Purpose: Explore the potential mediating effects of anxiety symptoms and hopelessness on the relationship between academic stress and depressive symptoms among Chinese college students. Patients and Methods: A total of 1309 college students with informed consent were recruited from a local university in China. Academic stress, anxiety symptoms, hopelessness, and depressive symptoms were assessed by self-report scales. Haye’s PROCESS macro for SPSS was used to test the hypothesized mediation effect of anxiety symptoms and hopelessness in the relationship between academic stress and depressive symptoms. Results: Anxiety symptoms, hopelessness, and depressive symptoms were common among college students and were all significantly positively associated with academic stress levels. Academic stress could indirectly affect depressive symptoms by anxiety symptoms, hopelessness, and both anxiety symptoms and hopelessness. The total effect of academic stress on depressive symptoms was 0.063. The total effect of three indirect pathway was 0.039 which account for 62% of the total effect. Conclusion: The study detailed the specific process of depressive symptoms caused by academic stress in college students. Anxiety symptoms and hopelessness could mediate the relationship between academic stress and depressive symptoms. Paying attention to the anxiety levels and hopelessness levels of college students with high academic pressure is suggested as a means of preventing depression and promoting mental health.

This study aims to understand suicidal ideation and suicide attempts among transgender individuals through an in-depth analysis of a nation-wide population general survey in China. Transgender Men (TM) and Women (TW) were investigated through a cross-sectional survey. A structured questionnaire was used to investigate participants' demographic information, perceived sexuality conflicts, childhood adversity and mental health conditions. Logistic regression models were utilized to investigate risk factors associated with suicidal ideation and suicide attempts in these groups. We also conducted a quasi-meta-analysis in order to compare the prevalence of suicidal ideation and attempted suicide between general and transgender populations in China. A total of 1309 participants across 32 provinces and municipalities in China took part in this survey, out of 2060 valid questionnaires. In this transgender population, the lifetime prevalence of suicidal ideation and an attempt at suicide were 56.4% and 16.1%, respectively. This estimated prevalence rate is far greater than in Chinese community samples. For all transgender people, disliking birth-assigned sex, seeking sex reassignment surgery, having intense conflicts with parents, lifetime history of suffering from major depressive disorder, a recent episode of depression, self-harm, and seeking mental health services were significantly associated with increased risk of suicidal ideation. An education level of high school or equivalent, being married and/or separated/divorced, having intense conflicts with parents, or self-harm and seeking mental health services were all significantly associated with increased risk of suicide attempt. Although most risk factors for TM and TW were equivalent across groups, differences were observed in both suicidal ideation and suicide attempt models. The cross-sectional study design and lack of follow-up data are limitations of this study. This is the first study to examine suicide within a Chinese transgender population. The clinical implications of these findings for Chinese mental health professionals are discussed. Also, the evidence from this study can be used to inform the practices of suicide prevention workers, and policy makers working with the transgender population.

Background: China has the world’s largest lesbian, gay, bisexual, and transgender (LGBT) population. This study assessed the discrimination experienced by LGBT individuals in China in a comprehensive way, covering discrimination perpetrated by family, media, medical services, religious communities, schools, social services, and in the workplace. Methods: The current study involved a national survey of 31 provinces and autonomous regions. Discrimination was measured both in terms of heterosexual participants’ attitudes towards LGBT individuals, and LGBT participants’ self-perceived discrimination. Pearson correlation analysis was performed to examine the difference between heterosexual participants’ attitudes towards LGBT individuals and LGBT participants’ self-perceived discrimination. Linear regression was used to investigate the association between gross domestic product per capita and discrimination. Results: Among 29,125 participants, 2066 (7.1%) identified as lesbian, 9491 (32.6%) as gay, 3441 (11.8%) as bisexual, 3195 (11.0%) as transgender, and 10,932 (37.5%) as heterosexual. Heterosexual people were generally friendly towards the LGBT community with a mean score of 21.9 (SD = 2.7, total scale score = 100) and the grand averaged score of self-perceived discrimination by LGBT participants was 49.9 (SD = 2.5). Self-perceived discrimination from family and social services is particularly severe. We created a series of provincial level choropleth maps showing heterosexual participants’ acceptance towards the LGBT community, and self-perceived discrimination reported by members of the LGBT community. We found that a higher level of economic development in provinces was associated with a decrease in discrimination, and we identified that every 100 thousand RMB increase in per capita GDP lead to a 6.4% decrease in discriminatory events perpetrated by heterosexuals. Conclusions: Chinese LGBT groups consistently experience discrimination in various aspects of their daily lives. The prevalence of this discrimination is associated with the economic development of the province in which it occurs. In order to reduce discrimination, it is important for future studies to discover the underlying reasons for discrimination against LGBT individuals in China.

Background: Non-suicidal self-injury (NSSI) is prevalent in adolescents and brings a series of serious consequences to their well-being. However, little is known about parents’ attitude toward NSSI in Chinese adolescents. The study aims to investigate the parents’ attitudes toward and perceptions of adolescents who have engaged in NSSI behaviors, and the impact of NSSI on their parents. Methods: Purposive sampling was used in the study. The biological parents of adolescents with NSSI were recruited from the psychiatric ward of a tertiary hospital in China. Semi-structured interviews were conducted which contained three aspects, that is the history of NSSI, the process of seeking or maintaining help and the impacts on the family. Each interview typically lasted 40–50 min. All of the interviews were audio-recorded. Their responses were analyzed by the thematic analysis. Results: Twenty participants completed the interview, consisting of 16 mothers and 4 fathers. Three themes and eight sub-themes were extracted: (1) the attitudes to children’s NSSI behaviors (ignorance, shame, and stereotype); (2) coping strategies of parents (the initial response to adolescents’ NSSI, and the way of help-seeking); (3) the impacts on family (altered parenting and communication styles, limited personal lives, and increased psychological pressure). Conclusion: The results showed that parents lack the knowledge about NSSI and its treatment and are suffering great emotional stress. It is recommended to expand the popularization of knowledge of NSSI in adolescents and more interventions adapted to China’s sociocultural climate are required for the well-being of parents and NSSI in adolescents.