其他摘要 | The COVID-19 pandemic has brought about a variety of negative impacts on children and individuals. Cognitive theory explains how individual differences, such as resilience and attentional bias, have different effects on psychological health outcomes when facing stressors. Therefore, in the context of the COVID一19 pandemic, it is crucial to understand these differences in specific manifestations. Network theory suggests that complex interactions among psychological symptoms are an essential characteristic of psychological development. This study first revised the COVID一19 stressors scale for children and adolescents and then used network and mediation analysis methods based on cognitive and network theories to systematically understand the complexity and developmental mechanisms of the impact of COVID一19 stressors on post-traumatic stress disorder (PTSD) and well-being.
In Study 1,we aimed to revise and validate a COVID一19 stressors scale suitable for Chinese children and adolescents and to examine the impact of demographic characteristics on the psychological stress of children and adolescents during the COVID-19 pandemic. A self-report questionnaire was sent to children and adolescents aged 10-18 years in Jiangsu and Fujian provinces in China using cluster sampling after a new round of COVID-19 outbreaks occurred. Based on the statistical analysis of 1815 responses, the COVID一19 stressors scale was revised. After revising the scale, differences in COVID-19 stress experienced by children and adolescents were analyzed using descriptive statistics. Hierarchical regression analysis was then employed to further examine the explanatory power of related factors on the variation of COVID一19 stressors sources. The revised COVID-19 stressors scale demonstrated good reliability and validity. Non-only children experienced higher levels of COVID一19 stress than only children, and the perceived COVID-19 stress of children and adolescents increased with grade level. Moreover, the fewer the COVID一19 infections in the surrounding area, the lower the COVID-19 stress felt by students.
In Study 2, a sample of 1527 Chinese children and adolescents aged 10 to 18 years completed a battery of self-report measures, including the Revised COVID一19 stressors scale, the Attention to Positive and Negative Information Scale, the Resilience Scale (CD-RISC), the Child Impact of Events Scale, and the Oxford Happiness Questionnaire, to assess their levels of COVID一19 stressors, resilience, attentional bias, well-being, and posttraumatic stress disorder symptoms. Using network analysis, we explored the complex relationships among symptoms, variables, and structures in a data-driven manner and visualized how they interacted with each other. The results showed that the variables formed a highly stable and precise network structure through specific symptom associations. The symptoms with high node strength were efficacy, self-negative attentional bias, satisfaction, and self-positive attentional bias, while the symptoms with high expected impact were self-positive attentional bias, satisfaction, self-negative attentional bias, efficacy, information stressors, and intrusion. In addition, key bridge nodes were identified, namely self-positive attentional bias, self-negative attentional bias, and psychological resilience, which had high predictability and bridge strength, indicating their important roles and connectivity in the entire network structure.
In Study 3, based on the cognitive theory and the network analysis results of Study 2, Study 3 established a model of the relationships among variables, proposed and tested the mediation hypotheses. This study explored the effects of COVID一19 stressors on PTSD and well-being. The results showed that COVID一19 stressors could not directly affect well-being and PTSD but could indirectly influence them through the mediating effects of resilience and negative attentional bias, respectively. Additionally, COVID-19 stressors could indirectly affect well-being through the chain mediation effects of resilience and positive attentional bias. Among all the path effects, the results revealed that negative attentional bias had a stronger explanatory power in influencing psychological outcomes.
The conclusions of this study are:
(1) The revised COVID一19 epidemic stressors scale includes four dimensions: disease stressors, information stressors, measures stressors and environmental stressors. The revised Scale is a suitable measurement tool for assessing COVID一19 stressors in children and adolescents in the Chinese cultural context. This study confirmed that information stressors had the greatest influence during the epidemic in COVID一19, and children and adolescents were more sensitive to self-related information. It enlightens us that we need to pay attention to information overload during the epidemic to maintain mental health.
(2) Under the stressor of COVID-19 epidemic, resilience can help individuals to produce positive attention bias (mainly self-positive attention bias), while the negative attention bias has nothing to do with resilience. At the same time, resilience and positive attention bias can help children and adolescents cope with the adverse effects caused by the stressors of COVID-19 epidemic, and play a parallel and chain intermediary role in weakening the symptoms of PTSD and restoring well-being.
(3) The stressors of COVID-19 epidemic situation can not directly lead to the decline of happiness or PTSD, but can lead to the decline of well-being and PTSD symptoms through negative attention bias. The specific manifestation is the invasion of self-negative attention bias, which leads to PTSD; At the same time, the self-negative attention bias affects the sense of efficacy, resulting in a decline in happiness. During the COVID-19 epidemic, children and adolescents are more likely to be attracted by negative information, which leads to the decrease of PTSD and well-being.
The findings of this study contribute to a more systematic evaluation of the psychological development process of children and adolescents in COVID一19 epidemic and provide more abundant information for intervention treatment. |
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