Residential greenness, as an essential aspect of the environment, contributes significantly to alleviating the negative impacts of accelerated urbanization and promoting sustainable urban development. However, the associations between residential greenness exposure and the risks of preterm birth (PTB) and small for gestational age (SGA), as well as the potential biological mechanisms underlying these associations, remain underexplored. In this study, we assessed the associations of residential greenness exposure across different periods of pregnancy (first, second, and third trimesters, as well as the entire pregnancy) with the risks of PTB and SGA, examined the interaction effects between greenness and PM2.5, and quantified the mediating role of the systemic immune-inflammation index (SII) in the associations between greenness and PTB or SGA using mediation analyses. We found that each 0.1-unit increment within 500-meter buffer (NDVI-500m) throughout pregnancy was associated with a 5.0-6.0 % lower risk of PTB and a 4.0-10.0 % lower risk of SGA. The third trimester emerged as the period during which greenness exposure had the most pronounced impact on these adverse outcomes. Non-linear exposure-response relationships were observed between residential greenness and the risks of PTB and SGA. Significant interactions were observed between NDVI-500m and PM2.5, whereby greater greenness combined with lower PM2.5 concentrations was jointly associated with the lowest risks of PTB and SGA. The SII mediated 8.6-16.1 % and 4.2-12.1 % of the effects of NDVI-500m on PTB and SGA, respectively. These findings support that exposure to residential greenness lowers the risks of PTB and SGA, and mitigates the adverse impacts of PM2.5 on these outcomes, and may partially exert its effects through SII.

The progression from suicidal ideation to attempt is a multi-stage process, yet it is unknown how different victimization contexts contribute uniquely to each stage. We compared the associations of school-based peer bullying and family-based childhood maltreatment with suicidal ideation, suicide planning, and suicide attempts in adolescents to identify the primary intervention target for halting suicidality at each step. A multicenter, school-based survey of 18,910 Chinese students aged 12–22 years was conducted. Participants were categorized into four groups: none, peer bullying only, childhood maltreatment only, and both. Logistic regression and population attributable fraction analyses were applied. Overall, 10.9

Background and aims:Problematic smartphone use are prevalent worldwide, particularly among adolescents, and it is strongly linked with aggressive behavior. However, the understanding of how PSU may contribute to the emergence of aggressive behavior remains incomplete. Methods:The purpose of this study was to examine the bidirectional links between aggressive behavior and PSU among adolescents, utilizing data from a two-wave longitudinal study (the time interval is 15 months) conducted among 2,650 students in middle and high school. Results:The cross-lagged models revealed that: (1) PSU at Time 1 (December 12) positively predicted aggressive behavior at Time 2 (March 2023, 15 months apart) among older adolescents (15-19 years), but this was not the case for younger adolescents (11-14 years); (2) aggressive behavior at Time 1 positively predicted PSU at Time 2 for both younger and older adolescents. Our findings have identified PSU as a risk factor for aggressive behavior among older adolescents, with those perceiving higher PSU may be particularly vulnerable to developing aggressive behavior over time. Discussion and Conclusions:These results not only enhance our understanding of the links between PSU and aggressive behavior but also provide significant theoretical perspectives for developing future prevention strategies and intervention measures to tackle aggressive behavior among adolescents.

The present study aimed to explore the mediating role of poor academic achievement and the moderating role of cumulative lifestyle risk factors (CLRF) in the relationship between mobile phone addiction and depression. In the cross-sectional study, a sample of 21,481 adolescents (mean age = 15.42 years, SD = 1.79) were recruited through a multi-stage cluster sampling method. Information was collected on demographic characteristics, Problematic Mobile Phone Use (PMPU), academic achievement, CLRF, and depressive symptoms. Mediation and moderation analyses were performed with the PROCESS macro v3.4 for SPSS. The results found that PMPU was significantly and positively associated with depressive symptoms, and the association was found to be mediated by poor academic achievement. In addition, CLRF moderated the pathways from PMPU to depressive symptoms. The present study enhances our understanding of how and under what conditions PMPU affects depressive symptoms. Practitioners should pay more attention to students with poor academic achievement and provide them with help and encouragement to reduce their depressive symptoms. Moreover, a variety of healthy lifestyle practices can be incorporated as a supplement in intervention programs to reduce depressive symptoms in adolescents.

