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Powell D. Growth in Suicide Rates Among Children During the Illicit Opioid Crisis. Demography 2023; 60:1843-1875. [PMID: 38009202 DOI: 10.1215/00703370-11077660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
This article documents child suicide rates from 1980 to 2020 in the United States using the National Vital Statistics System Multiple Cause of Death database. After generally declining for decades, suicide rates among children aged 10-17 accelerated from 2011 to 2018 in an unprecedented rise in both duration and magnitude. I consider the role of the illicit opioid crisis in driving this mental health crisis. In August 2010, an abuse-deterrent version of OxyContin was introduced and the original formulation was removed from the market, leading to a shift to illicit opioids and stimulating growth in illicit opioid markets. Areas more exposed to reformulation-as measured by pre-reformulation rates of OxyContin misuse in the National Survey on Drug Use and Health-were more affected by the transition to illicit opioids and experienced sharper growth in child suicide rates. The evidence suggests that children's illicit opioid use did not increase, implying that the illicit opioid crisis engendered higher suicide propensities by increasing suicidal risk factors for children, such as increasing rates of child neglect and altering household living arrangements. In complementary analyses, I document how living conditions declined for children during this time period.
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de Souza EL, Eshriqui I, Rebustini F, Masuda ET, de Paiva Neto FT, Lima RM, Bonfim D. Family vulnerability scale: Evidence of content and internal structure validity. PLoS One 2023; 18:e0280857. [PMID: 37878548 PMCID: PMC10599550 DOI: 10.1371/journal.pone.0280857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/12/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Territory view based on families' vulnerability strata allows identifying different health needs that can guide healthcare at primary care scope. Despite the availability of tools designed to measure family vulnerability, there is still a need for substantial validity evidence, which limits the use of these tools in a country showing multiple socioeconomic and cultural realities, such as Brazil. The primary objective of this study is to develop and gather evidence on the validity of the Family Vulnerability Scale for Brazil, commonly referred to as EVFAM-BR (in Portuguese). METHODS Items were generated through exploratory qualitative study carried out by 123 health care professionals. The data collected supported the creation of 92 initial items, which were then evaluated by a panel of multi-regional and multi-disciplinary experts (n = 73) to calculate the Content Validity Ratio (CVR). This evaluation process resulted in a refined version of the scale, consisting of 38 items. Next, the scale was applied to 1,255 individuals to test the internal-structure validity by using the Exploratory Factor Analysis (EFA). Dimensionality was evaluated using Robust Parallel Analysis, and the model underwent cross-validation to determine the final version of EVFAM-BR. RESULTS This final version consists of 14 items that are categorized into four dimensions, accounting for an explained variance of 79.02%. All indicators were within adequate and satisfactory limits, without any cross-loading or Heywood Case issues. Reliability indices also reached adequate levels (α = 0.71; ω = 0.70; glb = 0.83 and ORION ranging from 0.80 to 0.93, between domains). The instrument scores underwent a normalization process, revealing three distinct vulnerability strata: low (0 to 4), moderate (5 to 6), and high (7 to 14). CONCLUSION The scale exhibited satisfactory validity evidence, demonstrating consistency, reliability, and robustness. It resulted in a concise instrument that effectively measures and distinguishes levels of family vulnerability within the primary care setting in Brazil.
