Longitudinal study

纵向研究
  • 文章类型: Journal Article
    目的:尽管已经对OXIS接触者进行了一系列研究,缺乏关于OXIS接触随时间变化的研究。因此,这项研究旨在评估3-7岁儿童3年后初级磨牙之间接触类型的变化。
    方法:这项纵向研究使用926名儿童的2922个分段模具模型进行。在基线(T0),根据OXIS标准,通过截面模模法复制对乳牙之间的接触类型进行评分.三年后,使用相同的标准(T1)对相同儿童的分段模具模型进行评分.
    结果:McNemar的测试显示,从基线到3年的接触发生了显着变化。事后测试解释了观察到的显着接触的特定变化。这些是O到X(p<0.001),O至I(p<0.001),O到S(p=0.035),和I到X(p<0.001)。
    结论:观察到OXIS接触随时间的显着变化。O型接触经历了最大变化。最不稳定的联系人是\"O\"和\"I\"类型,分别。接触类型随年龄的变化可能会改变儿童龋齿的风险。
    OBJECTIVE: Although a series of studies on OXIS contacts have been performed, studies regarding changes in OXIS contacts over time are lacking. Therefore, this study aimed to evaluate the change in contact type between primary molars after 3 years in children aged 3-7 years.
    METHODS: This longitudinal study was conducted using 2922 sectional die models of 926 children. At baseline (T0), the contact type between the primary molars was scored using replication via the sectional die model method according to the OXIS criteria. After 3 years, the sectional die models of the same children were scored using the same criteria (T1).
    RESULTS: McNemar\'s tests revealed a significant change in contacts from baseline to 3 years. The post hoc test explained specific changes in the contacts that were observed to be significant. These were O to X (p < 0.001), O to I (p < 0.001), O to S (p = 0.035), and I to X (p < 0.001).
    CONCLUSIONS: A significant change in OXIS contact over time was observed. The O-type contact underwent the maximum change. The least and most stable contacts are the \"O\" and \"I\" types, respectively. This change in contact type with age may alter the risk of caries in children.
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  • 文章类型: Journal Article
    这项研究的目的是研究六年来习惯性乐观情绪的变化,并分析乐观情绪的变化与其他生活质量相关变量的变化之间的关系。
    对德国成年普通人群(N=4,965)的随机选择的社区样本进行了两次调查,时间间隔为6.04年。
    在6年的过程中,LOT-R总量表的平均得分提高(效应大小d=0.11).就测试-重测相关性而言,总样本的时间稳定性为r=0.61。在这种时间稳定性中只有轻微的性别差异,然而,年龄最大的≥70岁(r=0.50)的稳定性低于其他年龄组的稳定性。横断面相关性显示了乐观情绪与生活质量之间的明确关系,生活满意度,社会支持,另一方面,低水平的焦虑和身体不适。乐观情绪的变化与其他变量的变化之间的相应纵向相关性不太明显,但在同一个方向。
    该研究证实了LOT-R在纵向研究中的适用性。在70岁及以上参与者的样本中,在临床实践和流行病学研究中需要考虑乐观评估的有限稳定性.
    UNASSIGNED: The aims of this study were to examine changes in habitual optimism over a six-year period and to analyze the relationship between changes in optimism and changes in other quality of life-related variables.
    UNASSIGNED: A randomly selected community sample of the German adult general population (N = 4,965) was surveyed twice, with a time interval of 6.04 years.
    UNASSIGNED: During the course of the 6 years, the mean score of the LOT-R total scale improved (effect size d = 0.11). The temporal stability in terms of the test-retest correlation was r = 0.61 for the total sample. There were only marginal gender differences in this temporal stability, however, the stability in the oldest age group ≥70 years (r = 0.50) was lower than the stability of the other age groups. The cross-sectional correlations showed clear relationships between optimism on the one hand and quality of life, life satisfaction, social support, and low levels of anxiety and physical complaints on the other. The corresponding longitudinal correlations between changes in optimism and changes in the other variables were less pronounced, but in the same direction.
    UNASSIGNED: The study confirmed the applicability of the LOT-R in longitudinal studies. In samples with participants of 70 years and above, the limited stability in the optimism assessments needs to be considered in clinical practice and epidemiologic research.
