Suicidal ideation, parent-child relationships, and adverse childhood experiences: a cross-validation study using a Graphical Markov Model

Associations Between Family Function and Non-suicidal Self-injury Among Chinese Urban Adolescents with and Without Parental Migration

The study aims to explore the effect of family function on non-suicidal self-injury (NSSI) among Chinese urban adolescents with and without parental migration. Between April 21st to May 12th, 2021, adolescents were recruited from Shenzhen city of Guangdong province, China (n = 124,357). Of all the participants, 22,855 (18.4%) were left-behind children (LBC). Family function, NSSI, depression, and socio-demographic characteristics were assessed using a series of self-reported questionnaires. Urban LBC had a higher NSSI frequency, while a lower level of family function than non-LBC. After controlling for confounders, parental migration was significantly associated with NSSI, and family dysfunction was a robust risk factor for NSSI as well. The protective effect of family function on NSSI of LBC was stronger than non-LBC. This implies that children with higher levels of family function tend to exhibit a lower frequency of NSSI, especially in those with parental migration. In practice, adolescents' NSSI prevention and intervention strategies should focus on improving family function.

Life events and depression among children and adolescents in southwest China: a two-stage moderated mediation model of social support and cognitive styles

BACKGROUND

According to data from the National Health Commission in 2018, more than 30 million children and adolescents in China suffered from mental health problems of varying degrees, with depression accounting for the largest proportion. Life events occur at every stage of child and adolescent development. Many studies have found a relationship between life events and depression in children and adolescents, but few studies have further explored the mediating and moderating variables that influence this relationship. Based on theoretical and empirical research on social support and cognitive styles, this study established a two-stage moderated mediating model to test whether social support mediates life events to depression, and cognitive style moderates the two mediating pathways.

METHODS

We recruited 3540 participants from primary and secondary schools in Chongqing and collected 2814 valid data. All the participants completed self-report measures of life events, depression, social support and cognitive styles. The moderated mediation model was examined using SPSS PROCESS model 58.

RESULTS

(1) There were significant positive correlations between life events and depression. (2) Social support mediates the relationship between life events and depression in children and adolescents. (3) Cognitive style moderates life events to social support and social support to depression.

LIMITATIONS

This is a cross-sectional study and the questionnaire is self-reported.

CONCLUSIONS

In children and adolescents, life events can influence depression through the mediating role of social support and cognitive styles could moderate its two mediating pathways.

The Relationship of Family Functioning and Suicidal Ideation among Adolescents: The Mediating Role of Defeat and the Moderating Role of Meaning in Life

OBJECTIVE

To investigate the relationship between family functioning and suicidal ideation among adolescents.

METHOD

A total of 4515 junior and senior high school students were assessed using the Family APGAR, the Depressive Symptom Index-Suicidality Subscale, the Defeat Scale, and the Chinese Meaning in Life Questionnaire.

RESULTS

This study found pairwise correlations between suicidal ideation, family functioning, defeat, and meaning in life. Specifically, family functioning was an influencing factor of adolescent suicidal ideation, and defeat was a mediator of the relationship between family functioning and adolescent suicidal ideation; meaning in life was found to be a moderator of the first half of the mediation process by defeat, that is, it moderated the influence of family functioning on adolescent defeat.

CONCLUSIONS

This study demonstrated that the relationship between family functioning and adolescent suicidal ideation, as well as the influence of defeat and meaning in life on this relationship, constituted a moderated intermediary model. This finding has both theoretical and practical value for the implementation of a psychosocial model of adolescent suicide prevention and intervention.

The chain mediating role of cognitive styles and alienation between life events and depression among rural left-behind children in poor areas in Southwest China

BACKGROUND

Compared with no-left-behind children, left-behind children show more psychological and behavioral problems, among which depression is the most common and most influential psychological problem in childhood. Many studies have documented the impact of life events on depression among left-behind children, but few studies have focus on the mediating mechanisms behind this relationship. Based on theoretical and empirical research on cognitive style and alienation, this study constructed a chain mediation model to test whether cognitive style and alienation play a mediating role in life events and depression of left-behind children.

METHODS

We recruited 13,035 participants from 25 districts and counties in Chongqing. After screening, 5127 questionnaires of left-behind children were included in the data analysis. They all completed self-report measures of demographic information, life events, cognitive styles, alienation and depression. We used SIF, CDI, ASLEC, CCSQ and IAP to collect the information of the variables and used the SPSS to analyze the data.

