Gender differences in the relationships between different types of childhood trauma and resilience on depressive symptoms among Chinese adolescents

Symptomatic Pathways of Comorbid Depression, Anxiety, and Stress Among Adolescents Exposed to Childhood Trauma-Insights from the Network Approach

Background

Childhood trauma can have a long-lasting influence on individuals and contribute to mental disorders, including depression and anxiety. Depression, anxiety, and stress are highly comorbid among adolescents with the trauma experience. Yet, the evolution of comorbidity remains unclear. To fill this gap, the current study aimed to explore the symptomatic and changing patterns of depression, anxiety, and stress among adolescents exposed to childhood trauma.

Methods

A total of 1548 college students (females = 782 (50.98%), Meanage = 19.59, SDage = 1.14) in China completed the Childhood Trauma Questionnaire (CTQ) and the Depression, Anxiety, and Stress Scales (DASS-21), and 942 students (Females = 516 (54.78%), Meanage = 19.57, SDage = 1.16) met the selection standard based on the cut-off scores of the CTQ. The symptomatic network and directed acyclic graph (DAG) network approaches were used.

Results

The results revealed that males reported experiencing significantly more physical abuse, physical neglect, emotional neglect, and sexual abuse compared to females. However, females scored significantly higher than males on "Worried" (DASS9), "Agitated" (DASS11), "Panic" (DASS15), and "Scared" (DASS20). No significant difference between genders was observed in the network structure and global strength. Meanwhile, among all participants, "Down-hearted" and "Agitated" appeared to be the most interconnected symptoms, the bridge symptoms in the symptom network, as well as the most vital symptoms in the directed acyclic graph network. Apart from that, "Panic" also served as the most prominent symptom in the directed acyclic graph network.

Conclusion

The results suggested that intervention targeted at assisting adolescents in developing more adaptive coping strategies with stress and regulating emotion could benefit the alleviation of comorbid depression, anxiety, and stress.

Hyperactivity in male and female mice manifests differently following early, acute prenatal alcohol exposure and mild juvenile stress

Introduction

Chronic prenatal alcohol exposure (PAE) and severe juvenile stress independently contribute to hyperactive and depressive behavioral phenotypes, with their combination exacerbating these effects. However, while chronic PAE and traumatic juvenile stress are well-studied, little is known about the impact of early, acute PAE and mild juvenile stress on hyperactivity and depression. This knowledge gap is clinically relevant, as these milder early-life insults are common in Western societies. Here, we provide the first investigation into the effects of early, acute PAE and juvenile sub-chronic, unpredictable, mild stress (SUMS)-both independently and in combination-on hyperactivity and depressive-like behaviors in mice throughout the lifespan.

Methods

We assessed hyperactivity through movement-related measures (i.e., distance traveled, thigmotaxis, and rearing), whereas depressive-like behaviors were evaluated using the u-shaped two-choice field and forced swim tests. Behavioural testing was performed on equivalent numbers of male and female offspring and repeated at juvenile, adolescent, and adult timepoints to enable assessment of sex and age effects.

Results

Neither early, acute PAE, juvenile SUMS, nor their combination induced depressive-like behaviors at any age; findings in contrast to the more severe chronic PAE and stress insults used in previous studies. However, these milder early-life insults did result in various hyperactivity phenotypes in both the male and female offspring. For example, juvenile SUMS had the strongest impact on hyperactive behaviors across both sexes, but only the adolescent females exhibited increased emotionality-associated activity. Moreover, early, acute PAE-both alone and in combination with juvenile SUMS significantly increased movement during adolescence and adulthood exclusively in male offspring.

Discussion

Thus, our collective findings not only indicate that early, acute PAE and juvenile SUMS influence hyperactivity in a sex- and age-dependent manner, but also highlight that their influence on hyperactive and depressive phenotypes do not simply mirror those of the more severe early-life insults. Given the potential prevalence of early, acute alcohol exposure and juvenile stress in Western society, further research is warranted to fully understand their long-term behavioral consequences.

