Ting Zhou

Caregiver-mediated early interventions have been shown to benefit children with autism spectrum disorder (ASD). Yet caregivers, who often balance parent and interventionist roles, may struggle to recognize and interpret intervention-worthy moments during dynamic everyday interactions. Relationship-based intervention programs often leverage clinician-led retrospective video review to help caregivers reflect on such moments, but this workflow is difficult to scale because it is time- and expertise-intensive. Meanwhile, existing digital autism tools largely emphasize child-focused skill rehearsal or monitoring, offering limited support for caregiver-centered reflection. We investigate how multimodal sensing and large language models (LLMs) can support the offline video-review coaching workflow. Co-designed with ASD experts, CareAssist fuses synchronized video and photoplethysmography (PPG) signals to detect intervention-worthy moments involving emotional dysregulation or low social engagement and generates grounded moment-level draft guidance and post-session summaries. Through a field study with 56 families, we evaluate moment detection against expert labels and compare three prompting strategies using expert-defined rubrics; we additionally report a pilot caregiver case study as illustrative caregiver-perspective evidence. Quantitative analysis and qualitative feedback show that multimodal detection outperforms baseline models, while structured prompting improves selected expert-rated dimensions and reveals trade-offs among clarity, contextual fit, and ethical suitability. These findings demonstrate the potential of multimodal sensing and LLMs to support scalable offline caregiver coaching beyond clinical environments while identifying safeguards and design requirements for future deployment.

Background: Problematic internet use (PIU) is a growing public health concern among adolescents, often co-occurring with depression and anxiety. This study aimed to (1) examine network structures of PIU and its association with depressive and anxiety symptoms; and (2) compare these networks across PIU severity levels and educational stages. Methods: A total of 5,228 adolescents participated in the survey and were classified by PIU severity (PIU vs. non-problematic internet use, NPIU) and educational stage (primary vs. secondary school). Network analysis and network comparison test were performed to identify core and bridge symptoms and to assess group differences. Results: Significant differences in the global network strength were observed across PIU severity levels and educational stages. Compared with the PIU group, the NPIU group showed higher global strength, while network structure and node centrality remained comparable. Across educational stages, secondary school students displayed higher global strength and a significantly different overall network structure compared with primary school students, whereas local connectivity and centrality estimates were largely similar. In the joint network with depression and anxiety, global network strength differed by PIU severity, and both overall network strength and structure differed by educational stage. Bridge symptoms connecting PIU with depression and anxiety were identified in both PIU and NPIU groups, and across primary and secondary school groups. Conclusions: This study highlights developmental and severity-dependent patterns in PIU and its comorbidities, informing stage-specific and severity-adapted interventions. Clinical trial number: Not applicable.

Parents of children with autism spectrum disorder (ASD) face elevated risks of depressive symptoms, which may impair their daily functioning and hinder effective caregiving. Grounded in self-determination theory and conservation of resources theory, this study examined the bidirectional relationship between basic psychological needs (autonomy, competence, relatedness) satisfaction and depressive symptoms, as well as the potential mediating effect of parenting stress in this relationship. Using a two-wave cross-lagged design, we assessed 178 Chinese parents of autistic children at baseline and at the three-month follow-up. The participants completed questionnaires on basic psychological needs satisfaction, depressive symptoms, and parenting stress at two waves of survey. The results supported the reciprocal relationship between autonomy need satisfaction and depressive symptoms, as well as the predictive effect of depressive symptoms on subsequent competence/relatedness need satisfaction. The findings also established parenting stress as a bidirectional mediator: it not only mediated the negative effects of depressive symptoms on the three psychological needs satisfaction, but also served as a mechanism through which autonomy need satisfaction buffers against mental health decline. These findings highlight the necessity of developing interventions that enhance autonomy support and mitigate parental stress to improve the well-being of parents of autistic children.

Higher levels of parental reflective functioning are associated with normatively developing children’s secure attachment and better socioemotional functioning. Children with autism spectrum disorder (ASD) exhibit more severe behavioral problems than normatively developing children, which hinder social adaptation and impose significant parenting challenges. However, the relationship between parental reflective functioning and behavioral problems in children with ASD remains underexplored, with most studies being cross-sectional. The present study examined reciprocal associations between parental reflective functioning and behavioral problems over a 6-month period across three timepoints in a sample of 180 Chinese parents of children with ASD using cross-lagged panel analyses. The result revealed a bidirectional relationship between parental reflective functioning and children’s internalizing behavioral problems. Higher level of pre-mentalizing predicted increased internalizing behavioral problems at the subsequent time point, and vice versa. A child-driven effect was found in the association between externalizing behavioral problems and parental reflective functioning. A higher level of children’s externalizing behaviors was correlated with increased parental pre-mentalizing and decreased certainty about mental states, as well as reduced parental interest and curiosity, at subsequent time points. The results underscore the importance of developing parenting interventions aimed at enhancing parental reflective functioning to mitigate behavioral problems in children with ASD.