RESULTS

(1) There were significant positive correlations among life events and depression. (2) Left-behind children's depression was affected by life events through 3 different pathways: the mediating role of cognitive styles, the mediating role of alienation, and the chain mediating role of both cognitive styles and alienation.

LIMITATIONS

This is a cross-sectional study and the data used in our study is self-reported.

CONCLUSIONS

Cognitive styles and alienation could mediate the association between life events and depression among left-behind children.

Annual Research Review: Translational machine learning for child and adolescent psychiatry

Children and adolescents could benefit from the use of predictive tools that facilitate personalized diagnoses, prognoses, and treatment selection. Such tools have not yet been deployed using traditional statistical methods, potentially due to the limitations of the paradigm and the need to leverage large amounts of digital data. This review will suggest that a machine learning approach could address these challenges and is designed to introduce new readers to the background, methods, and results in the field. A rationale is first introduced followed by an outline of fundamental elements of machine learning approaches. To provide an overview of the use of the techniques in child and adolescent literature, a scoping review of broad trends is then presented. Selected studies are also highlighted in order to draw attention to research areas that are closest to translation and studies that exhibit a high degree of experimental innovation. Limitations to the research, and machine learning approaches generally, are outlined in the penultimate section highlighting issues related to sample sizes, validation, clinical utility, and ethical challenges. Finally, future directions are discussed that could enhance the possibility of clinical implementation and address specific questions relevant to the child and adolescent psychiatry. The review gives a broad overview of the machine learning paradigm in order to highlight the benefits of a shift in perspective towards practically oriented statistical solutions that aim to improve clinical care of children and adolescents.

Familial Risk Factors in Relation to Recurrent Depression Among Former Adolescent Psychiatric Inpatients

Treating recurrent depression is a challenge for clinical practitioners. We investigated which family environmental factors contribute to differences between recurrent and non-recurrent depression by the young adulthood of the former adolescent inpatients. The initial sample covered 237 adolescent psychiatric inpatients with depression, of which 35.4% had later diagnosed with recurrent depression. Recurrence in depression was associated to distant maternal relationships in both male (p = 0.022) and female patients (p = 0.042). In females, the likelihood for recurrent depression was also related to psychiatric problems of the father (p = 0.013) and siblings (OR = 3.7, p = 0.032), and having a grand multiparous mother (p = 0.005). Our results emphasise the need for effective family-centred approaches in treatment of adolescents with depression.

Depresión Infanto-Juvenil y exposición temprana a la violencia

Este artículo de revisión bibliográfica  tiene como objetivo conocer las aproximaciones teóricas de la depresión en el curso de vida infanto juvenil, a partir de la exposición temprana a situaciones de violencia, en tanto los procesos de mielinización se obstruyen, en la medida en que en los primeros años de vida, se es  víctima de violencia, influyendo esto directamente en alteraciones, cognitivas, comportamentales y emocionales. Resulta del interés en conocer los avances de  las disciplinas, las metodologías, las categorías y las preguntas que están motivando a los investigadores sobre el la depresión como síntoma arraigado en la violencia, hoy.  El análisis de la información fue desarrollada a través del estado del arte que constaba de 8 (ocho) ítems y 50 (cincuenta) filas, con el fin de ordenar y categorizar la información a partir de  conceptos relacionales. Las perspectivas disciplinares indagadas en esta revisión son la Psicología, la psiquiatría, la neuropsicología y las ciencias sociales. Las principales categorías indagadas por los autores son: mielinización, violencia infantil, depresión, consecuencias Neuropsicológicas y emocionales de la violencia. Las preguntas que formulan los investigadores se  ubican en cuatro campos: procesos neurobiológicos, violencia y maltrato infantil, pautas de crianza, depresión infanto juvenil, y  trastornos comportamentales, emocionales y cognitivos. Por los resultados obtenidos, se identificó que los problemas cardinales abordados en las investigaciones son, la violencia intrafamiliar, las pautas de crianza como uno de los ejes articuladores, y la depresión infanto juvenil.

Childhood Maltreatment, Self-esteem, and Suicidal Ideation in a Low-SES Emerging Adult Sample: The Moderating Role of Heart Rate Variability

Childhood maltreatment is associated with risk for suicidal ideation later in life, yet more research is needed on the indirect effects and bioregulatory protective factors in this association. The present study aimed to investigate the indirect influence of childhood maltreatment on suicidal ideation in emerging adulthood via level of self-esteem, and examine the moderating role of heart rate variability (HRV; a proxy for emotion regulation) in this indirect association. The study included a sample of 167 non-metropolitan emerging adults (M_age = 21.17, 55.8% female) of low-socioeconomic status (low-SES). HRV data were obained using an electrocardigram, whereas childhood maltreatment, suicidal ideation, and self-esteem data were obtained via self-report. Childhood maltreatment was indirectly associated with suicidal ideation via reduced self-esteem. HRV buffered this indirect association. Childhood maltreatment poses a risk for the development of suicidal ideation. Interventions that bolster self-esteem and emotion regulation may reduce suicide risk for emerging adults with a history of childhood maltreatment.

