BackgroundWith the rapid development of the networking technologies， internet addiction has increasingly become a serious mental health issue. Previous studies have revealed the link between childhood trauma and internet addiction， while the mediating role of perceived stress in this link is not yet clear. ObjectiveTo investigate the role of medical students' perceived stress in the relationship between childhood trauma and internet addiction， so as to provide references for the intervention of internet addiction. MethodsFrom February to March 2023， a random sampling technique was used to select 1 232 undergraduate students from the School of Clinical Medical Sciences of Southwest Medical University as research subjects. The Childhood Trauma Questionnaire-Short Form （CTQ-SF）， Perceived Stress Scale （PSS）， Internet Gaming Disorder Scale （IGDS）， and Bergen Social Media Addiction Scale （BSMAS） were used for assessment. Pearson's correlation coefficients were calculated. The mediation effect of perceived stress in the relationship between childhood trauma and internet addiction was tested using Model 4 in the SPSS Process 4.1， and Bootstrapping procedure involving 5 000 replicates was employed to confirm the statistical significance. ResultsA total of 1 016 （82.47%） valid completed questionnaires were gathered. The CTQ-SF scores of medical students were positively correlated with PSS scores， IGD scores， and BSMAS scores （r=0.583， 0.474， 0.465， P<0.01）. PSS scores were positively correlated with IGD scores and BSMAS scores （r=0.369， 0.479， P<0.01）. Childhood trauma in medical students was found to positively predict perceived stress （β=0.191， P<0.01）， social media addiction （β=0.160， P<0.01）， and internet gaming disorder （β=0.106， P<0.01）. Perceived stress played a significant mediating role in the relationship between childhood trauma and internet gaming disorder， indirect effect value was 0.018 （95% CI： 0.009~0.027）， accounting for 16.98%. Perceived stress also exhibited a significant mediating role in the relationship between childhood trauma and social media addiction， indirect effect value was 0.063 （95% CI： 0.048~0.079）， accounting for 39.38%. ConclusionChildhood trauma in medical students may affect internet gaming disorder and social media addiction through perceived stress. ［Funded by 2022 Annual Research Project of Sichuan Applied Psychology Research Center，（number，CSXL-22102）］

BackgroundPatients with depressive disorder often exhibit impaired decision-making functions. However， the relationship between decision-making abilities and depressive and anxiety symptoms in these patients remains unclear. ObjectiveTo explore the characteristics of decision-making behavior in patients with depressive disorder， and to analyze its relationship with clinical symptoms. MethodsA total of 48 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） were recruited from the Department of Psychosomatic Medicine of the Affiliated Hospital of Southwest Medical University from October 2020 to May 2023. Concurrently， 52 healthy individuals matched for age and gender were recruited from Luzhou as the control group. Beck Depression Inventory （BDI） and Beck Anxiety Inventory （BAI） were used for assessment， and decision-making behavior was evaluated using Probabilistic Reversal Learning （PRL） task. Indicators assessed included the number of trials to criterion， perseverative errors， win-stay rate and lose-shift rate. Spearman correlation analysis was used to assess the correlation between BDI and BAI scores and PRL task indicators. ResultsThe depression group showed a significantly higher lose-shift rate compared with the control group （t=3.684， P<0.01）. There were no statistically significant differences between two groups in trials to criterion， perseverative errors and win-stay rate （t=0.329， 0.132， 0.609， P>0.05）. In depression group， BDI and BAI scores were positively correlated with the win-stay rate（r=0.450， 0.398， P<0.01）. ConclusionPatients with depressive disorder are more likely to change their decision-making strategies following negative outcomes. Furthermore， the severity of depressive and anxiety symptoms is associated with a greater propensity to maintain existing decisions after receiving positive feedback. ［Funded by 2019 Joint Project of Luzhou Science and Technology Bureau-Southwest Medical University （number， 2019LZXNYDJ39］