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  • 文章类型: Journal Article
    背景:目前的纵向调查有两个主要目标。首先,我们旨在澄清抑郁症患者在急性疾病期间是否表现为对自我和他人的情绪意识受损,以及这些受损在住院精神病治疗计划期间是否减轻。先前基于情绪意识量表(LEAS)的绩效测量水平的研究提供了有关临床抑郁症中情绪自我意识的不一致发现。第二,我们调查了抑郁症患者的认知和情感共情能力从急性疾病到康复是否发生变化。
    方法:58名抑郁症患者在入院时和住院精神病治疗6-8周后进行测试。还以6-8周的间隔对53个健康个体的样本进行了两次检查。LEAS和人际反应指数(IRI)用于评估情绪意识和移情能力。将书面文本数字化,然后使用电子评分程序geLEAS进行分析,德国电子情感意识水平量表。
    结果:抑郁患者报告的抑郁症状比健康对照组更多,与第1时间相比,第2时间的抑郁症状症状较少。独立于时间,与健康个体相比,抑郁个体倾向于表现出较低的geLEAS自我评分,并且具有较低的geLEAS其他评分.在两个测量时间,抑郁患者的个人困扰评分均高于健康个体。IRI(透视和幻想)和移情关注的认知移情量表未观察到组差异,但是从时间1到时间2,抑郁症患者的共情关注显着下降。IRI评估的移情能力与他人的情绪意识没有显着相关,在整个样本中都没有,在患者和对照子样本中也没有。
    结论:抑郁患者在急性疾病和康复期间似乎表现为他人的情绪意识受损,但与健康个体相比,他们也倾向于表现出情感自我意识的缺陷。抑郁症患者自我报告的认知移情能力似乎处于正常水平,但是他们自我集中的情感同理心的增强可能代表了抑郁症的脆弱性因素。
    BACKGROUND: The present longitudinal investigation had two major goals. First, we intended to clarify whether depressed patients are characterized by impairments of emotional awareness for the self and the other during acute illness and whether these impairments diminish in the course of an inpatient psychiatric treatment program. Previous research based on the performance measure Levels of Emotional Awareness Scale (LEAS) provided inconsistent findings concerning emotional self-awareness in clinical depression. Second, we investigated whether cognitive and affective empathic abilities change from acute illness to recovery in depressed patients.
    METHODS: Fifty-eight depressed patients were tested on admission and after 6-8 weeks of inpatient psychiatric treatment. A sample of fifty-three healthy individuals were also examined twice at an interval of 6-8 weeks. The LEAS and the Interpersonal Reactivity Index (IRI) were administered to assess emotional awareness and empathic abilities. Written texts were digitalized and then analyzed using the electronic scoring program geLEAS, the German electronic Levels of Emotional Awareness Scale.
    RESULTS: Depressed patients reported more depressive symptoms than healthy controls and less severe depressive symptomatology at time 2 compared to time 1. Independent of time, depressed individuals tended to show lower geLEAS self scores and had lower geLEAS other scores than healthy individuals. Depressed patients showed higher personal distress scores than healthy individuals at both measurement times. No group differences were observed for the cognitive empathy scales of the IRI (perspective taking and fantasy) and empathic concern, but empathic concern decreased significantly in depressed patients from time 1 to time 2. Empathic abilities as assessed by the IRI were not significantly correlated with emotional awareness for others, neither in the whole sample, nor in the patient and control subsample.
    CONCLUSIONS: Depressed patients seem to be characterized by impairments in emotional awareness of others during acute illness and recovery, but they also tend to show deficits in emotional self-awareness compared to healthy individuals. Self-reported cognitive empathic abilities seem to be at normal levels in depressed patients, but their heightened self-focused affective empathy may represent a vulnerability factor for depressive disorders.