[Impact of Parents' Problem Drinking on Suicidal Ideation of Their University Student Children: The Multiple Mediating Effects of Childhood Trauma, Experiential Avoidance and Depression]

PURPOSE

The purpose of this study was to construct and test a hypothetical model about impact of parents' problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model.

METHODS

A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model.

RESULTS

We found no significant direct effect on depression and suicidal ideation of parents' problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents' problem drinking and depression (B=.38, p=.001). The path from parents' problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616).

CONCLUSION

Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents' problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.

Mediators between adverse childhood experiences and suicidality

We investigated whether psychiatric symptomatology, impulsivity, family and social dysfunction, and alcohol use mediate the relationship between adverse childhood experiences (ACEs) and suicidality. The study population comprised 206 adolescent psychiatric inpatients and 203 age- and gender-matched adolescents from the community. ACEs and suicidality were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version, the Life Events Checklist, and a structured background data collection sheet. Psychiatric symptomatology was measured using the Symptom Checklist -90. Impulsivity, social dysfunction, and family dysfunction were measured using the Offer Self-Image Questionnaire, and alcohol use was assessed with the Alcohol Use Disorders Identification Test. A simple mediation test and multiple mediation analyses were conducted. A positive direct effect of ACEs on suicidality was observed. Also seen was a positive indirect effect of ACEs on suicidality through psychiatric symptomatology, impulsivity, and family and social dysfunctions. Alcohol misuse did not, however, mediate the relationship between ACEs and suicidality. According to the multiple mediation analyses, psychiatric symptomatology was the most significant mediator, followed by impulsivity. Psychiatric symptoms, impulsivity, and family and social dysfunctions are factors that should be taken into consideration when assessing suicidality in adolescents.

Suicidality and its relationship with depression, alcohol disorders and childhood experiences of violence: results from the ESEMeD study

BACKGROUND

Suicidality constitutes a major health concern in many countries. The aim of the present paper was to analyse 10 of its risk factors and their interdependence.

METHODS

Data on suicidality, mental disorders and experience of childhood violence was collected from 8796 respondents in the European Study of the Epidemiology of Mental Disorders (ESEMeD). The CIDI was used to assess mental disorders. Individuals were randomly divided into two subgroups. In one, a Graphical Markov model to predict suicidality was constructed, in the second, predictors were cross-validated.

RESULTS

Lifetime suicidality was predicted mainly by lifetime depression and early experiences of violence, with a pseudo R-square of 12.8%. In addition, alcohol disorders predicted suicidality, but played a minor role compared with the other risk factors in this sample.

CONCLUSION

In addition to depression, early experience of violence constitutes an important risk factor of suicidality.

LIMITATIONS

This is a cross-sectional and retrospective study assessing risk factors for suicidality, not for suicide itself.

Depression risk of 'left-behind children' in rural China

The study aims to explore the risk of depression in left-behind children in grades four-six in rural China and to identify the factors associated with increased depression risk in this population. In Hubei Xiantao, a school-based sample of 1000 children was recruited with 875 children (590 left-behind children, 285 controls) providing all relevant information. The adjusted mean children's depression inventory (CDI) score of left-behind children was significantly higher than that of controls (P<0.01). Left-behind children's depression risk rate was much higher than control's (P<0.01). Left-behind children had a higher likelihood of depression risk than controls (migrant fathers: adjusted odds ratio (OR)=3.42, 95% confidence interval (CI)=1.86-6.28; migrant mothers: OR=2.62, 95% CI=1.10-6.22; migrant parents: OR=2.73, 95% CI=1.77-4.20). Respondents with low socioeconomic status (SES) (OR=2.64, 95% CI=1.42-4.93) had a higher likelihood of depression risk than the middle SES cohort. With middle levels of social support as the referent, respondents with low levels of social support (OR=5.86, 95% CI=3.90-8.79) had a higher likelihood of depression risk; respondents with high levels of social support (OR=0.50, 95% CI=0.29-0.86) had a lower likelihood of depression risk. The results indicate that the left-behind children are at greater risk for developing depression.