Wai Kai Hou

Education University of Hong Kong | ied · Department of Psychology

Sustainment of daily routines requires greater psychological resilience and may lead to greater resilience in the face of stressors. Existing scales tend only to focus on emotions and engagement, rather than how well individuals sustain routine behaviors. To address this gap in the literature, we developed the Sustainability of Living Inventory (SO...

Purpose To examine the joint associations of civil unrest and COVID-19 with probable anxiety and depression during the first half of 2020 in Hong Kong. Associations were compared between persons with low or high assets. Methods A population-representative sample of 4011 Hong Kong Chinese residents aged 15 years or older were recruited between Febr...

The present meta-analytic review examined the associations between different forms of trauma and mental disorders among prisoners and ex-prisoners. Studies published from 1998 to March 31, 2021 were identified by searching PsycINFO, PubMed, Medline and Web of Science. Data were meta-analyzed using a random-effect model. Moderator and mediator analy...

Background There is currently a deficit of knowledge about how to define, quantify, and measure different aspects of daily routine disruptions amid large-scale disasters like COVID-19, and which psychiatric symptoms were more related to the disruptions. This study aims to conduct a systematic review and meta-analysis on the probable positive associ...

Positive adjustment to chronic diseases reduces psychiatric comorbidity and enhances quality of life. Very little is known about the benefit of internet-based and mobile-based Cognitive Behavioral Therapy (IM-CBT) on physical outcomes and its reciprocal interactions with psychiatric outcomes, the active therapeutic elements, and effect moderators a...

Introduction This study examined the prevalence and correlates of probable mental health disorders, including psychological distress, somatization, depression, anxiety, phobic anxiety (PHO), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and insomnia among Chinese primary health care (PHC) physicians and nurses amid the...

This survey study evaluates the association between sociopolitical factors and mental health following the 2023 Turkey-Syria earthquake.

Research on experiencing workplace cyberbullying (WCB) and its underlying mechanisms that impact the well-being of teachers is scarce. We propose that cognitive reappraisal, which is a useful and adaptive emotion–regulation strategy for reinterpreting emotion-eliciting situations, is a mediator explaining the inverse relationships between experienc...

Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better ment...

Cognition and behavior could reciprocally impact each other and together determine mental health amid large-scale disasters such as COVID-19. This study reports a six-month cohort study of a population-representative sample of Hong Kong residents ( N = 906) from March–August 2021 (T1) to September 2021–February 2022 (T2). Cross-lagged panel analyse...

Background: Previous research has highlighted the importance of regularizing daily routines for maintaining mental health. Little is known about whether and how regularity of daily routines is associated with reduced post-traumatic stress disorder (PTSD) symptoms. Objective: We aimed to examine the associations between regularity of daily routines...

The COVID-19 pandemic presents challenges to psychological well-being, but how can we predict when people suffer or cope during sustained stress? Here, we test the prediction that specific types of momentary emotional experiences are differently linked to psychological well-being during the pandemic. Study 1 used survey data collected from 24,221 p...

Mental ill health is more common among juvenile offenders relative to adolescents in general. Little is known about individual differences in their long-term psychological adaptation and its predictors from multiple aspects of their life. This study aims to identify heterogeneous trajectories of probable psychiatric conditions and their predictors....

This article on stress covers four topics. An overview is given on how persons cope with chronic stress and trauma. Classic theories of the psychology of stress, namely the Transactional Model of Stress and Coping, the Salutogenic Model, and the Conservation of Resources Theory, are outlined. Next, the meaning-making process, the Shift-and-Persist...

In this prospective study, we identified different patterns of daily routine disruptions and investigated their associations with anxiety and depressive symptoms between 2020 and 2021. A population-representative sample (N = 671) was assessed at the acute phase of the pandemic (April–July 2020, T1) and again at 1-year follow-up (April–August 2021,...

Introduction As being an initiating actions and resisting short-term temptations, self-control is negatively related to digital media addiction. However, many studies indicate that there are variables that may mediate this relationship. The present study investigated the mediating role of media multitasking and time style in the relationship betwee...

Introduction Psychological resilience can be viewed as a personality trait, an ability to bounce back, or a positive outcome after life adversities. Although there have been increasing reports of the importance of sleep and circadian factors in contributing to an individual’s resilience, current studies were devoid of objective measurements and in-...

