Objective:This study aims to explore the impact of fertility stress on depressive symptoms, with a focus on analyzing the potential mediating effects of infertility stigma and family function in this process. Methods:A cross-sectional design was employed in which 1294 female partners of infertile couples were recruited from two tertiary-grade A hospitals in Hainan Province, China. Fertility stress, depressive symptoms, infertility stigma, and family function were assessed with validated self-report questionnaires. Structural equation modeling (SEM) was used to estimate the direct effect of fertility stress and the parallel mediating effects of infertility stigma and family function. Results:The prevalence rate of depressive symptoms was 26.35%. The direct effect model indicated a significant positive association between fertility stress and depressive symptoms (β = 0.260, p < 0.001). The parallel mediation model revealed that infertility stigma (β = 0.176, p < 0.001) and family function (β = 0.052, p < 0.001) exerted full mediating effects. Specifically, fertility stress indirectly increased depressive symptoms by exacerbating infertility stigma; concurrently, low levels of family function exacerbated the negative impact of fertility stress on mental health. Conclusion:Fertility stress not only directly affects depressive symptoms, but also indirectly exacerbates depressive symptoms by intensifying infertility stigma and impairing family function. This study provides a new perspective for understanding the mental health mechanism in female partners of infertile couples, emphasizing that psychological interventions need to simultaneously focus on reducing infertility stigma and improving family function, which may offer a basis for informing relevant clinical practices and public health policies.

Chinese transgender women have a higher prevalence of intimate partner violence (IPV) compared to their cisgender counterparts. To mitigate the risk of IPV, it is crucial to comprehend the symptoms of emotional distress that are most closely associated with IPV. This network analysis investigated the item-level connections among depressive symptoms, anxiety symptoms, and IPV among Chinese transgender women. Between February and December 2022, 264 adult transgender women in Shenyang, China, were recruited through snowball sampling with support from a community-based non-governmental organization. Data were collected using the Intimate Partner Violence Scale, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Questionnaire (GAD-7). The network structure of depressive symptoms, anxiety symptoms, and IPV was examined using “Expected Influence” and “Bridge Expected Influence” as measures of centrality. The stability of the network was assessed through a case-dropping bootstrap approach. A Network Comparison Test was conducted to examine whether network characteristics differed based on the presence or absence of IPV. Among 264 participants, 221 (83.7

Herpes zoster (HZ) imposes a substantial disease burden, yet vaccine uptake remains suboptimal in China. While eHealth literacy is a known determinant of health behaviors, its role in bridging socioeconomic disparities and its varying impact across different age groups of vaccine-eligible adults remain understudied. Specifically, it is unclear whether eHealth literacy acts as a "compensatory resource" for disadvantaged populations and if the digital skills required to reduce hesitancy differ between middle-aged and older adults. This study aimed to examine the association between eHealth literacy and HZ vaccine hesitancy among adults aged 40 years and older in Shanghai, China, with a specific focus on identifying age-dependent "digital thresholds" and the compensatory effect of literacy on socioeconomic status (SES). A community-based cross-sectional study was conducted from October to December 2022 across three districts in Shanghai. A total of 1302 adults aged ≥40 years were recruited via convenience sampling. eHealth literacy was assessed using the eHealth Literacy Scale (eHEALS). Multivariable logistic regression models were used to analyze the associations, adjusting for sociodemographic characteristics, health status, and behaviors. Stratified analyses were performed to evaluate interactions among literacy, age, and SES. The prevalence of HZ vaccine hesitancy was 88.2% (1149/1302). In the fully adjusted model, participants with medium (odds ratio [OR] 0.538, 95% CI 0.326-0.886; P=.015) and high (OR 0.472, 95% CI 0.264-0.844; P=.011) eHealth literacy demonstrated significantly lower odds of hesitancy compared to those with low literacy. Age-stratified analyses revealed a distinct "digital threshold" effect: for middle-aged adults (40–59 years), medium literacy was sufficient to significantly reduce hesitancy (OR 0.501, 95% CI 0.265-0.949; P=.034), whereas older adults (≥60 years) required high literacy to achieve a significant protective effect (OR 0.347, 95% CI 0.136-0.882; P=.026). Crucially, eHealth literacy exhibited a strong compensatory effect for socioeconomic disadvantage. Among participants with low SES, high eHealth literacy was associated with an 83.1% reduction in the odds of hesitancy (OR 0.169, 95% CI 0.054-0.528; P=.002), a magnitude of effect not observed in higher SES groups. Additionally, a history of HZ infection was identified as a robust protective factor (OR 0.473, 95% CI 0.309-0.724; P=.001). eHealth literacy serves as a critical compensatory resource that can mitigate the disadvantage of low socioeconomic status in HZ vaccine acceptance. However, the protective mechanism is age-dependent, indicating a higher "digital threshold" for older adults (≥60 years) compared to their middle-aged counterparts. Public health interventions should prioritize digital empowerment for low-SES populations and tailor educational strategies to meet the higher digital competency needs of older adults. Not available

