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

The path of depression in rural children: A fuzzy-set qualitative comparative analysis across multiple provinces in China

OBJECTIVES

This study explores the combinations of conditional variables contributing to depressive symptoms in rural children.

METHODS

We analyzed data from 715 children from a rural mental health database, conducting detailed follow-up investigations on 129 children in Zhejiang and Henan provinces. We used fuzzy set Qualitative Comparative Analysis (fsQCA) and regression analysis to identify causal pathways leading to depression.

RESULTS

The results indicate that depression in rural children does not stem from a single, necessary condition but arises from multiple factors. Our findings highlight significant contributions from both maternal and paternal involvement. Specifically, maternal involvement, combined synergistically with peer support and problematic behaviors, as well as paternal involvement, together with peer support and anxiety, significantly affects depressive outcomes. Additionally, anxiety and strong peer relationships independently have a substantial impact on these outcomes. Effective mitigation strategies involve active parental engagement and robust peer support, reducing the influence of risk factors such as problematic behaviors and anxiety.

LIMITATIONS

The generalizability of the results is limited by cultural and geographical variations. The study also does not account for all potential factors influencing depression in rural children.

CONCLUSION

Depression in rural children results from multiple interacting factors. Tailored interventions addressing these specific combinations are recommended.

The impact of parental migration patterns, timing, and duration on the health of rural Chinese children

Background

Parent-child separation raises concerns for the well-being of 69 million left-behind children (LBC) in China. However, the effects of parental migration status, timing of migration, and migration duration on the health of children remain unclear. This study aims to explore the association between different parent-child separation experience and a range of health outcomes in rural Chinese children.

Method

A sample of 2,355 students, grades 5 to 8, from two provinces in China were recruited. Standardized self-report instruments collected data on demographics, separation status, and children's health conditions.

Results

Full data were available for 274 children with both parents currently migrating (BLBC), 638 children with one parent currently migrating (SLBC), 658 children with parents previously migrated (PLBC) and 785 children with non-migrating parents (NLBC). Regression model results showed that, compared to the NLBC group, BLBC and PLBC exhibited lower self-rated health (p < 0.05), higher depression (p < 0.05), and higher rates of non-suicidal self-injury behaviors (p < 0.05) and suicidal ideation (p < 0.05). Children who experienced parental separation before the age of three were at a higher risk for four health indicators. Additionally, children left behind by parents for more than 7 years had significantly worse health outcomes.

Conclusion

Children who have experienced both current and previous parental migration, as well as earlier parental migration age and longer migration duration, are at a disadvantage in terms of health. These findings highlight the need for targeted interventions focusing on the most vulnerable children.

Maternal victimization and neglected offspring: Child marriage, IPV and depression symptoms among Salar Muslim women

BACKGROUND

Child neglect is prevalent in western rural China, yet there is limited research among ethnic minority communities. The Salar, a Turkic-Muslim ethnic minority residing primarily in western China, also face this specific problem. The group is deeply influenced by ethnicity, Islam and Chinese Confucianism, which in turn makes women vulnerable to child marriage and IPV. These victimizations, coupled with various life stressors, further complicate the challenges of providing adequate care for their children.

OBJECTIVE

This study hypothesizes a relationship between child neglect and maternal child marriage, IPV victimization, and depression symptoms.

PARTICIPANTS AND SETTING

201 married Salar women from five villages in Xunhua Salar Autonomous County, China, were randomly selected to participate in the study.

METHOD

A probability proportional to size (PPS) sampling approach was used to collect a random representative multi-stage cluster sample in 2022. Random effects Poisson regression models were used to test the hypotheses.

RESULTS

The participants reported a 65.6 % rate of child neglect and a 30.8 % rate of IPV in the past year. 37.6 % experienced child marriage. Results revealed significant associations between child neglect and child marriage, IPV, and depression symptoms. A two-way interaction between IPV and depression symptoms was strongly positively associated with child neglect.

CONCLUSIONS

This research indicates that Salar Muslim mothers who have experienced child marriage, adulthood victimization, and depression are at a higher risk of neglecting their children. The findings represent a valuable initial step toward researching and addressing the protection needs of women and children from Muslim ethnic minorities in China.

Prevalence of Suicidal Ideation, Suicide Plans, and Suicide Attempts Among Children and Adolescents Under 18 years of Age in Mainland China: A Systematic Review and Meta-Analysis

Despite suicide in younger population having become a severe public health issue, information on the prevalence of suicidality among Chinese children and adolescents is still limited. This study aims to estimate the prevalence of suicidal ideation, suicide plans, and suicide attempts in Chinese children and adolescents aged under 18 years. A meta-analysis was conducted based on English and Chinese publications from January 1, 2010 to December 31, 2020 using random-effects models. Based on 132 eligible studies with a combined total of 1,103,309 Chinese children and adolescents below 18 years old, the pooled prevalence of the overall suicidal ideation, suicide plans, and suicide attempts were 15.4% (95% CI [14.3, 16.6]), 6.4% (95% CI [5.5, 7.4]) and 3.5% (95% CI [3.1, 4.1]), respectively. The subgroup analyses showed that there were significant variations of prevalence of suicidal risks across genders, school stages, and geographical areas in mainland China. It was the first systematic review and meta-analysis to show suicidality among younger population aged below 18 years is prevalent in mainland China. This study suggests that gender-age-region-specific prevention and intervention programs should be urgently needed to reduce suicidal risks among Chinese children and adolescents.

Factor structure and measurement invariance of the Depression anxiety stress scale (DASS-21) in Chinese left-behind and non-left-behind children: an exploratory structural equation modeling approach

BACKGROUND

Comprehensive data has shown that adolescents often suffer from depression, anxiety, and low self-esteem, and are in a particularly fragile stage of psychological, physiological, and social development. Left-behind children in particular tend to have significantly higher, state anxiety and depression compared to non-left-behind children. The Depression, Anxiety, and Stress Scale (DASS-21) is an effective tool for evaluating depression, anxiety, and stress, and is used to measure levels of depression, anxiety, and stress in groups from a variety of backgrounds. The purpose of this study was to determine the effectiveness, reliability, and measurement invariance of the DASS-21 in Chinese left-behind children.

METHOD

The test and re-test method was used (N = 676), and the exploratory structural equation model (Mplus v.8.3) used to verify basic measurement models. For measurement invariance, the configural, weak, strong, and strict models were tested. The reliability of the DASS-21 was also tested using the collected data.

RESULTS

Analysis results showed that the DASS-21 had a stable three-factor structure in the sample of left-behind children in China. The measurement invariance test showed that gender and time not only had strong invariance, but also strict invariance. The results of cross left and non-left invariance indicated a lack of strict invariance. Finally, the McDonald's omega coefficient of the DASS-21 total scale was 0.864, and the internal consistency of each subscale was also good.

CONCLUSIONS

The DASS-21 is shown to be an effective and reliable tool for measuring depression, anxiety and stress in Chinese left-behind children.

A school-based intervention programme to prevent anxiety and depression among Chinese children during the COVID-19 pandemic

BACKGROUND

Child and adolescent mental health is a major public health concern worldwide. The development of children's social and emotional skills helps to improve mental health and wellbeing, and prevent anxiety and depression. The school-based social emotional learning (SEL) programmes have proved effective in a number of countries. But in Mainland China, there has been no empirical research of the effectiveness on children's mental health. The study conducted a SEL programme in China during the COVID-19 pandemic and aimed to determine whether: (1) a SEL programme can reduce anxiety and depression, (2) the intervention effect is influenced by sociodemographic characteristics, (3) the programme effects change children's emotion management and communication.