Background The number of ex-prisoners worldwide has constantly been increasing in recent years. Currently, little is known about post-release daily adaptation, not to mention valid and reliable instruments for post-release daily routines pertinent to mental health. Objective This study aims to develop and validate a self-report instrument, hereaft...

The international school sector in Hong Kong makes a substantial contribution to educational provision in the city, employing many expatriate teachers. Wellbeing has taken on increasing prominence in international school discourses, but little research has investigated how the wellbeing of international school teachers is influenced by school-level...

Currently little is known about the interrelations between changes in psychiatric symptoms and changes in resources (personal, social, financial) amid large-scale disasters. This study investigated trajectories of psychiatric symptoms and their relationships with different patterns of changes in personal, social, and financial resources between 202...

Resilience is the cornerstone to mental health, and entails multiple biological and psychological mechanistic processes. However, the interplay of the psychobiological processes in shaping resilience is unclear. Here we report the results of testing whether an acute cortisol response and positive affectivity traits moderate the relationship between...

In the early stages of the COVID-19 pandemic, Italy, Spain, New York, and Hong Kong stood out for the ir high rates of infections. Given this scenario, a web-based international multisite and cross-sectional study was conducted between April and May 2020 to investigate the psychological impact of the pandemic and the restrictions imposed by the gov...

Humans experience multiple biological and emotional changes under acute stress. Adopting a multi-systemic approach, we summarized 61 studies on healthy people’s endocrinological, physiological, immunological and emotional responses to the Trier Social Stress Test. We found salivary cortisol and negative mood states were the most sensitive markers t...

Background In face of large-scale disasters, persons with fewer assets are at greater risk of persistent poorer mental health than persons with more assets. Everyday daily routine disruptions and financial hardship could mediate this association. Methods This prospective population-representative study in Hong Kong aimed to investigate the relatio...

Organizational virtuousness is defined as collective positive attributes and behaviors supported by and characteristic of an organization that promote hedonic well-being, eudaimonic well-being, and optimal performance. The underlying mechanisms through which organizational virtuousness operate remain largely unknown. Drawing from the broaden-and-bu...

Background This study investigated whether subjective unrest-related distress was associated with probable depression during and after the 2019 anti-ELAB movement in Hong Kong. Methods Population-representative data were collected from 7157 Hong Kong Chinese in four cross-sectional surveys (July 2019–July 2020). Logistic regression examined the as...

This study examined the mediating effects of coping resources in the prospective associations between daily routine disruptions in the acute phase of COVID-19 and persistent probable anxiety and depression. A prospective, population-representative cohort of 1318 Hong Kong Chinese respondents completed a baseline survey between February and July 202...

Heterogeneity in adaptation outcomes among adolescents following major disasters needs further elaboration. Both ongoing stressors and positive psychological changes should be concerned in evaluating the heterogeneity. This study examined the prospective trajectories of posttraumatic stress disorder (PTSD) symptoms among adolescent survivors follow...

We explored the role of perceived coronavirus disease (COVID-19) threats and people’s sustainment of primary (e.g., personal hygiene) and secondary (e.g., exercising) routines for two indicators of individual functioning at work, that is, job satisfaction and work concentration. We conducted an online questionnaire study with Hong Kong and German e...

This study aims to test the associations of nature contact with multiple dimensions of psychological functioning. A total of 90 university employees were randomly assigned to spend their lunch breaks on (1) a 30-min structured protocol of nature contact and (2) a control group for 10 consecutive weekdays. Psychological distress, psychological well-...

The spread of SARS-CoV-2 led to rapid vaccine development. However, there remains considerable vaccine hesitancy in some countries. We investigate vaccine willingness in three nations with very different vaccine histories: Israel, Japan and Hungary. Employing an ecological-systems approach we analyse associations between health status, individual c...

Both COVID-19 and unrest are posing a significant threat to population mental health across the globe. This study examined trends of probable depression and anxiety during a time of civil unrest and concurrent COVID-19 in Hong Kong. Four random digit dialing telephone surveys were conducted in July 2019 (n = 1112), February–March 2020 (n = 2003), A...

Objective There is a socioeconomic gradient to depression risks, with more pronounced inequality amid macroenvironmental potential traumatic events. Between mid-2019 and mid-2020, the Hong Kong population experienced drastic societal changes, including the escalating civil unrest and the COVID-19 pandemic. We examined the change of the socioeconomi...

