OBJECTIVES: To study the influence of family structure on depression and anxiety symptoms in adolescents and its mechanism. METHODS: The cluster sampling method was used to select the students from seven middle schools in Shanghai, China. An online questionnaire survey was conducted using a self-made general status questionnaire, Childhood Trauma Questionnaire, Children's Depression Inventory, and Screen for Child Anxiety Related Emotional Disorders. The methods including one-way analysis of variance, chi-square test, binary logistic regression analysis, and mediating effect analysis were used to evaluate depression and anxiety symptoms in adolescents and the difference in childhood trauma and its mediating effect. RESULTS: Compared with the adolescents from nuclear families, the adolescents from three-generation lineal families had a lower risk of depression symptoms (OR=0.794, 95%CI: 0.649-0.972, P<0.05), while those from host families had a higher risk of depression symptoms (OR=4.548, 95%CI: 1.113-18.580, P<0.05). The adolescents from inter-generational families and host families had a significantly higher score on the Childhood Trauma Questionnaire subscale of emotional neglect (P<0.05). Emotional neglect played a mediating role in the influence of inter-generational families and host families on depression symptoms in adolescents. CONCLUSIONS Parents and grandparents have a certain positive effect in family structures. Separation from parents may make adolescents perceive more emotional neglect, which may increase the occurrence of depression symptoms.
Child ; Humans ; Adolescent ; Depression/epidemiology* ; Family Structure ; Child Abuse/psychology* ; China ; Anxiety/epidemiology* ; Surveys and Questionnaires

Objective: To analyze the association between exposure patterns of adverse childhood experiences (ACEs) and anxiety symptom trajectories in medical college students. Methods: A survey was conducted on first-year students from Anhui Medical College and Anqing Medical College, using the Childhood Abuse Questionnaire, Family Disability Questionnaire, Childhood Adverse Social Experience Item, and Anxiety Self Rating Scale. The baseline survey was conducted from November to December 2019, and two follow-up visits were conducted once every six months until November to December 2020. The latent class analysis (LCA) was used to analyze the exposure patterns of ACEs. The latent class growth analysis (LCGA) was used to analyze the development trajectory of anxiety symptoms. The multiple logistic regression model was used to analyze the correlation between different exposure patterns of ACEs and the trajectory of anxiety symptom trajectories. Results: A total of 3 662 college students aged (19.2±1.0) were surveyed. The LCA showed that the exposure patterns of ACEs could be divided into the "high ACEs" group (13.4%), "high neglect/emotional abuse" group (25.7%), "high family dysfunction" group (6.9%), "high neglect" group (27.1%), and "low ACEs" group (26.3%). The LCGA divided anxiety trajectories into four groups: "high anxiety decline" (7.1%),"anxiety increase "(4.1%), "moderate anxiety"(52.9%), and "low anxiety"(35.9%). Using the low ACEs group as a reference group, compared with the low anxiety trajectory, the high ACEs group, high neglect/emotional abuse group, high family dysfunction group, high neglect group, and medium to high-level anxiety trajectory were all associated with an increased risk (P<0.05). Conclusion: There is heterogeneity in ACEs exposure patterns among medical college students, and ACEs exposure patterns are important influencing factors for anxiety symptom trajectories.
Humans ; Adverse Childhood Experiences ; Anxiety/epidemiology* ; Child Abuse/psychology* ; Students/psychology* ; Surveys and Questionnaires ; Adolescent ; Young Adult

