Exploring the Pathways From Economic Pressure to Depression Among Chinese Adolescents

Prevention of Depression in Children and Adolescents

Objective: The purpose of this study is to gain insight into the effect of family support, school connectedness, and school environments on depressive symptoms among adolescents across racial/ethnic groups on both the student-level and school-level. Method: This study uses a sample of 4228 students (2122 girls and 2016 boys) from the public use data of the National Longitudinal Study of Adolescent Health. Students were measured at two time points (one year apart) on school connectedness, family support, socio-demographic factors, and the Center for Epidemiological Studies’ Depression Scale. Hierarchical Linear Modeling was used to examine potential predictors on adolescent depressive symptoms. This is, to the best of the author’s knowledge, the first study to examine the interplay of school connectedness, school racial composition, and adolescent depression. Results: School connectedness partially mediates the effects of family support on depressive symptoms, but both remain strong predictors of depressive symptoms. African American adolescents are the only racial/ethnic group that has constantly higher CES-D scores than the non-Hispanic white adolescents. School-level connectedness is positively related to students’ depressive symptoms. The racial composition of a school has different effects on students’ depressive symptoms on student’s race. Conclusions: Low perceived family support, low school connectedness, being female, and being African American are consistently associated with greater depressive symptoms one year later. The overall level of school connectedness of a school is found to be related with greater individual student’s depressive symptoms, while the effects of school proportion of minority students on students’ depressive symptoms differ significantly across the race/ethnicity of students. Future study is needed to explore the association between racial/ethnic segregation and adolescent depression while considering students’ racial/ethnic status.

Rising rates of the ethnic minority population in the United States have resulted in a plethora of research addressing minority adolescents’ and adults’ experiences with stress and discrimination as they reside in the United States. While many studies have focused on the negative impact of both racial discrimination and economic stress that can lead to poorer psychological and academic outcomes, fewer studies have addressed protective factors that can help them to cope with these negative experiences over time. Utilizing data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a longitudinal study that examines adolescents and their families, this study extended the current state of the literature by examining the relationship between discrimination, economic pressure, depressive symptoms and educational attainment using a national representative, multiethnic sample. In addition, the moderating role of school connectedness on adolescents’ psychological well-being and later educational attainment during emerging adulthood was also addressed. Overall, school connectedness did not buffer the relationship between perceived discrimination and depressive symptoms or educational attainment. Similarly, school connectedness did not buffer the relationships between economic pressure and depressive symptoms, nor its relationship with educational attainment. School connectedness had an interaction on the relationship between depressive symptoms and educational attainment, and the nature of its interaction effect was discussed. The present study also compared and found both gender and ethnic differences on the aforementioned relationships among African American, Latino American, and Asian American adolescents. Further research on these relationships, as well as implications for interventions that serve ethnic minority adolescents, are discussed.

This study examined the associations of interpersonal conflict and school connectedness with depressive symptoms in Chinese adolescents. A cross-sectional study was conducted among 6576 adolescents in Shenzhen, China. Participants completed a battery of questionnaires that assessed adolescents’ depressive symptoms, conflict with parents, teachers, and peers, school connectedness, and demographics. Multiple linear regression analysis was used to explore the association of interpersonal conflict and school connectedness with depressive symptoms in adolescents. Results showed that conflicts with their mother, father, teachers, and peers were associated with higher levels of depressive symptoms in adolescents, while greater school connectedness was related to lower levels of depressive symptoms in adolescents. Gender proved to be a moderator of these relationships in that the associations of quarreling with mothers, mothers’ use of emotional punishments, teachers’ use of emotional punishments, and school connectedness with depressive symptoms were stronger in females than males. Moreover, grade level proved to be another moderator, with the associations of teachers’ use of physical punishment and fighting with peers with depressive symptoms being stronger in primary school students than in secondary school students. Our findings suggest that gender and grade level moderated the association of interpersonal conflict and school connectedness with depressive symptoms in Chinese adolescents.

