Simon T. M. Chan

The differential mediating effects of pain and depression on the physical and mental dimension of quality of life in Hong Kong Chinese adults

ObjectiveThe impact of pain and depression on health-related quality of life (QoL) is widely investigated, yet the pain-depression interactions on QoL remain unclear. This study aims to examine the pain-depression-QoL mediation link.MethodsPain severity were assessed in a sample of Chinese professional teachers (n = 385). The subjects were also assessed on depressive symptoms and QoL. Regression models were fitted to evaluate the pain-depression-QoL relationships.ResultsAbout 44% of the sample had 3-5 painful areas in the past 3 months. Shoulder pain (60%) and headache (53%) were common painful areas. The results of regression analyses showed that pain mediated the effects of depression on the mental aspect of QoL (standardized β = -0.111; Sobel test: z = -3.124, p < 0.005) whereas depression mediated the effects of pain on the physical aspect of QoL (standardized β = -0.026; Sobel test: z = -4.045, p < 0.001).ConclusionsOur study offered tentative evidence that pain and depression impacted differently on the mental and physical aspect of QoL. As these findings were based on a Chinese teacher sample, future studies should employ more representative samples across cultures to verify the present data.

The Comorbidity of Chronic Pain and Sleep Disturbances in a Community Adolescent Sample: Prevalence and Association with Sociodemographic and Psychosocial Factors

PURPOSE   The comorbidity of chronic pain and sleep disturbances has received increasing research attention in Western clinical pediatric populations; yet, little is known about its sociodemographic and psychological correlates in non-Western community pediatric populations. This study aimed to examine the prevalence of comorbid chronic pain and sleep disturbances and its associated factors in a community sample of Chinese adolescents. METHODS   A total of 1,518 adolescents aged from 11 to 19 years participated in this school-based study. Apart from sociodemographic background, participants were assessed on chronic pain, sleep disturbances, depression, perceived stress, and social support. Prevalence of co-occurrence of chronic pain and sleep disturbances was determined. Participants with single symptom were compared with those with symptom co-occurrence on pain characteristics and sleep patterns. Multiple regression model evaluated factors associated with symptom comorbidity. RESULTS   While the prevalence of chronic pain and sleep disturbances was 11.4% and 25.6%, respectively, the overall prevalence of comorbid chronic pain and sleep disturbances was 19.1% (95% confidence interval: 16.9, 21.4). Fully adjusted stepwise regression analysis identified being female, more depressive symptoms, and higher perceived stress to be significantly associated with comorbid symptoms. Adolescents with both symptoms reported significantly more pain sites, higher worst pain, and higher pain-associated interference than those reported chronic pain only. Participants with comorbid symptoms also had poor subjective sleep quality, greater sleep disturbances, and more daytime dysfunction than those reported sleep disturbances only. CONCLUSIONS   Our data offered preliminary evidence that comorbid chronic pain and sleep disturbances occurred among about one-fifth in the present sample of Chinese community adolescents. Future studies should examine whether the two symptoms interact with each other in affecting the physical, mental, and cognitive development of adolescents.

The Lens of Masculinity: Trauma in Men and the Landscapes of Sexual Abuse Survivors

The aim of this study was to identify the implications of masculinity for male sexual abuse survivors. To address the lack of research on male sexual abuse survivors, this study focuses on the trauma sustained by male survivors and the interplay of the cultural concept of masculinity. Given the sensitive nature of this topic and to protect the respondents, a three-phase methodological design was used. Initial observation of the participants in the treatment groups was followed by fieldwork involving focus groups and, eventually, in-depth individual interviews. This study’s implications for social workers helping male sexual abuse survivors are discussed through the lens of masculinity.

