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Chang Q, Shi Y, Yao S, Ban X, Cai Z. 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. TRAUMA, VIOLENCE & ABUSE 2024; 25:2090-2102. [PMID: 37902618 DOI: 10.1177/15248380231205828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
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.
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Affiliation(s)
| | - Yu Shi
- Xiamen University, Fujian, China
| | | | | | - Ziyi Cai
- University of Hong Kong, Hong Kong, China
- Newcastle University, UK
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Wang Y, Liu J, Chen S, Zheng C, Zou X, Zhou Y. Exploring risk factors and their differences on suicidal ideation and suicide attempts among depressed adolescents based on decision tree model. J Affect Disord 2024; 352:87-100. [PMID: 38360368 DOI: 10.1016/j.jad.2024.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/04/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Suicide has been recognized as a major global public health issue. Depressed adolescents are more prone to experiencing it. We explore risk factors and their differences on suicidal ideation and suicide attempts to further enhance our understanding of suicidal behavior. METHODS 2343 depressed adolescents aged 12-18 from 9 provinces/cities in China participated in this cross-sectional study. We utilized decision tree model, incorporating 32 factors encompassing participants' suicidal behavior. The feature importance of each factor was measured using Gini coefficients. RESULTS The decision tree model demonstrated a good fit with high accuracy (SI = 0.86, SA = 0.85 and F-Score (SI = 0.85, SA = 0.83). The predictive importance of each factor varied between groups with suicidal ideation and with suicide attempts. The most significant risk factor in both groups was depression (SI = 16.7 %, SA = 19.8 %). However, factors such as academic stress (SI = 7.2 %, SA = 1.6 %), hopelessness (SI = 9.1 %, SA = 5.0 %), and age (SI = 7.1 %, SA = 3.2 %) were more closely associated with suicidal ideation than suicide attempts. Factors related to the schooling status (SI = 3.5 %, SA = 10.1 %), total years of education (SI = 2.6 %, SA = 8.6 %), and loneliness (SI = 2.3 %, SA = 7.4 %) were relatively more important in the suicide attempt stage compared to suicidal ideation. LIMITATIONS The cross-sectional design limited the ability to capture changes in suicidal behavior among depressed adolescents over time. Possible bias may exist in the measurement of suicidal ideation. CONCLUSION The relative importance of each risk factor for suicidal ideation and attempted suicide varies. These findings provide further empirical evidence for understanding suicide behavior. Targeted treatment measures should be taken for different stages of suicide in clinical interventions.
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Affiliation(s)
- Yang Wang
- College of Management, Shenzhen University, Shenzhen, China
| | - Jiayao Liu
- College of Management, Shenzhen University, Shenzhen, China
| | - Siyu Chen
- College of Management, Shenzhen University, Shenzhen, China
| | - Chengyi Zheng
- College of Management, Shenzhen University, Shenzhen, China
| | - Xinwen Zou
- School of Business Informatics and Mathematics, University of Mannheim, Mannheim, Germany
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China.
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Cheng J, Peng C, Rong F, Wang Y, Tan Y, Yu Y. Mobile phone addiction and suicide behaviors among Chinese adolescents: The mediation of poor sleep quality. J Behav Addict 2024; 13:88-101. [PMID: 38224348 PMCID: PMC10988414 DOI: 10.1556/2006.2023.00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/18/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024] Open
Abstract
Background and aims Mobile phone addiction (MPA) is emerging among adolescents, especially during the COVID-19 pandemic. Nevertheless, there is a dearth of knowledge regarding the correlation between MPA and suicide behaviors and its mechanism. The objective of the current study is exploring the direct effect of MPA on suicide behaviors and the indirect effect through poor sleep quality. Methods A total of 18,900 Chinese adolescents aged 12 to 18 were recruited via a multi-stage cluster sampling method. Results The prevalence of MPA and poor sleep quality was 26.2 and 23.1%, respectively. During the past year, 24.4% participants were involved in suicide behaviors. Specifically, suicide ideators, suicide planners, and suicide attempters were 10.7, 8.4, and 5.3%, respectively. Particularly, rural females had the highest prevalence of suicide behaviors, MPA, and poor sleep quality. Logistic regression analysis showed that MPA was significantly associated with suicide ideators (OR = 1.22, 95% CI: 1.09-1.37, p < 0.001) and planners (OR = 1.18, 95% CI: 1.04-1.34, p < 0.05), but not for suicide attempters (p > 0.05). Structural equation modelling demonstrated that MPA had direct effect on suicide behaviors (β = 0.145, 95% CI = 0.127-0.160), and poor sleep quality partially mediated the relationship (the mediating ratio was 46.7%). The mediating ratio of poor sleep quality was the highest in urban males. Conclusions MPA has both direct and indirect effects on suicide behaviors. For suicide prevention, limited mobile phone use and improvement sleep quality may be practical for adolescents. Additionally, more efforts of intervention could give priority to rural girls.
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Affiliation(s)
- Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yafei Tan
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Guo HB, Li SY. Discrimination Experiences of Orphans and Left-Behind Children in China as Predictors of Suicidal Thoughts and Behaviors. CRISIS 2023; 44:518-524. [PMID: 37051836 DOI: 10.1027/0227-5910/a000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Background: Suicide has been recognized as a serious problem in orphans and left-behind children. It is important to examine the differences in the factors affecting suicidal thoughts and behaviors between the two groups. Aims: To compare the lifetime rates of suicidal thoughts and behaviors between orphans, left-behind children, and other children, and to assess the impact of discrimination experiences and the mediating role of self-esteem. Methods: A total of 2,413 children from middle schools in China completed standardized anonymous questionnaires that assessed child type, suicidal thoughts and behaviors, discrimination experiences, and self-esteem. Data analysis employed χ2 test, Pearson correlation test, and structural equation modeling (SEM). Results: Left-behind children had a significantly higher lifetime rates of suicidal ideation than orphans and other children (χ2 = 9.35, p < .05). Discrimination experiences significantly and positively predicted suicidal thoughts and behaviors through the mediating effect of self-esteem in orphaned children, and there was no self-esteem mediating effect found for left-behind children. Discrimination experiences had a greater impact on suicidal thoughts and behaviors for orphans than for left-behind children. Limitations: Cross-sectional studies based on self-report might lead to biased results and mean that causality cannot be inferred. Conclusions: Attention should be paid to suicidal thoughts and behaviors among vulnerable groups, especially left-behind children. Reducing discrimination and improving orphans' self-esteem can be considered as targets of prevention and intervention for suicidal thoughts and behaviors.
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Affiliation(s)
- Hui-Bing Guo
- Department of Student Affairs Management, West China School of Medicine/ West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Shi-Ying Li
- School of Public Administration, Sichuan University, Chengdu, People's Republic of China
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Nguyen LV, Nguyen TTA, Trinh LT, Nguyen HHV. Factors affecting loneliness among left-behind children. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2023; 12:41-50. [PMID: 38756197 PMCID: PMC11094462 DOI: 10.5114/cipp/162007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 10/30/2022] [Accepted: 03/08/2023] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND In Vietnam, research on the impact of parental migration on left-behind children (LBC) has discussed various dimensions of the subject such as subjective well-being, emotional states, social skills, self-esteem and nutrition of LBC. However, there are still gaps in studies on loneliness among LBC in Vietnam. The study aims to explore the status of loneliness in LBC, including associated protective and risk factors, to make suggestions on preventive measures against LBC's loneliness. PARTICIPANTS AND PROCEDURE The conveniently selected sample includes 439 LBC in 4 Vietnamese provinces: Thai Nguyen, Bac Ninh, Thai Binh and Nghe An. The mean age is 12.73 (SD = 1.68). Female children account for 47.80%. The Children's Loneliness Scale was employed in the study. RESULTS The total loneliness score of LBC is 28.62 (SD = 9.40), 95% CI: 27.75-29.48. Perceived social support from friends, caregivers and resilience factors of affect control (RAC), family support (RFS) and help-seeking (RHS) are protective factors for loneliness of LBC, with regression coefficient of -.27, -.18, -.11, -.11 and -.09 respectively. CONCLUSIONS Perceived social support from friends, care-giving attachment and resilience factors of RAC, RFS, and RHS are protective factors for LBC against loneliness. Parents, teachers and guardians are encouraged to have a close connection with LBC, provide adequate care giving; and create a supportive environment for LBC in pursuing healthy peer relationships and train/improve children's skills to strengthen their resilience.