Background and Objective This study examined the association of loneliness with depressive symptoms across various age groups. Loneliness is a significant risk factor for precipitating depressive symptoms. Rumination, a mechanism that underpins depression, can become intense when a person feels lonely. In addition, age is a major factor associated...

Objective: Children and adolescents are found to be more vulnerable to developing PTSD than adults over time after major disasters. This study aims to investigate the network structures of PTSD and the directions of relationships between symptoms among adolescent survivors in the year after the Yancheng Tornado in China. Method: A total of 395 yout...

Self-compassion has been shown to be protective against stress. Whether its stress buffering effect differs between cancer caregivers and non-caregivers is unknown. This study examined the moderating effect of self-compassion among cancer caregivers relative to non-caregivers by recruiting cancer caregivers from the hospital and a community sample...

Positive emotions are linked to numerous benefits, but not everyone appreciates the same kinds of positive emotional experiences. We examine how distinct positive emotions are perceived and whether individuals’ perceptions are linked to how societies evaluate those emotions. Participants from Hong Kong and Netherlands rated 23 positive emotions bas...

The rapid international spread of the SARS-CoV-2 virus 19 led to unprecedented attempts to develop and administer an effective vaccine. However, there is evidence of considerable vaccine hesitancy in some countries and sub-populations. We investigated willingness to vaccinate in three nations with historically different levels of vaccine willingnes...

The Adjustment Disorder New Module (ADNM) is a self-report instrument for assessing Adjustment disorder (AjD), but uncertainties remain in evaluating factor structure and psychometric properties of ADNM in previous studies. Three studies were conducted to examine the factor structure, psychometrics properties, and clinical utility of the 20-item ve...

Positive emotions are linked to numerous benefits, but not everyone appreciates the same kinds of positive emotional experiences. We examined how distinct positive emotions are perceived and whether individuals’ perceptions were linked to how societies evaluate those emotions. Participants from Hong Kong and the Netherlands rated 23 positive emotio...

This study examined prevalences of anxiety and depression and their correlations with daily routines among Hong Kong Chinese during the COVID-19 pandemic. Random digit dialing recruited two population-representative samples of 6029 residents during a period of low infection and limited intervention (survey 1: n = 4021) and high incidence and intens...

A vignette approach was adopted to investigate flexibility of sustaining daily routines and whether and how this ability was related to mental health at different levels of financial strain. Three separate studies were conducted with community-dwelling adults (N = 1685) in the USA. In Study 1, we drafted, tested, and modified vignettes with referen...

Background To assess the prevalence of elevated risk of serious mental illness and probable ICD-11 adjustment disorder in the UK population at two time points during COVID-19, and their association with COVID-19-related stressful events. Aims To check the dose–response model for stress between the number of COVID-19-related stressful events and me...

Background Previous research has suggested a socioeconomic gradient of mental health in the face of potentially traumatic events. Nevertheless, few studies examined the intermediary mechanisms of this gradient. This study tested a hypothesised mediating effect of disruptions to daily routines (eg, eating/sleeping habits) between socioeconomic statu...

Background This study examined the associations between components of psychological resilience with mental health at different levels of exposure to COVID-19 stressors. Methods A population-representative sample of 4,021 respondents were recruited and assessed between February 25th and March 19th, 2020. Respondents reported current anxiety symptom...

This study examined the associations of perceived social capital and income change since the outbreak with probable depression and preventive behaviors during the COVID-19 pandemic in Hong Kong. Random digit dialing recruited a population-representative sample of 3011 Hong Kong Chinese aged ≥ 15 years (mean = 44, 55% females) between February 25 an...

Introduction: Despite the burgeoning literature on COVID-19, there has been little cross-national work on the correlates of mental health or its association with pandemic behaviours. We considered psychological distress, quarantine status, social distancing and self-medication in China and the UK. Methods: We conducted online surveys in China (N...

Purpose: This study examined prevalence and correlates of probable depression and suicidal ideation among Hong Kong Chinese residents amidst the anti-extradition bill protests. Methods: Random digit dialing recruited a population-representative sample of Hong Kong residents aged 15 years or older during the first three weeks of July, 2019. Respo...

Limited by conventional data collection methods, it is unclear how community-dwelling multimorbid people's daily routines are affected by their co-occurring illnesses. This study investigated the differences in everyday life schedules between multimorbid and nonmultimorbid people. Three hundred community-dwelling adults, representative of the Hong...