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Affiliation(s)
| | - Ilana Eshriqui
- Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Flávio Rebustini
- Department of Gerontology, School of Arts, Sciences and Humanities (EACH), University of São Paulo, São Paulo, São Paulo, Brazil
| | | | | | | | - Daiana Bonfim
- Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
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Zhang M, Xu X, Jiang J, Ji Y, Yang R, Liu Q, Li S, Li Y, Liu Q. The association between physical activity and subjective well-being among adolescents in southwest China by parental absence: a moderated mediation model. BMC Psychiatry 2023; 23:493. [PMID: 37430260 DOI: 10.1186/s12888-023-04982-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES Built on the Positive Youth Development (PYD) framework, this study examined how physical activity affected the subjective well-being of adolescents in the multi-ethnic area of southwest China. The mediating role of school connectedness as an external development asset and the moderating role of resilience as an internal development asset were specified and tested within the framework of sport-based PYD. METHODS A cross-sectional survey of 3143 adolescents (47.2% boys with mean age = 12.88 and SD = 1.68) was conducted in 2020. A structural equation model (SEM) was developed to estimate the direct effect of physical activity, the mediating effect of school connectedness, and the moderating effect of resilience on adolescents' subjective well-being. Multi-group comparison was made to investigate differences and similarities across three parental absence subgroups: (1) both parents present, (2) one parent absent, and (3) both parents absent. RESULTS As surmised, physical activity, school connectedness, and resilience all positively and significantly affected adolescents' subjective well-being. SEM analyses revealed that school connectedness mediated the effect of physical activity on subjective well-being. Moreover, resilience moderated both the direct and indirect effects of physical activity (through school connectedness) on subjective well-being. Finally, the multi-group comparison revealed a moderating effect of parental absence on the moderated mediation model. LIMITATIONS This study is a cross-sectional survey, so inference of causal associations among the study variables is impossible. CONCLUSIONS Healthy lifestyle behaviors, school-supportive settings, and positive individual development assets can enhance the subjective well-being of adolescents in southwest China, especially those whose parents were absent. Physical activity interventions informed by the PYD framework should be incorporated into public health programs designed to foster the physical and mental health of left-behind adolescents in southwest China.
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Affiliation(s)
- Ming Zhang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Xiaohe Xu
- Department of Sociology, University of Texas at San Antonio, San Antonio, USA
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, P.R. China
| | - Jianjun Jiang
- Department of Palliative Care, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Yuanyi Ji
- Nosocomial Infection Management Department, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, P.R. China
| | - Ruixi Yang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Qijiao Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China
| | - Shiying Li
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, P.R. China
| | - Yuchen Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Qiaolan Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West, Research Center for Palliative Care, China Fourth Hospital, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, P.R. China.
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Mordeno IG, Bigcas JD, Mordeno ER. Examining the Latent Dimensions of Social Anxiety Disorder. Psychol Rep 2023:332941231156815. [PMID: 36773037 DOI: 10.1177/00332941231156815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
While the body of literature has investigated the latent dimensions of Social Anxiety Disorder (SAD), only few have directly anchored in the DSM-5 SAD symptoms. Similarly, a continuing issue on measuring mental health disorders pertains to whether a symptom's frequency, intensity, or both, are appropriate and sufficient indicators of severity. To address this gap, the present study developed and validated a DSM-5-based measurement tool, the Social Anxiety Symptom Severity Inventory (SASSI), which assesses both the intensity (intensity of disturbance) and frequency (frequency of occurrence) of SAD symptoms. In study 1 (n = 6458, college students), the results revealed a two-factor structure using exploratory structural equation modeling. In study 2 (n = 425, left-behind emerging adults), confirmatory factor analysis, measurement invariance testing, and latent class analysis were used. Findings demonstrated the importance of using both frequency and intensity of symptoms in assessing SAD severity. Moreover, a five-class solution best fitted the sample. Studies 1 and 2 demonstrated the good psychometric properties of SASSI and filled an important gap among available measures in assessing SAD severity through symptom frequency and intensity.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, College of Education, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Jimayma D Bigcas
- School of Graduate Studies, College of Education, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Emelyn R Mordeno
- Department of Psychology, College of Arts and Social Sciences, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
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Han K, Ji L, Chen C, Hou B, Ren D, Yuan F, Liu L, Bi Y, Guo Z, Wu N, Feng M, Su K, Wang C, Yang F, Wu X, Li X, Liu C, Zuo Z, Zhang R, Yi Z, Xu Y, He L, Shi Y, Yu T, He G. College students’ screening early warning factors in identification of suicide risk. Front Genet 2022; 13:977007. [DOI: 10.3389/fgene.2022.977007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
This study aimed to explore the main influencing factors of suicide risk among Chinese students and establish an early warning model to provide interventions for high-risk students. We conducted surveys of students in their first and third years from a cohort study at Jining Medical College. Logistic regression models were used to screen the early warning factors, and four machine learning models were used to establish early warning models. There were 8 factors related to suicide risk that were eventually obtained through screening, including age, having a rough father, and CES-D, OHQ, ASLEC-4, BFI-Neuroticism, BFI-Openness, and MMC-AF-C scores. A random forest model with SMOTE was adopted, and it verified that these 8 early warning signs, for suicide risk can effectively predict suicide risk within 2 years with an AUC score of 0.947. Among the factors, we constructed a model that indicated that different personality traits affected suicide risk by different paths. Moreover, the factors obtained by screening can be used to identify college students in the same year with a high risk of suicide, with an AUC score that reached 0.953. Based on this study, we suggested some interventions to prevent students going high suicide risk.