BACKGROUND:Sexuality is a key component of psycho-physical well-being among older adults. We aimed to understand sexual attitudes and conversations, and their correlates among older adults. METHODS:This study was based on a cross-sectional survey conducted from June 2020 to December 2022 in China. Community-dwelling heterosexual older adults aged ≥50 were recruited. Sexual attitudes included believing that sex is harmful to health and supporting sex education. The conversation was defined as talking about sex with a partner. Logistic regressions were used to assess the correlates of sexual attitude and conversation. RESULTS:A total of 3001 older adults (60.6% men, 39.4% women) were included. Of these, 13.3% believed sex is harmful to health, 53.2% supported sex education and 34.6% reported conversation. For men, age (60-69 years: aOR 0.57, 95% CI: 0.39-0.82), living in urban areas (aOR 2.78, 95% CI: 1.90-4.05), being employed (aOR 0.44, 95% CI: 0.29-0.66), higher annual incomes (aOR 0.42, 95% CI: 0.22-0.78) and being sexually active (aOR 0.54, 95% CI: 0.36-0.79) were associated with believing that sex is harmful. For women, higher educational levels (aOR 0.48, 95% CI: 0.29-0.79) and sexual knowledge acquisition (aOR 1.95, 95% CI: 1.24-3.05) were significantly associated with this negative belief. Notably, older adults who reported life satisfaction (men: aOR 1.70, 95% CI: 1.32-2.18; women: aOR 2.66, 95% CI: 1.90-3.72) and sexual knowledge acquisition (men: aOR 2.00, 95% CI: 1.53-2.43; women: aOR 1.56, 95% CI: 1.13-2.17) were more likely to talk about sex. CONCLUSION:A minority of older adults believed that sex was harmful to health, whereas over half supported sex education, and approximately one-third reported conversations with their partner about sex. Targeted interventions are needed to adjust sexual attitudes and facilitate sex-related conversations.

Background:Global mpox outbreaks have exposed healthcare inequities in testing accessibility. Socioeconomic disparities and medical discrimination and distrust influence testing service utilization among vulnerable populations. We examined how medical discrimination and distrust affect testing intention across socioeconomic strata among men who have sex with men (MSM) in China. Methods:We conducted a nationwide cross-sectional study across six regions of China (November 2023 to March 2024). MSM aged ≥ 18 years who reported male sexual partners within previous six months were recruited through local Centers for Disease Control and Prevention and community-based organizations. Participants completed anonymous questionnaires measuring medical discrimination and distrust (DS), structural determinants, behavioral factors, psychosocial factors, and mpox testing intention. Path analysis was used to examine the effects of medical discrimination and distrust on testing intention, stratified by socioeconomic status (SES). Results:50.7% of 2403 participants reported high testing intention. Path analysis revealed that medical discrimination and distrust were associated with testing intention through distinct mechanisms across SES groups. For high-SES participants, positive indirect associations were found between medical discrimination and distrust and testing intention (β = 0.061, P < 0.001) mediated by voluntary HIV counseling and testing services, social support and depression. For low-SES participants, medical discrimination and distrust demonstrated a negative direct effect (β = -0.218, P < 0.001) and indirect effects through social support, depression, and mpox prevention-related self-efficacy (β = -0.028, P < 0.001). Social support emerged as a crucial mediator among low-SES groups, while depression served as the crucial mediator among high-SES groups. Conclusions:Healthcare inequities manifest through socioeconomically patterned pathways affecting mpox testing intention. Our findings suggest differentiated intervention strategies: integrating services with existing healthcare infrastructure for high-SES populations while strengthening community-based support for low-SES groups. These insights inform efforts to address healthcare disparities in infectious disease responses, particularly in resource-limited settings.