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Affiliation(s)
- Luot V. Nguyen
- University of Social Sciences and Humanities, Vietnam National University, Hanoi, Vietnam
| | - Thu T. A. Nguyen
- University of Social Sciences and Humanities, Vietnam National University, Hanoi, Vietnam
| | - Linh T. Trinh
- University of Social Sciences and Humanities, Vietnam National University, Hanoi, Vietnam
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Grzejszczak J, Strzelecki D, Gabryelska A, Kotlicka-Antczak M. Affiliation to a Social Group as a Preventive Factor in Suicidal Behaviors in Children and Adolescents during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020333. [PMID: 36832461 PMCID: PMC9955561 DOI: 10.3390/children10020333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Suicide is one of the most common causes of death in the population of children and adolescents. Available data show the continuous growth of this phenomenon and the ineffectiveness of prevention programs. Additionally, the COVID-19 pandemic significantly affected young people's mental health, including an increased risk of suicidal behaviors due to limited direct contact with the school and peer groups in favor of the home environment. Therefore, the aim of this narrative review was to consider the risk factors and protective factors for suicidal behavior in the under-18 population, with a particular focus on the importance of belonging to a social group and building identification with it as a phenomenon protecting against suicidal behavior. Additionally, in this review, we evaluate how the COVID-19 pandemic affected these relationships. The PubMed database was used in the search with the following keywords: suicide, suicide behaviors, child and adolescent suicide behaviors, group affiliation, family affiliation, ethnicity, religious affiliation, and the COVID-19 pandemic, with articles published between 2002 and 2022 analyzed. Research conducted to date indicates that both sustained and stable family and peer relationships, as well as a sense of identification and belonging, noticeably reduce the risk of suicidal behavior. Ethnic or cultural affiliation seems to have been particularly important during the isolation in the home environment caused by the COVID-19 pandemic. Additionally, it has been shown that while in lockdown, contact through social media with individuals' identification groups was associated with a reduced chance of emotional crises. Furthermore, regardless of cultural background, attachment to a particular group correlates with enhanced psychiatric state of children and adolescents. Thus, available data highlight the need for building and maintaining affiliations with suitable groups as a protective factor against suicidal behaviors.
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Affiliation(s)
- Jagoda Grzejszczak
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 92-216 Lodz, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
- Correspondence:
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Hung J, Chen J, Chen O. Are the relationships between mental health issues and being left-behind gendered in China: A systematic review and meta-analysis. PLoS One 2023; 18:e0279278. [PMID: 37053133 PMCID: PMC10101478 DOI: 10.1371/journal.pone.0279278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/02/2022] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND While most existing studies reveal left-behind children (LBC) are prone to suffering from mental health issues, some other literature fails to develop a statistical significance between being left-behind and facing mental health dilemmas. In further detail, it is noteworthy that suicide ideation is a gendered issue. Here girls, relative to their male counterparts, are more likely to experience emotional and affective challenges, alongside a higher risk of suicide ideation. Aside from suicide ideation, the rate of suicide attempts is also higher among Chinese female than among male LBC. However, Chang et al. counter-argue that, within the LBC cohorts, it is not statistically significant to state that girls were more likely for suicide attempts than boys. METHODS In this paper, a systematic review of relevant literature and a meta-analysis of all qualified randomised controlled trial (RCT) studies were conducted. The authors aim to examine all relevant studies with similar methodologies to observe the nuanced relationships between being left-behind and mental health issues in Chinese contexts. Specifically, the authors will, grounded on the findings from the systematic review and meta-analysis, assess whether the relationship between mental health issues and being left-behind is gendered in Chinese contexts by analysing all relevant findings derived from similar methodologies and the same method (i.e., RCT). RESULTS Aside from Wanjie et al.'s studies, it is noticeable that the rest of the studies share similar point estimates and their CIs overlapped to a large extent. As per the I2, given the presence of Wanjie et al.'s studies that demonstrate an observably higher degree of heterogeneity than the rest of the studies, the I2 values, each for the measurement of anxiety and depression, are 74.8 percent and 34.7 percent respectively. This shows that there is a considerable heterogeneity level for anxiety, while the heterogeneity level for depression is moderate. However, both p-values for the I2 statistics are larger than 0.05. Therefore, at the 0.05 significance level, it is statistically insignificant to reject the null hypothesis that there is no heterogeneity between individual studies in both the subgroups of anxiety and depression. Therefore, the concern of the potentially substantial heterogeneity should be irrelevant in this meta-analysis. Beyond the discussion from the forest plot, when looking at the single study addressing the relationship between being left-behind and having suicide attempts (note: LBC-OR is 1.22; 95 percent CI is 1.22 -and NLBC-OR is 1.42; 95 percent CI is 1.09-1.86 -at the p-value of 0.34), the findings demonstrate that such a relationship per se is not gendered at the 0.05 statistical significance level. However, when examining the relationship between being resilient and left-behind, such an association is gendered where the OR of female left-behind university students being resilient, relative to male left-behind university students, is slightly higher than that of female non-left-behind university students being resilient, relative to their male non-left-behind university student counterparts. It is noteworthy that this study focuses on studying left-behind and non-left-behind samples who entered universities. Since a raft of LBC are socially, educationally disadvantaged, they lack the opportunities to receive higher education. Therefore, the findings of this study might not be indicative of the LBC population at large. CONCLUSIONS While the findings of this meta-analysis project fail to reflect any gendered issues statistically, the authors are aware of the fact that the data included in this project were collected based on perception. Here samples, or their parents and teachers, were responsible for answering the questions with respect to samples' mental health status and demographic details. In China, especially in less developed rural regions, the discourse on mental health challenges might continue to be seen as taboo, so individuals giving responses might, consciously or not, tend to give socially desirable answers to avoid any potential social stigmatisation. Therefore, there is some extent of reservation regarding the validity of the included studies' data.
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Affiliation(s)
- Jason Hung
- Department of Sociology, The University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
- Institute of Sociology, Academia Sinica, Taipei City, Taiwan
| | - Jackson Chen
- Department of Sociology, The London School of Economics, London, Greater London, United Kingdom
| | - Olivia Chen
- Department of Social Policy, The London School of Economics, London, Greater London, United Kingdom
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Li B, Hu T, Tang W. The effects of peer bullying and poverty on suicidality in Chinese left behind adolescents: The mediating role of psychotic-like experiences. Early Interv Psychiatry 2022; 16:1217-1229. [PMID: 35192219 DOI: 10.1111/eip.13271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/05/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023]
Abstract
AIM This study investigated the influence of childhood adversity, such as peer bullying and socioeconomic status, on the suicidal behaviour of left-behind Chinese adolescents to determine whether psychotic-like experiences (PLEs) mediated the associations between these childhood adversities and suicidality; suicidal ideation (serious thoughts about taking one's own life), suicide plans, and suicide attempts. METHODS A representative group of rural adolescents (n = 3346) was recruited from 16 rural high schools in China. Suicidality was assessed using the suicide module from the Mini International Neuropsychiatric Interview Kid. Participants also completed questionnaires on bullying, socioeconomic status, left-behind characteristics, and PLEs. Structural equation modelling was then employed to explore the relationships between these variables. RESULTS Peer bullying, poverty, and left-behind status were all found to significantly increase adolescent suicide risk, the relationships between which were mediated by PLEs. Peer bullying was found to play the most significant role in the PLEs and suicidality, with the risk of suicide increasing with the length of time a child had been left behind. CONCLUSION Adverse life events can lead to a high risk of PLEs, which in turn can increase the risk of suicide. These results could assist in identifying individuals at risk of suicidality and the design of appropriate interventions. The results also highlighted the role PLEs play in suicidality and highlighted the need for further research in this area.