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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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Zhao X, Zhang A, Liu W, Tao F, Sun Y. Childhood Separation from Parents with Cognitive and Psychopathological Outcomes in Adolescence. Dev Sci 2022; 26:e13324. [PMID: 36065157 DOI: 10.1111/desc.13324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/22/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Abstract
To examine the effects of childhood parent-child separation with varying duration and form on later cognitive performance and psychopathological problems over a 6-year period, we use data from the China Family Panel Study, which is an ongoing, prospective nationally representative study across 25 provinces in China. Of the 4033 children aged 4-10 years followed in 2012, 3522 children with complete data on separation from fathers and mothers were included. In 2018, 2560 participants were followed and interviewed to assess cognitive performance, behavioral problems as well as depressive symptoms at age 10-16 years. A total of 3522 children (mean [SD] age at baseline, 6.9 [2.0] years) were included. About 17.9% and 13.3% had separated from father and mother over 11 months or more in the year prior to the survey. Prolonged separation from parents was associated with lower scores in vocabulary (maternal: adjusted β = -1.64, P = 0.002; paternal: adjusted β = -1.58, P<0.001) and mathematics performance (maternal: adjusted β = -1.10, P = 0.009; paternal: adjusted β = -0.94, P = 0.004) over a 6-year period. Prolonged maternal separation was associated with 0.34-point higher internalizing behaviors (P<0.001) and 0.21-point higher externalizing behaviors (P = 0.009), as well as 0.89-point higher depressive symptoms (P = 0.018), while prolonged paternal separation was associated with 0.23-point higher internalizing behaviors (P = 0.005) and 0.76-point higher depressive symptoms (P = 0.011). The finding demonstrates substantial negative impacts of childhood paternal and maternal separations on cognitive and mental well-being during adolescence, which might be dependent on the "stress-dose" (duration of separation) and urban-rural residence. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xudong Zhao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Anhui Zhang
- Wuhu Maternity & Child Health Care Center, Wuhu, Anhui, 230001, China
| | - Wanxu Liu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
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Akezhuoli H, Lu J, Zhao G, Xu J, Wang M, Wang F, Li L, Zhou X. Mother's and Father's Migrating in China: Differing Relations to Mental Health and Risk Behaviors Among Left-Behind Children. Front Public Health 2022; 10:894741. [PMID: 35719620 PMCID: PMC9203828 DOI: 10.3389/fpubh.2022.894741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIn China, the figure for left-behind children (LBC) of migrants stood at 68. 77 million in 2015. Despite being seen as a whole in the last few decades, LBC today differ broadly in parental migrating status. This study focused on LBC with both parents migrating (BLBC), LBC with only mothers migrating (MLBC), LBC with only fathers migrating (FLBC), and previous LBC with one or both parents migrating (PLBC), separately. We aimed at exploring the extent to which LBC were being affected by each migrant parent on both mental health and risk behaviors.MethodsData from 4,832 children were collected by a school-based survey in both rural and urban areas of China's Anhui province. Each participant anonymously completed a self-administered questionnaire containing the sociodemographics, the Strength and Difficulties Questionnaire (SDQ), the items from the Youth Risk Behavior Surveillance System (YRBSS), and Young's Internet Addiction Test for Chinese (YIAT-C). Data were analyzed using one-way ANOVA and the Chi-squared test. Associations were estimated by multiple linear regression and logistic regression analyses adjusted for several confounders.ResultsThe results suggested that BLBC (p < 0.001), MLBC (p < 0.05), FLBC (p < 0.01), and PLBC (p < 0.001) significantly scored higher for total difficulties along with emotional symptoms and conduct problems than never left-behind children (NLBC). Besides, BLBC, FLBC, and PLBC further reported a significantly higher rate of smoking (p < 0.001, p < 0.01, and p < 0.001, respectively) and drinking (p < 0.01, p < 0.05, and p < 0.01, respectively) than did NLBC. Also, MLBC appeared higher risks of smoking problems [OR = 2.31, 95% CI (1.45–3.69), p < 0.001] and the internet addiction [OR = 2.15, 95% CI (1.24–3.72), p < 0.01], when compared to NLBC.ConclusionsThe findings provided insight into LBC within the different contexts of parental migrations and contributed to a better understanding of their specific and potentially persistent health risks. Correspondingly, the study highlighted the implications for differentiating LBC to capture the more vulnerable group and tailored interventions to prioritize.