AIMS:Fine particulate matter (PM2.5) exposure and unfavourable lifestyle are both significant risk factors for mental health disorders, yet their combined effects on adolescent depression and anxiety remain poorly understood. This study aims to determine whether PM2.5 exposure and lifestyle are independently associated with adolescent depression and anxiety, and whether there are joint effects between these factors on mental health outcomes. METHODS:In this cross-sectional study, 19852 participants were analysed. PM2.5 concentrations were obtained from the ChinaHighAirPollutants (CHAP) dataset. Lifestyle factors were assessed through self-reported questionnaires, and a healthy lifestyle score was developed based on eight lifestyle risk factors. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales. Restricted cubic spline analysed dose-response relationships between PM2.5 exposure and mental health outcomes. The independent and joint effects were assessed using logistic regression models. Both multiplicative and additive interactions (relative excess risk due to interaction, RERI) were examined. Multiple classification approaches were incorporated to ensure robust results. RESULTS:The study included 19852 participants with a mean age of 15.16 years (SD 1.60), comprising 9886 (49.8%) males and 9966 (50.2%) females. Depression and anxiety were identified in 3845 (19.37%) and 3230 (16.27%) participants, respectively. PM2.5 exposure showed a linear dose-response relationship with depression and anxiety. Joint effects analysis at the 75th percentile of PM2.5 with a lifestyle risk score of 4 revealed the strongest associations, with adjusted odds ratios of 4.49 (95% CI: 3.79-5.33) for depression, 4.01 (95% CI: 3.36-4.78) for anxiety and 4.24 (95% CI: 3.52-5.10) for their comorbidity. Simultaneously, significant additive interactions (RERI > 0) between high levels of PM2.5 exposure and unfavourable lifestyle factors were detected, suggesting synergistic effects on mental health outcomes. Subgroup and sensitivity analyses confirmed the robustness of these findings. CONCLUSIONS:High PM2.5 exposure and unfavourable lifestyle factors demonstrated significant independent and joint effects on depression and anxiety among adolescents. These findings highlight that implementing stringent air pollution control measures, combined with promoting healthy lifestyle practices, may be crucial for protecting adolescent mental health.

Previous studies have found that parental migration is a risk factor for aggressive behavior in adolescents. However, the findings for five aggression subtypes are inconsistent. Besides, sex differences and the association between specific characteristics of parental migration (e.g., type, duration, age, contact frequency) and adolescent aggression have rarely been investigated. Given the importance of these questions in the prevention and intervention of adolescent aggression, we conducted this study to further explore these issues. Data were collected from 20,484 students (10,175 males, aged 12-18 years) in five provinces in China. Validated measures were used to investigate parental migration information and aggression. Multiple logistic regression analysis was used to determine the relationships between parental migration and aggression by sex, and the association between parental migration characteristics and aggression. Results showed that among the five subtypes of aggression, parental migration was only associated with hostility and indirect aggression, and were observed only among male adolescents. Furthermore, paternal migration, the duration of parental migration over 6 years, age below 2 years at the time of parental first migration, and contact less than weekly were associated with increased risk of certain types of aggressive behavior. Sex and parental migration characteristics should be taken into account in subsequent prevention and interventions for adolescent aggression. In particular, those adolescent males who have been separated from their immigrant father for more than 6 years before 2 years and who have contact with their parents less than once a week should be given the highest priority in aggression interventions.

