Effects Of Stressful Life Events Research Articles

How do stressful life events affect medical students’ academic adjustment? Parallel mediating mechanisms of anxiety and depression

BackgroundMedical students frequently face challenges in academic adjustment, necessitating effective support and intervention. This study aimed to investigate the impact of stressful life events on medical students’ academic adjustment, focusing on the mediating roles of depression and anxiety. It also differentiated the impacts between at-risk students (those with academic failures) and their peers respectively.MethodsThis case-control study involved 320 at-risk medical students and 800 other students from a university in western China. Participants anonymously completed the scales of stressful life events, depression, anxiety, and academic adjustment. T-tests, ANOVA, Pearson correlation, and structural equation modeling were employed for statistical analysis.ResultsDepression and anxiety were significantly more prevalent in at-risk students (46.8% and 46.1%, respectively) than in controls (34.0% and 40.3%, respectively). Notably, at-risk students had poorer academic adjustment (t = 5.43, p < 0.001). The structural equation modeling had good fit indices and the results indicated that depression and anxiety fully mediated the effects of stressful life events on academic adjustment. For at-risk students, stressful life events significantly decreased academic adjustment through increased depression and anxiety (p < 0.001). Conversely, anxiety had a positive effect on academic adjustment in other students.ConclusionTargeted interventions focusing on depression and anxiety could reduce the negative impact of stressful life events on medical students’ academic adjustment. However, educators have to distinguish the differences between at-risk students and others.

Effects of stressful life events on suicide risk among orphaned and left-behind adolescents in China: The mediating roles of loneliness and subjective well-being

BackgroundResearch has established a link between stressful life events and suicide risk among adolescents, but limited attention has been directed towards vulnerable groups regarding the impact of such events on suicide risk. ObjectivesThis study aimed to examine the influence of stressful life events on suicide risk among orphaned and left-behind adolescents in China and to explore potential variations in this effect across different types of adolescents. MethodsParticipants were from four schools located in four counties with high HIV/AIDS infection rates in the Liangshan Yi Autonomous Prefecture, Sichuan Province, China. A sample of 1912 students were recruited, and 1524 responses were retained for analysis. Participants completed questionnaires assessing stressful life events, suicide risk, loneliness, and subjective well-being. Orphaned and left-behind adolescents were identified through demographic questions. Multiple linear regression analyses were conducted to assess the mediating effects of loneliness and subjective well-being on the relationship between stressful life events and suicide risk, as well as to examine the moderating effect of adolescent type. ResultsStressful life events showed a significant positive association with suicide risk. Loneliness and subjective well-being played mediating roles in the relationship between stressful life events and suicide risk. Double and single orphans exhibited higher levels of loneliness and lower levels of subjective well-being. Moreover, stressful life events had a more pronounced effect on suicide risk among left-behind adolescents. ConclusionsStressful life events exerted a direct positive impact on suicide risk among adolescents, while also indirectly affecting suicide risk by elevating loneliness and diminishing subjective well-being. Adolescents who experienced parental bereavement were more susceptible to feelings of loneliness and unhappiness. However, left-behind adolescents demonstrated elevated suicide risk even when facing similar levels of stressful life events. The stress sensitization theory and the distinct effects of chronic and acute stressors may offer explanatory insights. Implications for practice were discussed.

An exploratory study of resilience to stressful life events in autistic children

BackgroundAutistic children experience more stressful life events (SLEs) than their neurotypical peers, which are related to poor mental health outcomes in both neurotypical and autistic individuals. However, there is a lack of longitudinal research assessing the perceived impact of stressful life events on autistic children’s mental health. MethodUtilizing a novel statistical technique (Ratcliff et al., 2019), called ‘area of resilience to stress events’ or ARSE in R, we aimed to quantify aspects of resilience, growth, and non-resilience for 67 autistic children (6–13 years old) enrolled in a larger longitudinal study who experienced a SLE. Parents reported demographic information (e.g., child age, biological sex, household income) as well as the child’s internalizing and externalizing symptoms and autism characteristics across multiple time points spaced one year apart (baseline, T2, T3, T4). ResultsThere was substantial variability in the resilience process within the sample. Older children exhibited a less adaptive resilience process (i.e., higher total scaled scores or arsets). Perceived stress of the disruptive event was not correlated with resilience; however, there was a significant child age x stress severity interaction, suggesting that younger children in households that perceived the disruptive event as highly stressful exhibited more efficient resilience, or lower arsets scores, compared to other children. ConclusionsThis study introduces an innovative methodological approach to understanding the effects of stressful life events on the mental health of autistic children. Results have implications for family-based policy and practice and highlight for whom services may be most beneficial.

