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A bidirectional relationship between insomnia and depression has been observed. However, few studies have used network analysis to explore the interaction patterns in that association at the symptom level. This study aimed to estimate network structures of insomnia and depressive symptoms among shift workers, as well as to compare the differences in network properties between individuals without and with insomnia symptoms and/or at risk of depression. A total of 1883 shift workers were included in our study. Insomnia symptoms were evaluated by three items based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, and depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale. Network analyses were used for the statistical analysis. "Difficulty initiating sleep", "Hard to get started", and "Depressed mood" with higher expected influence (EI) values were identified as the most central symptoms within the insomnia-depressive networks among shift workers. The significant differences between individuals without and with insomnia symptoms and/or at risk of depression were observed in symptoms of "Difficulty initiating sleep" and "Hard to get started". "Depressed mood", "Difficulty initiating sleep", or "Hard to get started" were the most key symptoms that trigger and sustain the structure of insomnia and depressive symptom among shift workers. Hence, timely intervention for the above three symptoms in future research or clinical practice (e.g., cognitive behavioral therapy for insomnia) may be crucial in alleviating insomnia and depressive symptoms among shift workers.

In China, recurrent pandemics require frequent city-wide lockdowns and quarantine actions to contain the impact of COVID-19, exposing college students to psychological problems, including hopelessness. Hence, the purpose of helping problematic college students alleviate hopelessness symptoms motivates us to carry out the present study to explore their interrelationship.Hopelessness (i.e., a complex phenomenon with important clinical consequences, such as depression and suicidality) was investigated in a large longitudinal sample of college students (N = 2787; 58.59% female; ageApplying the novel approach (i.e., symptom network analysis), the results indicated that the edge of #BHS1 (i.e., [NOT] hope-enthusiasm)-#BHS15 (i.e., [NOT] faith-in-the-future) showed the strongest association both in Wave 1 and Wave 2. Similarly, #BHS20 (i.e., not-trying) had the highest node expectedinfluence (centrality) in the hopelessness symptoms network both among Wave 1 and Wave 2. The Network Comparison Test indicated that the global network strength significantly differed between the two time points. As expected, college students' hopelessness will gradually dissipate with the end of segregation control. The stability and accuracy indicated that the network analysis results were trustworthy.The study findings provide evidence that central nodes and edges connecting symptoms should be addressed. Further interventions and treatments that may target these symptoms are essential to effectively alleviate the overall hopelessness level among college students. Theoretical and clinical potential consequences were discussed in detail.

Background: The COVID-19 pandemic and the shift to online learning have increased the risk of Internet addiction (IA) among adolescents, especially those who are depressed. This study aims to identify the core symptoms of IA among depressed adolescents using a cross-lagged panel network framework, offering a fresh perspective on understanding the interconnectedness of IA symptoms. Methods: Participants completed the Internet addiction test and the Patient Health Questionnaire-9. A total of 2415 students were initially included, and after matching, only 342 students (a cutoff score of 8) were retained for the final data analysis. A cross-lagged panel network analysis was conducted to examine the autoregressive and cross-lagged trajectories of IA symptoms over time. Results: The incidence rate of depression rose remarkably from 14.16% (N = 342) to 17.64% (N = 426) after the four-month online learning. The symptom of “Anticipation” exhibited the highest out-expected influence within the IA network, followed by “Stay online longer” and “Job performance or productivity suffer”. Regarding the symptom network of depression, “Job performance or productivity suffer” had the highest in-expected influence, followed by “Life boring and empty”, “Snap or act annoyed if bothered”, “Check email/SNS before doing things”, and “School grades suffer”. No significant differences were found in global network strength and network structure between waves 1 and 2. Conclusion: These findings prove the negative effects of online learning on secondary students’ mental health and have important implications for developing more effective interventions and policies to mitigate IA levels among depressed adolescents undergoing online learning.