OBJECTIVES:Self-injury behavior is a prevalent mental health problem among adolescents. Childhood maltreatment is closely associated with the development of alexithymia, impulsivity, and self-injury behavior in adolescents and young adults with mental disorders; however, the underlying mechanisms remain unclear. This study aims to classify psychiatric patients aged 12 to 24 years into psychological subtypes based on alexithymic and impulsive traits, to explore differences in self-injury behavior among these subtypes, and to examine whether different forms of childhood maltreatment are associated with specific psychological subtypes, thereby providing evidence for clinical intervention and prognosis improvement. METHODS:Clinical data of adolescents and young adults with mental disorders treated between 2021 and 2022 were retrospectively collected. Principal component analysis (PCA) was performed using 6 dimensions derived from the Toronto Alexithymia Scale (TAS)-20 and the Barratt Impulsiveness Scale (BIS)-11, including difficulty identifying feelings (DIF), difficulty describing feelings (DDF), externally oriented thinking (EOT), attentional impulsiveness, motor impulsivity, and non-planning impulsivity. Principal components with eigenvalues (λ) ≥1 were retained, and their scores were subjected to 2-step cluster analysis for automatic subtype classification. Differences among the subtypes were compared with respect to demographic characteristics, clinical features, and self-injury behavior-related characteristics. Multivariate Logistic regression models were subsequently used to examine associations between the identified psychological subtypes and different forms of childhood maltreatment. RESULTS:A total of 634 adolescents and young adults with mental disorders were included, among whom 459 (72.4%) had a history of self-injury behavior. The diagnostic distribution comprised depressive disorders (n=295, 46.5%), bipolar disorder (n=136, 21.5%), anxiety disorders (n=61, 9.6%), schizophrenia (n=14, 2.2%), and other disorders (n=128, 20.2%), including personality disorders, obsessive-compulsive disorder, post-traumatic stress disorder, somatoform disorders, and eating disorders. PCA reduced the 6 dimensions related to alexithymia and impulsivity into 2 independent principal components (Z1 and Z2). Based on individual scores on Z1 and Z2, 2-step cluster analysis automatically classified participants into 3 clusters (K1, K2, and K3). The psychological characteristics of the K1 group were characterized by high motor impulsivity accompanied by marked difficulties in identifying and expressing emotions. The K2 group exhibited relatively low levels of impulsivity and alexithymia. The K3 group was characterized by high attentional impulsivity, high non-planning impulsivity, and externally oriented thinking. No significant differences were observed among the 3 groups in the distribution of primary psychiatric diagnoses (P>0.05). Comparisons of self-injury behavior-related characteristics showed that the K2 group had significantly lower rates of self-injury, lower self-injury frequency, lower self-injury addiction scores, and lower self-injury motivation scores than the other 2 groups (all P<0.05). No significant differences were found between the K1 and K3 groups in self-injury prevalence, self-injury addiction scores, and external emotion regulation motives (P>0.05). However, the K1 group scored significantly higher than the K3 group on the motivational dimensions of social influence, internal emotion regulation, and sensation seeking, while exhibiting a lower frequency of self-injury behavior (P<0.05) in the last year. Multivariable Logistic regression analysis revealed that childhood emotional abuse may be a risk factor for developing the K1 psychological subtype; childhood physical abuse may be a risk factor for developing both K1 and K3 psychological subtypes; and childhood emotional neglect was associated with the development of K1 and K2 psychological subtypes. CONCLUSIONS:Adolescents and young adults with mental disorders can be classified into 3 distinct psychological subtypes based on alexithymia and impulsive traits. These subtypes differ in the prevalence and motivational characteristics of self-injury behavior, independent of clinical diagnosis. Furthermore, the development of different psychological subtypes may be associated with exposure to different forms of childhood maltreatment. These findings suggest that providing targeted emotional regulation and impulse-control interventions for adolescents exposed to specific childhood adversities may help reduce the occurrence and frequency of self-injury behavior.