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

Early regulatory problems (RPs) are associated with childhood internalising and externalising symptoms. Internalising and externalising symptoms, in turn, are associated with adolescent psychopathology (e.g. personality disorders, depression). We examined whether RPs are directly associated with adolescent psychopathology, or whether associations are indirect via childhood internalising and externalising symptoms. We used data from the Avon Longitudinal Study of Parents and Children. Mothers reported on their child's RPs at 6, 15-18 and 24-30months, and internalising and externalising symptoms at 4, 7, 8 and 9.5years. Adolescent psychotic, depression and BPD symptoms were assessed at 11-12years. Children were grouped by their patterns of co-developing internalising and externalising symptoms using parallel process latent class growth analysis (PP-LCGA). Path analysis was used to examine direct and indirect associations from RPs to the three adolescent outcomes. There were four groups of children with distinct patterns of co-developing internalising and externalising (INT/EXT) symptoms. Most children (53%) demonstrated low-moderate and stable levels of INT/EXT symptoms. A small proportion (7.7%) evidenced moderate and increasing INT and high stable EXT symptoms: this pattern was strongly predictive of adolescent psychopathology (e.g. depression at 11years: unadjusted odds ratio=5.62; 95% confidence intervals=3.82, 8.27). The other two groups were differentially associated with adolescent outcomes (i.e. moderate-high increasing INT/moderate decreasing EXT predicted mother-reported depression at 12, while low stable INT/moderate-high stable EXT predicted child-reported depression at 11). In path analysis, RPs at each time-point were significantly indirectly associated with symptoms of BPD and child- and mother-reported depression symptoms via the most severe class of INT/EXT symptoms. Consistent with a cascade model of development, RPs are predictive of higher levels of co-developing INT/EXT symptoms, which in turn increase risk of adolescent psychopathology. Clinicians should be aware of, and treat, early RPs to prevent chronic psychopathology.

Unique and interactive effects of parental neglect, school connectedness, and trait self-control on mobile short-form video dependence among Chinese left-behind adolescents

Asymmetric bidirectional associations of myopia with anxiety and depressive symptoms: Evidence from a one-year follow-up of 40,575 Chinese adolescents.

Adolescent depression is shaped by biological, psychological, and social factors. Traditional models often fail to capture complex interrelations among depressive symptoms. This study uses network analysis to identify Chinese adolescents' depressive symptoms and their key correlates. Data from a large sample of Chinese adolescents were analyzed using the EBICglasso method to construct a Gaussian graphical model, estimating partial correlations between depressive symptoms and 51 related factors. Centrality and bridge centrality analyses identified influential symptoms and connections. Robustness was assessed via bootstrapping, and symptom pathways via flow network analysis. Analyses revealed sadness, loneliness, and effort as the central symptoms, while the symptom anhedonia demonstrated low centrality among Chinese adolescents. Key correlates included academic pressure and health status, with the former closely linked to feelings of effort, and the latter to sleep disturbances and depressive mood. Parent-child interactions, particularly parental criticism, trust, and praise, showed strong associations with adolescents' depressive symptoms. This study highlights the centrality of sadness and the significant roles of academic pressure, health status, and parent-child interactions in shaping depressive symptoms among Chinese adolescents. The findings suggest that interventions targeting sadness, academic pressure and health-related concerns, and especially parent-child relationships, are promising strategies for reducing adolescent depression.

This study investigated how mothers' depressive symptoms were related to their children's depressive symptoms through children's perceived attachment security to their mother. Ninety‐six mothers reported on their depressive symptoms. Children reported on their depressive symptoms and their attachment security with their mothers. The results indicated that children's perception of security with their mothers indirectly linked mothers' depressive symptoms to their children's depressive symptoms. Furthermore, this indirect association was moderated by child's sex because only girls, whose mothers reported higher depressive symptoms, reported lower perceived attachment security. This study advances the literature on mechanisms explaining how mothers' depressive symptoms are related to their children's depressive symptoms, which have critical implications for the prevention and intervention of child and adolescent depression.Highlights Mothers' depressive symptoms were related to children's depressive symptoms through children's perceptions of mother–child attachment security One path in the indirect relation was moderated by child's sex such that maternal depression was associated with a less secure perceived attachment relationship for female youth but not male youth Child depression interventions may be improved by targeting attachment relationships, with particular attention for daughters of depressed mothers

