Dataset Information

The Indirect Effect of Sleep on the Association Between Protracted Social Stressors and Psychological Distress Among Hong Kong Young People.

ABSTRACT:

Purpose

Hong Kong youth and young adults experienced unprecedented stress amid social unrest and the COVID-19 pandemic. Few studies have examined how these stressors were related to psychological distress among youth and young adults. This study assessed how psychological distress is associated with stress from social unrest, financial circumstances, and the COVID-19 pandemic, and whether poor sleep quality may explain these associations.

Methods

Participants of a representative phone survey included 1,501 Hong Kong youth and young adults (Mage = 26.1 (4.0); 48.2% female). We examined the associations between psychological distress and three types of stress (social unrest, financial, and COVID-19 stress), and the indirect effect of poor sleep.

Results

Eleven point nine percent, 4.1%, and 9.7% of respondents reported feeling very seriously distressed by social unrest, financial circumstances, and the COVID-19 pandemic, respectively. All three forms of stress were associated with poor sleep. The indirect effects of poor sleep on the association between all three forms of stress and psychological distress were identified. Moderated indirect effect analysis indicated that being female intensified the effect of COVID-19-related stress on psychological distress and that younger female youth and older male youth were more vulnerable to financial stress and social unrest stress (vs. older female youth and younger male youth).

Discussion

Sleep may be one mechanism that accounts for the association between psychological distress and protracted stressors among Hong Kong youth and young adults. These results suggest the importance of prioritizing sleep improvement in mental health interventions during times of societal change.

SUBMITTER: Bi K

PROVIDER: S-EPMC9842456 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Publications

The Indirect Effect of Sleep on the Association Between Protracted Social Stressors and Psychological Distress Among Hong Kong Young People.

Bi Kaiwen K Chan Christian S CS Xiao Yunyu Y Yip Paul S F PSF

The Journal of adolescent health : official publication of the Society for Adolescent Medicine 20230117 5

<h4>Purpose</h4>Hong Kong youth and young adults experienced unprecedented stress amid social unrest and the COVID-19 pandemic. Few studies have examined how these stressors were related to psychological distress among youth and young adults. This study assessed how psychological distress is associated with stress from social unrest, financial circumstances, and the COVID-19 pandemic, and whether poor sleep quality may explain these associations.<h4>Methods</h4>Participants of a representative p ...[more]

PMID: 36653260

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Project description:ImportanceMental health issues among young people are increasingly concerning. Conventional psychological interventions face challenges, including limited staffing, time commitment, and low completion rates.ObjectiveTo evaluate the effect of a low-intensity online intervention on young people in Hong Kong experiencing moderate or greater mental distress.Design, setting, and participantsThis randomized clinical trial was conducted from May 12, 2022, to September 22, 2023, in Hong Kong. Participants (aged 12-30 years) were recruited from a community project, self-reported moderate to severe distress (Kessler Psychological Distress Scale score ≥5), and were randomized 1:1 to receive the low-intensity online intervention or self-help tips (waitlist group).InterventionThe low-intensity online intervention group received 4 weekly 1-on-1 online sessions on stress management, sleep, or problem-solving delivered by trained psychological well-being practitioners. The waitlist group received weekly mental health tips via text messaging.Main outcomes and measuresPrimary outcomes were changes in Kessler Psychological Distress Scale scores and depression and anxiety subscale scores of the Depression, Anxiety, and Stress Scale. Secondary outcomes included general stress, overall negative emotions, quality of life, sleep quality, resilience, and self-efficacy. The primary outcome analysis was based on intention to treat with the last observation carried forward approach. Sensitivity analyses were conducted using per-protocol and multiple imputation methods.ResultsOf 332 screened participants, 120 (mean [SD] age, 22.4 [3.4] years; 87 [72.5%] female) were randomized. From baseline to 4 weeks, the low-intensity online intervention group and the control group both saw reductions in scores for depression (mean [SD] difference, 6.0 [7.7] and 4.8 [7.9]; P = .17; ηp2 = 0.02), anxiety (mean [SD] difference, 6.0 [7.7] and 3.5 [7.7]; P = .07; ηp2 = 0.03), and psychological distress (mean [SD] difference, 3.8 [3.8] and 2.9 [3.8]; P = .24; ηp2 = 0.01), but none of these differences were statistically significant. However, the intervention group showed greater reductions in general stress (mean [SD] difference, 7.5 [7.2] vs 4.4 [7.2]; P = .02; ηp2 = 0.05), negative emotion (mean [SD] difference, 20.3 [19.2] vs 12.7 [19.2]; P = .03; ηp2 = 0.04), and increased resilience (mean [SD] difference, 0.5 [0.6] vs 0.2 [0.6]; P = .01; ηp2 = 0.05) compared with the waitlist group. Younger participants and those with lower initial distress experienced greater improvements. The findings were supported by the per-protocol analysis but not by multiple imputation analysis.Conclusions and relevanceA low-intensity online intervention did not significantly improve distress, depressive, or anxiety symptoms but showed some potential in reducing general stress and negative emotions and improving resilience. These findings are encouraging but not definitive, and caution is needed due to missing data. These data suggest that a low-intensity online intervention may offer a scalable option for youth mental health.Trial registrationClinicalTrials.gov Identifier: NCT05510453.