BACKGROUND:Herpes zoster (HZ) poses a growing health burden, yet vaccine uptake remains low in China. Amid ongoing digital transformation, eHealth literacy has emerged as a key factor in vaccination decisions. This study aimed to examine its association with HZ vaccination intention through Health Belief Model (HBM) constructs, focusing on variations across socioeconomic status (SES). METHODS:A cross-sectional survey was conducted among 2047 adults (18-59 years) in Shanghai from October to December 2022. Participants completed questionnaires assessing HZ vaccination intention, eHealth literacy, and HBM-related beliefs (perceived benefits, threat, barriers, and cues to action). SES was derived from education, income, and occupation using latent class analysis. Structural equation modelling was used to test direct and mediated pathways, with SES-stratified analyses. RESULTS:Only 10.3% of participants reported vaccination intention. eHealth literacy was positively associated with perceived benefits (β = 0.331, P < 0.001) and threat perception (β = 0.239, P < 0.001), and negatively associated with perceived barriers (β = -0.051, P = 0.024). Vaccination intention was positively associated with perceived threat (β = 0.193, P < 0.001) and cues to action (β = 0.220, P < 0.001), and negatively with perceived barriers (β = -0.259, P < 0.001). Associations between eHealth literacy and HBM constructs were stronger among high-SES participants. CONCLUSIONS:eHealth literacy is associated with HZ vaccination intention through multiple cognitive pathways, with distinct patterns across SES groups. Tailored strategies are needed to promote more equitable HZ vaccine uptake. High-SES groups may benefit from better online information, while external support is more crucial for disadvantaged groups.

OBJECTIVES:Stigma is multidimensional and undermines HIV care. We examined socio-environmental pathways linking HIV-related stigma, everyday discrimination and structural stigma to antiretroviral therapy (ART) adherence among men who have sex with men (MSM) and female sex workers (FSW) living with HIV in Kampala, Uganda. METHODS:We conducted a cross-sectional survey (06/2024-02/2025) among MSM and FSW aged 18-35 receiving HIV services from a key population clinic in Kampala. ART adherence was assessed using the Wilson 3-item adherence scale. We conducted stratified multivariable linear regression and multi-group structural equation modelling (SEM) to estimate direct and indirect associations from stigma to adherence through socio-environmental stressors (traumatic exposure severity to extreme weather [TESS], food insecurity, water insecurity), adjusted for socio-demographic variables. RESULTS:Participants included MSM (n = 225, mean age: 27.65, standard deviation [SD] = 3.54) and FSW (n = 240, mean age: 25.68, SD: 2.90). SEM showed acceptable fit. In adjusted SEM analyses (a) among MSM, higher TESS, HIV-related stigma and everyday discrimination were directly associated with lower ART adherence and (b) among FSW, higher TESS, HIV-related stigma, water and food insecurity were directly associated with lower ART adherence. There were significant indirect associations between HIV-related stigma and ART adherence via TESS for FSW and MSM, and between everyday discrimination and structural stigma with ART adherence via TESS for MSM. CONCLUSIONS:Stigma and socio-environmental stressors, including traumatic exposure to extreme weather events, were associated with reduced ART adherence among MSM and FSW participants. Population-tailored HIV care interventions may benefit from integrating intersectional stigma reduction with economic and disaster preparedness supports.