Loneliness and depression are significant mental health challenges among college students; however, the intricate relationship between these phenomena remains unclear, particularly in the context of self-compassion. In this comprehensive study, we employ a cross-lagged panel network (CLPN) analysis to investigate the symptom-level association between depression and loneliness while exploring the potential moderating influence of self-compassion. Our sample consisted of 2785 college students, who were categorized into high- and low-self-compassion groups based on scores from the Self-Compassion Scale. Depressive symptoms were assessed using the Patient Health Questionnaire-9, while the UCLA Loneliness Scale-8 measured loneliness expressions. Our findings indicate that self-compassion plays a crucial role in the relationship between depression and loneliness. Specifically, we observed distinctive patterns within the high and low-self-compassion groups. In the low-self-compassion group, “energy” emerged as the most influential symptom, whereas “motor function” exhibited the highest influence in the high-self-compassion group. Furthermore, among individuals with high self-compassion, the pathway from depression to loneliness was characterized by “guilt—being alone when desired,” while the reverse path from loneliness to depression encompassed “left out—feeling sad” and “left out—anhedonia.” Conversely, in the low-self-compassion group, depression and loneliness demonstrated a more intricate mutual triggering relationship, suggesting that self-compassion effectively moderates the association between these variables. This study provides valuable insights into the underlying mechanisms driving the interplay between depression and loneliness, shedding light on the pivotal role of self-compassion in this intricate dynamic.

Despite previous research has illustrated there is high-coexistence between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in the aftermath of traumatic events, few studies have conceptualized the coexistence mechanism of the two psychological phenomena. Using the network analysis, this study aimed to identify the key bridge symptoms and compare sex differences between PTSD symptoms and PTG elements in survivors 10 years after the Wenchuan earthquake in China. A total of 744 survivors 10 years after the Wenchuan earthquake in China completed self-reported questionnaires on demographics, PTSD symptoms (4-item of Posttraumatic Stress Disorder Checklist), and PTG (10-item of Posttraumatic Growth Inventory). Network analysis was used to identify the network structure of PTSD symptoms and elements of PTG, along with bridge symptoms. Additionally, sex differences in the network structure were compared by the Network Comparison Test. Results revealed that the network of PTSD symptoms and elements of PTG was robust to stability and accuracy tests. The key bridge symptoms in the network were "Stronger religious faith", "Changed priorities", and "Easily startled". There were significant differences in network global strength across sex, and network structure across the severity of property loss other than house damage. Future interventions targeting the three key bridge symptoms are expected to relieve the severity of PTSD and promote growth following exposure to traumatic events.

Purpose This study aimed to explore the perceived changes in sexual behaviour during COVID-19 lockdown, anxiety symptoms, and couple relationship of patients with infertility. Methods We performed an observational cross-sectional study between 20 November 2020 and 15 January 2021. We used stratified analysis of different stress levels and Quality of Marriage Index (QMI) scores to compare the perceived changes in sexual behaviour, anxiety symptoms, and couple relationship. The logistic regression model was performed to assess factors correlated with couples’ relationship quality during the lockdown. Furthermore, we performed pathway analyses to assess whether the changes in sexual behaviour, stress level, or psychological anxiety during the lockdown could predict the quality of couple relationship. Results A total of 940 patients with infertility were included in this study. When we conducted a stratified analysis of the participants, significant differences were found between the changes in their sexual behaviour, stress levels, and couple relationship quality. The logistic regression model showed that sex, anxiety symptoms, decreased sexual satisfaction, sexual activity frequency, and income levels were closely related to couple relationship quality. Pathway analyses indicated that changes in their sexual behaviour, anxiety symptoms, and stress levels could all predict the quality of couple relationship. Conclusions The perceived changes in sexual behaviour with different stress levels and couple relationship quality showed significant differences. Analysing the related factors that affect the quality of couple relationship, especially in times of crisis, is of great significance as this information can contribute to the improvement of treatment for patients with infertility. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-021-02361-4.

Symptoms of depression and anxiety usually co-occur and are inextricably linked to sleep disturbance. However, little is known about the symptom-to-symptom relationships among these three mental disorders. Hence, to improve our understanding of concurrent depression, anxiety, and sleep disturbance, we used the network analysis approach to construct an interplay relationship among the above three mental disorders and identify which specific symptoms bridge these aggregations. We collected data from a large sample (