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  • 文章类型: Journal Article
    慢性肾脏疾病(CKD),与环境因素密切相关,构成了重大的公共卫生挑战。这项研究,基于来自国家重点环境污染领域和多个基因相关公共数据库的529次重复措施,采用各种流行病学和生物信息学模型来评估联合重金属暴露的影响(铬[Cr],镉[Cd],和铅[Pb])对老年人早期肾损伤和CKD的影响。介绍新的环境靶向孟德尔随机化方法,我们的研究探讨了金属与CKD之间的因果关系。研究结果表明,金属水平升高与肾损伤呈正相关,联合暴露引起的肾损害比单独暴露更显著。研究表明,金属主要通过氧化应激和金属离子抗性途径影响CKD的发展,关注三个相关基因(SOD2、MPO、NQO1)和转录因子(NFE2L2)。发现金属通过增加SOD2,MPO的表达来调节体内的氧化应激水平,NQO1和NFE2L2降低,导致CKD发病。我们的研究建立了一个新的因果推断框架,将环境污染物-途径-基因-CKD联系起来,评估金属暴露对CKD的影响和机制。未来的研究需要更广泛的体外证据和更大的人群来验证。
    Chronic Kidney Disease (CKD), closely linked to environmental factors, poses a significant public health challenge. This study, based on 529 triple-repeated measures from key national environmental pollution area and multiple gene-related public databases, employs various epidemiological and bioinformatics models to assess the impact of combined heavy metal exposure (Chromium [Cr], Cadmium [Cd], and Lead [Pb]) on early renal injury and CKD in the elderly. Introducing the novel Enviro-Target Mendelian Randomization method, our research explores the causal relationship between metals and CKD. The findings indicate a positive correlation between increased levels of metal and renal injury, with combined exposure caused renal damage more significantly than individual exposure. The study reveals that metals primarily influence CKD development through oxidative stress and metal ion resistance pathways, focusing on three related genes (SOD2, MPO, NQO1) and a transcription factor (NFE2L2). Metals were found to regulate oxidative stress levels in the body by increasing the expression of SOD2, MPO, NQO1, and decreasing NFE2L2, leading to CKD onset. Our research establishes a new causal inference framework linking environmental pollutants-pathways-genes-CKD, assessing the impact and mechanisms of metal exposure on CKD. Future studies with more extensive in vitro evidence and larger population are needed to validate.
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  • 文章类型: Journal Article
    在过去的10年中,孕妇和产后个体的致命药物过量急剧增加。该人群非致命药物过量的趋势和特征,然而,仍然未知,尽管这一结果对母婴健康很重要。我们在全州范围内使用,来自加利福尼亚州的纵向联系医院和急诊科的行政索赔数据来表征发病率,趋势,药物类型参与,2010年至2019年期间妊娠相关药物过量的社会人口统计学差异。使用解释每个个体多次交付的广义线性模型来测试趋势;描述性统计用于其他研究分析。在2010年至2018年期间进行现场分娩的加利福尼亚州个体中,约有0.2%的人患有与怀孕相关的药物过量。非致命性用药过量的发生率是致命性用药过量的近60倍。涉及兴奋剂的过量发生率增加,而涉及镇静/催眠药物和精神药物的过量发生率下降。在年轻的分娩个体中,服药过量的风险高得多,非西班牙裔黑人,医疗补助患者,或者住在非大都市地区的人。持续的公共卫生监测和临床干预以减少与妊娠相关的非致命药物过量事件对于预防工作至关重要。
    Fatal drug overdoses among pregnant and postpartum individuals have risen dramatically over the past 10 years. Trends in and characteristics of nonfatal drug overdoses in this population, however, remain unknown, despite the importance of this outcome for maternal and infant health. We used statewide, longitudinally-linked hospital and emergency department administrative claims data from California to characterize the incidence, trends, drug type involvement, and sociodemographic disparities in pregnancy-associated drug overdose between 2010 and 2019. Generalized linear models accounting for multiple deliveries per individual were used to test for trends; descriptive statistics were used for other study analyses. Of California individuals with a live delivery between 2010 and 2018, approximately 0.2% had a pregnancy-associated drug overdose. Nonfatal overdoses were nearly 60 times more common than fatal overdoses. Incidence of overdoses involving stimulants increased in frequency, while incidence of overdoses involving sedative/hypnotic drugs and psychotropic medications decreased in frequency. Risk of overdose was substantially higher among delivering individuals who were young, non-Hispanic Black, Medicaid patients, or who lived in non-metropolitan areas. Ongoing public health surveillance of and clinical interventions to reduce pregnancy-associated nonfatal drug overdose events are critical for prevention efforts.