METHODS

Participants were 230 children aged 8-12 years in the intervention school and 325 in the control school in two poor villages in central China. The study was a quasi-experimental trial, comprising 16 weekly 90-minute sessions. It used a mixed-methods design, with a quantitative survey administered at baseline, post-intervention, and 5-month follow-up, and qualitative interviews. Linear mixed effects regression modeling was used to analyse the intervention effectiveness, linear models were conducted to examine the moderation effect of sociodemographic variables, and the inductive thematic analysis approach was used for interview data.

RESULTS

The intervention had no significant effect on anxiety or depression, except that intervention school children who lived with neither parent (left behind children) reported lower depression scores than control school at post-intervention and 5-month follow-up. Qualitative interviews showed after intervention children were more able to control tempers and better communicated their thoughts and feelings, improving their relationships with family and friends.

CONCLUSIONS

The programme was cheap, easy to implement, and warmly welcomed by children, schools and caregivers, suggesting it was feasible and potentially sustainable. More research is needed on the adaptation of the SEL programme in the Chinese context.

Association Between Parental Absence and Depressive Symptoms in Adolescence: Evidence From a National Household Longitudinal Survey

Longitudinal evidence demonstrating the association between parental absence and depressive symptoms in adolescence is limited. The present study aimed to explore this relationship in a Chinese national representative sample. This research was based on the China Family Panel Studies and included 1481 subjects. Depressive symptoms were assessed using the self-reported Center for Epidemiologic Studies Depression questionnaire. A multiple logistic regression model with a generalized estimating equation was used to test the association between parental absence and adolescent depressive symptoms. In the baseline year, 2012, 29.03% and 43.75% of adolescents had maternal and paternal absence, respectively. The prevalence of depressive symptoms increased from 23.23% to 28.12% in subsequent years. After controlling for covariates, maternal absence was positively associated with depressive symptoms (odds ratio 1.69, 95% confidence interval 1.06-2.68). Maternal absence led to depression in adolescents. It may be beneficial for adolescents with depression to spend more time with their mothers.

The role of childhood left-behind experience on childhood trauma exposure and mental health outcomes: a propensity score matching (PSM) analysis

BACKGROUND

China has a significant number of left-behind families. This study focuses on the long-term effects of childhood left-behind experience on different type of childhood trauma and mental health outcomes in later life development.

METHODS

participants were 67 795 Chinese young adults. Psychosocial characteristics were screened by sleep quality, the nine-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, trauma screening questionnaire for post-traumatic stress, a short form of the Childhood Trauma Questionnaire for childhood trauma. Propensity score matching (PSM) and multivariate linear regression were applied to analyze the data.

RESULTS

the results of the post-PSM analysis showed that the distributions of propensity scores for the two groups were approximately equal. And the total sample size in post-analysis dropped to 2358 (Nnuclear family = 1179, Nleft-behind family = 1179), with unmatched cases excluded. Post-matching results showed that the students from left-behind family were significantly associated with severer post-traumatic stress (b = 0.39, 95% CI = [0.15, 0.62]), loneliness (b = 0.29, 95% CI = [0.16, 0.42]), depressive symptoms (b = 0.44, 95% CI = [0.06, 0.82]) and CTQ-physical neglect (b = 0.34, 95% CI = [0.11, 0.58]).

CONCLUSION

our study showed that childhood left-behind experiences are tightly related to childhood trauma experience and mental health issues (post-traumatic stress, loneliness and depression) in late adolescents.

Decreased frontal lobe complexity in left-behind children during joint attention: a fNIRS study with multivariable and multiscale sample entropy analysis

Human brain development is shaped by experiences, especially during preschool, the critical period for cognitive and socioemotional development. This study employed the functional Near-Infrared Spectroscopy technique to explore the neural differences between left-behind children (LBC) and non-left-behind children (NLBC) on joint attention. Through collecting brain image data of 50 children (26 boys, aged 65.08 ± 6.28 months) and conducting multivariable and multiscale sample entropy (MMSE) analysis, the present study found that: (i) LBC showed lower brain complexity than NLBC in right prefrontal cortex; (ii) all participants demonstrated higher brain complexity in responding to joint attention conditions, compared to initiating joint attention ones; (iii) their brain complexity during joint attention was negatively associated with their emotional abilities. The findings advance our understanding of early brain development in LBC by providing evidence for the neural process characteristics of joint attention. Implications for early intervention to promote their brain development are also addressed.

The Unique Role of Peer Support: Exploring the Effects of Various Sources of Social Support on the Mental Health of Unaccompanied Children in China under Residential Education

This study investigates the impact of various sources of social support on the mental health of unaccompanied children under residential education in China. Unaccompanied children refer to those whose parents are still alive but unable to raise them due to various reasons. The study utilized self-reported questionnaires administered at two time waves, with the first wave (T1) evaluating family support, teacher support, and peer support, and the second wave (T2) evaluating depression, subjective well-being, and resilience. A total of 202 participants completed both surveys. To examine the predictive effect of different sources of social support on the mental health of these children, the study used the structural equation model with depression and subjective well-being as indicators. The results show that neither family support nor teacher support (T1) had a significant effect on the mental health (T2) of the children. However, peer support (T1) had a significant positive predictive effect on mental health (T2), indicating the unique role of peer support in promoting the mental health of unaccompanied children. The study also explored the mediating role of resilience between social support and well-being, revealing that though the direct effect of teacher support (T1) on mental health (T2) was not significant, the indirect mediating effect of resilience on the relationship between teacher support and mental health was significant. Both the direct and indirect effect of family support (T1) on mental health (T2) were not significant. These findings highlight the importance of creating a positive peer environment for unaccompanied children to promote their mental health. This study has important practical implications for the development of effective intervention programs aimed at improving the mental health of this population.

Peer effects of depression between left-behind and non-left-behind children: quasi-experimental evidence from rural China

PURPOSE

The aim of the study is to investigate the interactive influence of depression on left-behind (LB) and non-left-behind (NLB) children from the perspective of peer effects. The roles of teachers, parents, and friends are also explored.

METHODS

Data on 1817 children, 1817 parents, and 55 teachers were obtained from a field survey in December 2021. All students in the sample were randomly assigned to classrooms. A peer effect model and OLS methods were used to estimate the peer influence of depression. Robustness tests were conducted by randomly removing schools from the sample.

RESULTS

Depression was contagious among different groups of rural children, and the peer effect of the NLB children's depression played a dominant role. Both LB and NLB children were more affected by their NLB classmates' depression. LB children were not significantly affected by depression in other LB children. This conclusion remains robust after robustness testing. In addition, heterogeneity analysis showed that outgoing and cheerful teachers, effective parent-child communication and high-quality friendship all alleviated peer influence on depression.

CONCLUSIONS

LB children have more severe depression than NLB children, but LB children are more affected by depression in their NLB peers. Policymakers should train teachers to engage in positive communication with students to improve mental health in children. In addition, this article recommends that children move and live with their parents when family conditions permit.