Background Social network site addiction (SNS-addiction) is a growing concern among teenagers, with potential links to psychological states such as entrapment and defeat. In China, unique sociocultural factors including Gaokao-related academic stress, excessive parental expectations and control, and the proliferation of addictive digital platforms may exacerbate SNS-addiction risks. This study investigated the network structure of SNS-addiction, entrapment and defeat in teenagers in Shenzhen, China. Methods 2,258 secondary school students from Shenzhen were surveyed by self-administered questionnaires. The Social Network Addiction Tendency Scale for Adolescents, as well as the defeat and entrapment scales were used to assess SNS-addiction, defeat, and entrapment, respectively. The centrality of entrapment and defeat symptoms was characterized using “Expected Influence” and “Bridge Expected Influence”. A case-dropping bootstrap procedure was used to test the network stability. A network comparison test was conducted to examine whether the network features varied according to gender. Results The survey indicated the mean score for SNS-addiction tendency was 17.201 (SD = 6.029). “Life’s Loser” and “Self-detachment” were identified as central symptoms within the network of defeat and entrapment. “Exitless Predicament” and “Achievement Doubt” emerged as significant bridge symptoms. “Sense of Success” and “Inherent Winner” revealed the most substantial connections in both networks. “Inescapable Relationship” exhibited the most pronounced direct connection to SNS-addiction. Conclusion Symptoms such as “Inescapable Relationship”, “Life’s Loser” and “Exitless Predicament” are crucial targets for interventions aimed at reducing SNS-addiction and its associated psychological burdens. This network analysis offers insights into the intricate relationships within the mental health of teenagers.

Free mpox self-testing often requires disclosure of personal contact information (e.g., phone numbers or social media IDs). Among men who have sex with men (MSM), this requirement can function as an access gate with unequal impacts across socioeconomic and regional contexts. Using the Capability, Opportunity, Motivation–Behavior (COM-B) framework, we examined psychosocial and socioeconomic correlates of willingness to disclose among MSM in China. We conducted an anonymous online cross-sectional survey (November 2023–March 2024) in six provincial regions representing three development tiers. MSM (n = 2,403) were recruited via community-based organizations using snowball sampling. Guided by the COM-B framework, we fitted hierarchical logistic regression models with sequential adjustment for sociodemographic, health, and behavioral covariates to estimate associations with disclosure willingness. Prespecified stratified analyses by education, income, and regional development assessed heterogeneity. Overall, 57.9

BACKGROUND:Arts-based sexual health workshops may improve adolescent sexual health, yet limited studies have evaluated outcome trends over time. This study examined HIV prevention outcomes before and after school-based workshop participation among adolescents in the Northwest Territories (NWT), Canada. METHODS:We analyzed seven waves of pretest and immediate posttest data from adolescents aged 13-18 years in 17 NWT communities from 2018-2019 to 2024-2025. Surveys assessed sociodemographic characteristics, HIV knowledge, and condom use self-efficacy (CUSE). Paired-samples t-tests examined pretest to posttest differences. Mixed-effects linear regression models examined trends in change scores across school years and adjusted for the number of previously completed arts-based sexual health workshops. RESULTS:The pretest sample included 1,936 workshop observations; 1,579 had paired outcome data. Mean age was 13.64 years (SD=1.47); 48.86% were cisgender girls, 19.62% identified as lesbian, gay, bisexual, or queer, 70.05% identified as Indigenous, and 68.16% lived outside of Yellowknife in rural settings. HIV knowledge increased from 2.74 (SD=3.13) to 8.05 (SD=4.18), with a large effect size (Cohen's dz=1.30). CUSE increased from 19.59 (SD=4.40) to 20.32 (SD=4.70), with a small effect size (Cohen's dz=0.15). HIV knowledge gains increased across school years, particularly among older adolescents and cisgender girls. CUSE gains also increased; no sociodemographic interaction was statistically significant. CONCLUSION:Arts-based sexual health workshop participation was associated with immediate improvements in HIV knowledge and CUSE across seven school years among Northern and Indigenous adolescents in the NWT. Findings support continued evaluation of culturally responsive, arts-based HIV prevention in Northern and remote settings.