Gender Differences in the Relationship Between Interpersonal Childhood Adversities and Later Life Depressive Symptoms

There is very little research on the relationship between interpersonal adverse childhood experiences and depressive symptoms in later adulthood in China. This study examines gender differences in the relationships between childhood physical abuse, bullying victimization, witnessing domestic violence, and depressive symptoms in Chinese middle-aged and older adults, controlling for self-rated physical health and sociodemographic characteristics.The study was based on a nationally representative sample of 4,775 males and 5,596 females aged 45 and older collected through the China Health and Retirement Longitudinal Study (CHARLS). Childhood adversity indicators in the 2014 Life History Survey were merged with the harmonized 2018 CHARLS dataset. Structural equation modeling was conducted for males and females simultaneously.Physical abuse was not significantly associated with depressive symptoms for either males or females. However, bullying victimization was significantly associated with depressive symptoms for both males and females. This association was stronger for males compared to females, but the gender difference was not statistically significant. Additionally, witnessing domestic violence had a significant association with depressive symptoms for both males and females, with a stronger association for females but this gender difference also was not statistically significant.Being bullied and witnessing domestic violence were still influential in middle and late life. To provide more effective prevention and interventions, further investigations are needed regarding the mechanisms behind the significant relationships and to explore why childhood physical abuse was not significantly associated with depressive symptoms among these Chinese participants.

Association between childhood trauma and depressive symptoms in adolescents during the post COVID-19 pandemic: the mediating role of social peer rejection

This study aimed to investigate the associations of childhood trauma and its facets with depressive symptoms in depressed adolescents during the post COVID-19 epidemic, and explore the potential mediating role of social peer rejection in these associations. A total of 413 adolescents with depressive disorders completed the Chinese version of the Child Trauma Questionnaire Short Form, the Social Peer Rejection, and the Children's Depression Inventory. Childhood trauma (β = 0.42, p < 0.01) and social peer rejection (β = 0.18, p < 0.01) were positively related to depressive symptoms, after adjustment for demographic factors. Furthermore, social peer rejection partly mediated the relationship between childhood trauma and depressive symptoms, and the mediation effect ratio was 17.0% (p < 0.001). This study found that childhood trauma and social peer rejection are both risk factors for depressive symptoms, and social peer rejection played a mediating role in the relationship between childhood trauma and depressive symptoms.

Linear and curvilinear association of pain tolerance and social anxiety symptoms among youth with different subgroups of childhood trauma

BACKGROUND

Social anxiety is a common symptom that occurs after exposure to childhood trauma (CT), and pain tolerance is a protective factor against social anxiety in generic populations with CT. However, few studies have investigated whether and how this association varies across different CT subgroups. Thus, this study aimed to investigate (1) the effects of pain tolerance on social anxiety symptoms among youth with different subgroups of CT; (2) the nonlinear relationship between pain tolerance and social anxiety symptoms among different CT categories.

METHODS

In this study, 15,682 college or university students with experiences of CT were identified in a large sample and divided into five CT subgroups. Linear and quadratic regression models were conducted to explore the association between pain tolerance and social anxiety symptoms among youth with different CT subgroups.

RESULTS

The results of model revealed a linear relationship between pain tolerance and social anxiety symptoms among youth with most CT subgroups. Notably, an inverted U-shaped curve was found between pain tolerance and social anxiety symptoms in youth with emotional abuse. Social anxiety symptoms increased gradually with pain tolerance scores between 0 and 16, and then sharply decreased when scores reached above 16.

LIMITATIONS

Limited by self-report measurements, the results of this study focused only on perceived pain tolerance and ignored behavioral pain tolerance.

CONCLUSION

These findings highlight the importance of assessing pain tolerance thresholds in youth with emotional abuse and improving pain tolerance to prevent social anxiety symptoms in youth with different subgroups of CT.