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Affiliation(s)
- Bin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Wanjie Tang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,Centre for Educational and Health Psychology, Sichuan University, Chengdu, China
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Wen X, Zhu F, Yuan Z, Mao Z. Relationship between physical activity, screen-related sedentary behaviors and anxiety among adolescents in less developed areas of China. Medicine (Baltimore) 2022; 101:e30848. [PMID: 36181048 PMCID: PMC9524945 DOI: 10.1097/md.0000000000030848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This study aimed to explore the association between physical activity, screen-related sedentary behaviors, and anxiety. The current study used latent profile analysis (LPA) to identify homogenous subtypes of anxiety among adolescents in less-developed areas of China. Data were aggregated from 6 schools in the less-developed areas of China in September 2018. In total, 900 students were evaluated using the 100-item Mental Health Test (MHT) and Youth Risk Behavior Surveillance System (YRBSS) questionnaire. The LPA was conducted to explore the potential classification of anxiety, which makes full use of all the sample data and explore heterogeneous classifications within groups. Logistic regression was used for the multifactor analysis. A P value <.05 was considered statistically significant. The entropy value suggested that the model with 3 latent profile was the best choice. There were 223 adolescents in the severe anxiety group, accounting for 24.78%. Logistics regression analysis of anxiety revealed that the risk of severe anxiety in boys was lower (odds ratio [OR] = 0.317, P < .001) than in girls. Students had a significantly lower probability of suffering from severe anxiety in using cellphones or computers ≤ 2 hours/day than those used cellphones or computers>2 hours/day (OR = 0.391, P = .004). Decreasing screen-related sedentary behaviors should be a target of community and school-based interventions, because high screen-related sedentary behaviors were associated with higher odds of anxiety among adolescents in less developed area of China.
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Affiliation(s)
- Xiaotong Wen
- School of Public Health, Wuhan University, Wuhan, P.R. China
- Global Health Institute, Wuhan University, Wuhan, P.R. China
- School of Public Health, Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, P.R. China
| | - Fuying Zhu
- School of Nursing, Nanchang University, Nanchang, P.R. China
| | - Zhaokang Yuan
- School of Public Health, Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, P.R. China
| | - Zongfu Mao
- School of Public Health, Wuhan University, Wuhan, P.R. China
- Global Health Institute, Wuhan University, Wuhan, P.R. China
- * Correspondence: Zongfu Mao, School of Public Health, Wuhan University, Wuhan 430071, P.R. China (e-mail: )
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Zhang H, Li Y. Child Neglect and Life Satisfaction among Left-behind Children in Rural China: The Roles of Self-compassion and Gratitude. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15649-NP15669. [PMID: 34144666 DOI: 10.1177/08862605211016348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child neglect is a social problem that causes great concern and affects the long-term well-being of left-behind rural Chinese children against the backdrop of their parents having to leave them in the care of others for extended periods while they have to go and work in cities. However, previous studies have disproportionally focused on the negative processes through which child neglect may influence their life satisfaction. Guided by positive psychology, this study examined the role of self-compassion and gratitude on the association between child neglect and life satisfaction. Our research questionnaire Likert survey used a sample of 1,091 left-behind children and 754 non left-behind children from Shanxi Province and Hunan Province. The results indicated that left-behind children reported a higher level of child neglect, and that child neglect was negatively associated with left-behind children's life satisfaction through decreased self-compassion and gratitude. The implications of these findings are that policy measures and interventions that focus on increasing the self-compassion and gratitude of neglected left-behind children may have a positive effect on their life satisfaction.
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Affiliation(s)
- Huiping Zhang
- Center for Studies of Sociological Theory and Method
- The School of Sociology and Population Studies, Renmin University of China
| | - Yali Li
- The School of Sociology and Population Studies, Renmin University of China
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Zhou YM, Mak L, Zhao CX, He F, Huang XN, Tian XB, Yi-zheng, Sun J. Correlates of suicidal ideation in rural Chinese junior high school left-behind children: A socioecological resilience framework. Front Psychiatry 2022; 13:901627. [PMID: 35935415 PMCID: PMC9354399 DOI: 10.3389/fpsyt.2022.901627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Suicide is one of the top five causes of adolescent mortality around the world. The socioecological resilience framework in explaining the risk factors and protective factors for suicidal ideation in left-behind children (LBC) has not been well explored. The current study aims to compare the prevalence of suicidal ideation in LBC and non-LBC, and explore its correlations with resilience factors among LBC. Methodology This study was part of an epidemiological survey conducted by UNICEF exploring mental health outcomes in left-behind children. We implemented a cross-sectional study collecting data from 11 provinces and 1 municipal, with 5,026 participants (3,359 LBC, 1,667 controls) in year one junior high school living in impoverished areas of rural China. Data on suicidal ideation, self-harm, resilience factors including health-risk behaviors, psychological wellbeing as it was measured by the Strengths and Difficulties Questionnaire, peer relationship within the school environment, and family support were collected. Results Overall prevalence of suicidal ideation among LBC was 7.2% which is significantly different from 5.5% reported by NLBC (χ2 = 4.854, p = 0.028). LBC reported a higher prevalence of self-harm (16.4%) than NLBC (13.0%; χ2 = 10.232, p = 0.001), but there was no difference in the prevalence of suicide plan, suicide attempt or help-seeking. LBC had significantly poorer psychological feeling, and greater emotional and behavioral difficulties peer relationship in the school environment than controls. In the multiple logistic regression, history of self-harm was the greatest predictor for suicidal ideation among LBC (OR = 2.078, 95% CI: 1.394-3.100, p < 0.001). Health risk behavior including previous smoking attempt, poor psychological feeling, and emotional and behavior difficulties, and poor peer relationship within school environment, were also significant risk factors for suicidal ideation among LBC. Conclusion The prevalence of suicidal ideation and self-harm was greater among left-behind than non-left-behind children. Our results show resilience factors including previous self-harm, emotional and behavioral problems, smoking, and poor peer relationship are significantly associated with suicidal ideation in left-behind adolescents.
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Affiliation(s)
- Yu-ming Zhou
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Leona Mak
- Menzies Health Institute Queensland, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Chun-xia Zhao
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Fan He
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-na Huang
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Xiao-bo Tian
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Yi-zheng
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Sun
- Menzies Health Institute Queensland, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
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Yang Y, Lu X. Social Anxiety and Subjective Quality of Life Among Chinese Left-Behind Children: The Mediating Role of Social Support. Front Psychol 2022; 13:836461. [PMID: 35360582 PMCID: PMC8962371 DOI: 10.3389/fpsyg.2022.836461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2022] Open
Abstract
The issue of left-behind children has become a key focus in China. In this study, we investigate the mediating role of social support between social anxiety and the subjective quality of life among left-behind children in China (N = 379, Mage = 13.65). A total of 710 junior high school students were recruited using clustering random sampling from five middle schools in China and investigated using the Social Anxiety Scale for Children, Social Support Rating Scale for Adolescents, and Inventory of Subjective Life Quality. The results show that social anxiety is negatively associated with social support and subjective quality of life, and social support is positively correlated with subjective quality of life. In addition, social support partially mediates the relationship between social anxiety and subjective quality of life. In conclusion, these findings provide new insights to improve the subjective quality of life of left-behind children. The focus should be on alleviating social anxiety and increasing social support in order to help left-behind children improve their subjective quality of life.
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Affiliation(s)
- Ying Yang
- School of Educational Sciences, Anshun University, Anshun, China
| | - Xiaozhou Lu
- School of Educational Sciences, Anshun University, Anshun, China
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13
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Zhou TJ, Yuan MY, Ren HY, Xie GD, Wang GF, Su PY. Childhood Separation From Parents and Self-Harm in Adolescence: A Cross-Sectional Study in Mainland China. Front Psychol 2022; 12:645552. [PMID: 35153880 PMCID: PMC8825502 DOI: 10.3389/fpsyg.2021.645552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
As the prevalence of self-harm among adolescents in Chinese escalates, finding out the potential risk factors associated with self-harm behaviors has aroused much attention. This study aims to explore the association between parent-child separation and series of self-harm (SH) subtypes among Chinese adolescents. We survey a total of 4,928 middle school students aged from 12 to 18 years at school. Parent-child separation was investigated from four dimensions-occurrence of parental separation, separation status, age at first separation and duration of separation. Self-harm series are deemed as five subtypes-highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviors with latent damage and psychological self-harm. Multivariate logistic regression is used to explore the associations between parent-child separation and different subtypes of self-harm among adolescents. Paternal separation is associated with each type of self-harm whilst maternal separation is not correlated with highly lethal self-harm. Except for highly lethal self-harm, the other four subtypes of self-harm demonstrate a relation with both length of paternal separation and maternal separation with aOR ranging from 1.02 to 1.06. Individuals who suffer parental separation prior to the age of three were at a higher risk for four types of less-lethal self-harm. The association of parent-child separation with self-harm deserves our attention, and future research is needed to identify the underlying mechanisms.