Impact of training on primary care physicians' management of depression and anxiety disorders in rural China

BACKGROUND

Primary care physicians (PCPs) in rural township health centers are the most easily accessible doctors to the residents in rural China, which covers 35% of the population. High prevalence of depression was reported among rural left-behind elderly and children as many workers had migrated to urban cities.

AIM

This study explored mental health care provision by PCPs in rural China and the association with their training background.

METHODS

Rural township health centers in both developed and less developed counties of Zhejiang Province, China were chosen as the study sites. A total of 697 PCPs completed questionnaires between December 2019 and January 2020, and the number of valid questionnaires was 673, with a valid response rate of 79.3%.

RESULTS

The rural PCPs reported a median range of seeing 1 to 5 mental health patients per week. Over two-thirds (68.2%) of the respondents had never received any training on treating common mental health disorders (depression and anxiety) while 20.3% received at most 2 days of training; 6.4% received 3 to 20 days of training; and 5.1% received over 20 days of training. PCPs with mental health training were significantly associated with better mental health care in terms of confidence and practice characteristics (e.g. having patients who brought up mental health issues, providing follow-up), while years of practice made a difference in practice but not confidence.

CONCLUSIONS

Training is the key determinant of the practice of mental health care by the PCPs in rural China. Our findings have implications for national policy to target two-thirds of rural PCPs who received no mental health training.

Self-compassion and depression in Chinese undergraduates with left-behind experience: Mediation by emotion regulation and resilience

OBJECTIVES

The protective role of self-compassion in emerging adult depression has garnered empirical support. It makes more sense to understand the psychological processes underlying this relationship. Based on the stress appraisal patterns, the present study examined the mediating roles of emotion regulation (ER) and resilience in the link between self-compassion and depression among college students with left-behind experience (LBE).

METHODS

A total of 391 LBE college students (M_age  = 18.43 years; SD = 0.79 years) in Chongqing reported their demographic information and self-compassion (the Self-Compassion Scale) level at baseline (T1) and reported their levels of ER (the Emotion Regulation Scale), resilience (the Connor-Davidson Resilience Scale), and depression (the Depression-Anxiety-Stress Scale) 3 months later (T2).

RESULTS

The results revealed that (a) both ER (cognitive reappraisal and expressive suppression) and resilience separately mediated the association between self-compassion and depression; (b) cognitive reappraisal and resilience sequentially mediated this association.

CONCLUSIONS

These findings reveal the underlying mechanisms of the associations between self-compassion and depression among LBE college students and have implications for interventions aimed at mitigating their depression.

Multicenter analysis on the non-suicidal self-injury behaviors and related influencing factors-A case study of left-behind children in northeastern Sichuan

BACKGROUND

Few studies have been conducted focusing on the non-suicidal self-injury (NSSI) incidence rate and influencing factors among left-behind children in northeastern Sichuan, China. In this study, we investigated the incidence rate of the NSSI behaviors, levels of anxiety and depression in left-behind children in northeastern Sichuan, and relevant sociodemographic factors.

METHODS

The NSSI behaviors were identified using the Ottawa Self-injury Inventory (Chinese version). Its incidence rate and related influencing factors were evaluated by Cluster sampling; the Depression Anxiety Stress Scale-21 Items (DASS-21) was adopted to assess the levels of anxiety, depression, and stress.

RESULTS

A total of 9450 adolescents met the inclusion criteria, including 543 with NSSI behaviors, and the prevalence of NSSI was 5.7 %. There were 3596 left-behind children, and 243 of them had NSSI behaviors, the NSSI incidence in left-behind children was 6.8 %. There were 5854 non-left-behind children, and the NSSI incidence in non-left-behind children was 5.1 %. Left-behind children's NSSI behaviors were remarkably correlated with five risk factors: being female (OR = 2.411, 95%CI = 1.773-3.279), parents' divorce (OR = 1.742, 95%CI = 1.262-2.404), elder age (OR = 1.120, 95%CI = 1.028-1.219), severe depression (OR = 1.212, 95%CI = 1.148-1.281), and high anxiety (OR = 1.170, 95%CI = 1.093-1.251).

LIMITATIONS

This is a cross-sectional study, we cannot probe into the causality between NSSI behaviors and corresponding risk factors. Reporting and recalling biases may be unavoidable as questionnaires are performed by self-rating scales and retrospective reports.

CONCLUSION

The NSSI behaviors are common in left-behind children in northeastern Sichuan. This study proposes that prevention and intervention measures are necessary for the healthy growth of such children.

Psychological Resilience among Left-Behind Children in a Rural Area of Eastern China

Childhood is an important period for individuals’ psychological development. Due to long-term separation from the parents, left-behind children (LBC) more easily develop deviation in cognition and abnormal personality. In this study, we aimed to explore the status of psychological resilience among LBC in a rural area of eastern China. We carried out a cross-sectional survey including middle and high school students from Qingyuan County of Zhejiang Province. Psychological resilience was measured using a modified scale developed for Chinese children. Data from a total of 1086 participants were collected, and the mean ± standard deviation score of psychological resilience was 4.11 ± 0.42. Multivariable linear regression analyses revealed that being a class leader (p = 0.010) and having high self-evaluation of academic performance (p < 0.001) were related with psychological resilience. Moreover, high contact frequency between parents and children (p = 0.019) was associated with better psychological resilience among LBC. In conclusion, we found that being a class leader and having high self-evaluation of academic performance were associated with better psychological resilience among the children in this rural area and contact between parent and child was an essential factor associated with psychological resilience among LBC.

Parental migration and left-behind children in Georgia - school teachers' experience and perception: a qualitative study

INTRODUCTION

Georgia, like other Eastern European countries, showed a dramatic increase of international labour emigration after becoming independent in 1991. The collapse of the Soviet Union caused economic instability, unemployment and poverty resulting in labour migration. Since then, thousands of children have been left behind in the care of extended family members while their parents work abroad. The aim of this study is to explore schoolteachers' perceptions on parental migration and left-behind children (LBC) in Georgia as schoolteachers are the main contact persons for LBC and their caregivers.  METHODS: We conducted six focus-group discussions with public school teachers, namely class-tutors and six in-depth interviews with school principals from two migrant sending regions. We applied reflexive thematic analysis to systematically analyse the data and identify main and sub-themes. The contextual model of family stress underpins this study.

RESULTS

We identified the following themes expressed by both, teachers, and school principals: social and economic impact of migrant labour and relationships between schools and migrant families. School teachers and principals acknowledged some positive aspects of migrant labour, but primarily perceived parental migration as a negative experience for children leading to problems in mental health, well-being, and academic performance. Structural factors, lack of support and lack of community involvement were expressed to further worsen the situation. Teachers saw themselves as one of the main supporters for LBC while they described the role of caregivers ranging from caring to unhelpful or even destructive. School principals stated mitigating the situation by regular meetings with class tutors, extra-tutoring for LBC, psychological counselling, and developing/enacting internal guidelines.

CONCLUSIONS

Our findings suggest that LBCs and transnational families could benefit from the provision of psychological services at schools.

Long-term effects of left-behind experience on adult depression: Social trust as mediating factor

Background

Despite much attention paid to the mental health of left-behind children, there has not been sufficient research on whether and how left-behind experiences have long-term effects on adults among the general population. This paper aims to evaluate the long-term effects of left-behind experience on adult psychological depression.