Protective role of resilience on the associations between childhood maltreatment and internalising and externalising problems

Different types of childhood maltreatment have negative effects on individual mental and behavioural outcomes. However, most of previous studies investigated their effects separately. Little is known about the effects of co-occurring maltreatment profiles on adolescents' developmental outcomes and the potential protective factor. The current study sought to identify distinct profiles of childhood maltreatment and examine the effects of profiles of childhood maltreatment on internalising and externalising problems and the protective role of resilience based on two-wave longitudinal data, which was collected from a sample of 670 Chinese adolescents (Mage = 15.50, SDage = 0.75, 48.4% boys). Four profiles of childhood maltreatment, that is, No maltreatment (67.9%), High neglect (23.0%), High abuse and neglect/Low sexual abuse (5.0%), and Multi-maltreatment (4.1%), were identified. Adolescents in High neglect, High abuse and neglect/Low sexual abuse, and Multi-maltreatment profiles were more likely to report internalising and externalising problems. Further, significant moderating effects of resilience only emerged for the association between the High neglect profile and internalising problems, such that high levels of resilience may weaken the association between the High neglect profile and internalising problems. Our findings revealed the importance and utility of identifying maltreatment profiles to tailor treatment based on specific maltreatment experiences. Resilience-oriented intervention could be considered for Chinese adolescents who have experienced high neglect.

The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem

BACKGROUND

The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients.

METHODS

Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships.

RESULTS

Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality.

CONCLUSIONS

Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.

Childhood emotional abuse and depression among Chinese adolescent sample: A mediating and moderating dual role model of rumination and resilience

BACKGROUND

Childhood emotional abuse (CEA) has been identified as a distal risk factor for later depression in adolescents. However, the underlying psychological mechanisms between CEA and adolescent depression are still poorly understood.

OBJECTIVES

This study aimed to explore the roles of rumination and resilience played in the association between CEA and depression among Chinese adolescents.

PARTICIPANTS AND SETTING

The sample included 919 students (52.56 % boys) with an average age of 13.47 years from a central province in China.

METHODS

Participants completed multiple measurements of CEA, rumination, resilience, and depression. Multivariate path analysis was applied to examine the relations among these variables.

RESULTS

Results showed (a) CEA was significantly positively related to adolescent depression; (b) Rumination partially mediated the relationship between CEA and depression and moderated the relationship between resilience and depression; (c) Resilience partially mediated the relationship between CEA and depression and moderated the relationship between rumination and depression.

CONCLUSIONS

The results revealed that both rumination and resilience played not only mediating but also moderating roles in the relationship between CEA and depression among Chinese adolescent sample, suggesting that the indirect effects of CEA on depression via resilience and rumination are dependent on each other. Hence, these findings deepened the understanding of the psychological mechanisms between CEA and depression and had several practical implications.

Association between childhood trauma and affective lability among adolescents: A moderated mediation model

BACKGROUND

Affective lability is an important feature of psychopathology. However, there is limited relevant research involving adolescents. To fill this research gap, the present study assessed the relationship between childhood trauma and affective lability among adolescents using a moderated mediation model.

METHODS

A total of 3738 students were recruited from four high schools in Shenzhen, China, between September and December 2019. The participants completed self-reported questionnaires measuring childhood trauma, affective lability, body image dissatisfaction, and the experience of being bullied. Linear regression and moderated mediation analyses were used in this study.

RESULTS

Linear regression analysis showed that emotional abuse and body image dissatisfaction positively predicted affective lability in boys and girls (all p < 0.001). Body image dissatisfaction mediated the relationship between emotional abuse and affective lability. In the moderated mediation model, being bullied moderated the direct path from emotional abuse to affective lability (p = 0.0236, p = 0.0188), and gender did not have a significant moderating effect on any direct or indirect path (all p > 0.05).

LIMITATIONS

A causal relationship could not be ascertained due to the cross-sectional design, and the results cannot be generalized to other populations.

CONCLUSIONS

The findings support that childhood trauma has an impact on affective lability in adolescents. Specifically, body image dissatisfaction and being bullied affect the relationship between emotional abuse and affective lability.

