Mengxuan Wang

Background/Objectives: School refusal tendency is an important school adaptation issue, but its upstream psychosocial correlates remain insufficiently understood. We examined whether baseline multidimensional social interaction was prospectively associated with later school refusal tendency and whether an exploratory statistical indirect association was observed through psychological and behavioral difficulties. Methods: This three-year longitudinal observational study included 314 students in grades 5–9 aged ≥12 years at baseline in 2020 and followed through 2023. Social interaction was assessed using the Index of Social Interaction (ISI), psychological and behavioral difficulties using the parent-reported Strengths and Difficulties Questionnaire (SDQ), and school refusal tendency using a parent-reported binary item. Adjusted regression and Monte Carlo product-of-coefficients analyses were conducted. Results: School refusal tendency was observed in 84 participants (26.8%). Higher baseline ISI scores were associated with lower follow-up SDQ total difficulties (β = −0.830, 95% CI: −1.033 to −0.627) and lower odds of school refusal tendency (OR = 0.832, 95% CI: 0.741–0.934). The indirect effect through follow-up SDQ total difficulties was significant (−0.120, 95% CI: −0.193 to −0.055). After adjustment for baseline SDQ total difficulties, the indirect effect remained significant (−0.067, 95% CI: −0.124 to −0.020); Firth and parsimonious models yielded similar estimates. Baseline-domain-adjusted analyses retained indirect effects through emotional symptoms, peer problems, and internalizing problems. Conclusions: Higher baseline multidimensional social interaction was associated with lower subsequent psychological and behavioral difficulties and school refusal tendency. Baseline-SDQ-adjusted analyses supported an exploratory indirect association, particularly through internalizing-related difficulties; however, concurrent assessment of follow-up SDQ and school refusal precludes causal interpretation.

Background/Objectives: Social interaction may be associated with sleep health, but longitudinal evidence among working-age adults is limited, and ceiling-concentrated scores may complicate linear modeling. We examined baseline social interaction, three-year follow-up sleep quality, and the exploratory role of life satisfaction. Methods: Data came from 487 adults aged 20–58 years surveyed in 2020 and 2023. Social interaction was assessed using the 18-item Index of Social Interaction (ISI). Normal sleep required at least 6 h of sleep and adequate restfulness. Models were adjusted for baseline sleep, demographics, lifestyle, health, depression, and anxiety. The ISI functional form was assessed using natural cubic splines and a piecewise model with a knot at 14. Results: In the initial linear summary model, a higher ISI score was associated with normal follow-up sleep (OR = 1.24, 95% CI: 1.09–1.42). The spline model fit better (likelihood-ratio χ² = 19.69, df = 2, p < 0.001). Below 14, each 1-point increase was associated with higher odds of normal sleep (OR = 2.81, 95% CI: 1.64–4.82); no additional association was observed at 14 or higher (OR = 0.99, 95% CI: 0.83–1.19). The ISI × life satisfaction interaction was sensitive to parameterization. Spline-based analysis showed an average indirect association through life satisfaction (estimate = 0.0077, 95% bootstrap CI: 0.0019–0.0153), while direct and total associations were not significant. ISI was associated with restfulness but not duration. Conclusions: The ISI–sleep association was nonlinear, concentrated in lower scores, and plateaued near the upper end. Life-satisfaction findings were exploratory; concurrent measurement precluded causal mediation inference.

This study examined the relationship between changes in social interactions and sleep status, specifically sleep duration and restoration, among older adults in Japan to inform interventions for healthy aging. A 6-year longitudinal study (2017–2023) was conducted under the Community Empowerment and Care Project in suburban Japan. A total of 473 older adults with normal sleep in 2017 were followed. Sleep duration (< 6 h defined as deprivation) and sleep restoration (subjective restfulness) were assessed according to national guidelines. Social interaction was measured using the 18-item Index of Social Interaction (ISI). Changes in the ISI were analyzed continuously and categorically. Lo-gistic regression models were used to examine the association between ISI changes and sleep outcomes. After six years, 16.3% of the participants experienced sleep deprivation, and 26.2% reported non-restorative sleep. Declining ISI scores were significantly asso-ciated with a higher risk of sleep deprivation and non-restorative sleep. Persistently low or declining ISI scores increased the odds of poor sleep. A one-point ISI increase re-duced the risk of sleep deprivation and non-restorative sleep, even after adjusting for confounders. Negative or persistently low social interaction is linked to worse sleep outcomes; maintaining or improving social interaction may protect sleep quality.

Background: Work characteristics play a crucial role in the mental well-being of physicians. However, limited research in Bangladesh has explored the association between these characteristics and specific mental health outcomes such as depression, anxiety and stress among physicians, particularly in relation to gender differences. Aims: This study aimed to explore the link between various work characteristics and mental health outcomes among male and female physicians in Bangladesh. Method: We conducted a cross-sectional study among physicians working in various healthcare settings in Bangladesh. The data were collected online between November 2023 and January 2024 using a convenience sampling technique. Work characteristics, including job characteristics, social characteristics and organisational characteristics, were assessed using previously validated scales. Mental health, on the other hand, was measured using the Depression, Anxiety and Stress Scale (DASS-21). We performed logistic regression analyses adjusted for the covariates, and further stratified by gender, to explore potential differences in work characteristics and mental health outcomes between male and female physicians. Results: In our study, social characteristics were significantly inversely associated with depression (adjusted odds ratio 0.37 (0.20–0.71)), anxiety (adjusted odds ratio 0.53 (0.30–0.92)) and stress (adjusted odds ratio 0.45 (0.26–0.81)). Organisational characteristics showed a significant inverse association only with stress (adjusted odds ratio 0.42 (0.24–0.74)). Among male physicians, organisational characteristics were significantly inversely associated with depression (adjusted odds ratio 0.42 (0.19–0.90)), anxiety (adjusted odds ratio 0.44 (0.21–0.91)) and stress (adjusted odds ratio 0.42 (0.20–0.89)), while social characteristics were significantly inversely linked only to stress (adjusted odds ratio 0.43 (0.19–0.97)). By contrast, among female physicians, only social characteristics demonstrated a significant inverse association with depression (adjusted odds ratio 0.30 (0.12–0.78)). Conclusions: This study highlights the importance of social characteristics as a protective factor for psychological well-being in the healthcare context. Therefore, fostering a work culture that prioritises peer support and strong interpersonal relationships can be crucial in alleviating mental health challenges among physicians.