Abstract
BackgroundThere are 68.77 million left-behind children in China, who are at a great risk of depression associated with negative life events. Our study aims to investigate the most central symptoms of depression in left-behind children and the relationship between depressive symptoms and negative life events using network analysis.MethodA cross-sectional data set (N = 7255) was used, which included children and adolescents aged 7 to 17. Network analysis was used to evaluate: 1) the most central symptoms among the items included in Child Depression Inventory (CDI) of the left-behind children; 2) bridge symptoms between depressive disorder and Adolescent Self-Rating Life Events Check List (ASLEC) of the left-behind children; 3) differences in networks of depressive disorders between left-behind and non-left-behind children, and 4) differences in the network of depression and negative life events between left-behind and non-left-behind children. The stability and centrality indices of the network were also evaluated in the study.ResultsThe most central symptoms in the CDI among the left-behind children included self-hatred, crying, fatigue, and sadness. The items with the highest bridge strength centrality in the CDI-ASLEC network included academic stress, discrimination, and school performance decrement. Higher bridge strength values indicate a greater risk of contagion to other communities. The connections in the CDI-ASLEC network are denser in the left-behind children than in non-left-behind children.LimitationsThe study which was conducted based on cross-sectional data shows that network analysis can only make undirected estimation, but not causal inferences.ConclusionsWe identified the core symptoms of depression and the bridge symptoms between negative life events and depression in the left-behind children. These findings suggest that more attention should be paid to self-hatred, sadness, and fatigue in the treatment of depression in left-behind children. Intervention for academic stress and discrimination of the left-behind children may help to reduce the contagion of negative life events to depression symptoms.
Highlights
China’s reform and opening-up and the subsequent social and economic development have led to the prosperity of many cities
These findings suggest that more attention should be paid to self-hatred, sadness, and fatigue in the treatment of depression in left-behind children
Intervention for academic stress and discrimination of the left-behind children may help to reduce the contagion of negative life events to depression symptoms
Summary
China’s reform and opening-up and the subsequent social and economic development have led to the prosperity of many cities. A large amount of the population in the undeveloped areas in central and western China began to move to the developed area for employment opportunities. The left-behind children are defined as children who have lived in undeveloped areas for more than 6 months and have one parent or both work in developed areas. In 2015, there were 68.77 million leftbehind children in China, including 40.51 million in rural areas [1]. These children are usually taken care of by their relatives, especially grandparents, who pay more attention to their physiological needs rather than their psychological needs. There are 68.77 million left-behind children in China, who are at a great risk of depression associated with negative life events. Our study aims to investigate the most central symptoms of depression in left-behind children and the relationship between depressive symptoms and negative life events using network analysis
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