Depression is a common mental illness among Chinese adolescents. Although the Epidemiological Studies Depression Scale (CES-D) has been widely used in diverse populations, the reported factor structures are inconsistent, and its longitudinal invariance is under-researched. This study examined the psychometric properties and factorial invariance across gender and time of the CES-D among Chinese adolescents. Adolescents aged above 11 years from five schools in Chengdu responded to a questionnaire at Wave 1 (n = 5690). Among them, 4981 participants completed the same questionnaire after six months (Wave 2). The matched sample was composed of 4922 students (51.5% were girls; mean age = 13.15 years) at Wave 1. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the factor structure and performed multi-group CFA to test the factorial invariance across gender and time. A three-factor solution was identified, including “positive affect”, “somatic complaints”, and “depressed affect”. Results of multi-group CFA comparisons supported the factorial invariance of the resultant three-factor solution. Using a new sample of Chinese adolescents in Southwestern China, the present study reproduced earlier findings on adolescents in other areas in China. This study has implications for depression assessment and research in Chinese adolescents.
BackgroundChina adopted a Flexnerian model as its medical institutions developed over the recent past but the political, social, and economic environment has changed significantly since then. This has generated the need for educational reform, which in other countries, has largely been driven by competencies-oriented models such as those developed in Canada, and the United States. Our study sought to establish the competencies model, relevant to China, which will support educational reform efforts.MethodsData was collected using a cross-sectional survey of 1776 doctors from seven provinces in China. The surveys were translated and adapted from the Occupational Information Network General Work Activity questionnaire (O*NET-GWA) and Work Style questionnaire (O*NET-WS) developed under the auspices of the US Department of Labor. Exploratory factor analysis and confirmatory factor analysis ascertained the latent dimensions of the questionnaires, as well as the factor structures of the competencies model for the Chinese doctors.ResultsIn exploratory factor analysis, the questionnaires were able to account for 64.25 % of total variance. All responses had high internal consistency and reliability. In confirmatory factor analysis, the loadings of six constructs were between 0.53 ~ 0.89 and were significant, Construct reliability (CR) were between 0.79 ~ 0.93 respectively. The results showed good convergent validity. The resultant models fit the data well (GFI was 0.92, RMSEA was 0.07) and the six-factor competencies framework for Chinese doctors emerged.ConclusionsThe Chinese doctors’ competencies framework includes six elements: (a) technical procedural skills; (b) diagnosis and management; (c) teamwork and administration; (d) communication; (e) professional behavior; and (f) professional values. These findings are relevant to China, consistent with its current situation, and similar to those developed in other countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0495-y) contains supplementary material, which is available to authorized users.
Stress is associated with relapse to drugs after abstinence, but the mechanisms for this association are unclear. One mechanism may be that stress enhances abstinent addicts' recall of memories of drugs as stress relievers. This study assessed the effects of stress on free recall and cued recall of 10 heroin-related and 10 neutral words learned 24 h earlier by 102 abstinent heroin addicts. These participants were randomly assigned to three experiments that also assessed attention and working memory. Experiment 1 used a psychosocial stressor (Trier social stress test (TSST)) before testing for recall of heroin-related words. Experiment 2 added administration of the b-adrenoceptor antagonist propranolol 1 h before the psychosocial stressor. Experiment 3 added administration of either cortisol with propranolol, cortisol alone, or propranolol alone 1 h before word recall to determine whether stress enhancement of heroin-related word recall required noradrenergic-glucocorticoid interactions. We found that free recall of heroin-related words in abstinent addicts was enhanced after stress or cortisol administration when compared with a non-stress condition or placebo, respectively, whereas these interventions had no effect on neutral word recall. b-adrenergic blockade blocked the enhancing effect of stress or cortisol on free recall of heroin-related words. Neither stress nor cortisol affected cued recall, attention, or working memory. The potential of b-adrenergic blockade to reduce or block stress-induced enhancement of drug-related memory retrieval may be relevant to preventing stress-induced relapse in abstinent heroin addicts.
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