Gratitude Buffers Against the Effects of Stressful Life Events on Adolescents’ Externalizing Behavior but Not Internalizing Behavior

AbstractThe identification of psychological strengths that foster healthy development in youth has become a major topic of exploration in the field of positive psychology. Gratitude is a trait-like characteristic with qualities indicative of a potential psychological strength that may serve as a protective factor for early adolescents in the face of stressful life events (SLEs). This two-wave longitudinal study utilized data from a sample of 830 middle school students from the Southeastern United States. Path analysis was employed to investigate gratitude’s role as a moderator in the relations between prior SLEs and early adolescents’ frequencies of externalizing and internalizing coping behaviors. The interaction between SLEs and gratitude significantly predicted early adolescents’ subsequent frequencies of externalizing behaviors, but not internalizing behaviors. The results provided support for gratitude as a key psychological strength in early adolescents. The results also implied the benefits of promoting youths’ gratitude in efforts to prevent externalizing behavior.

Acculturation stress magnifies child depression effect of stressful life events for Latinx youth 3 years later.

Acculturation stress magnifies child depression effect of stressful life events for Latinx youth 3 years later.

Suicide Risk Moderates the Relationship Between Stressful Life Events, the Suicidal Narrative, and the Suicide Crisis Syndrome: A Brazilian Cross-Sectional Study

BackgroundStressful life events are associated with higher odds of suicidal thoughts and behaviors. Furthermore, stressful life events can trigger specific symptoms, including the suicidal narrative and suicide crisis syndrome, resulting in an increased risk of suicidal thoughts and behaviors. This study examined the moderating role of suicide risk in the relationship between stressful life events, the suicidal narrative, and the suicide crisis syndrome.Methods2,260 adults completed an online survey recruited through advertisements on social media. The level of emotional distress was assessed through the Suicide Narrative Inventory, Suicide Crisis Inventory-2, Stressful Life Events Questionnaire, and Mini International Neuropsychiatric Interview. The PROCESS macro (Hayes) was used to analyze the moderation models.ResultsStressful life events were positively correlated with the suicidal narrative and suicide crisis syndrome. The effects of stressful life events on suicidal narrative and suicide crisis syndrome were strongest when suicide risk was low and weakest when suicide risk was high.ConclusionsThese findings suggest that including stressful life events as part of suicide risk assessment in general and clinical settings is critical to managing treatment for suicidal thoughts and developing adaptive coping.

The role of inflammation in the effects of peer victimisation and stressful life events on mental health in childhood

BackgroundPeer victimisation represents a salient stressor during childhood. However, studies investigating the mechanism of its impact on children's mental health typically examine socio-cognitive factors as mediators. The current study sought to provide novel insight through testing a potential biological mechanism, inflammation. It also tested for pathway-specific effects by comparing how inflammation may mediate the effect of peer victimisation and that of another important stressor in childhood: adverse life events. MethodData from 4,583 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) were used. Path analysis was carried out to investigate whether inflammation (IL-6 and CRP) at age 9 years mediates the effect of peer victimisation and stressful life events at age 8 years on internalising (peer and emotional) or externalising (hyperactivity and conduct) problems (measured at age 11 years), both before and after adjustment for potential confounders. ResultsIL-6 partially mediated the effect of peer victimisation on peer problems, even after adjustment for potential confounders. Inflammation did not mediate the effect of stressful life events on either type of internalising problems. Neither stressor predicted externalising problems via inflammation. ConclusionWe did not find evidence that inflammation mediates the effect of stressful life events on mental health in childhood when they are considered alongside experiences of peer victimisation. Inflammation may already represent a form of biological embedding of peer victimisation in the early years.

