Ray C. Hsiao’s research while affiliated with Washington School of Psychiatry and other places

Background: The present study investigated the 1‐month, 2‐month, and 3‐month prospective associations of Google search terms with suicide in Taiwan from 2012 to 2022. Methods: We analyzed daily suicide data from Taiwan’s Cause of Death Statistics between January 1, 2012, and December 31, 2022. Data on Google search volumes for 37 terms related to suicide‐related, socioeconomic status, familial problems, and physical and psychiatric problems were extracted from Google Trends. Cross‐correlation coefficients between monthly Google search term volumes and monthly suicide were calculated at lags of 3 months (lag‐3), 2 months (lag‐2), and 1 month (lag‐1). Results: The monthly Google search volumes of two terms, “pain” and “Taiwan economy”, positively predicted monthly suicide in the total population. The search term “hypnotic” lag‐3 negatively correlated with monthly suicide in the population aged ≥65. The search term “allergy” lag‐1 positively correlated with monthly suicide in the population aged ≥65. Conclusions: The monthly Google search terms of “pain” and “Taiwan economy” positively correlated with monthly suicide. The search terms “hypnotic” and “allergy” negatively and positively correlated with monthly suicide in the population aged ≥65, respectively. These terms may enable more accurate forecasting of future suicides.

Background/Objectives: Peer victimization and aggression can be detrimental to the physical and mental health of adolescents. Adolescents with attention-deficit/hyperactivity disorder (ADHD) are one of the risk groups involved in peer victimization and aggression. The association between multiple types of domestic violence and engagement in peer victimization and aggression warrants more examination in adolescents with ADHD. This study examined the associations of parent-to-child aggression (PCA), witness to domestic violence (WDV), and child-to-parent violence (CPV) with the experiences of peer victimization and aggression among adolescents with a clinical diagnosis of ADHD in Taiwan. Materials and Methods: In total, 247 adolescents with ADHD (206 boys and 41 girls, mean age [SD] = 13.2 [2.0] years) agreed to participate in this study. Adolescents’ peer victimization and aggression, PCA, WDV, and CPV in the previous year were collected. Results: This study found that 28.3% and 12.6% of adolescents with ADHD reported experiences of peer victimization and aggression, respectively. The rates of having PCA, WDV, and CPV ranged from 38.1% to 56.3%. The results of multivariable logistic regression analysis found that child-to-parent financial demand (p = 0.016) and child-to-parent control or domination (p = 0.018) significantly correlated with the experiences of peer victimization. PCA (p = 0.010) and child-to-parent control or domination (p = 0.042) significantly correlated with the experiences of peer aggression. Conclusions: The results of this study show that both CPV and PCA significantly correlate with the experiences of peer victimization and aggression in adolescents with ADHD. CPV and PCA should be included in adolescent prevention programs.

Purpose: Child-to-parent violence (CPV) is a major concern for adolescents with attention-deficit/hyperactivity disorder (ADHD). The Child-to-Parent Violence Questionnaire (CPV-Q) is a valid instrument for assessing a wide variety of CPV behaviors and the reasons; however, the psychometric properties of the Chinese version of CPV-Q (C-CPV-Q) in adolescents with ADHD have not been examined yet. This study examined the psychometric properties of both child and parent versions of C-CPV-Q in adolescents with ADHD. Participants and Methods: In total, 247 adolescents with ADHD and their parents participated in the study. Confirmatory factor analyses (CFAs) were conducted to examine the factor structure for CPV types and reasons. Internal consistency, cross-validation, and concurrent validity of the parent and child versions of C-CPV-Q were also evaluated. Results: The results of CFA found that both child and parent versions of the C-CPV-Q contained four domains of CPV types and two domains of CPV reasons in adolescents with ADHD. The correlations between parent and child reports of the C-CPV-Q assessing the same factors were stronger than those assessing different factors. Concurrent validity of the C-CPV-Q was supported by their positive correlations with internalizing, externalizing, attention deficit/hyperactivity, oppositional defiant, and conduct problems. Except for the financial aggression factor, the entire C-CPV-Q had acceptable internal consistency. Conclusions: The results indicate that the child and parent versions of the C-CPV-Q are valid instruments for assessing a wide variety of CPV behaviors and the reasons among adolescents with ADHD.