OBJECTIVES:The associations between childhood maltreatment (CM) and mobile phone addiction (MPA), as well as non-suicidal self-injury (NSSI) have been extensively explored. However, the dose-response relationship between CM and NSSI remains inconsistent. Furthermore, there is limited understanding of the potential mediation effect of MPA on the relationship between CM and NSSI. This study aimed to explore the dose-response relationship between CM and NSSI and investigate the potential mediating role of MPA in this relationship. STUDY DESIGN:Cross-sectional study. Cross-sectional study. METHODS:In the cross-sectional study, a total of 21481 adolescents were selected using a multi-stage cluster sampling method in China. CM, MPA, and NSSI were obtained via self-reports. Data were analyzed using logistic regression models, restricted cubic spline (RCS) functions, and mediation models. RESULTS:A total of 38.1 % of adolescents reported engaging in NSSI at least once. Compared with participants without CM, participants with more types of CM (cumulative childhood maltreatment, CCM) had a higher risk of NSSI (P-trend in all models <0.001). RCS further confirmed the dose-response relationships between the continuous change in CM (scores) and the risk of NSSI (P for non-linearity <0.001). Mediation analysis indicated that the relationship between CM (scores) and NSSI was mediated by MPA, and the indirect effect (β = 1.07 × 10-3, 95 % CI: 9.62 × 10-4, 1.19 × 10-3) accounted for 22.23 % of the total effect. CONCLUSIONS:There was a dose-response relationship between CM and the NSSI, and the relationship was mediated by MPA. Interventions targeting MPA may reduce the risk of NSSI among adolescents who have experienced CM, particularly those with CCM.

BACKGROUND:Mental health is an important aspect of adolescents' development and well-being. Mental health problems, such as depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt, are recognized to be interconnected and to occur often. Research has found that aggression is connected to a variety of mental health problems. However, there's limited knowledge about the patterns of how depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt co-occur, and only few studies describe their association with aggression and sex differences. METHODS:A cross-sectional study that involved 18,555 Chinese adolescents was performed to explore the mental health latent classes and the relationship with aggression. RESULTS:The results showed four latent classes of mental health problems: low-symptom class (70.8%), self-harm class (9.1%), emotional symptom class (13.4%), and high-symptom class (6.7%). A significant co-occurrence between depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt was found in the high-symptom class. Notably, higher levels of adolescent aggression were associated with comorbid moderate to high mental health problems. Similar four latent classes and associations were found across sexes. CONCLUSIONS:The present study emphasized the heterogeneity of mental health problems and revealed their co-occurrence patterns. Aggression levels are associated with the latent classes in adolescents, with the most pronounced association observed in the high-symptom class. Preventing aggression could contribute to reducing the severity and co-occurring patterns of mental health problems among adolescents.

BACKGROUND:Limited research has examined the relationship between heatwaves and adolescent mental health, particularly depression and anxiety. This study aimed to explore the relationship between heatwaves and depression and anxiety. METHODS:We conducted a cross-sectional study including 19,852 adolescents (mean age 15.16 years; 50.2 % females). Air temperature data were from the fifth generation European ReAnalysis-Land (ERA5-Land) dataset. Heat exposure was assessed using three heatwave metrics: The excess heat factor-based (HWM1), maximum temperature-based (HWM2), and minimum temperature-based (HWM3) heatwave magnitude indices. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales. Subgroup analyses evaluated interactions with sex, grade and region of school. RESULTS:Depression and anxiety prevalence were 19.37 % and 16.27 %, respectively. Heatwaves were associated with depression (OR [95 % CI]: 1.13 [1.09-1.17]) and anxiety (OR [95 % CI]: 1.12 [1.08-1.16]) based on HWM1. Significant associations existed for depression alone (OR [95 % CI]: 1.14 [1.09-1.20]), anxiety alone (OR [95 % CI]: 1.13 [1.06-1.21]), and comorbid depression and anxiety (OR [95 % CI]: 1.13 [1.09-1.18]). Associations using HWM2 and HWM3 showed consistent directions but varied significance. We observed significant interactions between heatwaves and sex for anxiety alone, and between heatwaves and region of school for both depression alone and comorbid depression-anxiety (all P for interaction <0.05). LIMITATIONS:The cross-sectional design constrained our capacity to draw causal inferences. CONCLUSIONS:Heatwaves were associated with a significant of prevalence depression, anxiety, and their comorbidity, with males and rural students potentially more susceptible to these effects.