Objective: The nine diagnostic criteria for Internet Gaming Disorder (IGD) proposed in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) have been widely adopted, but have also faced significant criticism. This study evaluated the psychometric properties of the nine DSM-5 criteria for IGD using item response theory (IRT). Methods: Four DSM-5-based scales, including the Game Addiction Scale, the Internet Gaming Disorder Scale Short-Form, the Ten- Item Internet Gaming Disorder Test, and the Internet Gaming Disorder Scale, were administered to 1,530 Chinese adolescents and young adults. IRT models were used to assess the psychometric properties of these criteria. The potential for differential item functioning (DIF) related to sex and between adolescents and adults was also evaluated. Results: All nine DSM-5 criteria demonstrated very high to perfect discrimination (a >1.38), providing substantial diagnostic information (item information >0.476) for diagnosing IGD. These scales, despite variations in wording and scoring methods, exhibited strong correlations in total scores (r≥0.502, p<0.001) and high consistency (Kendall’s W ≥0.656, p<0.05) concerning the fitted IRT parameters. Among the nine criteria, escape showed the lowest cross-scale discrimination, item information, and difficulty. In contrast, withdrawal showed the highest item information and discrimination, and the second highest difficulty. Additionally, there was no evidence of DIF related to sex or age (adolescents vs. adults) across nearly all scale items. Conclusion These findings indicate that the nine DSM-5 criteria generally possess acceptable psychometric properties for diagnosing IGD. Notably, withdrawal may represent a core symptom of IGD. Conversely, escape demonstrated inferior performance compared to the other eight criteria, indicating a potential need for further revision.

Background Metacognition,the capacity to monitor and control one's cognitive processes,has been identified as a crucial component of effective decision-making and behavioral adaptation.Previous research has revealed cognitive deficits in patients with major depressive disorder(MDD),while findings about metacognitive capacities in patients with MDD have been inconsistent across studies,and the exact relationship between metacognitive capacities and clinical symptoms in MDD patients remains uncertain.Objective To examine the metacognitive capacities of adolescent hospitalized patients with MDD and to explore its relationship with depressive and anxiety symptoms,thus providing an unprecedented insight into the prevention of MDD.Methods A coherent 56 adolescent hospitalized patients with MDD in the Psychiatry Department at the Affiliated Hospital of Southwest Medical University from March 2022 to June 2023 and met the diagnostic criteria for depression as defined by the Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV)were enrolled as MDD group.At the same time,62 healthy individuals matched with the age and sex of the MDD group residing in Luzhou were concurrently selected as control group.The metacognitive ability of the two groups was evaluated by perceptual decision-making task and confidence rating task,and the indicators included confidence deviation,reaction time of confidence evaluation and metacognitive efficiency.Additionally,the severity of depressive and anxiety symptoms was measured with Beck Depression Inventory(BDI)and Beck Anxiety Inventory(BAI).Pearson correlation analysis was utilized to examine the relationship between metacognitive capacities and clinical symptoms.Results MDD group scored higher on BDI and BAI when compared with control group(t=-13.722,-9.674,P<0.01).In terms of decision-making performance,no statistically significant difference was noted in accuracy and response time between two groups(t=-0.655,0.975,P>0.05).In terms of metacognitive performance,MDD group reported a reduction in overall confidence,confidence in correct decisions,confidence in incorrect decisions and metacognitive efficiency compared with control group(t=3.044,2.769,2.836,3.667,P<0.01).MDD group demonstrated significantly longer confidence evaluation response time than that of control group(t=-2.561,P<0.05).Correlation analysis revealed that among the MDD patients,overall confidence,confidence in correct decisions and confidence in incorrect decisions were negatively correlated with BDI score(r=-0.310,-0.307,-0.298,P<0.05),and the overall confidence and confidence in correct decisions were negatively correlated with BAI score(r=-0.284,-0.280,P<0.05),while no statistical significance existed in the correlation between confidence in incorrect decisions and BAI score(r=-0.229,P>0.05).Furthermore,metacognitive efficiency in MDD patients exhibited negative correlation with both BDI and BAI scores(r=-0.269,-0.290,P<0.05).Conclusion Hospitalized adolescent patients with MDD have impaired metacognition,and metacognitive capacity is found to be associated with severity of depressive and anxiety symptoms.