English version was supported by the data, and all factor loadings were between 0.42 and 0.76. The whole scale achieved good reliability (Cronbach's α = 0.88 and ω = 0.90). Conclusions The AIR SDS-C appears to be a valid and reliable scale. This study examined adult groups as well as student groups. The application of the scale can thus be extended to a wider population. The implications for theory building and practice are discussed.

This pilot study attempted to examine the effectiveness of a brief cognitive behavioural therapy (CBT) psychoeducational group for Chinese people with chronic illness in Hong Kong. It adopted a single group design, and 52 participants joined the group. A questionnaire with three outcome measures, measuring general mental health, quality of life and dysfunctional attitudes and beliefs, was administered to participants at pre-test, post-test and six month follow-up. Repeated measures ANOVAs were employed and revealed positive changes in most of the outcome measures across the three time points. Cohen’s d showed a moderate to large effect size for most outcome measures. From a step care perspective, a culturally attuned brief CBT psychoeducational group may serve as an early intervention and a triage to attract suitable people with chronic illness to engage in the treatment process.

Purpose: Chinese people generally lack knowledge of mental illness. Such phenomenon may lead to a delay in seeking psychiatric treatments. This study evaluated the effectiveness of Mental Health First Aid (MHFA) program in improving mental health knowledge of the general public in Hong Kong. Methods: A quasi-experimental design was adopted whereby 138 participants received MHFA training and 139 partook in seminars on general health, respectively. All participants filled out a standardized questionnaire before, at the end, and 6-month after the training. Results: Findings demonstrated that MHFA training might be effective in enhancing participants’ knowledge of mental disorders, reducing stigma, and improving perceived confidence in providing help to people with mental illness. Effect size statistics revealed mostly modest to moderate improvements in major variables in the experimental group. Conclusion: It is recommended that culturally attuned MHFA program can be used as prevention strategy to promote good mental health in Chinese communities.

Objectives: The aims of this study were to examine the effects of group cognitive–behavior therapy (CBT) on improving anxiety symptoms and enhancing personal growth among adolescents at risk of developing anxiety disorders in school settings in Hong Kong. Method: A total of 26 participants received an eight-session CBT group and 20 received treatment as usual in the waitlist control condition. Instruments measuring anxiety symptoms, types of anxiety in children, dysfunctional thoughts, and personal growth were used to assess the changes in severity of anxiety symptoms, dysfunctional thoughts, and personal growth among the participants. Results: A 2 × 2 mixed model analyses of variance were employed, results demonstrated significantly greater improvements in overall anxiety symptoms, generalized anxiety symptoms, and personal growth—use of resources in the participants of the CBT group compared to the control group. Conclusion: Group CBT may potentially improve anxiety symptoms of adolescents in school settings in Hong Kong.

Children caregivers contributed significantly to care and support dementia parents globally. In the caregiving journey, making sense of providing care plays significant role in their caregiving journey. In an ageing society such as Hong Kong, different generations of children caregivers take up dementia caregiver roles. We hypothesized that from studying baby boomers (BB, born in 1946-1964) and generation X (GX, born in 1965-1980), generations have impacts on their meaning making and well-being outcomes. 601 Caregivers completed a paper or online battery of questionnaires on burden (ZBI-4), mental well-being (PHQ-9), caregiving factors (ADL, IADL, caregiving hours, Positive Aspect of Caregiving; PAC) and the meaning making factors (Finding Meaning Through Caregiving; FMTC). Results showed that significant difference between caregivers from two generations. GX have significantly lower meaning made, measured by PAC affirming self and enriching life, as well as FMTC provisional meaning. While they spent less caregiving hours for the more independent care recipients, they suffered from higher burden, higher FMTC loss/powerless and worse psychological well-being (PHQ). The findings demonstrated generation X caregiver suffered from lower level of the meaning made and worse psychological wellbeing outcomes than BB caregivers. Future caregiver studies should take generational effect into account and services shall be provided in a generation-responsive approach.