The role of only-child status in the effect of childhood trauma and parental rearing style on depressive symptoms in Shanghai adolescents

Introduction

After decades of the one-child policy, China changed its rules to allow two children in 2016, which altered family dynamics. Few studies have examined the emotional problems and the family environment of multi-child adolescents. This study aims to explore the role of only-child status in the impact of childhood trauma and parental rearing style on depressive symptoms of adolescents in Shanghai, China.

Methods

A cross-sectional study was conducted on 4,576 adolescents (M = 13.42 years, SD = 1.21) from seven middle schools in Shanghai, China. Childhood Trauma Questionnaire-Short Form, the Short Egna Minnen Beträffande Uppfostran, and Children's Depression Inventory were used to evaluate childhood trauma, perceived parental rearing style, and depressive symptoms of adolescents, respectively.

Results

Results showed that girls and non-only children reported more depressive symptoms, while boys and non-only children perceived more childhood trauma and negative rearing styles. Emotional abuse, emotional neglect, and father's emotional warmth significantly predicted depressive symptoms in both only children and non-only children. Father's rejection and mother's overprotection were related to adolescents' depressive symptoms in only-child families, but not non-only child families.

Discussion

Therefore, depressive symptoms, childhood trauma, and perceived negative rearing styles were more prevalent among adolescents in non-only child families, while negative rearing styles were especially associated with depressive symptoms in only children. These findings suggest that parents pay attention to their impacts on only children and give more emotional care to non-only children.

Intraindividual phenotyping of depression in high-risk youth: An application of a multilevel hidden Markov model

BACKGROUND

Traditionally, depression phenotypes have been defined based on interindividual differences that distinguish between subgroups of individuals expressing distinct depressive symptoms often from cross-sectional data. Alternatively, depression phenotypes can be defined based on intraindividual differences, differentiating between transitory states of distinct symptoms profiles that a person transitions into or out of over time. Such within-person phenotypic states are less examined, despite their potential significance for understanding and treating depression.

METHODS

The current study used intensive longitudinal data of youths (N = 120) at risk for depression. Clinical interviews (at baseline, 4, 10, 16, and 22 months) yielded 90 weekly assessments. We applied a multilevel hidden Markov model to identify intraindividual phenotypes of weekly depressive symptoms for at-risk youth.

RESULTS

Three intraindividual phenotypes emerged: a low-depression state, an elevated-depression state, and a cognitive-physical-symptom state. Youth had a high probability of remaining in the same state over time. Furthermore, probabilities of transitioning from one state to another did not differ by age or ethnoracial minority status; girls were more likely than boys to transition from a low-depression state to either the elevated-depression state or the cognitive-physical symptom state. Finally, these intraindividual phenotypes and their dynamics were associated with comorbid externalizing symptoms.

CONCLUSION

Identifying these states as well as the transitions between them characterizes how symptoms of depression change over time and provide potential directions for intervention efforts.

Reciprocal relationship between interpersonal communication and depressive symptoms and the mediating role of resilience across two years: Three-wave cross-lagged panel model

BACKGROUND

Depression among children has been a growing public health concern. It is generally recognized that individuals with depression are likely to have interpersonal malfunctioning. However, there remains a limited scientific understanding of the reciprocal relationship between interpersonal communication and depressive symptoms among rural Chinese children in a longitudinal approach.

METHODS

Therefore, guided by the interpersonal model of depression and the developmental cascade model, the present study conducted a cross-lagged panel analysis study to explore the bidirectional relationship between interpersonal communication and depressive symptoms across three waves among 2188 elementary school students in rural areas of one county of Gansu Province, China. We also examined the mediating effect of resilience and sex differences of the models.

RESULTS

Our results showed that depressive symptoms negatively predicted interpersonal communication from T1 to T2 and T2 to T3. Interpersonal communication negatively predicted depressive symptoms from T1 to T2, but not T2 to T3. Furthermore, resilience showed significant partial mediating effects in the reciprocal relationship between interpersonal communication and depressive symptoms. In terms of sex differences, the significant relationship between depressive symptoms at T1 and interpersonal communication at T2 was found to be significant among male students and marginally significant among female students. The full mediating effect of resilience at T1 was found only among male students, whereas resilience at T2 functioned as a full mediator between depressive symptoms at T2 and interpersonal communication at T3 only among female students.