ObjectiveDepression is highly prevalent in adolescents and may have adverse social and health consequences. To investigate the effect of diet on the occurrence of depression in adolescents, this study examined the correlation between dietary patterns and depression in adolescents.MethodsA total of 853 participants were recruited in September to October 2022 in Taizhou, Zhejiang, China. The Chinese version of the Patient Health Questionnaire-9 was used to assess the subjects’ depressive symptoms in the past 2 weeks. Relevant dietary information was obtained through a food frequency questionnaire. The associations between dietary patterns and the risk of depression were assessed using a logistic regression model.ResultsFour dietary patterns were identified by factor analysis, including the modern pattern, the snack-aquatic pattern, the traditional pattern, and the vegetarian pattern. The risk of mild depression among adolescents was higher in the Q2 and Q3 groups of the modern model than in the Q1 group of this type, and the risk of mild depression was higher in the Q4 group of the snack-aquatic model than in the Q1 group of this type; while the risk of moderate depressive symptoms was lower in the Q3 group of the vegetarian model compared with the Q1 group.ConclusionModern and snack-aquatic patterns are associated with an increased risk of depression in Chinese adolescents, and vegetarian patterns are associated with a reduced risk of depression. The current findings emphasize the importance of adolescents consuming moderate amounts of rice flour, adequate vegetables and fruits, and reducing snack intake.

The association of soft drink consumption with mental problems in Asian adolescents has not been reported. The present study aimed to investigate the association of soft drink consumption and symptoms of anxiety and depression in adolescents in China. A cross-sectional study to investigate the association of intake of soft drinks and sugars from soft drinks with symptoms of anxiety and depression measured by the two-item Generalized Anxiety Disorder (GAD-2) and the Patient Health Questionnaire (PHQ-2), respectively. A comprehensive university in Changsha, China. Newly enrolled college students in 2017. In total, 8226 students completed the investigation and 8085 students with no systemic disorders were finally analysed. Students consuming soft drinks ≥7 times/week had significantly higher (mean difference; 95 % CI) GAD-2 (0·15; 0·07, 0·23) and PHQ-2 (0·27; 0·19, 0·35) scores compared with those barely consuming soft drinks, adjusted for demographic and behavioural factors. Those consuming >25 g sugar/d from soft drinks had significantly higher GAD-2 (0·11; 0·04, 0·18) and PHQ-2 (0·22; 0·15, 0·29) scores compared with non-consumers. The mediation effect of obesity in the associations was not clinically significant. Adolescents consuming soft drinks ≥7 times/week, or >25 g sugar/d from soft drinks, had significantly higher levels of anxiety and depression. Dietary suggestion is needed to prevent anxiety and depression in adolescents.

Depressive symptoms in Chinese children and adolescents: Parent, teacher, and self reports

The goal of the current study was to compare diathesis-stress and transactional models of cognitive vulnerability to depression in samples of Canadian (n = 118) and Chinese (n = 405) adolescents. We utilized a six-month multi-wave, longitudinal design in order to examine whether (a) perceived control moderated the association between the occurrence of dependent interpersonal stressors and subsequent increases in depressive symptoms (i.e., a diathesis-stress perspective) and (b) dependent interpersonal stressors mediated the association between perceived control and subsequent increases in depressive symptoms (i.e., a transactional perspective). Results from idiographic, time-lagged, hierarchical linear modeling analyses indicated that for Canadian adolescents both diathesis-stress and transactional models were significant predictors of depressive symptomology. When examining the diathesis-stress model, boys, but not girls, who reported lower perceived control, reported higher levels of depressive symptoms following the occurrence of dependent interpersonal stress. Gender differences, however, were not present in the transactional model. In contrast, transactional, but not diathesis-stress, models were significant in Chinese adolescents, and gender differences did not emerge. Overall, these results may reflect culturally-relevant differences in the etiology of depression in Canadian and Chinese adolescents.

In examining associations of sexual orientation, school connectedness (SC), and depression, no studies have used a continuum of sexual orientation. Additionally, no study has examined whether individuals with higher SC within subgroups of the continuum of sexual orientation are protected from symptoms of depression when compared to others within their own group. Our study aimed to address these deficiencies. Data were from a cross-sectional survey of 6643 public high school students. Logistic regression was used to determine if higher SC was associated with protection from symptoms of depression comparing students with minority sexual orientations to heterosexual students, and whether SC was protective within subgroups of orientation. Mean SC scores were higher in heterosexuals than in all other orientation subgroups. Except for bisexual boys, compared with being heterosexual, being in other subgroups of orientation was associated with symptoms of depression, independent of SC. In both sexes SC was protective against depression risk within all categories of orientation except mostly/100% homosexual girls. Within all subgroups of sexual orientation except mostly/completely homosexual girls, SC was protective for symptoms of depression, indicating its potential importance for prevention of depression in all students, including perhaps particularly those with minority orientation.