Methods

By using the China Labor-force Dynamics Survey in 2018 (CLDS 2018), we assessed depression by the Center for Epidemiological Studies, Depression Scale (CES-D) and used a cut-off score of 20 for detecting depression (Yes = 1, No = 0). The Binomial logistic regression was used to compare the odds ratio across groups. We used the KHB method in the mediation analysis, to measure the indirect effect of social trust on the relationship between left-behind experience and depression.

Results

The rate of depression (χ2 = 17.94, p < 0.001) for the children who have left-behind experience (LBE) (10.87%) was higher than the children who have non-left-behind experience (N-LBE) (6.37%). The rate of social trust (χ2 = 27.51, p < 0.001) of LBE (65.70%) was lower than N-LBE (75.05%). Compared with the other three groups, left-behind experience occurred in preschool (OR = 2.07, p < 0.001, 95% CI = [1.45, 2.97]) was more likely to suffer from depression. The indirect effect of social trust (OR = 1.06, p < 0.01, 95% CI = [1.02, 1.10]) is significantly on the relationship between LBE and psychological depression, with the total effect (OR = 1.71, p < 0.001, 95% CI = [1.27, 2.31]) and direct effect (OR = 1.62, p < 0.01, 95% CI = [1.20, 2.18]) are both significantly. The proportion of indirect effect in the total effect is 10.69%.

Conclusion

The left-behind experience that occurred in childhood has a significantly negative effect on adult psychological depression, in which preschool left-behind experience played the most critical role. Social trust is the mediating factor associated with left-behind experience and psychological depression. To mitigate the long-term effects of the left-behind experience on psychological depression, parents need to be prudent about the decision-making of migration in the preschool stage of their children. and subsequent policies should strengthen social work targeting vulnerable youth groups especially those with left-behind experience at an early age in terms of their psychological depression.

To assess and compare the mental health of current-left-behind children, previous-left-behind children with never-left-behind children

The study's goal was to compare the mental health of children who are now left-behind (current-LBC) to children who have never been left-behind (never-LBC). Recruits were culled from rural Chinese schools. The Strengths and Difficulties Questionnaire (SDQ) and the Parent-Adolescent Communication Scale (PACS) were used to examine participants' migratory status, mental health, and parent-child communication (PACS). A total of 2,000 current-, 500 previous-, and 300 never-LBCs in had complete data readily accessible for research and analysis. A number of mental health issues, such as emotional symptoms, conduct, and hyperactivity issues as well as overall challenges were considerably increased when all confounding factors were taken into account in the analysis. Our findings also showed a substantial link between children's overall issues and their inability to effectively communicate with parents. Children suffer long-term consequences as a result of their parents' frequent moves. The mental health of children is closely linked to the quality of communication between parents and children. Migrant parents' ability to comprehend and communicate with their children is critical to their children's development, according to the findings of this study.

Internet addiction and child physical and mental health: Evidence from panel dataset in China

BACKGROUND

The number of internet users has increased substantially in the last decade and these increasing rates of internet use also apply to children. Children usually have poorer self-control and poorer cognition than college-age populations or adults, the impact of Internet addiction on the health of this group has important implications not only for their individual economic and social outcomes but also the future human capital development in China.

METHODS

We use data from the 2016 and 2018 China Family Panel Survey, a survey that collected data from a large and nationally representative sample of the Chinese population, to construct a sample of children from 25 provinces, and then use DID and PSM-DID methods to investigate whether Internet addiction (increased screen time in this article) impacts the physical and mental health of children (ages 10-15) in China.

RESULTS

Internet addiction has a significant negative impact on child physical and mental health. The mediating effect model shows that Internet addiction impairs child physical and mental health by reducing their sleep and exercise time. The heterogeneity analysis shows that, Internet addiction has a stronger negative effect on urban children than rural children. Additionally, Internet addiction has a significant correlation with the mental health of left-behind children (LBC), but not children living with both parents (CLP).

LIMITATIONS

Our research has several weaknesses. First, this article uses time spent online to measure Internet addiction and this measurement method is not perfect. Also, given that the sample is made up of only Chinese children, conclusions about generalizability remain tentative. Future studies should be conducted in other countries.

CONCLUSION

This study systematically studied the effects of Internet addiction on the physical and mental health of Chinese children. This study can help government leaders make targeted programs to prevent children from Internet addiction in the future, especially to reduce internet dependence among students.

Childhood Socioeconomic Status and Adult Subjective Wellbeing: The Role of Hope and Sense of Control

The study investigates the unexplored link between childhood socioeconomic status and adult subjective wellbeing using data from a field survey of 568 rural residents from poor areas in China. This study focuses on exploring the relationship between childhood socioeconomic status, hope, sense of control, and adult subjective wellbeing using a structural equation model. Results indicated that hope and sense of control mediated the links between childhood socioeconomic status and adult subjective wellbeing, revealing that hope and sense of control may buffer the negative impacts of childhood poverty experiences on subjective wellbeing. The findings provide new insights into the impacts of childhood socioeconomic status on adult subjective wellbeing and expand the literature on key factors in adult subjective wellbeing.

A prospective study of peer victimization and depressive symptoms among left-behind children in rural China: the mediating effect of stressful life events

BACKGROUND

The Ministry of Civil Affairs of the People's Republic of China reported that in 2018, 6.97 million left-behind children (LBC), children who live in rural areas away from their parents, were being cared for by grandparents, relatives, elder siblings, or often living alone. Their parents have migrated to cities for better income opportunities. While a number of studies have detailed elevated depressive symptoms among LBC, relatively little is known about the causes of poorer mental health in LBC.

METHODS

This study used longitudinal data to examine associations between peer victimization, stressful life events, and depressive symptom severity in LBC from four randomly-selected middle schools in Guizhou Province, China. A total of 862 children aged 11-18 years, with 472 LBC (54.76%) and 390 non-left-behind children (NLBC) (45.24%), were included in the analysis. T-test was used to compare the depressive symptoms, peer victimization, and stressful life events between LBC and NLBC at baseline and follow-up (6 months later). Multivariable linear regression models were used to examine the mediation effect of follow-up stressful life events on the relationship between baseline peer victimization and follow-up depressive symptoms among LBC.

RESULTS

Results suggested that LBC had higher peer victimization and stressful life events than NLBC (β = 1.28, p = 0.04), and peer victimization and stressful life events at baseline were associated with increased follow-up depressive symptoms among LBC (Peer victimization: β = 0.25, p < 0.0001; Stressful life events: β = 0.15, p < 0.001). Peer victimization affected depressive symptoms partially through stressful life events for female LBC and completely through stressful life events for male LBC, controlling for age, perceived socioeconomic status, and school.

CONCLUSIONS

This study highlights the vulnerability of LBC exhibiting negative mental health outcomes as they were found to experience more peer victimization and feel more stressed when stressful life events happened, compared with NLBC. Results of this study suggested that protecting LBC from peer victimization experiences can potentially prevent LBC from experiencing an increased impact of other stressful life events, thus decreasing the likelihood of their depressive symptoms. Intervention design should consider the different mediating effects of stressful life events on the relationship between peer victimization and depressive symptoms among female and male LBC.