LIMITATIONS

First, the present sample consisted of only third and fourth grade (i.e., in T1) students from one county in rural China. Second, the present study examined depressive symptoms instead of depression as a clinical diagnosis. Third, the third wave of the data was collected during COVID-19. The impact of the COVID-19 pandemic could unexpectedly pose on child mental health.

CONCLUSIONS

The finding underlined the importance of providing comprehensive depression prevention and intervention from fostering children's inner resilience and promoting their ability to navigate interpersonal resources.

Measuring childhood trauma in young adults with depression: A latent profile analysis

Childhood traumas are important risk factors for depression in young adults. However, the co-occurrence of childhood traumas is complex, and the specific effects of different types of childhood traumas on depression need further exploration. The aim of this study was to assess the co-occurrence of childhood traumas and the impact of different profiles of childhood trauma on depression. A total of 1053 young adults with depression in China participated. PHQ-9, SHAPS, GAD-7, CTQ-SF, and NLES were evaluated. Latent profile analysis (LPA) was conducted to identify profiles of childhood trauma. The effects of different childhood trauma profiles on depression, anxiety, and anhedonia were assessed using stepwise linear regression. LPA suggested three profiles: no or low childhood traumas, moderate childhood trauma with emotional abuse and childhood neglect, and high childhood trauma with high levels of all trauma types. Regression analyses suggested that high levels of emotional abuse and childhood neglect significantly affected anhedonia. Childhood adverse events cluster in young adults with depression, allowing grouping into three distinct profiles. Specific childhood trauma patterns predict anhedonia symptoms in adult depression.

Childhood experiences of threat and deprivation predict distinct depressive symptoms: A parallel latent growth curve model

BACKGROUND/AIM

There is growing awareness that specific childhood trauma (CT) may confer to the unique risk of depression, but little is known about this. The present study seeks to provide insight into how CT subtypes may impact distinct depressive symptoms over time based on the dimensional model of adversity (DMA).

METHODS

A total of 3535 college freshmen participated in a 2-year, four waves longitudinal tracking study. A conditional parallel latent growth curve model (LGCM) was constructed to examine the impacts of different types of CT (threat and deprivation) on the development of depressed mood and anhedonia, and whether these relationships vary across gender.

RESULTS

Our findings revealed that threat and deprivation could differentially relate to depressed mood and anhedonia. Both threat and deprivation predicted initial depressed mood levels (β = 0.309, p < 0.001; β = 0.175, p < 0.001, respectively) and its trajectory (β = -0.139, p = 0.068; β = -0.168, p < 0.05, respectively). Only deprivation predicted anhedonia levels (β = 0.318, p < 0.001) and trajectory (β = -0.218, p < 0.001). This pattern of relationships between CT and depressive symptoms varied across gender.

CONCLUSION

These findings highlight specific pathways and symptomatic manifestations of the impacts of different CT subtypes on depression and are consistent with the hypothesis of DMA. Threat and deprivation predicted more severe depressed mood, whereas deprivation uniquely conferred to the risk of depression via elevated anhedonia. Meanwhile, the deleterious effects of CT would persist during early adulthood. Gender differences were also discussed.

The relationship between childhood abuse and depression among adolescents: The mediating role of school connectedness and psychological resilience

BACKGROUND

Adolescent depression is a major public health concern worldwide, and depressive symptoms among adolescents in Chinese secondary school increase with grade. Although numerous studies noted that childhood abuse was associated with the development of depression in adolescents, the underlying mediators involved in this pathway remain unclear. Therefore, our study aims to explore whether psychological resilience and school connectedness mediate the association between childhood abuse and depression among Chinese adolescents.