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  • 文章类型: Journal Article
    背景:先前的研究报道了成人中血细胞指数失调和外周炎症标志物与抑郁症的相关性,但有限的研究在青少年早期研究了这种相关性。
    方法:本研究使用中国早期青少年队列研究的数据,这是在安徽进行的,中国。使用中文版的儿童流行病学研究中心抑郁量表反复测量学生的抑郁症状。学生的血液样本是在2019年9月和2021年9月收集的。使用血常规检测外周血细胞计数和炎症标志物水平。在整个样本和性别分层样本中,使用多变量回归模型来探索血细胞指数与青少年抑郁症状之间的关联。
    结果:白细胞(WBC)计数,中性粒细胞计数(NC),血小板(PLT)计数,中性粒细胞与淋巴细胞比率(NLR),血小板与淋巴细胞比率,全身免疫炎症指数(SII)与随访期间抑郁症状严重程度呈正相关。平均红细胞体积(MCV),平均血红蛋白(HGB)体积(MCH),平均红细胞HGB浓度(MCHC)与抑郁症状呈时间负相关。此外,几种性别特异性血细胞标志物与抑郁症相关.红细胞(RBC)增加的男性青少年和HGB水平降低和WBC上调的女性青少年,NC,NLR,和SII水平在随访时表现出严重的抑郁症状。
    结论:这些发现提示外周血细胞指数在评估青少年早期抑郁中的潜在作用。
    BACKGROUND: Previous studies have reported the correlation of dysregulated blood cell indices and peripheral inflammatory markers with depression in adults but limited studies have examined this correlation in early adolescents.
    METHODS: This study used data from the Chinese Early Adolescents Cohort Study, which was conducted in Anhui, China. Students\' depression symptoms were repeatedly measured using the Chinese version of the Center for Epidemiological Studies Depression Scale for Children. Students\' blood samples were collected in September 2019 and September 2021. The peripheral blood cell counts and inflammatory marker levels were determined using routine blood tests. Multivariate regression models were used to explore the associations between blood cell indices and adolescent depressive symptoms in both the whole sample and the sex-stratified samples.
    RESULTS: The white blood cell (WBC) count, neutrophil count (NC), platelet (PLT) count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and systemic immune inflammation index (SII) were positively correlated with the severity of depressive symptoms during follow-up. The mean corpuscular volume (MCV), mean hemoglobin (HGB) volume (MCH), and mean corpuscular HGB concentration (MCHC) exhibited a negative temporal correlation with depressive symptoms. Additionally, several sex-specific blood cell markers were correlated with depression. Male adolescents with increased red blood cell (RBC) and female adolescents with decreased HGB levels and upregulated WBC, NC, NLR, and SII levels exhibited severe depressive symptoms at follow-up.
    CONCLUSIONS: These findings suggested the potential usefulness of peripheral blood cell indices in the assessment of depression in early adolescents.
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  • 文章类型: Journal Article
    目的:肌少症肥胖是肌少症和肥胖的组合,这与残疾的发作有关。脂肪肌肉比(FMR)是评估肌肉质量与脂肪质量之比的筛选量度。然而,FMR与残疾之间的关系尚未调查。
    方法:这项研究包括11,427名年龄≥65岁的社区居住老年人参加NCGG-SGS(国家老年病和老年病学中心-老年综合征研究),日本的一项全国性队列研究。通过生物电阻抗分析测量FMR,并通过将脂肪质量除以肌肉质量来计算。使用校正了协变量的Cox比例风险回归分析来调查FMR与5年新护理需求发展风险之间的关联。FMR除以大约五分之一,以五分位数5为高。
    结果:高FMR组的残疾发生率最高,女性为20.8%,男性为20.1%。在女性中,FMR与残疾之间的关联存在显著差异(风险风险[HR]:1.43,95%置信区间[CI]:1.16~1.75).男性FMR与残疾之间没有关联(HR:0.98,95CI:0.76-1.25)。考虑反向因果关系的滞后分析并没有改变这种关系。
    结论:FMR与女性社区居住老年人的残疾风险增加相关,而与男性无关。因为男性肌肉力量下降的速度比女性快,早期肌肉力量下降可能比肌肉质量或脂肪质量更影响男性的残疾风险。
    OBJECTIVE: Sarcopenic obesity is a combination of sarcopenia and obesity, which is associated with the onset of disability. Fat to muscle ratio (FMR) is a screening measure that assesses the ratio of muscle mass to fat mass. However, the relationship between the FMR and disability has not been investigated.
