Hong Wang Fung

Dissociative disorders (DDs) are psychiatric conditions characterized by pathological dissociation, which refers to failures in the process of integrating one’s psychophysiological experiences (e.g...

Aims: Self-report checklists are commonly used to collect health information in social and epidemiological studies. Little is known about the reliability of such self-report data. This study examined the 6-month test–retest reliability of 28 clinical diagnoses and health histories as self-reported by a sample of adult female mental health service users. Methods: A convenience sample of female mental health service users ( N = 293) provided self-report data on their health histories – including physical, psychiatric, neurodevelopmental and functional domains – two times, approximately 6 months apart. We calculated the agreement rates and Cohen’s kappa of the results. Results: The results demonstrated high levels of temporal consistency. Agreement rates were ≥84.5% for all conditions, while Cohen’s kappa values were above 0.50 for 21 out of 28 conditions. Conclusions: Self-report checklists, as widely used in survey studies, can yield reliable health data. Social and health science researchers can employ such checklists to collect health background information of research participants, especially when clinical validation is not feasible or when hospital records are not accessible.

Introduction: Trauma is a risk factor for mental health problems. Pathological dissociation is often theorized as a response to trauma, yet it remains a controversial topic. Aim: The present study is one of the very few to examine trauma and dissociation in a representative general population sample and is the first of its kind in the Chinese context. We examined the prevalence of pathological dissociation and its association with trauma, potential iatrogenic effects, and functional impairment. Methods: A random sample of community Hong Kong Chinese adults ( N = 945) completed validated measures of trauma exposure, dissociative symptoms, depressive symptoms, and functional impairment. Results: In this sample, 33.3% endorsed at least one potentially traumatic event; 16.5% exhibited clinically significant pathological dissociation, of whom only 14.8% had ever sought professional mental health services. Childhood betrayal and non‐betrayal trauma and adulthood betrayal trauma were significantly associated with dissociative symptoms, while adulthood non‐betrayal trauma was not. Dissociative symptoms were the strongest predictor of functional impairment ( β = 0.443, p < 0.001), even stronger than depressive symptoms ( β = 0.384, p < 0.001). Discussion: This study highlights the public health and clinical importance of recognizing dissociation, which is comparably prevalent to depression and even more strongly linked to functional impairment. Our results support the trauma model in general, but do not support the betrayal trauma theory or the iatrogenic model. Implications: Dissociative symptoms are prevalent and clinically significant in the community. Nurses should be trained to identify and support people affected by pathological dissociation.

Dissociation refers to failures in the process of integrating one’s own psychophysiological experiences, such as emotions, behaviors, memories, and identities (Loewenstein et al., 2024; Ross, 1997;...

Aligning with an integrated biopsychosocial models of stress-related psychopathology, Garcia-Toro and Gomez-Juanes argued that anxiety-spectrum disorders can be understood as a biopsychosocial dissociation driven by 'schismogenesis', the runaway feedback across neurobiological, psychological, and social systems that disrupt integration and creates rigid hyperactivity and hypoactivity across systems. They reframe anxiety disorders through complex systems (or cybernetics), suggesting psychopathology may emerge when reciprocal feedback overwhelms regulatory mechanisms, producing disintegration across these systems.Several empirical studies offer new insights into how vulnerability to stress-related psychopathology is shaped by developmental, dispositional, and social-environmental factors. First, Inoue et al. conducted a bibliometric analysis mapping research trends in obsessive-compulsive disorder (OCD). Their main finding is that OCD research is increasingly organized around neurocircuitry, genetics, oxidative stress and inflammation, as well as metabolic interventions, rather than purely descriptive phenomenology, especially after the COVID-19 pandemic. This aligns with the Research Topic's broader emphasis on psychiatric disorders as heterogeneous conditions that require multimodal investigation and treatment.In addition, Li et al. showed that the association between childhood trauma and physiological stress responses may be genetically determined and sex-specific. Using a sample of non-clinical young adults (N = 190), they found that the relationship between childhood trauma and hair cortisol concentration varied by brain-derived neurotrophic factor (BDNF) Val66Met genotype and sex, with the association more prominent among female Val/Val carriers. This suggests that childhood traumarelated changes in hypothalamic-pituitary-adrenal (HPA) reactivity may be moderated by gene-bysex processes.Relatedly, Ecker et al.'s study suggested that heightened stress sensitivity is already reflected in personality and temperament in non-clinical adolescents (N = 73). Under experimentally induced social stress, lower extraversion was associated with greater salivary cortisol reactivity, while higher harm avoidance was associated with both stronger cortisol responses and higher subjective stress. These findings suggest that dispositional traits may shape physiological and subjective responses to stressors long before the onset of a psychiatric disorder.More importantly, stress-related psychopathology may also show meaningful day-to-day temporal variation. Biggs et al. used ecological momentary assessment to assess PTSD symptoms four times daily for 15 days among U.S. service members with probable PTSD (n = 80) and without probable PTSD (n = 79). They found that symptom clusters in the probable PTSD group varied across the week and were generally higher on weekdays than weekends, suggesting that symptoms may fluctuate in response to recurring work-related pressures.Finally, focusing on EEG-derived brain dynamics together with peripheral lactate and lactate dehydrogenase (LDH) in remitted patients with bipolar I disorder (N = 20), Kesebir and Demirer et al. suggested that bipolar I disorder may involve a bioenergetic signature, with serum lactate and LDH linked to theta and gamma EEG activity. This EEG-metabolite association may reflect integrated neuroenergetic and neuroprotective processes that may be relevant to stress sensitivity and longer-term neurodegenerative risk in bipolar I disorder.Social and cultural specificity in the clinical presentation of stressors and psychopathology are highlighted in several empirical studies included in this Research Topic. Region-specific stressors play an important role in mental health difficulties and reduced well-being in specific populations. Mohammad et al. examined long-term mental health outcomes among survivors of the 1988 chemical attacks in Kurdistan. Among 534 participants, 78.8% met the PTSD threshold, and nearly half (46.3%) showed comorbid somatic and mood symptoms. Greater trauma exposure, female sex, and lower educational attainment were associated with more severe symptoms. These findings suggest that trauma burden and social vulnerability interact such that socially-disadvantaged individuals had a more severe symptom presentation.Johnson et al. examined the association between adverse childhood experiences and interpersonal difficulties, including interpersonal sensitivity, paranoid ideation, and hostility, among Jamaican adults (N = 1,633). Most participants (70.5%) reported high ACE exposure, and greater ACE burden was associated with worse scores on all three outcomes, with bullying, physical neglect, and home and community violence particularly salient. These findings indicated that early adversity is highly prevalent in Jamaican adults and contributes to later interpersonal difficulties, including paranoia and hostility.Eid et al.'s narrative review of somatic symptom and related disorders in Arab populations identified correlates of these disorders in a region where mental health stigma and distinct explanatory models of illness are common. The 35 studies included in the review suggested that, across Arab populations, female sex, lower educational attainment, chronic medical comorbidity, trauma exposure, stigma, and culturally-specific explanatory models influenced symptom expression, help-seeking, and diagnostic recognition, highlighting the importance of culturally-sensitive understanding of stress-related psychopathology and help-seeking behavior.Two empirical articles examined country-specific stressors in China. First, Lu et al. (2025) found that, among Chinese adolescents (N = 1,421), cyberbullying victimization at baseline predicted higher depression and academic burnout, and lower self-esteem at six-month follow-up. These longitudinal associations were partly mediated by reduced mindfulness. Second, Xue et al. (2025) found...