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Affiliation(s)
- Tao-Jie Zhou
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Meng-Yuan Yuan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Hao-Yang Ren
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Guo-Die Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Geng-Fu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Pu-Yu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
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14
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Guo Y, Lu MK, Dong HY, Zhao Y, Zhang L, Shen XL, Shen SY, Meng YZ. Rural Left-Behind Children are Seriously Afflicted with Intestinal Helminth Infections in Southern Sichuah, China. J Parasitol 2022; 108:53-56. [DOI: 10.1645/20-173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yue Guo
- School of Medicine, Huzhou University, 759 Er Huan Rd., Huzhou, Zhejiang, Peoples Republic of China
| | - Ming-Ke Lu
- School of Life Sciences, Xiamen University, 4221-120 Xiangannan Road, Xiang'an District, Xiamen, Fujian, Peoples Republic of China
| | - Hai-Yan Dong
- School of Medicine, Huzhou University, 759 Er Huan Rd., Huzhou, Zhejiang, Peoples Republic of China
| | - Yu Zhao
- School of Medicine, Huzhou University, 759 Er Huan Rd., Huzhou, Zhejiang, Peoples Republic of China
| | - Lu Zhang
- School of Medicine, Huzhou University, 759 Er Huan Rd., Huzhou, Zhejiang, Peoples Republic of China
| | - Xiao-Ling Shen
- School of Medicine, Huzhou University, 759 Er Huan Rd., Huzhou, Zhejiang, Peoples Republic of China
| | - Shu-Yi Shen
- School of Medicine, Huzhou University, 759 Er Huan Rd., Huzhou, Zhejiang, Peoples Republic of China
| | - Yuan-Zheng Meng
- School of Life Sciences, Xiamen University, 4221-120 Xiangannan Road, Xiang'an District, Xiamen, Fujian, Peoples Republic of China
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15
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Wen YJ, Hou WP, Zheng W, Zhao XX, Wang XQ, Bo QJ, Pao C, Tang YL, Tan T, Li XB, Wang CY. The Neglect of Left-Behind Children in China: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2021; 22:1326-1338. [PMID: 32308147 DOI: 10.1177/1524838020916837] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the neglect of left-behind children (LBC) in China. METHOD Participants: Children separated from one or both parents for at least 6 months. Intervention: Trauma of separation. Comparison: Non-left-behind children (NLBC). Outcomes: Neglect rates and severity. Only case-control studies were included. RESULTS Thirteen studies were included; there were 18,688 LBC in a large sample (N = 42,003) of children aged 0-18 years in China. The overall neglect rate was significantly higher in LBC compared to NLBC (odds ratio [OR] = 1.58, 95% confidence interval [CI] = [1.50, 1.67], p < .01) based on the Chinese Rural Child Neglected Evaluation Model (CRCNEM) and the Parents-Child Conflict Tactics Scales (OR = 1.44, 95% CI [1.35, 1.54], p < .01). The overall neglect severity in LBC was also significantly higher than NLBC (SMD = 0.31, 95% CI [0.28, 0.33], p < .01). The same trends were observed in sex subgroups. With regard to subtypes, LBC were significantly more likely to have emotional neglect (OR = 2.29, 95% CI [1.88, 2.78], p < .01), medical neglect (OR = 1.79, 95% CI [1.62, 1.98], p < .01), physical neglect (OR = 1.75, 95% CI [1.60, 1.91], p < .01), security neglect (OR = 1.52, 95% CI [1.32, 1.75], p < .01), educational neglect (OR = 1.50, 95% CI [1.31, 1.72], p < .01), and social neglect (OR = 1.33, 95% CI [1.18, 1.51], p < .01). Furthermore, LBC had significantly higher severity in medical neglect (SMD = 0.31, 95% CI [0.27, 0.35], p < .01), emotional neglect (SMD = 0.28, 95% CI [0.24, 0.32], p < .01), physical neglect (SMD = 0.24, 95% CI [0.18, 0.29], p < .01), security neglect (SMD = 0.26, 95% CI [0.23, 0.29], p < .01), educational neglect (SMD = 0.25, 95% CI [0.20, 0.31], p < .01), and social neglect (SMD = 0.25, 95% CI [0.10, 0.40], p < .01). CONCLUSION The neglect rates and severity in LBC in China were both significantly higher than those in NLBC. There was a strong association between neglect and LBC. Public policy changes are urgently needed to improve the dire situation and the well-being of the LBC.
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Affiliation(s)
- Yu-Jie Wen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, China
| | - Wen-Peng Hou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, China
| | - Xi-Xi Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, China
| | - Xue-Qi Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, China
| | - Qi-Jing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, China
| | - Christine Pao
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Tony Tan
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, FL, USA
| | - Xian-Bin Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, China
| | - Chuan-Yue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, China
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16
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Peng C, Wang M, Cheng J, Tan Y, Huang Y, Rong F, Kang C, Ding H, Yu Y. Association between internet addiction and suicidal ideation, suicide plans, and suicide attempts among Chinese adolescents with and without parental migration. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Mediation of Internet addiction on association between childhood maltreatment and suicidal behaviours among Chinese adolescents. Epidemiol Psychiatr Sci 2021. [PMCID: PMC8518027 DOI: 10.1017/s2045796021000524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Abstract
Aims
The associations between suicidal behaviours and childhood maltreatment (CM), as well as Internet addiction (IA) have been extensively examined. However, few studies pay attention to different types of CM and all stages of suicidality, including suicidal ideation (SI), suicidal plans (SP) and suicidal attempts (SA). Moreover, little is known regarding the mediation of IA on the relationship between CM and suicidal behaviours. The study aims to explore the direct effect of CM and IA on three stages of suicidal behaviours, and the indirect effect of CM on suicidality via IA.
Methods
A total of 16 130 high-school students aged 12–18 were recruited using a stratified cluster sampling strategy across five representative provinces in China. Relevant information was collected by a self-administered anonymous questionnaire. Multinomial logistic regression analysis and structural equation model were used to examine the associations.
Results
During the last year, 16.0% of participants reported suicidal behaviours. Specifically, 7.9% reported SI only, 4.6% reported SP but no SA, and 3.5% reported SA. The prevalence of neglect, physical abuse and IA in moderate to severe were 28.9, 19.9 and 33.1%, respectively. After controlling for demographic characteristics and confounding factors, such as loneliness, psychological resilience, and social support, moderate and severe neglect, physical abuse and IA were associated with an increased risk of SI, SP and SA (p < 0.01). The total effect of neglect and physical abuse on suicidal behaviours were 0.152 and 0.172, respectively (p < 0.001). The mediation proportion of IA on the association between neglect and suicidal behaviours, as well as physical abuse and suicidal behaviours were 22.4 and 18.0%, respectively.
Conclusions
CM and IA are independently associated with suicidal behaviours among Chinese adolescents. Moreover, IA plays a mediating role on the relationship between CM and suicidality. Targeted interventions for adolescents’ suicidal behaviours should focus on those who have experience of CM and IA.