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Affiliation(s)
- Hailati Akezhuoli
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Lu
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Guanlan Zhao
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiayao Xu
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Menmen Wang
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Feng Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Feng Wang ;
| | - Lu Li
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
- Zhejiang Shuren University, Hangzhou, China
- Lu Li ;
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
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Relations between parental response to children's negative emotions and suicidal ideation in chinese adolescents: Internalizing problems, emotion regulation, and perceived relationship quality with parents as mediators. J Affect Disord 2022; 301:205-216. [PMID: 35033594 DOI: 10.1016/j.jad.2022.01.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 11/22/2022]
Abstract
Past work points to the crucial role of parents' responses to children's negative emotions (PRCNE) in adolescents' socioemotional adjustment. The presence of suicidal ideation (SI) is an important sign of significant distress and suicide risk. However, research on the relations between PRCNE and adolescents' SI is lacking. This research aimed to investigate whether parental reactions to children's negative emotions (PRCNE) was related to adolescents' SI and, if so, through which processes. This research utilized data from a sample of Chinese adolescent families (N = 4,574; Parents: 35.81% males, M = 44.07 years old; Adolescents: 55.40% males, M = 16.28 years old), with parents giving their reports on PRCNE and adolescents self-evaluating their psychosocial development (i.e., internalizing problems, emotion regulation, perceived relationship quality with parents) and SI. We examined the relations between six types of PRCNE and adolescents' SI, and analyzed the mediating roles of adolescents' internalizing problems, emotion regulation (i.e., cognitive reappraisal and expressive suppression), and perceived relationship quality with parents. The results showed that emotion-focused response, problem-focused response, and expression encouragement negatively predicted, while punitive response and distress response positively predicted adolescents' SI. However, no statistically significant association emerged between minimization and adolescents' SI. Moreover, adolescents' internalizing problems, usage of expressive suppression, and perceived relationship quality with parents could mediate the relations between PRCNE and adolescents' SI. Contrary to our hypothesis, the results did not support an indirect effect of PRCNE on adolescents' SI through adolescents' cognitive reappraisal. The present research illuminates adolescents' SI by emphasizing the roles of PRCNE. The findings also highlight the importance of paying attention to adolescents' internalizing problems, expressive suppression, and perceived relationship quality with parents in relation to PRCNE in interventions aimed at reducing adolescents' SI.