This study examined the mediating role of self-esteem in the relationship between perceived discrimination and subjective wellbeing and explored how resilience and belief in a just world interact to buffer the detrimental influences of perceived discrimination on subjective wellbeing. A questionnaire survey was conducted on 872 impoverished college students in China. The results indicated that: (1) Self-esteem mediated the relationship between perceived discrimination and subjective wellbeing. (2) Belief in a just world played a moderating role between perceived discrimination and subjective wellbeing, and the harmful impact of perceived discrimination on wellbeing was weaker for those who had higher (vs.lower) levels of belief in a just world. (3) Resilience moderated the relationship between perceived discrimination and self-esteem, and the harm of discrimination on self-esteem was weakened for those who had lower (vs.higher) levels of resilience. Poverty indeed has a non-negligible and vital impact on the mental health of college students. Among impoverished Chinse college students, resilience and belief in a just world play a protective role in the relationship between discrimination and subjective wellbeing. However, the current finding suggests that we should not exaggerate the protective effect of resilience. It is crucial to change unfavorable factors in the environment, such as discrimination against poverty.

The impact of insecure attachment on hoarding behavior (HB) has been supported by empirical evidence. However, scant literature has focused on how anthropomorphism (attributing human-like traits, characteristics, or emotions to nonhuman objects) and hoarding beliefs (motivations for ownership) affect the relationship between insecure attachment and HB, especially among Chinese adolescents. Using a cross-sectional study, we reserved 903 participants (561 males, 342 females, M = 20.20, SD = 1.85, age range = 18-24 years) to complete self-report questionnaires about close relationships, anthropomorphism, saving beliefs, and saving inventory to investigate the mediating role of anthropomorphism and the moderating role of hoarding beliefs in the relationship between insecure attachment and HB. Attachment anxiety and avoidance had a positive relationship with HB, and anthropomorphism is a mediating factor in the association between attachment anxiety and HB. In addition, hoarding beliefs moderated the relationship between attachment anxiety and HB. This study further elaborated on the relationships between insecure attachment, anthropomorphism, hoarding beliefs, and HB, which might shed some light on adolescent clinical interventions.

Recently, in the view of network analysis, depression has been conceptualized as a complex and dynamic network model combining individual symptoms. To date, no studies have systematically examined and compared depressive symptom networks across different populations.A total of 36,105 participants were recruited and asked to complete the Patient Health Questionnaire-9 among junior high school students, senior high school students, college students, and elderly adults who were more susceptible to depression during the COVID-19 lockdown in China. In the analysis, we applied the optimal cutoff score ≥ 8 for students and a score ≥ 6 for elderly adults to identify 5830 participants who were likely to be depressed. The index of "strength" was used to identify central symptoms in the network structure.The results showed that Sad Mood was the most central symptom among junior high school students, senior high school students, and college students, but the most central symptom in the elderly was Guilt. Among the top three central symptoms, Suicide Ideation was unique to senior high school students, while Anhedonia was most prevalent among college students. Guilt - Suicide Ideation, Anhedonia - Energy, Anhedonia - Sad Mood, and Sleep - Energy showed the strongest association among junior and senior high school students, college students, and elderly adults, respectively. NCT (i.e., Network Comparison Test) suggested that the network's global connectivity was ultimately inconsistent, but the network structure remained roughly intact.In treatment, targeting central symptoms may be critical to alleviating depression.

Zijuan Ma,1,2 Yanqiang Tao,3 Huilin Chen,4 Yifan Zhang,1,2 Ye Pan,1,2 Dongjing Meng,1,2 Fang Fan1,2 1School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China; 2Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People’s Republic of China; 3Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China; 4Department of Psychology, University of Bath, Bath, UKCorrespondence: Fang Fan, Email fangfan@scnu.edu.cnPurpose: Sleep inertia (SI) is the transitional state accompanied by compromised cognitive and physical performance and sleepiness. Network analysis offers a potential new framework to conceptualize a complex network of symptom–symptom interactions, and the network structure is analyzed to reveal the core characteristics. However, no previous study examined the network structure of SI symptoms. Thus, this study aimed to elucidate characteristics and compare sex differences of SI symptom networks in the general population.Materials and Methods: A total of 1491 participants from China were recruited from 30 May to 17 June, 2021. SI symptoms were assessed by using the Sleep Inertia Questionnaire (SIQ). The network structures were estimated and compared using network analytic methods in the R version 4.1.1.Results: Centrality properties analysis of the expected influence suggested that symptoms of “Feel sleepy”, “Groggy, fuzzy or hazy mind”, and “Dread starting your day” exerted greatest influences. The weighted adjacency matrix revealed that the “Dread starting your day” and “Anxious about the upcoming day” edge showed the strongest connection (edge weight value = 0.70). The network comparison test found no significant difference in network global strength (p=0.928), distribution of edge weights (p=0.194) and individual edge weights (all p values > 0.05 after Holm–Bonferroni corrections) between males and females.Conclusion: Symptoms of “Feel sleepy”, “Groggy, fuzzy or hazy mind”, and “Dread starting your day” were central in the SI symptom network. Intervention, such as the artificial dawn and change in body temperature, for symptoms of “Feel sleepy”, “Groggy, fuzzy or hazy mind”, and “Dread starting your day” might be crucial to hasten the dissipation of SI in the general population who may need to perform tasks upon waking.Keywords: sleep inertia, Sleep Inertia Questionnaire, network analysis, general population