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18
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Hou T, Xie Y, Mao X, Liu Y, Zhang J, Wen J, Chen Y, Luo Z, Cai W. The Mediating Role of Loneliness Between Social Support and Depressive Symptoms Among Chinese Rural Adolescents During COVID-19 Outbreak: A Comparative Study Between Left-Behind and Non-left-behind Students. Front Psychiatry 2021; 12:740094. [PMID: 34497549 PMCID: PMC8420998 DOI: 10.3389/fpsyt.2021.740094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/02/2021] [Indexed: 02/01/2023] Open
Abstract
Introduction: The COVID-19 pandemic has greatly impacted people's life across the globe. In a public health crisis, rural adolescents are more prone to mental health problems. The current study aimed to investigate the prevalence of depressive symptoms among Chinese rural adolescents during the COVID-19 outbreak, and examine the association between perceived social support and depressive symptoms and its underlying mechanisms. Method: Perceived Social Support Scale, UCLA Loneliness Scale, Patient Health Questionnaire-9 were administrated to 826 rural adolescents from Anhui Province, China, amid the COVID-19 crisis. Mackinnon's four-step procedure was employed to examine the mediating effect, while Hayes PROCESS macro was utilized to test the moderated mediation model. Results: The results showed the rate of depressive symptoms among rural adolescents in China was 77.6% during the outbreak of COVID-19. Female left-behind students and non-left-behind students from disrupted families experienced more depressive symptoms (all P < 0.05). Loneliness mediated the association between perceive social support and depressive symptoms and the indirect effect was stronger in left-behind adolescents in comparison to non-left-behind adolescents during the COVID-19 pandemic. Conclusion: Depressive symptoms are extremely prevalent among Chinese rural adolescents during the COVID-19 outbreak, and perceived social support plays a protective role against depressive symptoms. Chinese rural adolescents, especially left-behind students, could benefit from the interventions aimed at enhancing the perceived social support and reducing loneliness during the COVID-19 pandemic.
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Affiliation(s)
- Tianya Hou
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Yawei Xie
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Xiaofei Mao
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Ying Liu
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Jianguo Zhang
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Jing Wen
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Yan Chen
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Zhechao Luo
- College of Basic Medical Sciences, Second Military Medical University, Shanghai, China
| | - Wenpeng Cai
- Faculty of Psychology, Second Military Medical University, Shanghai, China
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19
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Hou T, Mao X, Shao X, Liu F, Dong W, Cai W. Suicidality and Its Associated Factors Among Students in Rural China During COVID-19 Pandemic: A Comparative Study of Left-Behind and Non-Left-Behind Children. Front Psychiatry 2021; 12:708305. [PMID: 34413801 PMCID: PMC8368983 DOI: 10.3389/fpsyt.2021.708305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. The harmful impact of COVID-19 is beyond just physical health concern. The unprecedented public health crisis has also taken its toll on the mental health of adolescents. The present study aims to estimate the prevalence of suicidal ideation and attempts and investigate the similarities and differences in the influential factors for suicidal ideation and attempts among left-behind children (LBC) and non-left-behind children (NLBC) in rural China during the COVID-19 pandemic. Method: A total of 761 rural Chinese students, of whom 468 were left behind, completed the cross-sectional questionnaires including demographic data, Cognitive Emotion Regulation Questionnaire, nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder Scale, suicidal ideation, and suicidal attempts. Chi-square test, independent-sample t-test, and logistic regression were performed in the statistical analysis. Results: Overall, 36.4 and 10.4% of rural Chinese students reported suicidal ideation (37.8% for LBC vs. 34.1% for NLBC) and attempts (11.3% for LBC vs. 8.9% for NLBC) during the COVID-19 pandemic. Among LBC, parental educational level (adjusted odds ratio, Adj. OR = 1.60), maladaptive strategies (Adj. OR = 1.04), anxious symptoms (Adj. OR = 2.61), and depressive symptoms (Adj. OR = 3.85) were significantly associated with suicidal ideation, while age (Adj. OR = 0.56), maladaptive strategies (Adj. OR = 1.08), symptoms of anxiety (Adj. OR = 3.85), and symptoms of depression (Adj. OR = 2.68) were significantly related to suicidal attempts during the COVID-19 outbreak. Among NLBC, gender (Adj. OR = 2.20), parental educational level (Adj. OR = 1.77), perceived family economic status (Adj. OR = 0.39), anxious symptoms (Adj. OR = 2.38), and depressive symptoms (Adj. OR = 2.77) were significantly associated with suicidal ideation, whereas only anxious symptom (Adj. OR = 5.85) was significantly related to suicidal attempts. Conclusion: Suicidal ideation and attempts are prevalent among students in rural China during the COVID-19 outbreak. Our findings also revealed the shared and unique factors for suicidal ideation and attempts among LBC and NLBC during the COVID-19 epidemic. With regard to the differences between LBC and NLBC, the use of maladaptive strategies and age might be vital factors for suicide prevention measures directed specifically toward LBC, whereas interventions sensitive to gender and perceived social economic status should be specifically designed for NLBC amid the COVID-19 pandemic.
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Affiliation(s)
- Tianya Hou
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Xiaofei Mao
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Xiaoqin Shao
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Fen Liu
- The Second Primary School, Shaoyang, China
| | - Wei Dong
- Faculty of Psychology, Second Military Medical University, Shanghai, China
- Department of Psychology, Fudan University, Shanghai, China
| | - Wenpeng Cai
- Faculty of Psychology, Second Military Medical University, Shanghai, China
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20
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Qu G, Shu L, Zhang J, Wu Y, Ma S, Han T, Zhang H, Wang J, Sun Y. Suicide ideation, suicide plan, and suicide attempt among left-behind children and adolescents: A systematic review and meta-analysis. Suicide Life Threat Behav 2021; 51:515-527. [PMID: 33486779 DOI: 10.1111/sltb.12731] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/01/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There are an increasing number of studies that discussed suicide ideation (SI), suicide plan (SP), and suicide attempt (SA) among left-behind children (LBC). However, the prevalence of these indicators of LBC has not been synthesized and the true correlation between these indicators and left-behind status remains unclear. METHODS Electronic databases were comprehensively searched, and eligible observational studies were selected to extract useful data. We pooled the rates and their 95% confidence intervals (95% CIs) to determine the prevalence of SI, SP, and SA among LBC. The odds ratios (ORs) and 95% CIs were calculated to reflect the association between left-behind status and risk of SI, SP, and SA. RESULTS Among LBC, the pooled prevalence was 18.7% (95% CI: 15.4-21.9) for SI, 6.4% (95% CI: 4.7-8.1) for SP, and 3.1% (95% CI: 2.6-3.6) for SA. Compared to non-LBC, LBC was at higher risk of SI (OR = 1.26), SP (OR = 1.20), and SA (OR = 1.14), but only the effect for SI achieved statistical significance. CONCLUSION Overall, the prevalence of SI, SP, and SA is common among LBC, and parental migration has a significant impact on the SI of LBC. Intervention plans and programs are urgently needed to prevent suicidality of this vulnerable group.
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Affiliation(s)
- Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Liqin Shu
- Department of Child Health Care, Maternal and Child Health Care Hospital of Anhui Province, Affiliated Maternal and Child Health Care Hospital of Anhui Medical University, Hefei, China
| | - Jian Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Neonatology, Children's Hospital of Anhui Medical University, Hefei, China
| | - Yile Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Tiantian Han
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Huimei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jun Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Center for Evidence-Based Practice, Anhui Medical University, Hefei, China
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21
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Wang Z, Zhang X. Peer Victimization, Resilience and Mental Well-Being Among Left-Behind Children: Dose Gender Make a Difference? Psychol Rep 2021; 125:2357-2383. [PMID: 34053352 DOI: 10.1177/00332941211018409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explores how resilience mediates the association between peer victimization and mental well-being among left-behind children in the Chinese cultural context, and how gender groups differ in certain path. Data are collected from a random sample of 471 left-behind children from the City of Huai'an in mainland China. Results of this study shows that peer victimization is not only significantly and directly related, but also indirectly associated with children mental well-being through the intermediary mechanism of resilience. The theoretical model is applicable to both male and female left-behind children with no gender difference. The findings provide empirical support for the proposed theoretical framework that resilience plays a crucial mediator in the relationship between peer victimization and children mental well-being. Empirical evidence also shows that interventions focused on anti-bullying and cultivating resilience may be effective to improve children mental well-being.