A Prospective Study on Resilience Among Children with Different Migrant and Left-behind Trajectories

Parental migration has been an important predictor of children's psychological resilience. The present study discusses the effect of parental migration on children's resilience in rural western China from a dynamic viewpoint. Using sequence analysis, this study investigates children's entire migration trajectory over the course of childhood (ages 1-12) and identifies the typical patterns of the dynamic family structure associated with parental migration: continuously nonmigrant (N = 4,238), continuously migrant (N = 923), continuously left behind by one parent (N = 872), continuously left behind by both parents (N = 796) and frequent transition between migrant or left-behind statuses (N = 1,624). The results show that the trajectories of left-behind status and transition have a significant negative impact on children's resilience, which demonstrates that both the effects of parent-child separation and family instability compromise children's psychological functioning. Family resources can buffer these negative effects, but they work asymmetrically across different groups of children. Family economic resources serve as a significant protective factor among children continuously left behind by both parents, while family social resources are more protective for children in unstable families.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12187-022-09945-1.

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.

Internal Migration and Depression Among Junior High School Students in China: A Comparison Between Migrant and Left-Behind Children

Using data from the China Education Panel Survey (CEPS), which was a nationally representative sample of junior high school students, this study examined the association of internal migration with depression among migrant and left-behind children, while exploring the moderating effect of gender difference and the mediating effects of social relationships. The results showed that migrant children had a significantly lower level of depression than left-behind children. Further, the difference in mental health between migrant children and left-behind children was more prominent for boys than girls. The mechanism analyses indicated that compared to left-behind children, internal migration positively predicted parent–child relationships and peer relationships of migrant children, which in turn reduced their depressive symptoms. Although migrant children suffered from a higher level of teacher discrimination than their left-behind counterparts, it had no significant relationship with depression after controlling for children’s social relationships with parents and peers. Our findings suggested that migrating with parents was helpful to reduce children’s depressive symptoms in comparison with being left behind. Therefore, actions should be implemented to reduce the occurrence of involuntary parent–child separation and the prevalence of children’s depressive disorders due to institutional constraints. In addition, necessary treatments are needed to improve the psychological wellbeing of disadvantaged children, especially among left-behind children with mental illness.

Perceived Stress, Social Support, Emotional Intelligence, and Post-Stress Growth among Chinese Left-Behind Children: A Moderated Mediation Model

Background: Several previous studies have revealed a negative impact of perceived stress on post-stress growth. Nevertheless, the potential mediating and moderating mechanisms are unclear, particularly for left-behind children in China. Therefore, this study aims to investigate the negative relationship between perceived stress and post-stress growth, the mediating effect of social support, as well as the moderating effect of emotional intelligence in a sample of Chinese left-behind children. Methods: A sample of 837 Chinese students in elementary and middle school was collected for this study. The Perceived Stress Scale, the Social Support Scale, the Emotional Intelligence Scale, and the Post-Stress Growth Scale were employed to examine them. The data were analyzed using SPSS 25.0 software. Results: The results indicate a significant negative association between perceived stress and post-stress growth. Among perceived stress and social support, the former acted as a mediator, while the latter as a moderator. This study sheds light on the post-stress growth of Chinese left-behind children. The findings validated a model of moderated mediation that shows the relationship between perceived stress, emotional intelligence, social support, and post-stress growth. Conclusion: This study confirmed that social support is one of the most important factors among left-behind children, from perceived stress to post-stress growth. Furthermore, the study reveals that emotional intelligence can adjust the relationship between perceived stress and social support to post-stress growth. Therefore, for both family education and school education, the result provides a new direction.

Decreased Right Prefrontal Synchronization Strength and Asymmetry During Joint Attention in the Left-Behind Children: A Functional Near-Infrared Spectroscopy Study

Although there are millions of left-behind children in China, the researches on brain structure and functions in left-behind children are not sufficient at the brain imaging level. This study aimed to explore whether there is decreased prefrontal synchronization during joint attention in left-behind children. Sixty children (65.12 ± 6.54 months, 29 males) with 34 left-behind children were recruited. The functional near-infrared spectroscopy (fNIRS) imaging data from the prefrontal cortex during joint attention, as well as behavioral measures (associated with family income, intelligence, language, and social-emotional abilities), were collected. Results verified that brain imaging data and behavioral measures are correlative and support that left-behind children have deficits in social-emotional abilities. More importantly, left-behind children showed decreased synchronization strength and asymmetry in the right middle frontal gyrus during joint attention. The findings suggest that decreased right prefrontal synchronization strength and asymmetry during joint attention might be vulnerability factors in the development of left-behind children.

Resilience mediates the association between self-harm and suicidal ideation in Chinese left-behind children

Background

A significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC). Existing literature suggests that resilience might be a mediator in this association. However, this hypothesis has not been effectively discussed. The major aim of our study is to analyze the possible mediation of resilience in SH-SI association in Chinese LBC.

Methods

A population-based clustering sampling survey of 2619 LBC was conducted in southwestern China Yunnan province. Self-developed structured questionnaire was used to collect relevant information. Univariate and multivariate Logistic regression models were applied to estimate the associations between SH and SI, resilience and SI, and SH and resilience. Path analysis was adopted to measure the mediation of resilience, as well as its 5 dimensions, in the association between SH and SI. A subgroup analysis was further done to explore the mediation of resilience in the associations between SH severity and SI, SH repetition and SI, among self-harmed LBC.

Results

Compared with LBC who reported no SH behaviors, the odds ratio (OR) for SI was 3.37 (95% CI: 2.63–4.31) among self-harmed LBC. Based on the path model, resilience significantly mediated a quarter of the total association between SH and SI. Among the 5 dimensions of resilience, emotion regulation, interpersonal assistance, and family support were the strongest mediators. Subgroup analysis revealed that, the mediation of resilience was only significant for SH severity and SI.

Conclusions

Resilience played as a prominent mediator in SH-SI association among Chinese LBC. Resilience-centered intervention measures could be considered to reduce suicidal risk of this disadvantageous group.

Educational Aspirations and Expectations of Adolescents in Rural China: Determinants, Mental Health, and Academic Outcomes

Educational aspirations and expectations of adolescents have implications for educational and psychological outcomes. This study aimed to determine factors associated with educational aspiration–expectation discrepancies and to examine the associations between the discrepancies and psychological and academic outcomes in rural left-behind children and non-left-behind children aged 14–16 in mainland China. Cross-sectional data from a self-report survey were collected in 2020 among 606 rural students (mean age = 14.85 years) in two public middle schools in Songzi county, Hubei Province. Participants filled in questionnaires measuring their socio-demographic information, educational aspirations and expectations, academic performance, parental and friends’ aspirations, academic self-perception, academic self-regulation, depression, and self-esteem. Results showed that more than half of the participants reported that they felt they were not likely to attain the level of education to which they aspired. Parental migration, academic performance, mother’s educational aspirations for children, and close friends’ educational aspirations were the main factors associated with students’ educational aspiration–expectation discrepancies. Both left-behind children and non-left-behind children whose aspirations exceed expectations were more likely to report lower self-esteem, higher depression, lower academic self-perception, and poorer self-regulation than those without a discrepancy. These findings have implications for families, schools, and policymakers through informing the development of interventions that target positive development in rural youth.