METHODS

A cross-sectional survey was carried out among 1607 adolescents at four high schools located in Henan Province, Central China. Structural equation modeling was performed to determine whether psychological resilience and school connectedness mediate the influence of childhood abuse on depression.

RESULTS

Findings revealed that childhood abuse was directly (β = 0.410, p < 0.001) and indirectly (β = 0.141, p < 0.001) related to depression. Specifically, psychological resilience (β = 0.018, p = 0.009), school connectedness (β = 0.087, p < 0.001), and school connectedness together with psychological resilience (β = 0.036, p < 0.001) partially mediated the relationship between childhood abuse and depression.

CONCLUSIONS

The detrimental impact of childhood abuse on adolescents' depression may be reduced by fostering psychological resilience and school connectedness.

Perceived stress and depressive symptoms among Chinese college students: A moderated mediation model of biorhythm and ego resilience

Objective

To explore whether biological rhythm disturbance mediates the association between perceived stress and depressive symptoms and to investigate whether ego resilience moderates the mediation model.

Methods

A cross-sectional study was carried out using an online self-report questionnaire distributed to college students from September 2021 to October 2021. Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Severity (PSS-10), the Biological Rhythms Assessment in Neuropsychiatry (BRIAN), and Ego Resilience (ER-96) were used for investigation. SPSS 23 was used for data analyses. The significance of mediation was determined by the PROCESS macro using a bootstrap approach.

Results

Among the participants, 9.2% (N = 1,282) exhibited significant symptoms of depression. Perceived stress was positively associated with depressive symptoms, and biorhythm partially mediated this relationship. The direct and indirect effects were both moderated by ego resilience. Perceived stress had a greater impact on depressive symptoms and biorhythm for college students with lower ego resilience, and the impact of biorhythm on depressive symptoms was also stronger for those with lower ego resilience. Perceived stress had an impact on depressive symptoms directly and indirectly via the mediation of biorhythm.

Conclusion

Schools and educators should guide college students to identify stress correctly and provide effective suggestions to deal with it. Meanwhile, maintaining a stable biorhythm can protect college students from developing depressive symptoms. Students with low resilience should be given more attention and assistance.

Childhood emotional abuse and adolescent flourishing: A moderated mediation model of self-compassion and curiosity

BACKGROUND

Resilience and positive mental health may be negatively influenced by childhood maltreatment. While many scholars have noted that adolescents exposed to childhood emotional abuse could meet the criteria for flourishing, little research has investigated the mediating effect of self-compassion and the moderating effect of curiosity on the relationship between childhood emotional abuse and adolescent flourishing.

OBJECTIVE

This study proposed and tested a moderated mediation model that attempted to explain the pathway from childhood emotional abuse to adolescent flourishing.

PARTICIPANTS AND SETTING

The sample consisted of 315 female students (mean age 12.81 years, range 12-14 years) in a girls' secondary school in Hong Kong, China.

METHODS

We conducted a three-wave study with six-month intervals. The participants completed self-administered questionnaires at school under the guidance of trained research assistants.

RESULTS

Self-compassion at Time 2 mediated the relationship between childhood emotional abuse at Time 1 and adolescent flourishing at Time 3. Furthermore, the mediating effect was moderated by adolescent curiosity at Time 1 and Time 2.

CONCLUSIONS

The findings of this study suggested that although childhood emotional abuse may hinder the development of self-compassion, reduced levels of self-compassion and curiosity (especially the stretch dimension of curiosity) could work together to promote flourishing in adolescents with a history of childhood emotional abuse. The results lent further support to the developmental psychopathology and resilience perspectives in explaining the relationship between childhood trauma and positive developmental outcomes.

Adolescent health outcomes: associations with child maltreatment and peer victimization

Background

Child maltreatment (CM) and peer victimization (PV) are serious issues affecting children and adolescents. Despite the interrelatedness of these exposures, few studies have investigated their co-occurrence and combined impact on health outcomes. The study objectives were to determine the overall and sex-specific prevalence of lifetime exposure to CM and past-month exposure to PV in adolescents, and the impact of CM and PV co-occurrence on non-suicidal self-injury, suicidality, mental health disorders, and physical health conditions.