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Affiliation(s)
- Zhiyou Wang
- Department of Social Work, 26451The Chinese University of Hong Kong, Hong Kong, China
| | - Xinwen Zhang
- Department of Social Work, 26451The Chinese University of Hong Kong, Hong Kong, China
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22
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Sun T, Tang Q, Liu D, Zhao L, Wang F, Xie H. Mental health literacy about depression among rural left-behind children in China: a comparative and cross-sectional study. J Ment Health 2020; 30:263-270. [PMID: 32816536 DOI: 10.1080/09638237.2020.1793117] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Mental health literacy (MHL) is vital for raising mental health awareness, reducing stigma, and improving health-related decision making, which may have lifelong consequences for patients with mental disorders. AIMS To examine MHL about depression among rural left-behind children (LBC) in China and explore differences between LBC and non-left-behind children (NLBC). METHODS A total of 3456 rural school children (mean age = 13.02 years) in fourth to ninth grades who were living in Sichuan, Anhui, and Henan provinces were surveyed in April and July 2018 using stratified random cluster sampling. RESULTS More NLBC correctly recognized depression compared with LBC (p < 0.05). The most common sources of mental health information were the TV and the Internet. LBC felt more uneasy if they asked for help (p < 0.01). Statistical differences in help-seeking barriers were observed between LBC and NLBC (p < 0.05). CONCLUSIONS Respondents showed low levels of depression-related MHL compared with peer groups in other countries, LBC showed lower MHL than NLBC in terms of the correct recognition rate of depression, attitude toward seeking help, etc. More school-based interventions should be implemented in rural schools, and parent involvement and digital-based educational strategies should be considered.
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Affiliation(s)
- Ting Sun
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, P. R. China
| | - Qishou Tang
- School of Marxism, Bengbu Medical College, Bengbu, Anhui, P. R. China
| | - Depei Liu
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, P. R. China
| | - Long Zhao
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, P. R. China
| | - Fuzhi Wang
- Department of Health Management, Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College (BBMC), Bengbu, Anhui, P. R. China
| | - Hui Xie
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, P. R. China
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23
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Wen X, Lin Y, Liu Y, Starcevich K, Yuan F, Wang X, Xie X, Yuan Z. A Latent Profile Analysis of Anxiety among Junior High School Students in Less Developed Rural Regions of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114079. [PMID: 32521646 PMCID: PMC7312008 DOI: 10.3390/ijerph17114079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to understand the potential types of anxiety among middle school students by analyzing the current situation of middle school students’ anxiety and its influencing factor. This study used a multistage stratified cluster random sampling to investigate students in grades 9 to 12. Mplus 7.4 was used for latent profile analysis. A total of 900 junior high school students were investigated. The junior high school students were divided into three subgroups by latent profile analysis. A total of 223 junior high school students experienced severe anxiety, accounting for 24.78%. Multivariate logistic regression analysis revealed that males are more likely to develop moderate and severe anxiety. The development of severe anxiety (OR = 0.562, p < 0.05) is less likely for students in schools with adequate mental health support. Students who were confident with their academic performances were less likely to develop moderate anxiety (OR = 0.377, p < 0.05). Students with extreme academic pressure are more likely to develop moderate anxiety (OR = 6.523, p < 0.05) and severe anxiety (OR = 11.579, p < 0.05). It is recommended that mental health counseling be set up in schools and to provide professional counselors to prevent serious anxiety for students. This paper also demonstrates a need to reduce students’ academic pressure.
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Affiliation(s)
- Xiaotong Wen
- School of Public Health, Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang 330006, China
| | - Yixiang Lin
- School of Public Health, Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang 330006, China
| | - Yuchen Liu
- Biology Department, Mellon College of Science, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Katie Starcevich
- School of Community Science, University of Nevada, Reno, NV 89557, USA
| | - Fang Yuan
- Office of Public Health Studies, the University of Hawaii at Mānoa, Honolulu, HI 96822, USA
| | - Xiuzhu Wang
- Administration Office of Floating Population, Jiangxi Provincial Health Committee, Nanchang 330006, China
| | - Xiaoxu Xie
- School of Public Health, Fujian Medical University, Fuzhou 350000, China
| | - Zhaokang Yuan
- School of Public Health, Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, Nanchang 330006, China
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24
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The prevalence of confirmed childhood trauma and its' impact on psychotic-like experiences in a sample of Chinese adolescents. Psychiatry Res 2020; 287:112897. [PMID: 32203750 DOI: 10.1016/j.psychres.2020.112897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 02/07/2023]
Abstract
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.
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25
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Cheng L, Chen Q, Zhang FY, Wu W, Cui W, Hu X. Functional health literacy among left-behind students in senior high schools in an ethnic minority area: A cross-sectional study. Medicine (Baltimore) 2020; 99:e19167. [PMID: 32080095 PMCID: PMC7034664 DOI: 10.1097/md.0000000000019167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 12/07/2019] [Accepted: 01/11/2020] [Indexed: 02/05/2023] Open
Abstract
To verify the validity of functional health literacy scale and analyze what influences functional health literacy.Using convenience sampling method based on cross-sectional data to select 589 left-behind senior high-school students in an ethnic minority area, using the functional health literacy scale.The scale results were relatively strong, and the absolute fitness index, value-added fitness index, and simple fitness index reached the fitness standards. The overall functional health literacy score was (0.65 ± 0.12), which falls within the upper middle class. Gender(t = 2.40, P < .05), ethnicity (t = 4.28, P < .001), place of residence (t = = 4.51, P < .001), mother's education level (F = 3.608, P < .05), self-assessment of grades for 1 year (F = 25.781, P < .001), and whether the participant liked the health education content (F = 9.416, P < .001) had impacts on overall functional health literacy.The study results show that relatively satisfactory reliability and validity and can be applied further analysis for improving students functional health literacy levels.
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Affiliation(s)
- Linan Cheng
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Qian Chen
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Feng ying Zhang
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Wenwen Wu
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
| | - Wenxiang Cui
- Wenxiang Cui, School of Nursing Yanbian University, Yanji, China
| | - Xiuying Hu
- West China Hospital/West China School of Nursing, Sichuan University Chengdu, Sichuan, No. 37, Guoxue Alley, Chengdu, Sichuan
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26
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Li J, Chen YP, Zhang J, Lv MM, Välimäki M, Li YF, Yang SL, Tao YX, Ye BY, Tan CX, Zhang JP. The Mediating Role of Resilience and Self-Esteem Between Life Events and Coping Styles Among Rural Left-Behind Adolescents in China: A Cross-Sectional Study. Front Psychiatry 2020; 11:560556. [PMID: 33329099 PMCID: PMC7714763 DOI: 10.3389/fpsyt.2020.560556] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/12/2020] [Indexed: 02/04/2023] Open
Abstract
Objective: This study aims to explore the association between life events and coping styles, and how resilience and self-esteem mediate the association. Methods: A cross-sectional study was conducted among 981 left-behind adolescents (LBAs) in five junior high schools in Hunan Province, China, from April 13 to April 20, 2020. We utilized self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale, and Simplified Coping Style Questionnaire to assess the mental health of LBAs. Statistic description, Pearson correlation analysis, and structural equation model were adopted to analyze the data. Results: Results revealed that life events could negatively predict resilience (β = -0.29, P < 0.001) and self-esteem (β = -0.39, P < 0.001) and positively predict LBAs' positive coping style (β = 0.28, P < 0.001) and negative coping style (β = 0.21, P < 0.001). Self-esteem could also positively predict the resilience of LBAs (β = 0.62, P < 0.001); resilience could negatively predict the negative coping style (β = -0.21, P < 0.001) and positively predict the positive coping style (β = 0.79, P < 0.001). Life events not only have direct effects on negative coping style (β = 0.21) and positive coping style (β = 0.28) but also have indirect effects on coping styles by affecting resilience (β = -0.29) and self-esteem (β = -0.39). The total effect of life events on coping styles was 0.32, where 34.37% was mediated by resilience and self-esteem. Conclusion: We proved that resilience and self-esteem mediated most of the effects of life events on coping styles. The findings had important implications for interventions to promote mental health of LBAs, particularly the enhancement of resilience and self-esteem.