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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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Obeid S, Al Karaki G, Haddad C, Sacre H, Soufia M, Hallit R, Salameh P, Hallit S. Association between parental divorce and mental health outcomes among Lebanese adolescents: results of a national study. BMC Pediatr 2021; 21:455. [PMID: 34657599 PMCID: PMC8522189 DOI: 10.1186/s12887-021-02926-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 09/23/2021] [Indexed: 01/18/2023] Open
Abstract
Background In Lebanon, divorce rates have jumped from nearly 7000 in recent years to 8580 in 2017, an increase of 22.5%, with North Lebanon recording the highest number, followed by Beirut, likely resulting in increased behavioral problems in the offspring of divorced parents. Furthermore, one out of two Lebanese adolescents whose biological parents were divorced, separated, or deceased has a psychiatric disorder. More information regarding the impact of divorce on the mental health of Lebanese adolescents is still missing. The objective of this study was to explore the association between divorce and mental health outcomes, particularly depression, anxiety, and suicidal ideation among Lebanese adolescents. Methods A cross-sectional study conducted between January and May 2019 enrolled 1810 adolescents aged 14 to 17 years, using a simple randomization method to choose schools. A proportionate number of schools was selected from each of the five Lebanese Mohafazat (Beirut, Mount Lebanon, North, South, and Beqaa), based on the list of the Ministry of Education and Higher Education. A total of 18 private schools were approached; two declined, and 16 accepted to participate. Results The mean age of participants was 15.42 ± 1.14 years, with 53.3% females. After adjustment for the covariates (age, sex, and house crowding index), the results showed that adolescents whose parents are separated compared to living together had more social fear (Standardized Beta (SB = 0.270) and avoidance (SB = 0.188), higher depression (SB = 0.045), and higher suicidal ideation (SB = 0.370). Conclusion Our findings reveal that teens with divorced parents had higher social fear and avoidance, depression, and suicidal ideation, highlighting the need for adequate prevention programs to support both children and parents during this emotionally difficult period.
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Affiliation(s)
- Sahar Obeid
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB: National Institute of Public Health, Clinical Epidemiology, and Toxicology, Beirut, Lebanon.
| | - Gloria Al Karaki
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - Hala Sacre
- INSPECT-LB: National Institute of Public Health, Clinical Epidemiology, and Toxicology, Beirut, Lebanon
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Pascale Salameh
- INSPECT-LB: National Institute of Public Health, Clinical Epidemiology, and Toxicology, Beirut, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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12
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Chiang YC, Lin YJ, Li X, Lee CY, Zhang S, Lee TSH, Chang HY, Wu CC, Yang HJ. Parents' right strategy on preventing youngsters' recent suicidal ideation: a 13-year prospective cohort study. J Ment Health 2021; 31:374-382. [PMID: 34559976 DOI: 10.1080/09638237.2021.1979490] [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: 10/20/2022]
Abstract
BACKGROUND Suicide remains the second leading cause of death among youths. Family-related factors are considered important determinants of children's suicidal ideation, whereas their short-/long-term influence is seldom quantified. AIMS We aim to confirm the simultaneous/lagged effects of family-related factors on the occurrence of recent suicidal ideation from childhood to young adulthood (aged from 10 to 22 years old). METHOD Data were derived from a longitudinal prospective cohort study. Participants included 2065 students who were followed up for 13 years. Generalized estimating equations were used to clarify the influential effects of family-related factors on suicidal ideation during the past month. RESULTS The peak of the rate of recent suicidal ideation arrived during junior high school years. Family interaction, family support, family involvement, and parental punishment had simultaneous effects on recent suicidal ideation. Family involvement, parental conflict, and psychological control had lagged and lasting effects on suicidal ideation. Notably, the lasting protective effects of family involvement were more obvious than simultaneous effects. CONCLUSIONS Providing parents with sustained support and education to improve their "positive parenting literacy" can help with their children's mental health development. This is especially the case during COVID-19 quarantine periods when families spend the most time together at home.
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Affiliation(s)
- Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, P. R. China
| | - Yu-Jung Lin
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Xian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, P. R. China
| | - Chun-Yang Lee
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou, P. R. China
| | - Shuoxun Zhang
- School of Business, Sichuan University, Chengdu, P. R. China
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chi-Chen Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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13
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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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14
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Lu J, Lin L, Roy B, Riley C, Wang E, Wang K, Li L, Wang F, Zhou X. The impacts of parent-child communication on left-behind children's mental health and suicidal ideation: A cross sectional study in Anhui. CHILDREN AND YOUTH SERVICES REVIEW 2020; 110:104785. [PMID: 32801409 PMCID: PMC7425803 DOI: 10.1016/j.childyouth.2020.104785] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study aimed to investigate the impact of previous maternal migration experiences on left-behind children's (LBC) mental health status and suicidal ideation, and the possible mediating role of parent-child communication. A cross-sectional study among rural children was conducted in Anhui, China, in 2018. LBC who self-reported that (a) their fathers were migrants and (b) they were living with their mothers at the time of the survey were included in this study. The participants were then divided into two subgroups by previous maternal migration experience. Previous maternal migration was associated with worse mental health and a higher prevalence of suicidal ideation among LBC compared with their peers. Healthy communication between children and parents fully mediates the adverse effects caused by previous maternal migration experiences on mental health among LBC, and communication with mother partially mediates the association with suicidal ideation. Communication classes for returning parents offered jointly by governments and schools could be an effective way to mitigate the impacts of maternal migration on child mental health and should be studied.