The effect of stressful life events on the risk for psychosis: differences between Mexican at clinical and familial high risk.

Stressful life events (SLEs) in the development of early psychosis have been little studied in low-income countries. This study examines differences in the prevalence of SLEs in Mexican at clinical high risk (CHR) and those with familial high risk for psychosis who do not meet CHR criteria (non-CHR FHR). We also analyze the association between SLEs and CHR. Participants included 43 persons with CHR and 35 with non-CHR FHR. CHR criteria were assessed with the Comprehensive Assessment of At-Risk Mental State. SLEs were assessed using the Questionnaire of Stressful Life Events. Participants with CHR reported more SLEs associated with negative academic experiences than those in the non-CHR FHR group. Bullying (OR = 7.77, 95% CI [1.81, 33.32]) and low educational level (OR = 21.25, 95% CI [5.19, 46.90]) were the strongest predictors of CHR, while starting to live with a partner (OR = 0.26, 95% CI [0.10, 0.84]) was associated with a lower risk of CHR. Negative school experiences increase the risk of psychosis, particularly bullying, suggesting that schools may be ideal settings for implementing individual preventive strategies to reduce risk factors and increase protective factors to improve the prognosis of those at risk of developing psychosis. In Latin America, there are multiple barriers to early intervention in psychosis. It is thus crucial to identify risk and protective factors at the onset and in the course of psychosis in order to design effective preventive interventions.

The Effects of Self-Criticism and Self-Compassion on Adolescents' Depressive Symptoms and Nonsuicidal Self-Injury.

Symptoms of depression increase during adolescence as do nonsuicidal self-injurious behaviors (NSSI). The present study aimed to investigate how self-criticism interacted with the effects of stressful life events on depressive symptoms and NSSI and whether self-compassion would buffer these negative effects. A total of 908 Chinese adolescents (Mage = 13.46, SD = 0.57) completed a cross-sectional survey. The main and interacted effects of stressful life events, self-criticism, self-compassion on depressive symptoms and NSSI were examined respectively. The results showed that self-criticism significantly moderated the relationships between stressful events and depression and NSSI. Self-compassion could buffer the negative impacts of stressful events and self-criticism on NSSI but not on depression. High self-compassion significantly reduced the magnitude of the association between stressful life events and NSSI in adolescents with low self-criticism but not in those with high self-criticism. Self-criticism exacerbated the negative impacts of stressful life events on both depressive symptoms and NSSI, but self-compassion only buffered the impact of stressful life events on NSSI. Interventions designed to reduce NSSI risk of Chinese adolescents may benefit from training them to improve self-compassion abilities and to be less self-critical.

A prospective study of the relative contribution of adolescent peer support quantity and quality to depressive symptoms.

During adolescence, peer support has an increasingly important role in identity formation and well-being. Prior research has identified that lack of social support from peers in adolescence is a potent risk factor for depression. Two ways that social support has been operationalized is by the number of one's friends (i.e., 'quantity') and perception of one's network (i.e., 'quality'). Typically, these aspects of peer support are assessed separately. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 3,857), this study sought to test whether (1) adolescent depression relates to having fewer friends versus lower quality friendships, (2) these aspects of adolescent peer support prospectively predict depression in adulthood, (3) gender moderates the effects of peer support on depression, and (4) these aspects of peer support buffer the effects of stressful life events on depression. Peer support quality uniquely predicted depression in adolescence and adulthood among both males and females. The effect of peer support quality on depressive symptoms, however, was greater for females than males. By contrast, peer support quantity did not uniquely predict depression for males or females. Qualitative aspects of adolescent peer support uniquely contribute to mental health not only in adolescence, but in adulthood as well. Potential processes through which peer support relates to depression are discussed, as well as implications for treatment.