    METHODS: This study included 11,427 community-dwelling older adults aged ≥65 years enrolled in NCGG-SGS (National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes), a national cohort study in Japan. FMR was measured by the bioelectrical impedance analysis and calculated by dividing fat mass by muscle mass. Cox proportional hazard regression analysis adjusted for covariates was used to investigate the association between FMR and the risk of developing new care needs at 5 years. FMR was divided by about quintile, with quintile 5 as the high.
    RESULTS: The high FMR group had the highest incidence of disability at 20.8 % for women and 20.1 % for men. In women, the association between FMR and disability was significantly different for the FMR (hazard risk [HR]: 1.43, 95 % confidence interval [CI]: 1.16-1.75). There was no association between FMR and disability in men (HR: 0.98, 95 %CI: 0.76-1.25). Lagged analyses accounting for reverse causality did not change the relationship.
    CONCLUSIONS: FMR is associated with increased risk of disability in women community-dwelling older adults but not among men. Because the rate of decreased muscle strength is faster in men than in women, early decreased muscle strength may affect men\'s risk of disability more than muscle mass or fat mass.
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  • 文章类型: Journal Article
    预防悖论描述了大多数自杀未遂病例来自低或中等风险人群的情况,只有少数来自“高风险”组。假设是,低基准利率与多种原因相结合,无法确定所有自杀企图的高危人群。研究首次自杀企图及其原因等事件的最佳方法是收集事件历史数据。在1980年至1985年出生的六个国家出生队列(N=300,000)的人群中,使用行政登记册来确定自杀行为风险较高的人群,随后年龄在15至29岁之间。风险参数的估计基于离散时间逻辑比值比模型。首次自杀未遂的终生患病率为4.5%。家庭背景和家庭抚养子女的因素是后来首次自杀未遂的预测因素。年轻人诊断患有精神病或神经发育障碍(ADHD,焦虑,抑郁症,PTSD),作为暴力或性犯罪的受害者,对解释模型做出了贡献。与预防悖论相反,结果表明,有可能在所有首次自杀未遂的三分之二的人群中确定一个离散的高危人群(<12%),但三分之一的自杀企图来自低风险到中等风险的人群。调查结果证实,需要一个普遍的综合战略,在政策制定以及战略和实践对策中采取有针对性和明确的预防方法,并提出了一些有希望的预防策略。
    The prevention paradox describes circumstances in which the majority of cases with a suicide attempt come from a population of low or moderate risk, and only a few from a \'high-risk\' group. The assumption is that a low base rate in combination with multiple causes makes it impossible to identify a high-risk group with all suicide attempts. The best way to study events such as first-time suicide attempts and their causes is to collect event history data. Administrative registers were used to identify a group at higher risk of suicidal behaviour within a population of six national birth cohorts (N = 300,000) born between 1980 and 1985 and followed from age 15 to 29 years. Estimation of risk parameters is based on the discrete-time logistic odds-ratio model. Lifetime prevalence was 4.5% for first-time suicide attempts. Family background and family child-rearing factors were predicative of later first-time suicide attempts. A young person\'s diagnosis with psychiatric or neurodevelopmental disorders (ADHD, anxiety, depression, PTSD), and being a victim of violence or sex offences contributed to the explanatory model. Contrary to the prevention paradox, results suggest that it is possible to identify a discrete high-risk group (<12%) among the population from whom two thirds of all first-time suicide attempts occur, but one third of observed suicide attempts derived from low- to moderate-risk groups. Findings confirm the need for a combined strategy of universal, targeted and indicated prevention approaches in policy development and in strategic and practice responses, and some promising prevention strategies are presented.