Most victims of childhood maltreatment have experienced more than one form. Yet, few studies have investigated co-occurrence of multiple childhood maltreatment subtypes (including physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect) using person-centered approaches in Chinese adolescents. Moreover, little is known about associations between different childhood maltreatment subtypes and smartphone addiction. This study aims to examine the specific effects of different childhood maltreatment patterns on smartphone addiction and the potential gender and residence differences. A multistage cluster sampling was adopted for Chinese adolescents aged 12 to 18 years across five representative provinces. The Childhood Trauma Questionnaire-Short Form was used to measure childhood maltreatment subtypes and Mobile phone Addiction Index was used to assess smartphone addiction. Childhood maltreatment patterns were analyzed via latent profile analysis (LPA) in Mplus. Of 23,478 Chinese adolescents, LPA yielded four distinct childhood maltreatment profiles: Low Maltreatment (Profile 1, 86.7%), High Emotional Maltreatment and Low Sexual Abuse (Profile 2, 9.2%), Moderate Multiple Maltreatment (Profile 3, 3.5%), and High Sexual Abuse with Multiple Maltreatment (Profile 4, 0.6%). Logistic regression analysis showed that members of Profile 2, 3, and 4 had higher odds ratio of smartphone addiction than members of Profile 1 (p < .01). Subgroup analysis indicated that members of Profile 4 had a higher odds ratio of smartphone addiction only for boys and rural adolescents (p < .01).. Childhood maltreatment subtypes rarely occur in isolation, and exposure to multiple childhood maltreatment subtypes will increase the risk of smartphone addiction. Particularly, boys and rural adolescents may deserve more attention in preventive strategy.

The prevalence of gestational diabetes mellitus (GDM) has risen significantly in recent years, yet the association between parity and GDM remains poorly understood. This study aimed to evaluate the impact of parity on GDM while exploring other contributing factors. We performed a population-based retrospective cohort study using data from women who delivered in Baoan District, Shenzhen, from January 2019 to December 2023. GDM was diagnosed through oral glucose tolerance testing (OGTT). Multivariable logistic regression models were applied to examine parity-GDM associations. A total of 198,237 women (including 89,792 primiparae and 108,445 multiparae) were included. Higher parity was found to be inversely associated with the development of GDM (OR [95

BACKGROUND:Childhood maltreatment (CM) is a recognized risk factor for suicide. Lesbian, gay, bisexual, and questioning (LGBQ) individuals tend to report CM and suicide more frequently compared to heterosexual individuals. However, limited research explored the association between CM and suicidal behaviors among LGBQ adolescents. OBJECTIVE:To explore the association between CM and suicidal behaviors among heterosexual and LGBQ adolescents in China. PARTICIPANTS AND SETTING:A cross-sectional survey was conducted among 9927 adolescents aged 15-19 years from five provinces in China, using a multi-stage cluster sampling method. METHODS:Demographic data, CM, and suicidal behaviors were collected through a self-reported questionnaire. The associations were examined via a set of logistic regression analyses. RESULTS:Among the participants, 27.0 % experienced CM, and 21.6 % reported suicidal behaviors in the past year. Among heterosexual adolescents, all five subtypes of CM were associated with suicidal behaviors, and the risk level increased with cumulative types of CM (CCM). In LGBQ individuals, emotional abuse (OR = 2.48, 95 % CI: 1.12-5.51) and emotional neglect (OR = 2.36, 95 % CI: 1.27-4.38) were associated with higher odds of suicidal behaviors. A potential "sensitive window effect" was observed in LGBQ individuals, with the suicide risk level peaking at exposure to two CCM (OR = 4.16, 95 % CI: 2.13-8.16), followed by a plateau with further exposure. PAF analysis indicated a higher CM-related suicide risk in LGBQ individuals, with emotional neglect accounting for 18.2 % of suicide attempts, compared to 12.6 % in heterosexuals. CONCLUSIONS:In this cross-sectional study, CM was significantly associated with suicidal behaviors, with the strength of the associations differing by sexual orientation. The cumulative impact of maltreatment also exhibited different patterns between sexual orientation groups. These findings suggest that incorporating sexual orientation into suicide risk assessment may enhance support for adolescents with histories of maltreatment.