Stressful life events and relapse of psychosis: analysis of causal association in a 2-year prospective observational cohort of individuals with first-episode psychosis in the UK

Despite accumulating evidence of an association between stressful life events and psychosis relapse, the extent to which this is a causal relationship remains unclear. We aimed to examine the association between exposure to, and number of, stressful life events after initial psychosis onset and psychosis relapse. In this 2-year prospective observational study, we recruited individuals with first-episode psychosis, aged 18-65 years, who presented to psychiatric services in south London, UK. Participants were assessed via interview, with additional data obtained from electronic clinical records. Stressful life events were recorded at psychosis onset and during the 2-year follow-up using a brief questionnaire that assesses 12 major life events. Psychosis relapse was defined as inpatient admission because of symptom exacerbation within 2 years from psychosis onset. We examined the time to first psychosis relapse and the number and length of relapses using survival and binomial regression analyses. We used fixed-effects regression and cross-lagged path analysis to examine the directionality of effects and control for unmeasured confounders. Between April 12, 2002, and July 26, 2013, 256 individuals with first-episode psychosis (100 [39%] female and 156 [61%] male; 16 [6%] Asian, 140 [55%] Black African or Caribbean, 86 [34%] White, and 14 [6%] mixed ethnicity) were recruited, with a mean age of onset of psychosis of 28·06 years (SD 8·03; range 17·21-56·03). 93 (36%) participants experienced at least one relapse during the 2-year follow-up. 253 individuals had all relevant data and were included in analyses. For people exposed to stressful life events after the onset of psychosis, the adjusted hazard (hazard ratio [HR] 2·60, 95% CI 1·63-4·16, p<0·0001), incidence (incidence rate ratio [IRR] 1·87, 1·24-2·80, p=0·0026), and length (IRR 2·53, 1·40-4·67, p=0·0011) of relapse were greater than for those who were unexposed. These relationships were dose dependent (HR 1·36; 1·09-1·69, p=0·0054; incidence IRR 1·26, 1·02-1·53, p=0·023; length IRR 1·52, 1·12-2·12, p=0·0028). Adjusted fixed-effects models showed a higher (odds ratio [OR] 3·82, 1·82-8·00, p=0·0004) and dose-dependent (OR 1·62, 1·18-2·21, p=0·0028) risk of relapse when stressful life events preceded relapse compared with the period when they did not. Cross-lagged path analysis confirmed an effect of stressful life events on the number of subsequent relapses (β=0·66, p=0·0055) that was dose dependent (β=0·29, p=0·029), but it did not show an effect of relapses on subsequent risk or number of stressful life events. These results provide converging evidence of a causal effect of stressful life events on the risk of relapse in psychosis. They suggest that there is a need to develop interventions at the individual and health-service level that could mitigate the harmful effects of stressful life events. National Institute for Health Research, UK.

Should stressful life events be monitored after a first episode of psychosis?

In the 3 years following a first episode of psychosis, 50% of individuals will experience a relapse, which could be expressed as symptom exacerbation or readmission to a psychiatric inpatient unit. 1 Alvarez-Jimenez M Priede A Hetrick SE et al. Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res. 2012; 139: 116-128 Crossref PubMed Scopus (312) Google Scholar Hence, finding the relevant risk factors for new episodes is an urgent matter in psychiatric research and clinical practice. Whereas risk factors such as substance misuse and non-adherence to medication are well understood and can be targeted by interventions, less is known about other factors that might also be important, such as sleep deprivation, depressive or manic symptoms, or stressful life events. 1 Alvarez-Jimenez M Priede A Hetrick SE et al. Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res. 2012; 139: 116-128 Crossref PubMed Scopus (312) Google Scholar Among these factors, stressful life experiences are associated with an increased risk of developing psychosis in people who are already considered as having a high risk of psychosis. 2 Betz LT Penzel N Kambeitz-Ilankovic L et al. General psychopathology links burden of recent life events and psychotic symptoms in a network approach. NPJ Schizophr. 2020; 6: 40 Crossref PubMed Scopus (20) Google Scholar , 3 Mayo D Corey S Kelly LH et al. The role of trauma and stressful life events among individuals at clinical high risk for psychosis: a review. Front Psychiatry. 2017; 8: 55 Crossref PubMed Scopus (110) Google Scholar Therefore, it could be possible that stressful life experiences also affect the risk of relapses after the first episode of psychosis. Stressful life events and relapse of psychosis: analysis of causal association in a 2-year prospective observational cohort of individuals with first-episode psychosis in the UKThese results provide converging evidence of a causal effect of stressful life events on the risk of relapse in psychosis. They suggest that there is a need to develop interventions at the individual and health-service level that could mitigate the harmful effects of stressful life events. Full-Text PDF Open Access