Background Youth between 18 and 25 years old are among the most active drug abusers in any community globally, including in Hong Kong. Disturbing evidence about the deleterious effects of drug use on their physical and psychological health has been reported. However, a literature search found very few outcome studies on the psychosocial treatment models for young Chinese people. The present study is one of the first that has systematically developed and implemented an innovative and culturally attuned integrated cognitive behavioural therapy (ICBT) model that comprises motivational interviewing, CBT and relapse prevention in helping Chinese youth with drug abuse problems in an Asian community. Method A quasi-experimental matched-pairs design was adopted. Thirty-nine participants were assigned to the experimental group (ICBT) and 38 were assigned to the control group (treatment as usual [TAU]). Assessments were conducted at baseline, 4 months after the intervention, at the completion of the intervention (9 months) and 4 months after the completion of the intervention. Multilevel modelling and hierarchical regression analysis were performed for data analysis. Results There were significantly greater improvements in negative emotions, drug use frequency in the past 3 months, quality of life and coping strategies reported by the participants in the ICBT compared to the TAU group. Mediation analysis found that changes in dysfunctional attitudes significantly accounted for the treatment effects of the ICBT programme on negative emotions and quality of life, and changes in substance use coping strategies significantly mediated the treatment effects of the ICBT programme on substance dependency severity (SDS). Conclusion The findings provide initial support for the effectiveness of our culturally attuned ICBT model in improving negative emotions, drug use frequency and drug dependency severity, quality of life and adaptive coping skills among the Chinese youth and young adults with drug abuse problems. Such effects were sustained at the 4-month follow-up.

The objective of the study reported here is to systematically estimate the prevalence of depressive symptoms among adolescents in secondary schools in mainland China.Literature searches were conducted in both English and Chinese databases from database inception to January 2018. This meta-analysis used a random-effects model to estimate the prevalence of depressive symptoms.Fifty-one eligible studies (n = 144,060) using probability sampling were identified. The results revealed a pooled prevalence of depressive symptoms of 24.3% (95% CI, 21.3%-27.6%), with high between-studies heterogeneity (Q = 9909, I² = 99.5%, p 0.001). The prevalence estimates reported by the individual studies ranged from 6.2% to 64.8%. There was an increased prevalence with increasing grades from year 1 in junior secondary school (24.5%; 95% CI, 17.8%-32.8%) to year 3 in senior secondary school (40.1%; 95% CI, 29.4%-51.9%) (Q = 7.1, p 0.01). Potential sources of high heterogeneity of prevalence among studies can be accounted for by screening instruments with different cutoffs. Further analysis stratified by gender, grade, household registration (hukou) and number of children in the household were performed.Limitations include the high level of heterogeneity between studies (mainly from the heterogeneity of measurement tools) and stringent inclusion and exclusion criteria.This study suggests that depressive symptoms are common among Chinese secondary school students. Further research is needed to identify the risk factors and effective strategies for preventing and treating depression among adolescents in secondary schools.

Background: Previous research has indicated that perceived discrimination has harmful effects on migrant children’s physical, mental and behavioral health. However, little is known as to whether these harmful effects cumulate to impact on migrant children’s personalities. Aims: This study examines the effect of perceived discrimination on personality, as well as the moderating role of parental support in the discrimination–personality linkage. Methods: A purposeful convenience sample of 215 migrant children in Beijing, China, completed a standardized questionnaire. Results: Migrant children experienced a moderate level of perceived discrimination, with Form 8 students experiencing greater discrimination than lower grades and those with lower family incomes also experiencing greater discrimination than those with higher family incomes. Perceived discrimination significantly predicted neuroticism; parental support significantly predicted extraversion, openness, agreeableness and conscientiousness, but the moderating effect of parental support was only marginally significant for the relation between discrimination and conscientiousness. Conclusion: This study underlines the need for researchers and policy makers to pay more attention to the impact of perceived discrimination on migrant children’s personality development.

Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission.

Objective: Over the past decade, cognitive behavioral therapy has been applied to an increasingly wider range of disorders and problems in Chinese societies. However, no meta-analysis has been conducted to synthesize the studies on cognitive behavioral therapy for Chinese clients. The purpose of this meta-analytic study was to examine the overall efficacy of cognitive behavioral therapy for Chinese people. Method: A literature search was conducted using electronic databases, including Web of Science, PsycINFO and PubMed. Pooled mean effect sizes were calculated using the random-effects model. Results: The literature search identified 55 studies with 6763 Chinese participants. The overall short-term effect of cognitive behavioral therapy on the primary outcome was medium in size. Effect sizes were medium for anxiety, depression/well-being and caregiving stress and small for psychotic symptoms and addictive behaviors. The effects of cognitive behavioral therapy on process variables, dysfunctional thoughts and coping, were in the small range. The overall longer-term effect of cognitive behavioral therapy on the primary outcome was medium in size. Moderator analyses showed that the short-term effect was stronger for culturally adapted cognitive behavioral therapy than for unadapted cognitive behavioral therapy. Type of primary outcome, type of control group, recruitment method, study design, the format of delivery and region were found to moderate the efficacy of cognitive behavioral therapy. Conclusion: The findings of this study provide evidence for the overall efficacy of cognitive behavioral therapy for Chinese people and the benefit of cultural adaptation of cognitive behavioral therapy to Chinese culture.