Particulate matter (PM) exposure affects the neurobehavioral function. However, the link between particulate matter (PM) and aggression remains incompletely elucidated. This study aimed to explore the associations between exposure to varying-sized PM and the risk of aggression in adolescents. In the cross-sectional study, a total of 19852 participants, aged 10 to 18 years, were recruited using a multi-stage cluster sampling method from April to December 2021. Ambient PM1, PM2.5, and PM10 concentrations were sourced from the ChinaHighAirPollutants (CHAP) dataset. The Chinese version of the Buss-Warren Aggression Questionnaire (BWAQ) was used to measure aggression. Among the adolescents surveyed, 4995 (25.16

Background and aims: Mobile phone addiction (MPA) is emerging among adolescents, especially during the COVID-19 pandemic. Nevertheless, there is a dearth of knowledge regarding the correlation between MPA and suicide behaviors and its mechanism. The objective of the current study is exploring the direct effect of MPA on suicide behaviors and the indirect effect through poor sleep quality. Methods: A total of 18,900 Chinese adolescents aged 12 to 18 were recruited via a multi-stage cluster sampling method. Results: The prevalence of MPA and poor sleep quality was 26.2 and 23.1%, respectively. During the past year, 24.4% participants were involved in suicide behaviors. Specifically, suicide ideators, suicide planners, and suicide attempters were 10.7, 8.4, and 5.3%, respectively. Particularly, rural females had the highest prevalence of suicide behaviors, MPA, and poor sleep quality. Logistic regression analysis showed that MPA was significantly associated with suicide ideators (OR = 1.22, 95% CI: 1.09-1.37, p < 0.001) and planners (OR = 1.18, 95% CI: 1.04-1.34, p < 0.05), but not for suicide attempters (p > 0.05). Structural equation modelling demonstrated that MPA had direct effect on suicide behaviors (beta = 0.145, 95% CI = 0.127-0.160), and poor sleep quality partially mediated the relationship (the mediating ratio was 46.7%). The mediating ratio of poor sleep quality was the highest in urban males. Conclusions: MPA has both direct and indirect effects on suicide behaviors. For suicide prevention, limited mobile phone use and improvement sleep quality may be practical for adolescents. Additionally, more efforts of intervention could give priority to rural girls.

Background: Numerous studies have examined the relationship between childhood maltreatment (CM) and nonsuicidal self-injury (NSSI). However, few studies have explored both the specific and cumulative effects of CM on NSSI. Additionally, the impact of sleep disturbance on the association between CM and NSSI remains unclear. Objectives: To comprehensively explore the effects of CM on NSSI, and to determine whether these effects are moderated by sleep disturbance. Participants and setting: A retrospective study was conducted in April 2021 among a representative sample of 21,340 students aged 11-20 years in China. Methods: All participants completed questionnaires assessing CM, sleep disturbance, and NSSI. Adjusted multivariate logistic regression models were utilized to evaluate the associations between CM and NSSI, as well as the impact of sleep disturbance. Results: The findings revealed that 13.0 % of adolescents reported occasional NSSI, while 25.2 % reported repetitive NSSI. Except for sexual abuse, all subtypes of CM were significantly associated with increased odds of both occasional and repetitive NSSI. A significant dose-response relationship was observed between cumulative CM and repetitive NSSI. Stratification analyses by sleep disturbance indicated that adolescents reporting sleep disturbance had a higher risk of developing repetitive NSSI, irrespective of the type of CM experienced. Furthermore, a doseresponse relationship was identified between cumulative CM and repetitive NSSI among adolescents reporting sleep disturbance. Conclusion: This study demonstrated that CM increases the risk of NSSI among Chinese adolescents, and sleep disturbance plays a moderating role. Interventions targeting sleep disturbance may hold significance in reducing NSSI.