Life stressors and immune aging: Protective effects of cognitive reappraisal

Stressful life events may accelerate aspects of immune aging, but habitual use of an adaptive emotion regulation strategy, cognitive reappraisal, may attenuate these effects. This study examined whether cognitive reappraisal moderates the associations between life stressor frequency and stressor desirability on aspects of immune aging, including late-differentiated CD8+ T and natural killer (NK) cells and inflammatory markers (IL-6, TNF-α, and CRP), both between and within people in a longitudinal sample of 149 older adults (mean age = 77.8, range: 64–92 years). Participants reported stressful life events, use of cognitive reappraisal, and provided blood semiannually for up to 5 years to assess aspects of immune aging. Multilevel models, adjusted for demographic and health covariates, tested the between-person (stable, trait-like differences) and within-person associations (dynamic fluctuations) among life stressors and reappraisal on immune aging. Experiencing more frequent life stressors than usual was associated with higher levels of late-differentiated NK cells within person, but this effect was accounted for by experiencing health-related stressors. Unexpectedly, experiencing more frequent and less desirable stressors were associated with lower average levels of TNF-α. As expected, reappraisal moderated the associations between life stressors and late-differentiated NK cells between people and IL-6 within people. Specifically, older adults who experienced less desirable stressors but also used more reappraisal had significantly lower proportions of late-differentiated NK cells on average and lower levels of IL-6 within-person. These results suggest cognitive reappraisal may play a protective role in attenuating the effects of stressful life events on aspects of innate immune aging in older adults.

Threat and challenge: Holocaust survivors, succeeding generations, and the coronavirus pandemic

AbstractObjectiveTo examine the “sense of threat” and “sense of challenge” among Holocaust survivors and second‐ and third‐generation cohorts during the first coronavirus lockdown in Israel.BackgroundAging, especially among people who experienced trauma during their early years, as did Holocaust survivors, can be challenging when unusual circumstances, such as the coronavirus pandemic, coincide with it. Studies are inconclusive regarding the effect of transgenerational transmission of trauma of survivors to their offspring.Methods129 participants filled out a questionnaire based on Lazarus and Folkman's cognitive theory of psychological stress and coping. Data were collected through online questionnaires or phone interviews.ResultsAll generations reported “feeling this is a difficult situation.” Compared with the second generation, survivors reported a significantly higher “sense of threat” and significantly lower “sense of challenge.”DiscussionThis study found that all generations felt some degree of vulnerability, although their response overall was resilient.ImplicationsAwareness of the harmful effects of stressful life events on the vulnerable Holocaust survivors and their descendants has prompted the need to establish support systems that can be activated to assist them. Future research should also investigate whether these reactions were prevalent among Holocaust survivors and their descendants in other countries.