The formation and influence mechanism of mathematics self-concept of left-behind children in mainland China

This study aimed at exploring the formation mechanism of mathematics self-concept of left-behind children and the influence mechanism of mathematics self-concept on their mathematics achievement. In study 1, the formation mechanism of mathematics self-concept was examined using multilevel analyses of 874 left-behind children. The results showed that (1) the individual mathematics achievement of left-behind children had a significant positive predictive effect on mathematics self-concept, Chinese achievement had a significant negative predictive effect on mathematics self-concept, and the class-average mathematics achievement had no significant effect on mathematics self-concept; and (2) when left-behind children were the majority group, there was an assimilation effect on downward interpersonal social comparison. When left-behind children were the minority group, there was a contrast effect on upward intergroup social comparison. In study 2, the influence mechanism of mathematics self-concept of 585 left-behind children was investigated with a tracking research. The results suggested that (1) Time 1 mathematics self-concept had significant effects on Time 2 mathematics school engagement at between-group and within-group levels; and (2) Time 2 mathematics school engagement played a partial mediating role between Time 1 mathematics self-concept and Time 2 mathematics achievement at the within-group level. These results indicate that the formation and influence mechanism of mathematics self-concept of left-behind children is influenced by contextualized characteristics.

Environmental Risk Factors and Their Different Effects in Depressive Symptoms of Left-Behind Children in Rural China Compared with Non-Left-Behind Children

In China, 61 million children were left behind in rural areas as a result of massive urbanization and migration of parents from the countryside to the cities in search of economic opportunities. This study explores the effects of environmental risk factors (i.e., peer victimization, perceived discrimination, and stressful life events) on depressive symptoms of left-behind children (LBC) and examines whether these risk factors have a higher impact on LBC compared with that of non-left-behind children (NLBC). Data collected involve 1548 first and second-year middle school students. Logistic regressions were conducted to examine the associations between environmental risk factors and LBC's depressive symptoms, the moderating effect of the parental separation duration on these associations, and to compare if the risk factors had a higher impact on LBC's depressive symptoms than on those of NLBC. Peer victimization is associated with an increased likelihood of depressive symptoms for LBC who were left behind for more than five years. Finally, stressful life events have a higher impact on LBC's depressive symptoms, while peer victimization has a higher impact on NLBC's depressive symptoms. The results suggest that stressful life events are an important risk factor that puts LBC at a disadvantage in terms of their mental health.

Attention Deficit Hyperactivity Disorder (ADHD) among elementary students in rural China: Prevalence, correlates, and consequences

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is a widely recognized mental health problem in developed countries but remains under-investigated in developing settings. This study examines the prevalence, correlates, and consequences of ADHD symptoms among elementary school students in rural China.

METHODS

Cross-sectional data were collected from 6,719 students across 120 rural primary schools in China on ADHD symptoms, demographic characteristics, and academic performance in reading and math. ADHD symptoms were evaluated using the caregiver-reported ADHD Rating Scale-IV.

RESULTS

The prevalence of ADHD symptoms was 7.5% in our sample. Male students, students in lower grade levels, and students with lower cognitive ability showed a significantly higher prevalence of ADHD symptoms (ORs = 2.56, 2.06, and 1.84, respectively; p<0.05). Left-behind children showed a significantly lower prevalence of ADHD symptoms than did children who were living with their parents (OR = 0.74, p < 0.05). Adjusted regressions show that students with ADHD symptoms scored 0.12 standardized deviations lower in reading (p < 0.05) and 0.19 standardized deviations lower in math (p < 0.01).

LIMITATIONS

The ADHD Rating Scale-IV is a screening scale rather than a diagnostic test. Caregiver self-report measures also may underestimate ADHD symptoms for our sample.

CONCLUSIONS

ADHD is a common disorder among rural students in China and appears to be contributing to poor academic outcomes. The higher prevalence of ADHD among students with low cognitive ability also suggests that many rural children in China face multifactorial learning challenges. Taken together, the findings indicate a need for educators and policymakers in rural China to develop programs to reduce risk and support students with ADHD symptoms.

Network analysis of the relationship between negative life events and depressive symptoms in the left-behind children

BACKGROUND

There are 68.77 million left-behind children in China, who are at a great risk of depression associated with negative life events. Our study aims to investigate the most central symptoms of depression in left-behind children and the relationship between depressive symptoms and negative life events using network analysis.

METHOD

A cross-sectional data set (N = 7255) was used, which included children and adolescents aged 7 to 17. Network analysis was used to evaluate: 1) the most central symptoms among the items included in Child Depression Inventory (CDI) of the left-behind children; 2) bridge symptoms between depressive disorder and Adolescent Self-Rating Life Events Check List (ASLEC) of the left-behind children; 3) differences in networks of depressive disorders between left-behind and non-left-behind children, and 4) differences in the network of depression and negative life events between left-behind and non-left-behind children. The stability and centrality indices of the network were also evaluated in the study.

RESULTS

The most central symptoms in the CDI among the left-behind children included self-hatred, crying, fatigue, and sadness. The items with the highest bridge strength centrality in the CDI-ASLEC network included academic stress, discrimination, and school performance decrement. Higher bridge strength values indicate a greater risk of contagion to other communities. The connections in the CDI-ASLEC network are denser in the left-behind children than in non-left-behind children.

LIMITATIONS

The study which was conducted based on cross-sectional data shows that network analysis can only make undirected estimation, but not causal inferences.

CONCLUSIONS

We identified the core symptoms of depression and the bridge symptoms between negative life events and depression in the left-behind children. These findings suggest that more attention should be paid to self-hatred, sadness, and fatigue in the treatment of depression in left-behind children. Intervention for academic stress and discrimination of the left-behind children may help to reduce the contagion of negative life events to depression symptoms.

Psychological Capital Differs Among Rural Left-Behind Children and Is Associated With Emotional and Behavioral Problems

This study aims to explore, through latent profile analysis (LPA), rural left-behind children’s psychological capital and its relationship with emotional and behavioral indicators. In this study, 677 rural-based left-behind children (average age 11.7 ± 1.58 years) in Hunan Province, China, were recruited and assessed using the Rural Left-behind Children’s Psychological Capital Questionnaire and the Children’s Strengths and Difficulties Questionnaire. We found that psychological capital was divided into three latent profiles: high (43.3% of the sample), medium (46.1%), and low (10.6%). Compared to the other two types, the children with low psychological capital returned higher scores for emotional symptoms, conduct disorder, hyperactivity and impulsivity, and peer-interaction problems, but lower prosocial behavior scores. Meanwhile, examination of the effects of gender and grade found that most of the elementary school students had high psychological capital, and that there was no significant difference among the groups in regard to gender. In summary, distinct differences in psychological capital were found among left-behind children, and the latent profiles were determined to be related to grade, emotional symptoms, hyperactivity and impulsivity, and prosocial behavior. There was also a significant difference in emotional and behavioral indicators across the different latent profiles.

A longitudinal study of depressive symptoms and delinquency among Chinese left-behind children

This study sought to identify the developmental trajectories of depressive symptoms and delinquency in Chinese left-behind children (LBC) over a three-year period, a topic that is less often studied. Overall, 578 Chinese LBC (M_age= 10.63 years; boys = 53.1%) were tested three times on their depressive symptoms and delinquency from grades four through six. Unconditional latent growth modeling revealed no linear change in LBC's depressive symptoms, whereas there was a linear decrease over time in LBC's delinquency. Multiple-group models revealed that the pattern of change in LBC's delinquency differed across parental migration status and gender. Moreover, mother-only migration LBC showed higher initial depressive symptoms and initial delinquency levels than father-only migration LBC. The results provided a more accurate developmental picture by charting patterns of stability and change among Chinese LBC's depressive symptoms and delinquency in the context of parental migration.

