BackgroundChildhood experiences can exert a huge impact on adult psychological conditions. Previous studies have confirmed the effects of adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) on psychological distress (e.g., stress, depression, and suicidal ideation) separately, but few studies explored a combined effect of ACEs and BCEs on psychological distress. The aim of this study was to explore a combined effect of ACEs and BCEs on psychological distress among Chinese undergraduates.MethodsParticipants were undergraduates aged 17–24 years (N = 1,816) and completed a self-reported questionnaire. A series of regression analyses were conducted to examine the association between childhood experiences and psychological distress.ResultsA total of 65.7% of undergraduates had BCEs, 27.1% of undergraduates had ACEs, and 12.9% of undergraduates had ACEs and BCEs simultaneously. Logistic regression analysis indicated that undergraduates who experienced high ACEs were more likely to have a high risk of psychological distress [odds ratio (ORs) = 1.46, 1.84, and 3.15 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively], while undergraduates who experienced High BCEs were less likely to have psychological distress (ORs = 0.33, 0.22, and 0.32 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively) compared with Low-Both group. The combined effect of ACEs and BCEs (High-Both group) could also play as a protective factor in uncertainty stress (OR = 0.56) and depressive symptoms (OR = 0.47).ConclusionOur findings suggested that ACEs and BCEs could not only predict the psychological distress independently, but also BCEs could counteract the negative effect of ACEs in psychological problems. There is an even greater need to identify and support the victims of ACEs and to increase BCEs in early childhood.

Background: The evidence on the association between benevolent childhood experience (BCE) and depressive symptoms in students is complex. This study aims to explore the underlying mediation mechanism of BCE toward depressive symptoms and whether this link was moderated by the family relationship among Chinese undergraduates.Methods: From March 2021 to May 2021, a cross-sectional study was conducted in China, and 1821 undergraduates were recruited in this study. Participants were asked to complete a self-reported electronic questionnaire. The software SPSS PROCESS macro was used to test the mediation and mediated moderated modeling analysis.Results: Mediation analysis indicated that uncertainty stress (US) partly mediated the link between BCE and depressive symptoms (indirect effect = −0.47, 95% bootstrap CI = −0.55, −0.39). The indirect effect of the US accounted for 39.63% of the total variance in depression. Moderation analysis indicated that the association between the US and depressive symptoms was significantly modified by family relationships (interact effect = −0.019, P < 0.001). An integrative moderated mediation analysis indicated that the indirect effect from BCE to depressive symptoms through the US was also moderated by family relationships (interact effect = −0.012, P = 0.014).Conclusion: Uncertainty stress plays a key role in bridging BCE and depressive symptoms while the family relationship can buffer the impact of the US on depressive symptoms among Chinese undergraduates. Enhancing tolerance of uncertainty and improving family relationships are needed to protect undergraduates from depressive symptoms.

No abstract

BackgroundTo determine the associations of animal products intake and physical activity and their combined effects with cause-specific and all-cause mortality among type 2 diabetes mellitus (T2DM) patients in China.MethodsBaseline data of 7311 type 2 diabetes mellitus (T2DM) patients recruited with a stratified random cluster sampling method were collected from December 2013 to January 2014. Participants were followed up until the date of their death or December 2019 for survivors, whichever came first. Nonlinear trends of cause-specific and all-cause mortality were assessed using restricted cubic splines with three knots placed at centiles 10, 50, and 90 of diet intake. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the combined relationship of physical activity and animal products with cause-specific and all-cause mortality.ResultsDuring a median follow-up of 6.1 years, 692 (9.5%) T2DM patients died. The main cause of death was cardiovascular disease (CVD) (35.8%), followed by cancer (20.6%). After multivariable adjustment, a higher level of physical activity was nonlinearly associated with lower all-cause and CVD mortality in a J-shaped pattern, with the protective effect observed >8 MET-h/d. Higher consumption of red meat, poultry, and aquatic products was associated with a lower risk of all-cause mortality (HR = 0.75, 0.64, 0.75, respectively, all P<0.05). In the highest tertiles of physical activity, a higher intake of red meat, poultry, and aquatic products was associated with a lower risk for all-cause mortality than in the lowest tertiles (red meat, HR = 0.80, 0.62, 0.51, and 0.48; poultry, HR = 0.85, 0.51, 0.48, and 0.45; aquatic products, HR = 0.80, 0.57, 0.55, and 0.40, respectively). Similarly, the protective effect of moderate to high intake of poultry, aquatic products, and eggs on CVD mortality in high physical activity was found. ConclusionsOur study highlights that in T2DM patients, better adherence to moderate to high consumption of animal products, including red meat, poultry, and aquatic products, together with engaging in moderate to high levels of physical activity exerts a beneficial effect in lowering cause-specific and all-cause mortality in China.