Methods

Adolescents aged 14–17 years (n = 2,910) from the 2014 Ontario Child Health Study were included. CM included physical, sexual, and emotional abuse, physical neglect, and exposure to intimate partner violence. PV included school-based, cyber, and discriminatory victimization. Logistic regression was used to compare prevalence by sex, examine independent associations and interaction effects in sex-stratified models and in the entire sample, and cumulative effects in the entire sample.

Results

About 10% of the sample reported exposure to both CM and PV. Sex differences were as follows: females had increased odds of CM, self-injury, suicidality, and internalizing disorders, and males had greater odds of PV, externalizing disorders, and physical health conditions. Significant cumulative and interaction effects were found in the entire sample and interaction effects were found in sex-stratified models, indicating that the presence of both CM and PV magnifies the effect on self-injury and all suicide outcomes for females, and on suicidal ideation, suicide attempts, and mental health disorders for males.

Conclusions

Experiencing both CM and PV substantially increases the odds of poor health outcomes among adolescents, and moderating relationships affect females and males differently. Continued research is needed to develop effective prevention strategies and to examine protective factors that may mitigate these adverse health outcomes, including potential sex differences.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13310-w.

Sex-Related Difference in the Association Between Child Neglect and the Accuracy of Body Weight Perception Among Chinese Primary Schoolchildren

Introduction: Body weight perception (BWP) directly determines weight management behaviors. Although child neglect is a well-established risk factor for managing body weight, little is known about its association with the accuracy of BWP. This study aimed to assess the cross-sectional and longitudinal associations between child neglect and BWP accuracy in primary schoolchildren, and explore how these differ based on the sex of the child. Methods: The sample included 1,063 primary schoolchildren (557 boys and 506 girls, aged 8-10 years) from a two-wave observational study between 2018 and 2019 in Wuhan, China. Child neglect and BWP were investigated using self-administered questionnaires. The accuracy of BWP was defined by comparing the BWP and actual body weight, and it was categorized into three groups-consistent, underestimated, and overestimated. Multinomial logistic regression analysis was conducted with fitting child neglect as the independent variable and the accuracy of BWP as the dependent variable. Results: The prevalence of weight misperception was ~44% at baseline (underestimation 40%; overestimation 4%) in Chinese primary schoolchildren. In the cross-sectional analysis, children with a higher level of neglect were more likely to misperceive their body weight. Moreover, there was an apparent sex-related difference that boys who experienced a higher level of neglect significantly reported more underestimation, while girls reported more overestimation. There was no significant longitudinal association between child neglect and the change in BWP accuracy. Conclusions: This study revealed that a higher level of neglect was significantly associated with underestimated BWP in boys and overestimated BWP in girls. The mechanisms of sex-related difference and whether child neglect is involved in the change in BWP, merit further investigations.

Resilience and mental health in children and adolescents: an update of the recent literature and future directions

PURPOSE OF REVIEW

In order to promote optimal development of children and adolescents at risk for psychiatric disorders, a better understanding of the concept resilience is crucial. Here, we provide an overview of recent work on clinical and epidemiological correlates of resilience and mental health in children and adolescents.

RECENT FINDINGS

Our systematic literature search revealed 25 studies that unanimously show that higher levels of resilience are related to fewer mental health problems, despite the heterogeneity of study populations and instruments. Correlates of resilience included multisystem factors, such as social, cultural, family and individual aspects, which is in line with the multisystem approach as described by recent resilience theories. Longitudinal studies are scarce but confirm the dynamical character of resilience and mental health. The application of longitudinal studies and innovative measurement techniques will improve our understanding on the cascade effects of stressors on resilience and mental health outcomes.

SUMMARY

Resilience is strongly associated with mental health in children and adolescents and deserves a more prominent role in research, prevention programs and routine clinical care. Including social, cultural and family context in the evaluation of resilience is of great value, as this can identify targets for early and preventive interventions.