Project description:BackgroundDespite over two years of COVID-19 worldwide, the outbreak of the Omicron variant has given rise to an unprecedented surge of infection with diverse lockdown measures implemented globally. Whether the emergence of a new wave of COVID-19 could further affect mental health in the population after nearly two years of the pandemic remains to be addressed. Furthermore, whether changes in smartphone overuse behaviours and physical activity - both of which are particularly relevant to young people - would together contribute to changes in distress symptoms during this wave of COVID-19 was also examined.MethodsA total of 248 young people from an ongoing household-based epidemiological study in Hong Kong who completed their baseline assessments prior to the Omicron variant outbreak, i.e., fifth wave of COVID-19 (July-November 2021), were invited for a 6-month follow-up study during this wave of infection (January-April 2022) (mean age = 19.7 years, SD = 2.7; 58.9% females). At both time points, levels of global distress symptoms, perceived stress, smartphone overuse, frequency of engagement in vigorous physical activity, and other potential risk and protective factors were assessed.ResultsThe proportion of young people presenting moderate-to-severe distress (6-item Kessler Psychological Distress Scale ≥ 5) significantly increased from 45.6 to 54.4% during the fifth wave of COVID-19 (p < 0.010). Significantly increased levels of smartphone overuse and reduced days of vigorous physical activity were also observed during the fifth wave. Notably, increased smartphone overuse and reduced physical activity both additively and interactively contributed to elevated distress at 6 months, even after accounting for demographic characteristics, psychiatric history, childhood adversity, as well as baseline distress symptoms, resilience, and recent personal stressors.ConclusionsThe findings suggest that the emergence of a new wave of COVID-19, specifically the Omicron outbreak, can further aggravate mental distress even after a protracted period of the pandemic. Awareness of the dynamic nature of COVID-19 is necessitated to address the pressing mental health needs of populations. Supporting young people in healthier patterns of smartphone use and physical activity can be helpful.

Project description:During the last years, the city of Hong Kong has made large investments to make its urban water supply system more water efficient and sustainable. As such, its municipal water abstraction - often defined as direct water use - has decreased from 355 litre per capita per day (l/cap/d) in 2005 to 326 l/cap/d in 2013. Due to its political history, Hong Kong is unique in the world in data availability on urban food consumption. It is therefore the ideal case study to show typical urban food consumption behaviour and its related indirect water use. The objective of this paper is to show the large water quantities associated with indirect water use and that the citizens of Hong Kong can additionally save much more water by looking at this indirect water use. The current average diet in Hong Kong is very different to the average Chinese diet. It is characterised by a high intake of water intensive products like animal products and sugar, leading to a food related indirect water use or water footprint (WFcons) of 4727 l/cap/d. According to recommendations from the Chinese Nutrition Society for a healthy diet, the intake of some product groups should be increased (vegetables and fruit) and of other product groups reduced (sugar, crop oils, meat and animal fats). This would result in a reduction of the WFcons of 40% to 2852 l/cap/d. Especially the reduced intake of meat (including offals) from currently 126 kg per capita per year (kg/cap/yr) to the recommended value 27 kg/cap/yrwould results in a substantial WFcons reduction. Meat consumption in Hong Kong is extremely high. A pesco-vegetarian diet would result in a reduction of 49% (to 2398 l/cap/d) and a vegetarian diet in a 53% (to 2224 l/cap/d) reduction. Hong Kong citizens can thus save a lot of water through a change in their diet. Many of the products consumed, contribute to different levels of blue water scarcity in the regions of origin Hong Kong imports from. This poses a water-related risk to food security in Hong Kong. As all diet scenarios also result in a lower blue WFcons, they decrease this risk. In order to become sustainable, (mega)cities should reduce their dependency on distant resources and ecosystems.

Project description:PurposeThe novel coronavirus disease 2019 (COVID-19) caused psychological distress and changed human living styles. However, rare studies have examined the psychological distress and protective behaviors across different populations. Therefore, the present study aimed to assess psychological distress, protective behaviors, and potential predictors of psychological distress and protective behaviors across the Hong Kong general population, Taiwan healthcare workers, and Taiwan outpatients.MethodsA cross-sectional design was used to recruit participants from Hong Kong and Taiwan. Telephone interviews were carried out for Hong Kong participants (n = 1,067; 30.2% male participants); online surveys were used for Taiwan healthcare workers (n = 500; 8.0% male participants) and Taiwan outpatients (n = 192; 32.8% male participants). All the participants completed questions on psychological distress and protective behaviors. Multiple linear regressions and multivariable logistic regressions were employed to explore the potential predictors of psychological distress and protective behaviors, respectively.ResultsHong Kong participants had significantly lower levels of psychological distress than Taiwan participants [mean (SD) = 0.16 (0.39) vs. 0.47 (0.59) in healthcare workers and 0.46 (0.65) in outpatients; p < 0.001]. Hong Kong participants (51.7%) and Taiwan outpatients had more people showing fear of COVID-19 (52.0%) than Taiwan healthcare providers (40.8%; p < 0.001). Moreover, Hong Kong participants engaged the most in protective behaviors, followed by Taiwan healthcare providers and Taiwan outpatients (p < 0.001). Moreover, being a female, fear of COVID-19 and worry about personal savings were associated with protective behaviors in general.ConclusionsDespite the greater COVID-19 severity and fear of COVID-19 in Hong Kong, the general population in Hong Kong experienced less psychosocial distress with higher compliance to protective behaviors than the other groups in Taiwan.

Dataset Information

The Indirect Effect of Sleep on the Association Between Protracted Social Stressors and Psychological Distress Among Hong Kong Young People.

Purpose

Methods

Results

Discussion

Publications

The Indirect Effect of Sleep on the Association Between Protracted Social Stressors and Psychological Distress Among Hong Kong Young People.

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