Background: Although aggression associated self-injury and suicidal ideation, but the specific impact of different subtypes of aggression is unclear. Therefore, the current study aims to quantify the associations between five subtypes of aggression, self-injury, and suicidal ideation in Chinese adolescents. Method: A total of 18,532 students were recruited in grades 7 to 12 using a stratified cluster sampling across five representative provinces in China. The Functional Assessment of Self-Mutilation (CH-FASM) and Buss and Warren's Aggression Questionnaire (BWAQ) assess self-injury and aggression, respectively. Results: During the last year, the proportion of self-injury, suicidal ideation, and self-injury plus suicidal ideation (SSI) were 13.4 %, 10.0 %, 12.4 %, respectively. Multivariate logistic regression indicated that hostility was associated with self-injury-only (OR = 1.033, 95 % CI = 1.021 -1.044), suicidal ideation-only (OR = 1.075, 95 % CI = 1.061 -1.088), and SSI (OR = 1.100, 95 % CI = 1.087 -1.114) (all P < 0.001) across five subtypes of aggression. In gender stratification, physical aggression was risk factor for self-injury-only, suicidal ideationonly, and SSI (OR = 1.028, 95 % CI = 1.018 -1.037, P < 0.001) in females. While anger was association with self-injury-only and suicidal ideation-only in males ( P < 0.05). Limitations: This study was a cross-sectional design and self-reported questionnaire. Conclusion: Hostility is a strong predictor of self-injury and suicidal ideation across five subtypes of aggression. There are gender differences in relationships. Prevention programs for adolescents' self-injury and suicidal ideation should consider different subtypes of aggression and gender differences.

It is unclear whether DNA methylation underlies the association between childhood maltreatment (CM) and non-suicidal self-injury (NSSI) in early adolescents. We aim to explore the mediation of specific DNA methylation sites in the associations of CM and its subtypes with NSSI, following investigation on the association between specific DNA methylation sites and NSSI. A case–control study was conducted to examine 155 adolescents aged 12–14 years who were identified to have engaged in NSSI and 201 controls. CM and its subtypes were evaluated by using the Childhood Trauma Questionnaire. The EPIC 850 k Bead Chip was used to discover differential methylation sites (DMSs) in the peripheral blood between 10 NSSI cases and 10 controls. Targeted pyrosequencing was employed to detect the levels of specific DMSs among the total study population, which were selected based on bioinformatics analyses and literature review. We discovered 456 DMSs between NSSI cases and controls, 219 were hypermethylated and 237 were hypomethylated. After controlling for potential confounders, CM or its subtypes, and the methylation of cg04622888 and cg05037505 were all significantly associated with NSSI (all P < 0.05). The total association of CM and its subtypes with NSSI were all significantly (all P < 0.05), with the standardized coefficient (β) ranged from 0.12 for physical neglect to 0.24 for emotional neglect and CM. Significant indirect association of physical neglect with NSSI through methylation of cg04622888 was observed and the mediating proportion was 0.14 (95

Importance In China, parental labor migration often leaves children behind and is potentially adversely associated with children’s health. However, the association between parental migration and aggression among their offspring remains largely underexplored. Objective To investigate the associations of parental labor migration with total and subtypes of aggression among their offspring as well as potential sex differences therein. Design, Setting, and Participants This cross-sectional study was conducted from February to October 2015 among students aged 11 to 20 years from 45 public middle and high schools across 5 provinces of China. Data analysis was performed from December 1, 2022, to August 1, 2023. Exposures Parental migration, including migration status (yes or no), pattern (father, mother, or both), and the child’s age at the initial parent-child separation. Main Outcomes and Measures Total and subtypes of aggression (including physical aggression [PA], verbal aggression [VA], indirect aggression [IA], anger, and hostility) were measured using the Chinese version of the Buss-Warren Aggression Questionnaire. Binomial logistic regression analyses were used separately to estimate adjusted odds ratios (aORs) and 95% CIs of parental migration by total and subtypes of aggression. Results A total of 15 301 participants (7900 [51.6%] male and 7401 [48.4%] female) aged 11 to 20 years (mean [SD] age, 15.1 [1.8] years) were included. Of these participants, 5961 (39.0%) experienced parental migration; 2451 (16.0%) met the criteria for total aggression, 2407 (15.7%) for PA, 2283 (14.9%) for VA, 2899 (18.9%) for IA, 2307 (15.1%) for anger, and 2564 (16.8%) for hostility. Parental migration was associated with total aggression (aOR, 1.11; 95% CI, 1.01-1.22); no significant association between parental migration and subtypes of aggression was found except for PA (aOR, 1.14; 95% CI, 1.03-1.25). Compared with children whose parents did not migrate, the aORs for total aggression and PA for participants whose father migrated were 1.12 (95% CI, 1.01-1.28) and 1.15 (95% CI, 1.03-1.29), respectively; for participants with both parents having migrated, the aORs were 1.16 (95% CI, 1.02-1.31) and 1.12 (95% CI, 1.04-1.24), respectively. Compared with children whose parents did not migrate, children who experienced initial separation from 1 or both parents at adolescence had an aOR for total aggression of 1.20 (95% CI, 1.04-1.36), children who experienced initial separation from 1 or both parents at school age or adolescence had an aOR for PA of 1.15 (95% CI, 1.01-1.32) and 1.26 (95% CI, 1.04-1.51), respectively. No sex differences were found in these associations. Conclusions and Relevance In this cross-sectional study of Chinese children and adolescents, we found that parental migration, mainly of the father or both parents or an initial separation at adolescence or school age from 1 or both parents, was associated with higher odds of total aggression and PA among offspring. These associations were similar between male and female participants.