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Affiliation(s)
- Jingjing Lu
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China
| | - Leesa Lin
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, USA
| | - Brita Roy
- Yale School of Medicine, New Haven, CT, USA
| | - Carley Riley
- Department of Pediatrics, University of Cincinnati College of Medicine, USA
- Division of Critical Care, Cincinnati Children’s Hospital Medical Center, USA
| | - Emily Wang
- Yale School of Medicine, New Haven, CT, USA
| | - Karen Wang
- Yale School of Medicine, New Haven, CT, USA
| | - Lu Li
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China
| | - Feng Wang
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China
| | - Xudong Zhou
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China
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15
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Wang L, Yao J. Life satisfaction and social anxiety among left-behind children in rural China: The mediating role of loneliness. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:258-266. [PMID: 31559649 DOI: 10.1002/jcop.22252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/04/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
This study examined the mediating effects of loneliness in the relationship between social anxiety and life satisfaction. Four hundred and forty two left-behind children in rural China, who completed the Social Anxiety Subscale, UCLA Loneliness Scale, and Satisfaction with Life Scale, participated in the study. Results indicated that compared with both parent migration children, the scores of life satisfaction in the mother-only and father-only migration children were strongly higher, but did not differ across genders and ages. Additionally, social anxiety and loneliness negative predicted life satisfaction. More important, the mediation analysis revealed a partial mediating effect of loneliness in the links from social anxiety to life satisfaction. These findings call on more attention from the government and related sectors of society, and propose that loneliness improvement program may have a preventive function for promoting the life satisfaction among left-behind children.
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Affiliation(s)
- Lei Wang
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu, China
| | - Jun Yao
- School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China
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16
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Wu W, Qu G, Wang L, Tang X, Sun YH. Meta-analysis of the mental health status of left-behind children in China. J Paediatr Child Health 2019; 55:260-270. [PMID: 30604503 DOI: 10.1111/jpc.14349] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 11/09/2018] [Accepted: 11/18/2018] [Indexed: 11/28/2022]
Abstract
The aims of this study were to systematically evaluate and comparatively analyse the mental health status of left-behind children (LBC) in China and to provide a scientific basis for mental intervention and healthy education for LBC. Six electronic databases were searched for studies (published from 1 January 2010 to 5 March 2018) of the mental health of LBC using the Mental Health Test scale. We only selected original articles that either reported the incidence of serious mental health status or the means and standard deviations of each factor score of the scale. The pooled rates and weighted mean difference were calculated. The results indicated that the incidence of serious mental health status of LBC is nearly 2.7 times higher than that of non-LBC. The scores for most of the factors analysed by the Mental Health Test of LBC were higher than those of non-LBC. In addition, the mental health status of left-behind girls is worse than that of left-behind boys. Except for impulsive tendency, there was no significant difference in the mental health status of LBC in primary and junior high schools. In terms of the different types of guardianship, the mental health status of LBC under a grandparent's guardianship and parental peer' guardianship is more serious than that of LBC under a single-parent guardianship. The mental health status of LBC is poor, particularly for left-behind girls. The primary mental problems faced by LBC are learning anxiety, social anxiety and physical symptoms. It is necessary to develop more targeted measures to prevent and manage LBC.
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Affiliation(s)
- Wei Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Lingling Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Xue Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Ye-Huan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Centre for Evidence-Based Practice, Anhui Medical University, Hefei, China
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