Purpose: The fear of COVID-19 can result in psychological distress and mental health problems. Individuals with schizophrenia (IWSs) are especially vulnerable to contracting COVID-19. This study with a 1-year follow-up examined whether individual characteristics (sociodemographic characteristics, schizophrenia symptoms, depression, and self-esteem) or factors related to individual-environmental interaction (self-stigma, loneliness, and perceived social support) predicted the level of fear of COVID-19 (FC) among IWSs. Patients and methods: In total, 257 IWSs (out of an initial pool of 300 IWSs) were enrolled, and their baseline data were collected. FC was assessed using the Fear of COVID-19 Scale at 1 year after the onset of the study. The associations of baseline factors with FC 1 year later were analyzed using bivariable and multiple linear regression analysis. Results: Bivariable linear regression results demonstrated that being a woman (p < 0.05), being unemployed (p < 0.05), having depression (p < 0.001), having low self-esteem (p < 0.05), experiencing loneliness (p < 0.01), and having feelings of self-stigma (p < 0.001) significantly predicted FC 1 year later. A multiple linear regression model further indicated that having feelings of self-stigma significantly predicted FC 1 year later (p < 0.01). Conclusion: Clinicians and policymakers should consider the predictors identified in this study when designing interventions to reduce FC among IWSs.

Purpose: This study examined the associations of passive and active online sexual risk behaviors with perceived family relationships, impulsivity, and attention-deficit/hyperactivity disorder (ADHD). Participants and methods: A total of 176 adolescents with ADHD and 173 adolescents without ADHD participated in this study. The participants’ parents rated their parenting style on the Parental Bonding Instrument. The adolescents self-reported their lifelong experiences of passive and active online sexual risk behaviors, perceived family relationship quality on the family domain of the Taiwanese Quality of Life Questionnaire for Adolescents, and three domains of impulsivity on the Barratt Impulsiveness Scale version 11. Multivariable logistic regression was used to examine the associations of online sexual risk behaviors with perceived family relationships, impulsivity, and ADHD. Results: Overall, 114 participants (32.7%) reported passive forms of online sexual risk behaviors, and 49 (14.0%) reported active online sexual risk behaviors. Lack of foresight and self-control was significantly associated with passive online sexual risk behaviors (p = 0.003). Good family relationship was significantly associated with a decreased risk of active online sexual risk behaviors (p = 0.011), whereas seeking novelty and making decisions hastily was significantly associated with an increased risk of active online sexual risk behaviors (p = 0.048). ADHD diagnosis and inability to plan were not significantly associated with online sexual risk behaviors (p > 0.05). Conclusion: A high proportion of Taiwanese adolescents reported exhibiting online sexual risk behaviors. The factors related to the manifestation of these behaviors should be considered when designing relevant intervention programs.

Objective: In this population-based cohort study, we compared the risks of incident hyperopia, myopia, astigmatism, and strabismus between children with autism spectrum disorder (ASD) and children without ASD. Methods: This study included children who were born in Taiwan at any time between 2004 and 2017. Data were collected from the Taiwan Maternal and Child Health Database. We included 20,688 children with ASD and 2,062,120 matched controls to estimate the risks of incident hyperopia, myopia, astigmatism, and strabismus. Cox proportional hazards regression models were constructed for risk assessment. The models were adjusted for sex, calendar year of birth, and gestational age at birth. Statistical significance was determined by calculating adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Results: Children with ASD had higher risks of incident hyperopia (aHR: 1.78; 95% CI: 1.70-1.86), myopia (aHR: 1.27; 95% CI: 1.24-1.30), astigmatism (aHR: 1.51; 95% CI: 1.46-1.56), and strabismus (aHR: 2.18; 95% CI: 2.05-2.32) than did those without it. Conclusion: Clinicians should screen children with ASD for potential ophthalmic conditions. Further studies are required to elucidate the mechanisms underlying the associations between ASD and ophthalmic diseases. The roles of types and severities of ASD symptoms in detecting ophthalmic disease also requires further study.