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Affiliation(s)
- Juan Li
- Xiangya Nursing School of Central South University, Changsha, China
| | - Yi-Ping Chen
- Xiangya Nursing School of Central South University, Changsha, China
| | - Jie Zhang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Meng-Meng Lv
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Yi-Fei Li
- Xiangya Nursing School of Central South University, Changsha, China
| | - Si-Lan Yang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Ying-Xiang Tao
- Xiangya Nursing School of Central South University, Changsha, China
| | - Bi-Yun Ye
- Xiangya Nursing School of Central South University, Changsha, China
| | - Chu-Xia Tan
- Xiangya Nursing School of Central South University, Changsha, China
| | - Jing-Ping Zhang
- Xiangya Nursing School of Central South University, Changsha, China
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27
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Guo L, Wang W, Du X, Guo Y, Li W, Zhao M, Wu R, Lu C. Associations of Substance Use Behaviors With Suicidal Ideation and Suicide Attempts Among US and Chinese Adolescents. Front Psychiatry 2020; 11:611579. [PMID: 33536951 PMCID: PMC7848020 DOI: 10.3389/fpsyt.2020.611579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/14/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Adolescence has been described as a period of increased health risk-taking behaviors. Given the variety of cultural contexts, healthcare systems, and public health policies in different regions, the present study aimed to determine whether there are similar or different associations of substance use behaviors with suicidal ideation and suicide attempts among US and Chinese adolescents. Methods: This study included a total of 14,765 US adolescents from the 2017 National Youth Risk Behavior Surveillance System (YRBSS) and 24,345 Chinese adolescents from the 2017 School-based Chinese Adolescents Health Survey (SCAHS). Results: The proportions of suicidal ideation and suicide attempts were 17.4 and 5.7% among US adolescents, which were higher than those among Chinese adolescents (suicidal ideation: 13.7% and suicide attempts: 2.7%). Among Chinese adolescents, the most common substance use behavior was "alcohol use (55.4%)," followed by "cigarette use (11.6%)." Among US adolescents, the most popular substance was alcohol (ever used: 55.9%), followed by marijuana (ever used: 34.6%). Moreover, alcohol use was significantly related to suicidal ideation/suicide attempts only in Chinese adolescents [suicidal ideation: Adjusted odds ratio (AOR) = 1.88, 95% CI = 1.71~2.06; suicide attempts: AOR = 2.12, 95% CI = 1.71~2.63], and marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group (suicidal ideation: AOR = 1.23, 95% CI = 1.06~1.44; suicide attempts: AOR = 1.51, 95% CI = 1.21~1.87). Moreover, although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were stronger in Chinese adolescents than in US adolescents (Chinese adolescents: AOR = 3.97, 95% CI = 2.76~5.72; US adolescents: AOR = 1.76, 95% CI = 1.43~2.16; P < 0.05). Conclusions: The associations of alcohol use with suicidal ideation and suicide attempts were only significant in Chinese adolescents. Marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group. Although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were significantly stronger for Chinese adolescents. These findings might be related to the differences in cultural contexts, healthcare systems, and public health policies in the two different countries.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Xueying Du
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Yangfeng Guo
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Meijun Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
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28
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Tian X, Chang W, Meng Q, Chen Y, Yu Z, He L, Xiao Y. Resilience and self-harm among left-behind children in Yunnan, China: a community-based survey. BMC Public Health 2019; 19:1728. [PMID: 31870359 PMCID: PMC6929398 DOI: 10.1186/s12889-019-8075-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Self-harm (SH) behaviors are established risk factors of suicide, however, in Chinese left-behind children (LBC), SH remains severely under-discussed. In this study, we aimed to investigate SH and explore its association between resilience in a large group of LBC. METHODS A community-based cross-sectional study of 2898 LBC was conducted in Yunnan province, China. Information was collected by self-reporting questionnaires. Descriptive analysis was used to depict and compare characteristics of the subjects. Univariate and multivariate logistic regression models were applied to estimate the associations between resilience and SH prevalence, SH severity, SH repetition. RESULTS The prevalence of SH in LBC was 48.8% (95%CI: 47.0-49.7%). Compared to LBC with lower level of resilience, a higher level of resilience was related to 0.40 folds of SH odds (95%CI: 0.34-0.48). Besides, among all dimensions of resilience, every 1 average score increase of emotion regulation and family support were associated with 0.13 (95%CI: 0.04-0.37) and 0.14 (95%CI: 0.04-0.47) folds of odds in severer SH, respectively; one unit increase in the average score of emotion regulation was related to an OR of 0.23 (95%CI: 0.07-0.71) for repeated SH. CONCLUSIONS Psychological resilience presented protective effect on SH in LBC, especially the dimensions of emotion regulation and family support. Intervention measures focusing on enhancing emotion regulation ability and building parent-child connection could be considered in order to reduce SH and suicidal risk in LBC.
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Affiliation(s)
- Xin Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China.,The First Affiliated School of Clinical Medicine, Kunming Medical University, Kunming, Yunnan, China
| | - Wei Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Qiong Meng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Ying Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Zhen Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Limei He
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Yuanyuan Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China. .,Department of Chronic Disease Epidemiology, Yale School of Public Health Yale University, New Haven, CT, USA.
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29
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Gao F, Yao Y, Yao C, Xiong Y, Ma H, Liu H. The Status of Pro-social Tendency of Left-Behind Adolescents in China: How Family Function and Self-Esteem Affect Pro-social Tendencies. Front Psychol 2019; 10:1202. [PMID: 31191399 PMCID: PMC6548201 DOI: 10.3389/fpsyg.2019.01202] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/07/2019] [Indexed: 12/25/2022] Open
Abstract
In China, adolescents are frequently left behind. To date, few studies have focused on the pro-social tendencies of left-behind adolescents and the relationship of family function, self-esteem, and pro-social tendency is yet to be examined. This study, therefore, aims to understand the status of pro-social tendency of left-behind adolescents and to explore the mediating and moderating roles of self-esteem in the relationship between family function and pro-social tendency. A large, school-based survey was conducted in three Chinese provinces. An analysis of covariance was first used to identify the differences in pro-social tendency between adolescents who were and were not left behind. We then analyzed the variance within left-behind adolescents using demographics, left-behind type, years of being left-behind, and caregiver related characteristics. A structural equation model was used to analyze the relationship of family function, self-esteem, and pro-social tendency, with bootstrapping used to explore the mediating role of self-esteem. Additionally, an ordinary least squares regression was used to examine the moderating effect of self-esteem. The results showed that the pro-social tendency of left-behind adolescents was lower than in non-left-behind adolescents (F = 15.11, p = 0.0001). Family function was positive related to pro-social tendency (r = 0.259), which had not only a direct effect on pro-social tendency (β = 0.254), but also an indirect effect through self-esteem (β = 0.071, bias-corrected 95% CI: 0.051:0.090; percentile 95% CI: 0.053:0.092). Additionally, 21.85% of the total effect of family function on pro-social tendency was mediated by self-esteem. Furthermore, self-esteem negatively moderated the relationship between family function and pro-social tendency (β = -0.208, p < 0.0001), such that the effect of family function on pro-social tendency became weaker as self-esteem increased. The current study verified the negative effect of being left behind on the social development of adolescents and contributed to the understanding of the importance of self-esteem in the relationship between family function and pro-social tendency. Interventions aimed at enhancing self-esteem should be developed and implemented in left-behind adolescents to promote wellness in the entirety of psychological and social outcomes.
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Affiliation(s)
- Feifei Gao
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China.,Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, China
| | - Yuan Yao
- Medical College, Qingdao University, Qingdao, China
| | | | - Yan Xiong
- Hospital of Xi-He Town, Chengdu, China
| | - Honglin Ma
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, China
| | - Hongbo Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China
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30
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Chai X, Du H, Li X, Su S, Lin D. What Really Matters for Loneliness Among Left-Behind Children in Rural China: A Meta-Analytic Review. Front Psychol 2019; 10:774. [PMID: 31057450 PMCID: PMC6482215 DOI: 10.3389/fpsyg.2019.00774] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/21/2019] [Indexed: 12/31/2022] Open
Abstract
In rural China, left-behind children are likely to suffer chronic loneliness. Research has identified a variety of factors that may be associated with loneliness among these children. A meta-analysis is needed to address the empirical inconsistencies and examine the strength of relations between different factors and loneliness. The current meta-analysis included 51 studies on predictors of loneliness published from 2008 to 2017. Results showed that one individual factor (social anxiety) is a key risk factor for loneliness, whereas eight individual (older age, self-esteem, resilience, extroversion) and contextual factors (family functioning, parent–child relationship, peer relationship, social support) serve as protective factors in predicting loneliness. In addition, boys were more likely to feel lonely than girls. Findings and implications of this study were discussed.