Understanding and predicting sexual behavior patterns through the lens of Social Cognitive Theory (SCT) is essential for identifying behavioral bridges that facilitate HIV transmission. MSM who engage in sexual activity with women (MSM-W) represent a critical yet underexplored subgroup in China. However, existing studies lack theory-driven predictive frameworks that explicitly integrate psychological mechanisms with robust analytics. This study aimed to develop and validate an SCT-guided machine-learning model to predict MSM-W behavior and to evaluate its discriminatory and calibration performance across population subgroups. We developed a theory-driven machine-learning framework integrating SCT with a random forest–guided logistic regression model. Data were collected from 2,403 MSM across six urban regions in China. Model development included: (1) SCT-guided candidate variable construction, (2) random-forest feature screening using mean decrease accuracy (MDA), (3) nested cross-validation and bootstrap optimism correction, (4) calibration assessment, and (5) threshold selection using the Youden index. Model performance was evaluated using ROC-AUC, PR-AUC, Brier score, calibration slope/intercept, subgroup analyses (age, education, marital status, migrant status), and comparison with a baseline demographic-only model. Among all participants, 406 (16.9%) reported sexual behavior with women in the past six months. The final SCT-guided model incorporating nine predictors (GAD-7, PHQ-9, self-esteem, age, education level, marital status, sexual orientation, recent group sex with men, and pre-sex drug use) demonstrated good discrimination (AUC = 0.80), moderate PR-AUC (0.53), and good overall accuracy (Brier score = 0.107). Calibration analysis showed a slope of 0.91 (95% CI: 0.76–1.09) and intercept of − 0.20 (95% CI: −0.53 to 0.15), indicating acceptable agreement between predicted and observed risks. The optimal probability threshold selected by the Youden index was 0.148 (sensitivity 0.72; specificity 0.77; NPV 0.93). Subgroup analyses demonstrated stable performance across age, education, marital, and migrant strata. Compared with the baseline demographic-only model (AUC = 0.76; Brier = 0.113), the full SCT-integrated model showed consistent improvement. Results were translated into an individualized nomogram for practical risk assessment. This study provides a theory-informed and statistically robust framework for predicting MSM-W behavior. By integrating SCT with machine learning, the model captures the joint influence of psychological distress, self-evaluation, and behavioral context on bisexual behavior patterns. The tool offers a non-stigmatizing, early-screening approach for identifying behavioral risk bridges in MSM populations and may inform targeted HIV prevention strategies in China.

Self-directed learning (SDL) is a core competency in medical education. The emergence of generative artificial intelligence (AI) has reshaped technology-enhanced learning, yet it remains unclear how AI-related contextual factors interact with personality traits to influence SDL. A cross-sectional survey was conducted among 1,208 medical undergraduates from universities in Shanghai and other regions of China. Data were analyzed using general linear modeling, hierarchical regression, conditional process analysis, and latent profile analysis (LPA). Sensitivity analyses and common method variance diagnostics were performed. In the GLM, conscientiousness (β = 2.76, p < 0.001, η²p = 0.16), self-esteem (β = 0.70, p < 0.001), openness (β = 0.70, p < 0.001), and self-control (β = 0.13, p = 0.036) all positively predicted SDLB. Conditional process analysis revealed that the indirect effect of openness on SDLB via AI cognition was significantly moderated by subjective norms (moderated mediation index = − 0.009, 95