The Effect of Stressful Life Events of Syrian Asylum Seekers on Attitudes Towards Seeking Psychological Help: The Mediation Effect of Multidimensional Perceived Social Support

Purpose: This study aims to understand whether there is a significant relationship between the effects of stressful life events that Syrian refugees are exposed to and their attitudes toward seeking psychological help. The study also aimed to examine the multidimensional perceived social support by Syrian asylum seekers between the impacts of stressful life events they were exposed to and their attitudes towards seeking psychological help in terms of mediating role. Method: The study population of the research consists of Syrian refugees who migrated to Turkey because of the Syrian war. A total of 467 Syrian asylum seekers (187 women, 280 men) aged between 18-65 years participated in the study. The Impact of Life Events Scale, the Attitude Towards Seeking Psychological Help Scale, and the Multidimensional Scale of Perceived Social Support were used as data collection tools. This study analyzed the mediating effect of the multidimensional perceived social support factor between stressful life events and the attitude factor towards seeking professional psychological help using structural equation modeling. Results: It has been observed that social support significantly affects Syrian refugees' attitudes towards seeking psychological help. In addition, it is thought that the negative relationship between stressful life events and social support affects attitudes towards seeking psychological help and reveals self-hiding behavior in this population. In addition, it is believed that a positive attitude toward seeking psychological help may be beneficial if it is accompanied by qualified social support.

Does emotion regulation mediate the effect of stressful life events on depressive symptoms in adolescents?

IntroductionAdolescents' exposure to stressful life events (SLEs) is highly prevalent and increases their risk of developing depression considerably. A small number of studies have addressed the extent to which resilience factors, such as the ability to emotionally regulate, mediate the relationship between SLEs and depression. This study examined whether emotion regulation mediates and significantly attenuates the direct path between SLEs and depressive symptoms in a nonclinical sample of adolescents. MethodA sample of 235 first- and second-year high-school students completed the Depression Anxiety Stress Scale, the Risk Factor Questionnaire, and the Difficulties in Emotion Regulation Scale. Mean age was 16.9 (SD = 1.8) years, and 65 % (n = 152) of the participants were female. To assess for mediation, a regression-based path analysis approach was used. ResultsSLEs were significantly (t = 5.13, p < 0.001) associated with depressive symptoms, explaining 59.1 % of the total variance. Controlling for the mediation variable (emotion regulation), we found a reduced but statistically significant direct effect (t = 2.87, p = 0.005) between SLEs and depressive symptoms. A statistically significant indirect effect explaining 64.6 % of the total effect demonstrated partial mediation from stressful life events to depressive symptoms via emotion regulation. LimitationsOur analyses are based on correlational and cross-sectional data and thus exclude statistical examination of temporal causal relationships, and assessments of whether reported affects are stable over time. ConclusionsOur results indicate that interventions that can modify the ability to regulate emotions may help reduce depressive symptoms in at-risk adolescents.

The Effects of Stressful Life Events on Alzheimer’s Disease Biomarkers, Neuroinflammation and Brain Integrity in Later Life: A Life Course Perspective

AbstractBackgroundStress is associated with adverse health outcomes, but the pathways through which stressful life events affect brain health, and the age periods most vulnerable to these effects, are unknown. We investigated these questions in relation to Alzheimer’s disease (AD) pathophysiology and brain integrity in cognitively unimpaired participants at risk for AD.MethodIn this cross‐sectional cohort study, 1168 participants completed the 18‐item Elder’s Life Stress Inventory measuring the occurrence (and age at occurrence) of stressful life events. Of these, 393 participants had data available on AD biomarkers (cerebrospinal fluid [CSF] phosphorylated‐tau and amyloid‐beta1−42/amyloid‐beta1−40 ratio measured with Elecsys® assays and NeuroToolKit panel of robust prototype assays [Roche Diagnostics International Ltd, Rotkreuz, Switzerland], respectively) and neuroinflammation markers (CSF interleukin 6 [IL‐6], soluble TREM‐2 and glial fibrillary acidic protein measured with NeuroToolKit). In total, 830 had structural magnetic resonance imaging data available for amygdala and hippocampal volume, and grey matter volume/thickness for areas of the prefrontal cortex. The association of stressful events with AD biomarkers, neuroinflammation and brain integrity (adjusting for total intracranial volume) was examined using multiple regression analyses adjusting for sex, age and education. Associations of stressful events during early life (ages 0−25), early adulthood (26−40), middle adulthood (41−55) and late adulthood (≥56) were also examined. Analyses were stratified by sex and Apolipoprotein ε4 (APOE ε4)‐status.ResultParticipants’ age ranged between 47−76 and 62.5% were women. A higher number of stressful events during life‐course was associated with an increase in IL‐6 levels among APOE ε4‐carriers; with a decreased amyloid‐beta ratio among APOE ε4‐noncarriers; and with a reduction in caudal anterior cingulate cortex volume among women. A higher number of events during early adulthood was associated with higher phosphorylated‐tau levels and prefrontal brain integrity, and during middle adulthood was associated with decreased prefrontal brain integrity (Table 1. &amp; 2.).ConclusionStress may affect later‐life brain health through multiple pathways, including neuroinflammation, amyloid‐beta and brain integrity, depending on APOE ε4‐carrier status and sex. Stressful events during early adulthood may promote phosphorylated‐tau in later‐life, while events during early/middle adulthood may have differential effects on brain integrity, suggesting potential windows for stress‐prevention strategies.