The COVID-19 pandemic presents a significant challenge to wellbeing for people around the world. Here, we examine which individual and societal factors can predict the extent to which individuals suffer or thrive during the COVID-19 outbreak, with survey data collected from 26,684 participants in 51 countries from 17 April to 15 May 2020. We show t...

Power is one of the vital components embedded within interpersonal interactions, but few studies have studied it in everyday life context. This experience sampling study examined the associations of subjective power with emotional well‐being and investigated the moderating effects of counterpart' postures in the associations. Our results demonstrat...

Background: There are a growing number of forced migrants worldwide. Early detection of poor adjustment and interventions to facilitate positive adaptation within these communities is a critical global public health priority. A growing literature points to challenges within the post-migration context as key determents of poor mental health. Aims: T...

Social media interactions are popularly implicated in psychological changes like radicalization. However, there are currently no viable methods to assess whether social media interactions actually lead to such changes. The purpose of the current research was to develop a methodological paradigm that can assess such longitudinal change in individual...

Positive emotion regulation is important for enhancing psychological well‐being. Previous studies have adopted a cross‐sectional design to examine the relationships between positive emotion regulation strategies and psychological functioning. Relatively little is known about the role of positive emotion regulation strategies in positive and negativ...

Multimorbid adults are more likely to have depression. However, existing data are mostly cross-sectional or retrospective with poor control of baseline depressive symptoms and a focus on long-term effects. This prospective study examined the short-term independent predictive association of multimorbidity with depressive symptoms. We collected basel...

Previous studies have investigated interdependence of the associations between predictors and negative psychological outcomes in dyads of cancer patients and family caregivers. This study examined the dyadic effects of perceived capability of savouring the moment on psychological well‐being. A total of 152 dyads of cancer patients and caregivers re...

Objective: This study tested the interactive relationships between college students' perceived capability of regulating negative emotions and savoring positive emotions on mental health outcomes, including anxiety and depressive symptoms. Participants: Participants were healthy undergraduates (n = 167) recruited from two universities in Hong Kon...

The ability to accurately perceive cues to contextual demands across different situations has been identified as a crucial component of successful self-regulation. However, previous attempts to measure context sensitivity have suffered from serious methodological limitations, most notably the possibility that respondents may not possess sufficient...

The present study tested the mediating role of perceived capability of savoring positive experiences in the associations between family functioning and emerging adults’ psychological outcomes, namely, depressive symptoms and life satisfaction. A sample of 167 Chinese emerging adults (112 female) were recruited from two major universities in Hong Ko...

We examined the incidence and predictors of threat perceptions toward people who oppose government action (i.e., protestors) following the Umbrella Movement in Hong Kong (September 28th to December 15th, 2014). A population-representative sample of 1,208 citizens (mean age = 46.89 years; 52.4% female) was recruited two months after the conclusion o...

This study examined concordances of cancer patients’ received and caregivers’ provided support and dyadic relationship quality, and their predictive utility in prospective psychological distress and well-being. A total of 83 Chinese cancer patient-caregiver dyads were recruited in two government-funded hospitals in Hong Kong. Participants reported...

Background: Evidence has shown that people living with nonpsychotic mental disorders experience difficulties in maintaining their daily living, consequently impacting on psychological well-being. However, the role of daily life experience remains unclear. This systematic review and meta-analysis aims to determine the association between daily life...

Emotion mobilizes and demobilizes a social movement while the movement itself impacts people’s emotions. An evidence base is needed for developing timely emotion-focused counseling services for affected populations worldwide. This experience sampling study investigated the impact of social movement on everyday emotional reactivity, variability, ins...

Prior work has considered demand and distress, temporal dynamics, and differential outcomes in defining human stress resilience but not the processes and mechanisms of resilience across different life challenges. The purpose of this chapter is to outline the Drive to Thrive (DTT) theory in an attempt to advance existing understanding of stress adap...

Purpose Macau is a Special Administrative Region in China that has experienced tremendous development in its gambling industry during its post-colonial years. To inform mental health planning, this study presents the first population estimates and correlates of current depression in Macau. Methods A population-representative sample of 1,068 Macau...

Relatively little is known about the emotional processes underlying the association between adult attachment styles and psychological distress. This study aims to examine the role of contentment in terms of intensity and duration in the positive associations between anxious and avoidant attachment styles and psychological distress. A sample of 284...