This study aimed to explore whether infertility duration has an impact on the sexual function and mental health of men from infertile couples.We conducted a case-control study of 558 men from infertile couples, and the participants were divided into four groups based on their infertility duration: group I: ≤ 2 years; group II: 2-5 years; group III: 5-8 years; and group IV: 8 years. Sexual function and mental disorders were measured using the International Index of Erectile Function-15 (IIEF-15), Premature Ejaculation Diagnostic Tool (PEDT), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire (PHQ-9) separately.As the years of infertility duration increase, the total IIEF-15 score and four domains (sexual desire, orgasmic function, erectile function, and intercourse satisfaction) significantly decrease (p 0.05). The PEDT score gradually increases significantly (p 0.05). Increased infertility duration is an independent risk factor for erectile dysfunction and premature ejaculation (p 0.05). However, increased infertility duration is not a risk factor for depression and anxiety (p 0.05).Our study is the first time to use the infertility duration as an independent variable and group this variable to analyze its impact on the sexual function and mental health of men from infertile couples comprehensively and systematically. The increased infertility duration is an independent risk factor for the occurrence of sexual dysfunction but not for mental disorders. In the process of infertility treatment, sexual health and mental health cannot be ignored, especially for patients with prolonged infertility.

With the continued spread of the COVID-19 pandemic and the strict implementation of quarantine policy, the levels of anxiety among university students surged in the lockdown period. Previous studies confirmed the effectiveness of social support in mitigating anxiety, so offering social support should be of high priority in COVID-19, especially in quarantine. However, various coping strategies against the pandemic may explain the link between social support and anxiety. The purpose of this study was to investigate the associations of social support, coping strategy against COVID-19, and anxiety, identifying the potential mediating effect of coping strategy between social support and anxiety during the COVID-19 quarantine. Home-quarantined Chinese university students (N = 2640; 68.79% female) completed online ratings of social support, coping, and anxiety from February 21st to 24th, 2020, when they had been confined to their homes in the peak of the pandemic. Sex and academic attainment being covariates, path analysis with parallel mediation were conducted using “lavaan” package in R environment. Anxiety was significantly negatively related to subjective support and counselor support, while family support did not demonstrate substantive associations with anxiety. The mediating role of cognitive coping was found between all the three social support sources and anxiety. Emotional coping and behavioral coping were found to partially mediate the relationship between subjective support and anxiety, fully mediate the associations of family support and anxiety. However, the impact of counselor support on anxiety was not found to be mediated by emotional coping and behavioral coping. This large-scale online study provides initial evidence that various coping strategies may mediate the relationship between three sources of social support and anxiety in quarantine to some extent. Given that coping against COVID-19 is a valuable reasearch goal upon the global ongoing challenge, the findings will shed more light on the mechanism in the link between coping, social support, and anxiety.