目的 了解中学生自杀未遂现状,并探讨其与父母依恋的关系,为中学生自杀行为的预防和控制提供依据.方法 采用分层整群随机抽样法,抽取湖北省鄂州市和孝感市4 419名七至十二年级在校学生作为调查对象,使用父母和同评依恋量表(IPPA)、罗森博格自尊量表(RSES)、凯斯勒心理疾患量表(K10)进行问卷调查,并评定中学生自杀未遂情况.结果 中学生自杀未遂检出率为6.8％.自杀未遂检出率在不同年级、家庭类型、父母感情、家庭管教方式、家庭月收入、自尊水平和心理困扰间差异均有统计学意义(x2/t值分别为3.88,10.12,18.00,52.54,13.90,2.37,8.99,P值均＜0.05),有自杀未遂组的父亲依恋和母亲依恋得分(14.64±13.45,14.77±12.26)均低于无自杀未遂组(22.05±16.08,23.79±14.93)(t值分别为-9.07,-12.11,P值均＜0.05).Logistic回归分析表明,父亲依恋和母亲依恋均与中学生自杀未遂负向关联(父亲依恋,OR=0.99,95％CI=0.98～0.99;母亲依恋,OR=0.97,95％CI=0.96～0.98,P值均＜0.05);分层分析发现,父亲依恋与女生自杀未遂负向关联(OR=0.98,95％CI=0.97～0.99,P＜0.05),而对男生影响无统计学意义.结论 父母依恋可能是中学生自杀未遂的保护因素,父亲依恋对自杀未遂的影响存在性别差异.父母应当注重培养与子女之间的良好依恋关系,促进中学生健康成长.

BackgroundThe Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely utilized instrument of childhood maltreatment (CM). However, psychometric properties and normative data of the CTQ-SF for Chinese adolescents are still unknown.ObjectiveTo examine psychometric properties and normative data of Chinese version CTQ-SF in a nationally representative sample of Chinese adolescents, including internal consistency reliability, test–retest reliability, structural validity, and convergent validity.MethodA total of 20,951 adolescents aged 12 to 18 years were recruited from five provinces across China. Item analysis was used for 25 clinical items of the CTQ-SF. Confirmatory factor analysis was performed to examine fit indices of the factor structure. The Adverse Childhood Experiences Scale (ACEs) was used to evaluate convergent validity. The percentile ranks for scores of the CTQ-SF and each subscales were presented.ResultsAccording to the results of three methods in Item analysis, Item 4 should be dropped. The remaining 24 clinical items achieved satisfactory fits in an alternative four-factor model. The alternative CTQ-SF showed acceptable internal consistency and the Cronbach’s α of the four subscales was 0.824 (Neglect), 0.755 (Sexual Abuse), 0.713 (Physical Abuse), and 0.666 (Emotional Abuse), respectively. Besides, test–retest reliability and convergent validity of the alternative CTQ-SF were also acceptable.ConclusionThe alternative four-factor model CTQ-SF exhibits good reliability and validity among Chinese adolescents. Additionally, the normative information of the CTQ-SF could provide practical support for determining severity of different subtypes of CM.