TRAUMA FROM SEXUAL ABUSE: THE UNTOLD STORY OF MALE VICTIMS IN HONG KONG

In Asian societies, the sexual abuse experiences of male victims are rarely studied due to social gender role stereotype, which enforces the discourse that men are supposed to be tough and impossible to be hurt, and not to report sexual abuse. This research examines the life journey of 12 sexually abused male survivors in Hong Kong to explore their struggles. Results show: firstly, male survivors are caught in shame and excitement when talking about their abusive incidents. Shamefulness leads some of them to have negative self-esteem while excitement makes some of them addicted to sexual activities or even become homosexual; secondly, they feel insecure to tell others about it after being abused, because of masculinity identity; thirdly, relationship building is always hard for them since they do not know how to maintain distance with the others.

A work‐individual‐family inquiry on mental health and family responsibilities of dealers employed in the Macau gaming industry

The anxiety, depression and sleep quality levels of a sample of 1124 Macau casino dealers are examined in this study which uses a mixed method study with a work-individual-family approach. In total, 113 dealers are interviewed on the impacts of casino employment on their family life. The results of the quantitative analysis shows that over half of the participants (55.4%) have a score that is over the cut-off point for depression, a quarter (25.8%) are considered to have anxiety, and about two-thirds (77%) report poor sleep quality. The qualitative analysis results indicate that despite the financial benefits, family responsibilities and dynamics, such as family activities and plans, parental care and guidance, child-parent interaction and bonding, marital intimacy, communication patterns, and gender roles are negatively affected to some degree by casino employment. Practitioner points Sensitivity towards work-family conflicts, families-in-transition, gender and class can facilitate engagement and intervention with the family of dealers in Macau Gender is a significant predictor of depression and anxiety levels Respondents with a lower income range have lower quality of sleep Absence from family activities, missed opportunities to carry out parental care, reduced marital intimacy and communication with family members are key concerns

Co‐constructing family therapy in the Asian Chinese family diasporas of mainland China, Malaysia, Macau, Singapore and Taiwan

Asian Chinese families are experiencing constant changes. While commonly known cultural themes such as ‘face’, ‘hierarchy’, ‘harmony’ and ‘filial piety’ are useful references and important caveats in clinical settings, they are most useful when the context of larger socio-economic and political developments of recent decades is taken into account. This article is co-authored by seven experienced Asian therapists from China, Hong Kong, Macau, Malaysia, Singapore, Taiwan and the United Kingdom. They share their insights into working with Chinese families in Asia. In addition to considering cultural dimensions, the authors attempt to consolidate the understanding of Asian Chinese families by focusing on the effects of socio-economic and political development. Other than focusing on the unique characteristics and challenges of working with Chinese families in their region, they highlight the most useful therapeutic stances and approaches when working with Asian Chinese families. Practitioner points Be mindful that changing family structures affect family dynamics, childcentric values and work-life balance. Chinese families expect to receive advice and instruction. Therapists need to be direct and authoritative where appropriate to avoid causing dissatisfaction Chinese families can be helped to negotiate their emerging needs for the differentiation of self A possible therapeutic option is use of self and the ability to embrace uncertainty

East and West: Exploration of the Father-Son Conflict in Chinese Culture from the Perspective of Family Triangulation in the West and the Classical Opera Stories of the East

The concept of family triangulation is one of the most important concepts in the field of family therapy. This concept has been widely accepted in the western world and a wonder has been formed: can it be applied in the nonwestern world? This chapter is going to give evidences that family triangulation can be applied in the nonwestern world, at least in the Chinese culture. Chinese culture expressed in Chinese operas and oral history has clearly documented some of the same concepts as seen in the concept of family triangulation in the West.

The manifestation of family triangulation in asian–chinese families and its relevance to father–son conflict

The concept of family triangulation has existed in the West for more than 30 years, but the extent to which it can be applied in the East has not been demonstrated. Using a case study conducted by a leader in the field and building on the interplay of three dyads, this study uses the four-step model of assessment (Minuchin et al., 2007, Assessing Families and Couples: From Symptom to System, Allyn and Bacon, New York) to articulate the manifestation of the phenomenon in Chinese families. The results show that father–son conflict arises from mother–son attachment and hidden father–mother conflict; the father–son conflict presented in the case study illustrates the intertwined relationship between these dyads. Finally, the significance of the triangular perspective in dealing with father–son conflict in Asian–Chinese families is noted.