Parental emotion regulation is closely associated with the development of young children's behavioral problems. The present study aims to investigate the potential mediating role of family emotional expressiveness in the association between parental emotion dysregulation and externalizing problems among Chinese preschoolers and to further examine whether this mediation depends on parental endorsement of the cultural value of Chinese familism. A survey study was conducted to examine the moderated mediation model. A total of 161 parents of preschoolers (aged 3-5 years, M = 4.24, SD = 0.60 at T1) participated in all three waves of assessment. The results showed that parental emotion dysregulation indirectly predicted preschoolers' externalizing problems through family negative expressiveness for parents with low endorsement of familism, whereas the mediating effect was not significant for parents with high endorsement of familism. The results contribute to the literature on emotional parenting in the Chinese cultural context and underscore the role of familism values in the relationship between emotional parenting factors and children's behavioral problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The present study aimed to examine the relationship between multiple risk exposures in family and school settings and the depressive symptoms of Chinese students in early adolescence living in the ethnic regions of Yunnan and Hebei, China, via different multiple risk analytic approaches. A total of 2940 students (47.3% females) in grades 4 to 9 (Mage = 12.08, SD = 2.04) from ethnic minority counties in Yunnan and Hebei participated in the survey. The participants completed the questionnaires and reported family risk, school risk, depressive symptoms, and demographic information. The cumulative risk model and the individual multiple risk models with logistic regression/association rule mining were used to examine the effects of cumulative risk, the relative contributions of individual risks, and combinations of multiple risks. We found that (1) when a cumulative risk model was used, the associations between family cumulative risk and school cumulative risk on depressive symptoms were significant, but the cross-domain interaction effect was not significant. (2) The results of logistic regression indicated that high levels of family conflict, low levels of family cohesion, low levels of teacher support, and low levels of peer support were significantly correlated with a high risk for depression. (3) The results of association rule mining revealed meaningful associations between multiple risk factor combinations and depressive symptoms. In conclusion, the use of association rule mining enhanced the analyses and understanding of the effects of multiple risk exposures. Interpersonal stressors in family and school settings need to be addressed in depression prevention and intervention programs for adolescents.

This study aimed to explore the characteristics of parent–adolescent emotional communication patterns from the perspectives of both parents and adolescents and to further examine their relationships with adolescent depressive symptoms. A mixed methods exploratory sequential design was used. In the qualitative phase, 21 parent–adolescent dyads (adolescents aged 15.1 years, with 11 reporting high depressive symptoms and 10 reporting low depressive symptoms) were interviewed, and the data were analyzed via inductive thematic analysis. The quantitative phase surveyed 369 parent–adolescent dyads (adolescents aged 13.5, 48.5% female). Emotional communication patterns were identified via latent profile analyses, and adolescent depressive symptoms were compared across patterns. The qualitative phase identified six parent–adolescent emotional communication patterns depending on parental behaviors, adolescents’ needs, and family arrangements. Different patterns were observed between groups with high and low depressive symptoms. In the quantitative phase, five patterns emerged from both adolescent and parent reports. Adolescents’ depressive symptoms significantly differed across patterns regardless of the data source, with the lowest in the adaptive communication pattern and the highest in maladaptive or limited communication patterns. Reporting concordance/discordance was also associated with adolescent depressive symptoms. Parent–adolescent emotional communication patterns differ in frequency and quality. Adolescent depressive symptoms varied across patterns. Concordance/discordance in reporting was associated with depressive symptoms in adolescents.

This study investigates rumination's mediating role between experiential avoidance and depression in university students. A sample of 600 students completed the AAQ-II, RRS, and SDS measures. Significant positive correlations were observed between experiential avoidance, rumination, and depression. Mediation analysis confirmed rumination's significant mediating role with an indirect effect of 0.592 (95% CI: 0.492 - 0.70, p < 0.001). Random forest analysis highlighted symptom-focused rumination as a key predictor of depression. These findings emphasize targeting experiential avoidance and rumination in therapies like ACT and CBT to reduce depressive symptoms. However, the cross-sectional design and self-report measures suggest a need for future longitudinal and objective studies.

Objective: This study aimed to examine the association between appearance comparison and adolescent depressive symptoms, the mediating role of body appreciation, and the moderating roles of gender and body-mass index (BMI) among adolescents in different age groups. Methods: A cross-sectional sample of 2645 Chinese students aged 12– 16 years (44.7% girls) participated. The measurements included depressive symptoms, appearance comparison, body appreciation, weight, and height. Multigroup path analysis was used to examine the moderated mediation model. Results: Compared with boys, adolescent girls presented greater levels of appearance, which increased with age. Body appreciation mediated the association between appearance comparison and depressive symptoms in girls, whereas appearance comparison directly correlated with depressive symptoms in boys. Body appreciation decreased with increasing BMI in boys but remained relatively stable in girls. Similar patterns were observed among junior and senior high school students. Conclusion: This study underscores the significant relationship between appearance comparison and adolescent depressive symptoms, suggesting varied mechanisms based on gender and BMI levels.