Left-Behind Children, Parent-Child Communication and Psychological Resilience: A Structural Equation Modeling Analysis

This study aims to examine the role of parental migration status and parent communication in the psychological and related behavioral status of left-behind children and their psychological resilience. A cross-sectional survey was conducted in Anhui Province of China, and a questionnaire survey was conducted with 1992 teens using the Chinese version of the Parent-Adolescent Communication Scale (PACS), Connor-Davidson Resilience Scale (CD-RISC), and Strength and Difficulties Questionnaires (SDQ). Compared with the never left-behind group, left behind children had relatively lower PACS, CD-RISC and SDQ scores. Absence of parents is related with poorer psychological resilience, while good parent communication is related with better psychological resilience. Better psychological resilience is related to fewer psychological problems regardless of parental migration status. Currently left-behind status demonstrated a negative influence on psychological resilience, while never left-behind status had a positive effect. Interventions are needed to enhance psychological resilience of left-behind children to prevent psychological and related behavioral problems.

Psycho-social factors associated with high depressive symptomatology in female adolescents and gender difference in adolescent depression: an epidemiological survey in China's Hubei Province

BACKGROUND

Exploring etiological clues to adolescent depression, especially in female adolescents, might be helpful to improve the social environment of female adolescents. The aim at this study is to explore psycho-social factors of female adolescents with high depressive symptomatology and gender differences in depressive symptoms among Chinese adolescents.

METHOD

We examined 4100 adolescents from Wuhan city and Jianli county via a cross-sectional study. Depressive symptomatology was screened through the Chinese version of Center for Epidemiology Studies Depression Scale. Multivariate logistic regression was performed to explore the factors related to high depressive symptomatology in female and male adolescents, respectively.

RESULTS

The prevalence of high depressive symptomatology in female and male were 38.9 and 30.2% respectively. The psycho-social factors of high depressive symptomatology in female adolescents were age (Adjusted odds ratio [aOR] = 1.201, 95% confidence interval [CI], 1.076 ~ 1.341), single parent family (aOR = 2.004, 95%CI, 1.448 ~ 2.772) and fathers' education level (compared to primary school and below, [Junior middle school, aOR = 0.641, 95%CI, 0.439 ~ 0.934; Senior middle school, aOR = 0.603, 95%CI, 0.410 ~ 0.888; College degree and above, aOR = 0.639, 95%CI, 0.437 ~ 0.936]).

CONCLUSION

Fathers' education level was associated with high depressive symptomatology in female adolescents. Female adolescents whose father with primary school education or below deserves more attention. Further epidemiologic researches need to be conducted to explore the different risk factors between female and male adolescents in China.

The Impact of Childhood Left-Behind Experience on the Mental Health of Late Adolescents: Evidence from Chinese College Freshmen

A paucity of public service afforded to migrant workers often begets a wide range of social problems. In China, hundreds of millions of migrant worker parents have to leave children behind in their hometowns. This paper investigated the long-term effects of the childhood experience of being left behind on the mental well-being of late adolescents. Mandatory university personality inventory (UPI) surveys (involving psychosomatic problems such as anxiety, depression, and stress) were conducted at a university in Jiangsu, China, during 2014–2017. The study sample consisted of 15,804 first-year college students aged between 15 and 28 years. The PSM method and the OLS regression model were employed. Controlling for the confounding factors (gender, age, single-child status, hometown location, ethnicity, and economic status), our empirical investigation demonstrated that childhood left-behind experience significantly worsened the mental health of the study sample, increasing the measure of mental ill-being by 0.661 standard deviations (p < 0.01). Moreover, the effects were consistently significant in subsamples divided by gender, single-child status, and hometown location; and the effects were greater for females, single-child students, and urban residents.

When Does Teacher Support Reduce Depression in Students? The Moderating Role of Students' Status as Left-Behind Children

Teacher support (TS) makes students feel loved and cared for because they believe that their teachers will provide them with opportunities to make choices, support them in independent problem solving, and understand their inner feelings. High TS levels reduce depression and anxiety, thereby improving students' mental well-being. This cross-sectional study involved 3,573 students from 29 schools in 16 counties/cities of six provinces, namely, Guizhou, Hubei, Jiangxi, Shanxi, Sichuan, and Yunnan. The aim was to examine the impact of TS on students' level of depression. The results indicated that for children in elementary schools, their status as left-behind children (LBC) played a moderating role between TS and depression. The level of depression in non-LBC children decreased significantly with increases in TS, but the reduction for LBC children was not significant. For children in middle/junior high schools, their LBC status did not play a moderating role between TS and depression. TS was negatively correlated with the children's level of depression, but there was a significant positive relationship between their LBC status and depression. The theoretical and practical significance of the research findings were further discussed.

Family Structure, Family Instability, and Child Psychological Well-Being in the Context of Migration: Evidence From Sequence Analysis in China

This study conceptualizes parental migration as a dynamic family process that exposes children to parental absence and family instability. Using detailed migration histories, this study identifies the left-behind trajectories of rural Chinese children throughout childhood (age 1-12) and examines the impact on psychological well-being (N = 3,961). Results indicate heterogeneity in children's experience of parental migration, which is characterized by both persistence (prolonged parental absence) and instability (repeated parental migration). A quarter of rural children experienced prolonged parental migration, and for half of these, by both parents. Another 50% of rural children experienced repeated parental migration. Children continuously left behind by both parents and children who experienced substantial family instability both fared worse in psychological development than those in stable two-parent families.

Family Unity or Money? The Roles of Parent-Child Cohesion and Socioeconomic Status in the Relationship Between Stressful Life Events and Nonsuicidal Self-Injury Among Chinese Left-Behind Children

OBJECTIVE

Chinese left-behind children have faced a high level of stress and tend to engage in nonsuicidal self-injury (NSSI) behavior. However, the impacts of parental migration on NSSI are complex. The improved family's socioeconomic status (SES) could have positive impacts on these children's mental health, yet the parental absence could have negative influences. To explore the complex dynamics of parental migration on NSSI, this study examined the roles of parent-child cohesion and SES in the relationship between stressful life events and NSSI.

METHOD

A total of 509 left-behind children completed self-report surveys that addressed stressful life events, NSSI, parent-child cohesion, and SES.

RESULTS

Stressful life events were positively related to NSSI in both the migrant father and two migrant parents' groups. Furthermore, for children with migrant fathers, father-child cohesion and SES significantly moderated the relation between stressful life events and NSSI. The interaction of stressful life events, mother-child cohesion, and SES also was significant. For children with two migrant parents, mother-child cohesion was negatively related to NSSI. No significant interactions were found in this group.

CONCLUSIONS

The findings suggested that, although parent-child cohesion and SES were both important for the prevention of NSSI among left-behind children, parent-child cohesion should remain a priority.