Background To date, there have been no reports on the sexual and psychological health of patients with azoospermia during the coronavirus disease 2019 (COVID-19) pandemic. Previous studies on the sexual health of couples with azoospermia are limited and are especially lacking in data on the wives of azoospermic men. Methods We conducted a case–control cross-sectional study between 1 July 2020 and 20 December 2020. In total, 100 couples with azoospermia comprised the experimental group and 100 couples with normozoospermia comprised the control group. The couples’ sexual health was measured using standardised sexual function questionnaires (male: International Index of Erectile Function-15 [IIEF-15] and Premature Ejaculation Diagnostic Tool [PEDT]; female: Female Sexual Function Index [FSFI]) and a self-designed questionnaire to evaluate changes in sexual behaviours (sexual satisfaction, desire, frequency of sexual activity, masturbation, and pornography use) during lockdown. The couples’ psychological health was measured using the 7-item Generalized Anxiety Disorder (GAD-7) scale and 9-item Patient Health Questionnaire (PHQ-9). The Actor–Partner Interdependence Model (APIM) was used to analyse the associations between sexual health and psychological health. Results The IIEF-15 scores (53.07 ± 11.11 vs. 57.52 ± 8.57, t = − 3.17, p = 0.00) were lower and the PEDT scores (6.58 ± 3.13 vs. 5.17 ± 2.22, t = 3.67, p = 0.00) and incidence of premature ejaculation (χ2 = 14.73, p = 0.00) were higher for men with azoospermia than for men with normozoospermia. Compared with those of wives of men with normozoospermia, the total FSFI scores (25.12 ± 5.56 vs. 26.75 ± 4.82, t = − 2.22, p = 0.03) of wives of men with azoospermia were lower. The chi-square test showed that the perceived changes in sexual satisfaction (χ2 = 7.22, p = 0.03), frequency of masturbation (χ2 = 21.96, p = 0.00), and pornography use (χ2 = 10.90, p = 0.01) were significantly different between the female groups with azoospermia and normozoospermia, but there were no significant changes in sexual behaviour between the male groups. The GAD-7 (men: 7.18 ± 5.56 vs. 5.68 ± 4.58, p = 0.04; women: 6.65 ± 5.06 vs. 5.10 ± 3.29, p = 0.01) and PHQ-9 scores (men: 10.21 ± 6.37 vs. 7.49 ± 6.10, p = 0.00; women: 8.81 ± 6.50 vs. 6.98 ± 4.43, p = 0.02) were significantly higher for couples with azoospermia than for couples with normozoospermia. The APIM showed that for couples with azoospermia, sexual function negatively correlated with their own anxiety (men: β = −0.22, p = 0.00; women: β = −0.38, p = 0.00) and depression symptoms (men: β = −0.21, p = 0.00; women: β = −0.57, p = 0.00) but not with their partner’s anxiety and depression symptoms (p > 0.05). Conclusions Couples with azoospermia had a lower quality of sexual function and higher levels of psychological distress than couples with normozoospermia. Their sexual health negatively correlated with psychological distress.

Previous studies have found a negative effect of depression and insomnia on the psychological health domain of quality of life (QOL) among earthquake survivors. However, little is known about the symptom-to-symptom interactions among the above psychological outcomes. This study thus aimed to assess the interplay among the above three variables in survivors 10 years after the Wenchuan earthquake at the symptom level.A total of 744 survivors completed the questionnaire at 10 years post-earthquake, reporting depressive symptoms, insomnia symptoms, and the psychological health domain of QOL. All network structures were estimated and compared using the network analysis approach in R version 4.1.1.Among the 744 survivors, 593 individuals did not have significant depressive and insomnia symptoms, while 151 individuals reported depressive and/or insomnia symptoms. "Little energy", "Suicidal ideation", and "Spirituality" were the key highest bridge symptoms in the three networks, respectively. Additionally, there were significant differences in network global strength, network structure, and individual edge weights between individuals with and without depression and/or insomnia.Intervention programs aimed at treating symptoms, such as exercise therapy, cognitive behavioural therapy, and spirituality education, may improve the QOL of survivors following an earthquake.

Behavioural studies have previously examined the fundamental psychological processes behind two moral dilemma types (e.g., impersonal vs. personal dilemmas) across conditions (e.g., emotion or cognition, etc.). However, it is unknown how individual personality traits influence moral decisions by inducing emotions. The goal of the present study was to examine whether different personality traits interact with different types of moral dilemmas by inducing emotions in moral decisions. 100 participants performed a moral decision-making task and data were analyzed using mixed-model ANOVA. The result revealed that when faced with personal moral dilemmas, introverted individuals will make more utilitarian decisions when experiencing induced negative emotion, supporting the hypothesis that moral types, emotional valence, and personality traits can play an essential role in moral decision-making.