Background: Dissociative symptoms are prevalent and disabling, but little is known about what factors can longitudinally predict dissociative symptoms. This study examined the protective role of perceived social support against dissociative symptoms. Methods: We analyzed data from the International Dissociative Depression Survey Project ( N = 152) and the International Female Mental Health Survey Project ( N = 293). In both samples, participants completed validated measures of dissociative symptoms and perceived social support at baseline, and then reported their dissociative symptoms after approximately 6 to 12 months. We tested the hypothesis that perceived social support would predict subsequent dissociative symptoms in each sample and see whether the results could be replicated across different samples. Results: After controlling for demographic variables, childhood trauma, and baseline dissociative symptoms, baseline perceived social support was significantly associated with fewer dissociative symptoms at follow-up (β = − 0.129 to − 0.198, p = .001). The results were replicated across the two samples. Conclusion: This study contributes to the very limited literature on the longitudinal predictors of dissociative symptoms. Our results point to the critical role of social-interpersonal and family interventions in preventing and treating dissociative symptoms.

Background: Although individuals typically spend more than 10 years in school, with school days often lasting 6 hours or more, little is known about the potential psychosocial and mental health benefits of teacher support for young people while considering the effects of childhood trauma. Methods: This study examined whether perceived teacher support would be positively associated with self-esteem and confidence in career development while negatively associated with depressive symptoms and post-traumatic stress (PTS) symptoms, after controlling for childhood trauma. This study analyzed data from two culturally different samples of young adults ( N = 781 Chinese speakers and N = 283 English speakers). Results: Perceived teacher support was significantly associated with self-esteem (β = 0.282–0.300, p < 0.001), confidence in career development (β = 0.324–0.352, p < 0.001), and fewer depressive symptoms (β = −0.173 to −0.220, p < 0.001) among young adults, even after controlling for age, gender, childhood trauma, and history of seeking mental health services. However, perceived teacher support was not associated with PTS symptoms ( p = 0.450–0.473). Conclusion: The findings are very consistent across two samples, despite differences in measures and sociocultural and language backgrounds. The study highlights the potential benefits of teacher support in promoting the well-being of young people, especially in the context of childhood trauma, although further longitudinal studies are needed. The findings point to the need to provide teachers with necessary training, support and resources so that they are ready to support students in need.

Self-compassion is a significant factor in mental health outcomes across various populations. Research has shown that self-compassion may improve mental health by promoting emotion regulation and resilience, as well as protecting people from depression and anxiety. Despite sufficient research on self-compassion and mental health, most current studies fail to demonstrate causality or track changes over time. Moreover, there is a significant gap in existing research regarding the use of SEM or path models to conceptualize the interplay among self-compassion components. By conceptualizing how these components interact, path models can provide deeper insights into the mechanisms through which self-compassion exerts its effects. This repeated measures study analyzed data from 232 participants who completed valid measures at two time points. The aim was to examine the relationship between self-compassion and mental well-being, as assessed by a validated self-rated measure of mental health (SRMH). Additionally, the study examined how distinct facets of self-compassion contributed uniquely to SRMH over time. Results revealed that the proposed models demonstrated a good fit to the data. This confirmed the differential predictive abilities of separate self-compassion dimensions regarding subsequent SRMH. Specifically, self-kindness emerged as the strongest predictor of positive mental health in subsequent analyses. In addition, mediating variables such as common humanity and isolation were identified as significant pathways through which self-kindness and over-identification influenced SRMH. Moreover, applying repeated measures panel analysis within a cross-lagged framework further substantiated this finding. Overall, the results supported consistent associations between facets of self-compassion and mental well-being across two measurement occasions. Based on these results, future studies should investigate interventions to cultivate self-kindness actions, such as through loving-kindness meditation or compassion-focused exercises. These methods are expected to be impactful in treating and preventing various mental health issues by embracing self-kindness and lessening isolation.