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Affiliation(s)
- Xiaoyun Chai
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Hongfei Du
- Department of Psychology, Social and Health Psychology Research Center, Guangzhou University, Guangzhou, China
| | - Xiaoyan Li
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Shaobing Su
- Eliot-Pearson Department of Child Study and Human Development, Institute for Applied Research in Youth Development, Tufts University, Medford, MA, United States
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
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31
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Wen YJ, Li XB, Zhao XX, Wang XQ, Hou WP, Bo QJ, Zheng W, Pao C, Tan T, Wang CY. The effect of left-behind phenomenon and physical neglect on behavioral problems of children. CHILD ABUSE & NEGLECT 2019; 88:144-151. [PMID: 30504096 DOI: 10.1016/j.chiabu.2018.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/04/2018] [Accepted: 11/12/2018] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Left-behind children have a high incidence of behavioral problems in some Eastern countries, especially China. We sought to assess the combined effects of physical neglect, a major embodiment of the left-behind phenomenon, and the trauma of being left behind on subsequent behavioral problems. METHOD 776 children (including 600 left-behind children) aged 12-16 years were chosen by cluster sampling in rural China. The Childhood Trauma Questionnaire-Short Form and the Conners Teacher Rating Scale were used to evaluate physical neglect and behavioral problems. RESULTS Left-behind children experienced more physical neglect (mean difference = 0.63; 95%CI 0.15-1.10; P = 0.01) and were more inattentive (mean difference=0.11; 95%CI 0.03-0.19; P = 0.009) than non-left-behind children. Physically neglected left-behind children had higher scores for conduct problems, inattention, and hyperactivity index than non-left-behind without physical neglect group (P < 0.05 for each). Among left-behind children, physical neglect group had significantly more conduct problems than those of controls (mean difference=0.14; 95%CI 0.05-0.23; P = 0.008). Physically neglected non-left-behind children had higher scores for conduct problems than those of left-behind children without physical neglect (mean difference=0.31; 95%CI 0.13-0.47; P = 0.003). Among physically neglected children, left-behind children had significantly higher scores for inattention than those of non-left-behind children (mean difference=0.13; 95%CI 0.04-0.22; P = 0.037). CONCLUSION Left-behind children have more behavioral problems than non-left-behind children. Physical neglect may result in more severe conduct problems than those associated with staying behind, and staying behind may lead to inattention. Exposure to both may lead to more obvious behavioral problems. Therefore, we should accord more attention to physically neglected and left-behind children.
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Affiliation(s)
- Yu-Jie Wen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Xian-Bin Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Xi-Xi Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Xue-Qi Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Wen-Peng Hou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Qi-Jing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Christine Pao
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tony Tan
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, USA
| | - Chuan-Yue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
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32
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Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, Sonmez H, Eder B, Blewitt A, Lertgrai W, Orcutt M, Ricci K, Mohamed-Ahmed O, Burns R, Knipe D, Hargreaves S, Hesketh T, Opondo C, Devakumar D. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet 2018; 392:2567-2582. [PMID: 30528471 PMCID: PMC6294734 DOI: 10.1016/s0140-6736(18)32558-3] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs). METHODS For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871. FINDINGS Our search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27-1·82]; SMD 0·16 [0·10-0·21]), anxiety (RR 1·85 [1·36-2·53]; SMD 0·18 [0·11-0·26]), suicidal ideation (RR 1·70 [1·28-2·26]), conduct disorder (SMD 0·16 [0·04-0·28]), substance use (RR 1·24 [1·00-1·52]), wasting (RR 1·13 [1·02-1·24]) and stunting (RR 1·12 [1·00-1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains. INTERPRETATION Parental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people. FUNDING Wellcome Trust.
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Affiliation(s)
- Gracia Fellmeth
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Kelly Rose-Clarke
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Chenyue Zhao
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Laura K Busert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Alessandro Massazza
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Hacer Sonmez
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Ben Eder
- Institute for Global Health, University College London, London, UK
| | - Alice Blewitt
- Institute for Global Health, University College London, London, UK
| | - Wachiraya Lertgrai
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Miriam Orcutt
- Institute for Global Health, University College London, London, UK
| | - Katharina Ricci
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Rachel Burns
- Institute for Global Health, University College London, London, UK
| | - Duleeka Knipe
- Department of Population Science, University of Bristol, Bristol, UK
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's, University of London, London, UK; International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Therese Hesketh
- Institute for Global Health, University College London, London, UK; Centre for Global Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Charles Opondo
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK.
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Zhao C, Egger HL, Stein CR, McGregor KA. Separation and Reunification: Mental Health of Chinese Children Affected by Parental Migration. Pediatrics 2018; 142:peds.2018-0313. [PMID: 30166365 PMCID: PMC6524772 DOI: 10.1542/peds.2018-0313] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Chenyue Zhao
- Department of Child and Adolescent Psychiatry, School of Medicine, New York University, New York, New York
| | - Helen L. Egger
- Department of Child and Adolescent Psychiatry, NYU School of Medicine, New York, NY
| | - Cheryl R. Stein
- Department of Child and Adolescent Psychiatry, NYU School of Medicine, New York, NY
| | - Kyle A. McGregor
- Department of Child and Adolescent Psychiatry, NYU School of Medicine, New York, NY,Department of Population Health, Division of Medical Ethics, NYU School of Medicine, New York, NY
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Yan L, Zhu Q, Tu X, Zuo X, Yu C, Lou C, Lian Q. Bullying victimization and child sexual abuse among left-behind and non-left-behind children in China. PeerJ 2018; 6:e4865. [PMID: 29888125 PMCID: PMC5991295 DOI: 10.7717/peerj.4865] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/08/2018] [Indexed: 11/21/2022] Open
Abstract
Background Bullying is one of the most important factors associated with child abuse. However, robust tests supporting the assumption that being bullied can contribute to child sexual abuse (CSA) among left-behind children (LBC) remain sparse. This study aims to investigate the association of bullying victimization with CSA among LBC in China. Methods A cross-sectional study was conducted in six middle schools of Sichuan and Anhui province in 2015. The bullying victimization was assessed by seven items from the Revised Olweus Bully/Victim Questionnaire. The experience of CSA was measured by ten items CSA scale with good consistency. Results A total of 1,030 children met the sampling criteria, including 284 LBC and 746 non-LBC. The prevalence of CSA was 22.89% in LBC and 20.19% in non-LBC (p > 0.05). Bullying victimization was related to CSA among both LBC (adjusted Odds Ratio [aOR] = 2.52, 95% CI [1.34–4.73]) and non-LBC (aOR = 2.35, 95% CI [1.58–3.53]). The association between bullying victimization and CSA was much higher among left-behind girls (left-behind girls: aOR = 7.36, 95% CI [2.16–24.99]; non-left-behind girls: aOR = 2.38, 95% CI [1.08–5.27]). Also, LBC of a young age (11–15), children with siblings, living in rural areas and non-traditional family structure who were bullied were more likely to suffer CSA than their non-LBC peers. Conclusions Bullying victimization is associated with a significant increase in CSA among both LBC and non-LBC. Anti-bullying programs should target vulnerable populations including female LBC and LBC with siblings to reduce the risk of CSA.
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Affiliation(s)
- Li Yan
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
| | - Qianqian Zhu
- Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaowen Tu
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
| | - Xiayun Zuo
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
| | - Chunyan Yu
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China.,School of Public Health, Fudan University, Shanghai, China
| | - Chaohua Lou
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
| | - Qiguo Lian
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China.,School of Public Health, Fudan University, Shanghai, China
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