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中国农村留守儿童同伴侵害与抑郁症状的前瞻性研究:应激性生活事件的中介作用

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

作者信息

Zhang Xiaoqing, Hong Houlin, Hou Wei, Liu Xia

机构信息

School of Health Professions, Stony Brook University, New York, USA.

School of Public Health and Health Policy, City University of New York, New York, USA.

出版信息

Child Adolesc Psychiatry Ment Health. 2022 Jun 29;16(1):56. doi: 10.1186/s13034-022-00485-8.

Abstract

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

摘要

背景

中华人民共和国民政部报告称,2018年,有697万留守儿童(即父母外出务工,留在农村生活的儿童)由祖父母、亲属、兄姐照顾,或经常独自生活。他们的父母为了更好的收入机会迁移到了城市。虽然一些研究详细阐述了留守儿童中抑郁症状的增加,但对于留守儿童心理健康较差的原因了解相对较少。

方法

本研究使用纵向数据,调查了中国贵州省四所随机选取的中学中留守儿童的同伴侵害、应激性生活事件与抑郁症状严重程度之间的关联。共有862名11 - 18岁的儿童参与分析,其中472名留守儿童(54.76%),390名非留守儿童(45.24%)。采用t检验比较留守儿童和非留守儿童在基线和随访(6个月后)时的抑郁症状、同伴侵害和应激性生活事件。多变量线性回归模型用于检验随访应激性生活事件对留守儿童基线同伴侵害与随访抑郁症状之间关系的中介效应。

结果

结果表明,留守儿童比非留守儿童遭受更多的同伴侵害和应激性生活事件(β = 1.28,p = 0.04),基线时的同伴侵害和应激性生活事件与留守儿童随访时抑郁症状的增加有关(同伴侵害:β = 0.25,p < 0.0001;应激性生活事件:β = 0.15,p < 0.001)。在控制年龄、感知社会经济地位和学校因素后,同伴侵害对女性留守儿童抑郁症状的影响部分通过应激性生活事件,对男性留守儿童抑郁症状的影响则完全通过应激性生活事件。

结论

本研究强调了留守儿童心理健康出现负面结果的脆弱性,因为与非留守儿童相比,他们遭受更多的同伴侵害,并且在应激性生活事件发生时感受更多压力。本研究结果表明,保护留守儿童免受同伴侵害经历可能会防止他们受到其他应激性生活事件增加的影响,从而降低他们出现抑郁症状的可能性。干预设计应考虑应激性生活事件对女性和男性留守儿童同伴侵害与抑郁症状之间关系的不同中介效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e3/9245339/8b9880db0795/13034_2022_485_Fig1_HTML.jpg

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