Parental Migration and Children's Psychological and Cognitive Development in China: Differences and Mediating Mechanisms

Internal migration has resulted in a large number of left-behind children in China. Despite growing attention to this population, important gaps remain in our understanding of their cognitive development and the factors that mediate the impact of migration on children. The present study draws on a new nationally representative survey of Chinese children to study the psychological and cognitive development of left-behind children. Results show that rural children left behind by both parents (but not by one parent) are worse off in both psychological well-being and cognitive development than rural children living with both parents. The disadvantage of left-behind children is mediated by their caregivers' emotional well-being, parenting practices, and education. We also find a pronounced rural-urban difference in children's cognitive development.

The prevalence of confirmed childhood trauma and its' impact on psychotic-like experiences in a sample of Chinese adolescents

Adolescents with childhood trauma may be associated with psychotic-like experiences (PLEs) and is at high risk for later development of psychoses. Exploring early age risk factors for childhood trauma may provide useful information for prevention of mental disorders and improvement of mental health, yet no studies have examined the association between exposure to specific forms of trauma and different types of PLEs in a sample of Chinese adolescents. Thus, the Childhood Trauma Questionnaire-Short Form was used to measure five types of childhood trauma (emotional abuse, EA; physical abuse, PA; sexual abuse, SA; emotional neglect, EA; physical neglect, PA) in junior middle school students. And the positive subscale of Community Assessment of Psychic Experiences divided into four types (bizarre experiences, perceptual abnormalities, persecutory ideation and magical thinking) was used to measure PLEs. Then the possible associations among demographic information and specific types of childhood trauma on specific forms of PLEs was compared. The rates of EA, PA, SA, EA and PA were 14.2%, 13.0%, 16.1%, 60.0%, and 78.6%, respectively. Moreover, childhood trauma seems to be a main role in the development of PLE, and EA and SA patients are particularly likely to experience PLEs.

Depressive Symptoms and the Link with Academic Performance among Rural Taiwanese Children

Previous studies reflect a high prevalence of depressive symptoms among Taiwanese adolescents (ages 13–18), but there is an absence of literature related to the risk of depression of children in Taiwan (ages 6–12), particularly among potentially vulnerable subgroups. To provide insight into the distribution of depressive symptoms among children in rural Taiwan and measure the correlation between academic performance, we conducted a survey of 1655 randomly selected fourth and fifth-grade students at 92 sample schools in four relatively low-income counties or municipalities. Using the Center for Epidemiological Studies-Depression Scale (CES-D) we assessed the prevalence of depressive symptoms in this sample, in addition to collecting other data, such as performance on a standardized math test as well as information on a number of individual and household characteristics. We demonstrate that the share of children with clinically significant symptoms is high: 38% of the students were at risk of general depression (depression score ≥ 16) and 8% of the students were at risk of major depression (depression score > 28). The results of the multivariate regression and heterogeneous analysis suggest that poor academic performance is closely associated with a high prevalence of depressive symptoms. Among low-performing students, certain groups were disproportionately affected, including girls and students whose parents have migrated away for work. Results also suggest that, overall, students who had a parent who was an immigrant from another country were at greater risk of depression. These findings highlight the need for greater resource allocation toward mental health services for elementary school students in rural Taiwan, particularly for at-risk groups.

Grandparents' Financial Contributions to Grandchildren in Rural China: The Role of Remittances, Household Structure, and Patrilineal Culture

OBJECTIVES

This investigation examined predictors of monetary transfers made by grandparents for the benefit of their grandchildren in rural China. Predictors included family factors related to financial supply (remittances received from the parents of grandchildren), household demand (living in a skipped-generation household), and patrilineal culture (targeting sons and grandsons).

METHOD

The 2015 wave of the Longitudinal Study of Older Adults in Anhui Province was used to study financial transfers made by 831 grandparents to grandchildren in the families of 1,633 parents. Two-part random-effects regression was used to predict whether a transfer was made and the value of transfers, given that one occurred.

RESULTS

Grandparents provided higher value transfers to grandchildren whose parents provided greater remittances and with whom they coresided in skipped-generation households. The likelihood of making a transfer fully followed the male lineage, and was greatest to grandson-only families in which parents were first-born sons.

DISCUSSION

Results show that economic, household, and cultural factors are independently associated with the largesse of grandparents. We conclude that grandparents' economic contributions to grandchildren in rural China are shaped by family demands in a highly mobile society, intergenerational interdependence, and a persistent patrilineal gender system that reaches to the level of grandchildren.

Associations among trauma exposure, post-traumatic stress disorder, and depression symptoms in adolescent survivors of the 2013 Lushan earthquake

BACKGROUND

Post-traumatic stress disorder (PTSD) frequently occurs in survivors of natural disasters, while symptom of depression is related mostly to interpersonal trauma. These conditions are highly correlated and strongly impact adolescent quality of life. This study aimed to explore the relationship among trauma exposure, PTSD symptoms, and/or depression symptoms in adolescent survivors of the 2013 Lushan (China) earthquake.

METHODS

A cross-sectional survey of 2921 adolescents in the Longmenshan seismic fault zone was conducted three years after the Lushan earthquake. Participants were evaluated using the Earthquake Experience Scale, the Adolescent Self-rating Life Events Checklist (ASLEC), the Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-Rating Scale (KADS-6). Stepwise regression was used to explore relationships between trauma exposure and PTSD or depression symptoms.

RESULTS

There was a strong correlation between PTSD and depression symptoms, with a 10.7% comorbidity. Earthquake-related exposure, negative life events, prior exposure to the 2008 Wenchuan (China) earthquake, and being left behind by parents all contributed to PTSD and depressive symptoms. Earthquake exposures contributed mainly to PTSD symptoms, while interpersonal traumas contributed mainly to depression symptoms.

CONCLUSION

PTSD and depression symptoms strongly correlate in adolescent survivors of the 2013 Lushan earthquake. The high comorbidity between PTSD and depression symptoms may reflect shared risk factors. Natural disasters are more likely to cause PTSD symptoms, while interpersonal traumas are more likely to cause depression symptoms.

The impacts of maternal separation experience and its pattern on depression and dysfunctional attitude in middle school students in rural China

BACKGROUND

In China, because of the growth of economically driven rural-to-urban migration, there are lots of children in rural area who are separating or have separation experience with their parents. Until now, few studies focused on solely maternal separation and no research studied whether its pattern will affect children's later psychological status.

AIM

The aim of this study was to determine whether early or late maternal separation affects depression and dysfunctional attitude in middle school students and what is the role of cumulative duration and meeting frequency.

METHODS

Maternal separation experience was obtained by using questionnaires. We got early maternal separation group first. Then, late maternal separation and control group were obtained with the same number by matching grade, sex and family socioeconomic status. All the students in the three groups completed the scales of Children's Depression Inventory (CDI) and Dysfunctional Attitude Scale (DAS).

RESULTS

Both CDI and DAS scores of early separation group are higher than the other two groups. When we split the data by sex, only females presented the same results. When cumulative duration is short, there is significant difference in both scores of CDI and DAS among the three groups, which showed the scores of early separation group are higher than the other two groups. When the cumulative duration is long, there is no significant difference among the three groups. When meeting frequency is high, there is no significant difference among the three groups. When it is low, there is significant difference among the three groups, which showed the CDI and DAS scores of early separation group are higher than the other two groups. Furthermore, the same results are also found in females.

CONCLUSION

Early maternal separation may exert negative influence on student's depression and dysfunctional attitude. The sex, cumulative duration and meeting frequency may also play important roles in the effect.