Mpox (formerly known as monkeypox) has disproportionately affected men who have sex with men (MSM), yet evidence from East Asia on psychosocial and behavioral correlates is limited. We examined factors associated with Mpox infection among MSM in China, with attention to health equity considerations. A multi-center cross-sectional survey was conducted in six Chinese cities (November 2023–March 2024). Eligible MSM (≥ 18 years; male-to-male sexual contact in the past six months) completed an anonymous questionnaire capturing sociodemographics, Human Immunodeficiency Virus (HIV) infection status (along with other health statuses like hypertension, diabetes, and hyperlipidemia), unprotected anal intercourse (UAI), multiple sex partnerships (MSP), pre-sex substance use (alcohol and drugs), recent voluntary counseling and testing for HIV (VCT), and psychosocial measures (perceived discrimination and self-esteem). Mpox infection was ascertained by self-reported clinical diagnosis or syndromic criteria aligned with national guidance. Multivariable logistic regression estimated adjusted odds ratios (aOR) and 95

The large-scale migration and significant gender imbalance over the decades are expected to elevate HIV sexual risk behaviors substantially in China. However, the mechanisms underlying these behaviors among male migrants in the context of gender imbalance remain poorly understood. This study explores the relationship between perceived environmental factors and HIV sexual risk behaviors, as well as the mediating role of sex with online partners. The data used in this study were obtained from a 2017 cross-sectional survey of 870 male migrants. We found that both peer norms and neighborhood characteristics were associated with sexual risk behaviors among male migrants. Furthermore, sex with online partners was a significant mediator, explaining 22.50% and 20.13% of the associations between peer norms, neighborhood characteristics, and HIV sexual risk behaviors. Notably, the mediating effect was only significant for unmarried male migrants, not for married migrant males. The findings suggest that sex with online partners plays an important role in unmarried male migrants' HIV sexual risk behaviors and that further prevention and intervention should enhance internet-based sex education.

BackgroundThe rapid development of digital technologies has intensified concerns about social media addiction, particularly among university students. The perceived parenting styles they experienced may influence this risk, with unmet interpersonal needs acting as potential mediators. ObjectiveThis study aimed to investigate whether perceived burdensomeness and thwarted belongingness mediate the relationship between perceived parenting and social media addiction among university students. MethodsA cross-sectional survey was conducted among 1766 university students from March 2023 to May 2023. Parenting styles were assessed using the short-form Egna Minnen av Barndoms Uppfostran (Swedish for “My memories of upbringing”) for Chinese, unmet interpersonal needs were assessed via the 15-item version of the Interpersonal Needs Questionnaire, and social media addiction was assessed through the Social Network Addiction Tendency Scale. Parenting profiles were identified using latent profile analysis, and mediation models were examined through path analysis. ResultsThree perceived parenting profiles were identified: supportive (1094/1766, 61.9%), emotionally distant (192/1766, 10.9%), and controlling-critical (480/1766, 27.2%). Path analyses indicated indirect effects of parenting profile on social media addiction via unmet interpersonal needs. Compared to the supportive group, the emotionally distant (β=0.107 for perceived burdensomeness; β=0.354 for thwarted belongingness) and controlling-critical (β=0.543 for perceived burdensomeness; β=0.457 for thwarted belongingness) groups reported higher unmet interpersonal needs, which in turn were positively associated with social media addiction (β=0.119 for perceived burdensomeness; β=0.158 for thwarted belongingness). Multigroup analyses further showed that perceived burdensomeness was significantly associated with social media addiction among male students (β=0.180; P<.001) but not among female students (β=0.038; P=.30). ConclusionsUnmet interpersonal needs mediate the link between maladaptive parenting and social media addiction. Early interventions that promote emotional warmth and reduce rejecting and controlling behaviors may help prevent digital dependence among young adults, particularly when tailored to specific interpersonal vulnerabilities.