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  • 文章类型: Journal Article
    背景:脆性X综合征(FXS)是一种与社交焦虑和回避风险增加相关的遗传性疾病。使用功能近红外光谱(fNIRS),我们先前证明了FXS交叉截面年轻女孩的异常神经活动对面部的反应。这里,我们检验了一个假设,即在65岁的FXS女孩中,神经激活和致敏的异常会随着年龄的增长而增加,年龄5-16岁,与年龄相匹配的对照组的52名女孩具有相当的认知功能和临床症状。
    方法:在两个时间点收集功能NIRS数据,在面部处理任务中相隔2.8±0.6年。线性混合效应模型检查了FXS和对照女孩的纵向神经分布。进行相关性分析以检查神经敏化(增加对重复刺激的神经反应)之间的关联。和临床评级。
    结果:在使用FXS的女孩中,32名参与者有一个,24人进行了两次fNIRS扫描。在控件中,21有一个,29人进行了两次fNIRS扫描。在两个时间点,FXS右中和上额叶回的大脑激活均高于对照组。当响应直立面时,FXS的神经敏化也比上额叶回的对照组高。对于FXS组,额上回的致敏性与焦虑和社交回避得分的纵向增加呈正相关。
    结论:患有FXS的女孩随着时间的推移表现出越来越异常的神经激活和对面部的敏感反应。FXS女孩的异常神经敏化与焦虑和社交技能的纵向变化有关。
    BACKGROUND: Fragile X syndrome (FXS) is a genetic condition associated with increased risk for social anxiety and avoidance. Using functional near-infrared spectroscopy (fNIRS), we previously demonstrated aberrant neural activity responding to faces in young girls with FXS cross-sectionally. Here, we tested the hypothesis that abnormalities in neural activation and sensitization would increase with age in 65 girls with FXS, ages 5-16 years, relative to an age-matched control group of 52 girls who had comparable cognitive function and clinical symptoms.
    METHODS: Functional NIRS data were collected at two time points, 2.8±0.6 years apart during a face-processing task. Linear mixed-effects models examined longitudinal neural profiles in girls with FXS and control. Correlational analysis was performed to examine associations between neural sensitization (increasing neural response to repeated stimuli), and clinical ratings.
    RESULTS: In girls with FXS, 32 participants had one, and 24 had two fNIRS scans. In controls, 21 had one, and 29 had two fNIRS scans. Brain activations in the right middle and superior frontal gyri were higher in FXS than controls at both time points. Neural sensitization also increased in FXS at a higher rate than controls in the superior frontal gyrus when responding to upright faces. For the FXS group, sensitization in the superior frontal gyrus positively correlated with longitudinal increases in anxiety and social avoidance scores.
    CONCLUSIONS: Girls with FXS show increasingly abnormal neural activation and sensitization responding to faces over time. Aberrant neural sensitization in girls with FXS is associated with longitudinal changes in anxiety and social skills.
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  • 文章类型: Journal Article
    背景:失眠已被确定为自杀的潜在危险因素。然而,到目前为止,很少有使用纵向设计的研究检查了这种关系的潜在机制。基于弹性的观点,这项研究旨在调查失眠之间的动态纵向关系,弹性,和自杀。
    方法:从中国大学生的大规模健康相关队列中抽取了5785名新生。这项研究跨越了六个浪潮,涵盖2020年至2022年期间。使用从T1到T4的数据,因为没有在基线(T0)和T5测量弹性。交叉滞后面板模型和潜在生长曲线中介模型用于检验失眠之间的纵向动态关系,弹性,和自杀。
    结果:结果显示失眠症状和自杀倾向相互预测,弹性在连接失眠症状和自杀方面起着纵向中介作用。
    结论:鉴于韧性在失眠症状和自杀之间的关系中起中介作用,一些以韧性为导向的预防和干预计划将有助于降低大学生自杀风险。
    BACKGROUND: Insomnia has been identified as a potential risk factor for suicidality. However, to date, few studies using the longitudinal-design have examined the underlying mechanism of this relationship. Based on a resilience perspective, this study aimed to investigate the dynamic longitudinal relationships between insomnia, resilience, and suicidality.
    METHODS: A total of 5785 freshmen were sampled from a large-scale health-related cohort among Chinese college students. This study spanned six waves, covering the period from 2020 to 2022. Data from T1 to T4 were used because resilience was not measured at baseline (T0) and T5. The cross-lagged panel models and the latent growth curve mediation model were used to examine the longitudinal dynamic relationships between insomnia, resilience, and suicidality.
    RESULTS: The results showed that insomnia symptoms and suicidality mutually predicted each other, and resilience played a longitudinal mediating role in linking insomnia symptoms and suicidality.
    CONCLUSIONS: Given that resilience served as a mediator in the relation between insomnia symptoms and suicidality, some resilience-oriented prevention and intervention programs will be helpful in reducing the risk of suicide among university students.
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