The relationship between abuse and neglect and adolescent suicidality: A moderated mediation model.

Abuse and neglect can lead to suicide in adolescents; however, the internal mechanisms between abuse and neglect and suicidality remain unclear. We hypothesized that abuse and neglect could affect adolescent suicidality, and that mediating and moderating mechanisms exist between these two variables. We tested the mediating effects of stressful life events (misunderstanding and discrimination by others, poor academic performance, failed exams, interpersonal problems, and school punishment) on suicidal tendencies and moderating effects of resilience among 5,852 adolescents from 37 middle schools in five provinces of North, south, East, west, and central China. We used a questionnaire to collect data and adopted structural equation modeling to verify the correlation, mediating, and moderating effects among the variables. The results showed that stressful life events mediated the relationship between abuse, neglect, and suicide. Furthermore, resilience moderated the direct effect and second half of the mediating effect.

Effect of stressful life events on subclinical psychotic symptoms in first-degree relatives and healthy controls

Exposure to Stressful Life Events (SLEs) has been linked to psychosis. However, the combined effect of SLEs and familial risk on subclinical psychotic symptoms over time remains unknown. The objective of the present study was to investigate the effect of SLEs on the level of subclinical psychotic symptoms in individuals with and without familial vulnerability for psychosis. Data were collected from siblings of individuals diagnosed with psychotic disorder and healthy controls at baseline (N = 293) and three years later at follow-up (N = 928). We assessed self-reported and observer-rated subclinical positive, negative, and depressive psychotic symptoms. Participants reported the number of SLEs in the preceding 6 months. A multilevel multivariate regression analysis revealed a positive association between the retrospectively assessed number of SLEs and symptom levels, regardless of vulnerability status (p < .001 for all outcomes). The prospective analysis demonstrated that exposure to SLEs at baseline predicted higher levels of subclinical psychotic symptoms at follow-up. However, after controlling for the level of symptoms at baseline, these associations were no longer significant. Again, the vulnerability status did not modify these results. Nevertheless, siblings in our sample were approximating the end of the critical period for the development of psychotic disorder (mean age at baseline M = 29 and follow-up M = 34). The findings partly support the vulnerability-stress model of psychosis, yet do not confirm the role of familial risk in this association. SLEs may represent a risk factor for psychosis at a population level, thus supporting the continuity of the psychosis spectrum in terms of associated risk factors.

Gratitude buffers the effects of stressful life events and deviant peer affiliation on adolescents' non-suicidal self-injury.

Although stressful life events have been shown to be a key risk factor for adolescent NSSI, the potential mediators and moderators of this relationship are unclear. Based on the social development theory and the organism-environment interaction model, we tested whether the link between stressful life events and adolescent NSSI was explained in part by deviant peer affiliation, and whether this process was buffered by gratitude. Chinese adolescents (N = 854; Mage = 16.35; 68.50% female) anonymously completed questionnaires to assess the study variables. The present study demonstrated that stressful life events was linked to NSSI in part because of deviant peer affiliation, and high gratitude was a key protective factor to buffer this indirect effect. Teaching gratitude may be a helpful component of prevention and intervention programs to reduce adolescent NSSI.