Background:Cyberbullying victimization is a significant risk factor for poor psychological well-being among college students. Existing tools fail to capture the distinct dimensions of victimization in social media contexts. Objective:This study aimed to adapt and validate a Social Media Cyberbullying Victimization Scale (SMCVS) and examine its associations with psychological outcomes among Chinese college students. Methods:In Shanghai, China, 1766 students from multiple universities completed questionnaires including demographic information, the SMCVS, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 scale. The psychometric evaluation of the SMCVS included content validity, construct validity, criterion validity, internal consistency reliability, split-half reliability, and test-retest reliability. Receiver operating characteristic analyses were used to evaluate predictive ability for depression and anxiety. Results:Content validity was satisfactory, and 13 items were retained, with item-level content validity index values ranging from 0.833 to 1 and a scale-level content validity index of 0.949. Exploratory factor analysis identified 2 dimensions-"information harassment" and "reputation and privacy violation"-explaining 82.2% of the total variance. Confirmatory factor analysis supported this structure (goodness-of-fit index=0.943, comparative fit index [CFI]=0.982, normed fit index=0.978, and root mean square error of approximation [RMSEA]=0.075). Multigroup confirmatory factor analysis supported configural and metric invariance across both gender and academic major (ΔCFI≤0.01, ΔRMSEA≤0.015); scalar invariance was achieved for gender but not for academic major. Both dimensions showed significant correlations with depression (r=0.433-0.457) and anxiety (r=0.356-0.372). Cronbach α, Spearman-Brown coefficient, and test-retest reliability coefficient were 0.959, 0.973, and 0.860, respectively. The SMCVS demonstrated moderate discriminative accuracy for depression (area under the curve [AUC]=0.738; optimal cutoff=19.5) and anxiety (AUC=0.739; optimal cutoff=22.5). Conclusions:The SMCVS demonstrates sound psychometric properties and may be useful for assessing social media cyberbullying victimization among Chinese college students. Its validated 2D structure clarifies distinct patterns of victimization and their psychological correlates, offering implications for targeted prevention and intervention.

Monkeypox (mpox) has emerged as a global public health concern, particularly among men who have sex with men (MSM). Stigma limits access to care, and the role of social support in shaping care-seeking through psychosocial mechanisms remains unclear. This study examined whether social support influences care-seeking intentions via stigma and perceived healthcare benefits among MSM in China. A cross-sectional study was conducted from October 2023 to March 2024 across 6 provinces in China. Descriptive statistics, chi-square tests, Spearman correlations, and logistic regression were performed to explore associations between HBM-related constructs and healthcare-seeking intentions. Structural equation modeling was used to examine the direct and indirect effects of social support via stigma and perceived healthcare benefits. Among participants, 83.4

Cyberbullying victimization is a significant risk factor for poor psychological well-being among college students. Existing tools fail to capture the distinct dimensions of victimization in social media contexts. This study aimed to develop and validate a Social Media Cyberbullying Victimization Scale (SMCVS) and examine its associations with psychological outcomes among Chinese college students. In Shanghai, China, 1,766 students from multiple universities completed questionnaires including demographic information, the SMCVS, the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder scale-7. The psychometric evaluation of the SMCVS included construct and criterion validity, internal consistency, split-half and test-retest reliability. Receiver operating characteristic analyses were used to evaluate predictive ability for depression and anxiety. Exploratory factor analysis identified two dimensions: Information Harassment and Privacy Violation, explaining 82.21% of the total variance. Confirmatory factor analysis supported this structure (goodness-of-fit index = 0.943, comparative fit index = 0.982, normed fit index = 0.978, root mean square error of approximation = 0.075). Both dimensions showed significant correlations with depression (r = 0.433-0.457) and anxiety (r = 0.356-0.372). Cronbach’s alpha, Spearman-Brown coefficient, and test-retest reliability coefficient were 0.959, 0.973, and 0.860, respectively. The SMCVS demonstrated moderate discriminative accuracy for depression (area under the curve [AUC] = 0.738) and anxiety (AUC = 0.739). The SMCVS demonstrates robust psychometric properties and is useful for assessing social media cyberbullying victimization among Chinese college students. Its validated two-dimensional structure clarifies distinct patterns of victimization and their psychological correlates, informing targeted prevention and intervention strategies.