Objective: To investigate the associations between adverse childhood experiences (ACE) and substance use behaviors among lesbians to provide a scientific basis for high-risk population identification and formulation of targeted intervention measures. Methods: Lesbians who participated in routine AIDS voluntary counseling, testing services, activities, and peer recommendations were recruited from July to December 2018, with the help of LesPark in Beijing. Convenient sampling method was used. Demographic characteristics, ACE, and substance use behaviors of subjects were investigated using an online platform powered by www.wjx.cn. Subsequently, the associations between ACE and adulthood substance use behaviors were evaluated using the logistic regression model. The SPSS 22.0 was used for statistical analysis. Results: A total of 294 lesbians were recruited in the study, 81.3% (239/294) of them were lesbians, and 18.7% (55/294) were bisexuals. Besides, 55.8% (164/294) of subjects reported they had had ACE, with proportions of lesbians experiencing abuse, neglect, and family dysfunction as 33.3% (98/294), 24.5% (72/294), and 32.7% (96/294), respectively. 55.1% (162/294) of the lesbians reported they had smoked in the past 30 days, 11.2% (33/294) reported having drug-use behavior in the past three months, and 22.8% (67/294) claimed drinking alcohol weekly. Multivariate logistic regression analysis showed that lesbians with ACE were at high risks to smoke (OR=1.87, 95%CI: 1.13-3.08), drink (OR=2.13, 95%CI: 1.18-3.84), and use drugs (OR=3.33, 95%CI: 1.29-8.61) in adulthood. Moreover, lesbians with childhood family dysfunction were at higher risk of smoking cigarettes (OR=2.60, 95%CI: 1.46-4.62) and drinking alcohol (OR=2.65, 95%CI: 1.44-4.87). At the same time, those with abuse experience were at higher risk of drug use (OR=3.17, 95%CI: 1.26-7.96). Conclusions: Substance use behaviors, including cigarette smoking, drinking alcohol, and drugs use, were common among lesbians. Positive associations were found between ACE and adulthood substance use behaviors.
Adult ; Adverse Childhood Experiences ; Child ; Child Abuse/psychology* ; Female ; Humans ; Risk Factors ; Sexual and Gender Minorities ; Substance-Related Disorders/psychology*

BACKGROUND/AIMS: The role of psychosocial factors on irritable bowel syndrome (IBS) in adolescents is incompletely understood. The aim of this study is to investigate the association between the psychosocial factors and the risk of developing IBS in college freshmen. METHODS: A cross-sectional survey was conducted in a randomly selected freshmen population in Wuhan China (n = 2449). Questionnaire evaluated demographics and psychosocial risks. The population was divided into 3 groups: non-discomfort, chronic abdominal discomfort and IBS. The association between the development of IBS and psychosocial factors was analyzed by ordinal and multiple logistic regression analysis. RESULTS: A total of 2053 (83.8%) completed this survey (mean age, 18.2 ± 0.9 years; female, 35.6%). Among them, 82 (4.0%) fulfilled the Rome III criteria for IBS. Female (odds ratio [OR], 3.31; 95% confidence interval [CI], 2.47–4.45), experience of abuse (OR, 2.44; 95% CI, 1.10–5.56), and suicidal intention (OR, 2.17; 95% CI, 1.15–4.17) were more likely to have IBS. Compared with chronic abdominal discomfort, however, depression (OR, 5.55; 95% CI, 1.36–22.71) was the only dependent risk factor for IBS. CONCLUSION: The prevalence of IBS in college freshmen is 4.0%, and to the freshmen, psychosocial factors such as experience of abuse, depression, and suicidal intention were associated with high risk of developing IBS.
Adolescent ; Asian Continental Ancestry Group ; Child ; Child Abuse ; China ; Cross-Sectional Studies ; Demography ; Depression ; Female ; Humans ; Intention ; Irritable Bowel Syndrome ; Logistic Models ; Prevalence ; Psychology ; Risk Factors ; Suicide

BACKGROUND: Building an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare. METHODS: The sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model. RESULTS: About half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference). CONCLUSIONS Greater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be proactive in prevention or intervention for adults with perpetration risk.
Adolescent ; Caregivers ; psychology ; Child ; Child Abuse ; psychology ; statistics & numerical data ; Child Protective Services ; statistics & numerical data ; Child, Preschool ; Domestic Violence ; psychology ; statistics & numerical data ; Family Characteristics ; Female ; Humans ; Incidence ; Infant ; Japan ; epidemiology ; Longitudinal Studies ; Male ; Mental Disorders ; epidemiology ; psychology ; Risk Factors ; Substance-Related Disorders ; epidemiology ; etiology

OBJECTIVETo explore the influence of interleukin-1 beta (IL1B) gene polymorphism and childhood maltreatment on antidepressant treatment.

METHODSTwo hundred and four patients with major depressive disorder (MDD) have received treatment with single antidepressant drugs and were followed up for 8 weeks. Hamilton depression scale-17 (HAMD-17) was used to evaluate the severity of depressive symptoms and therapeutic effect. Childhood maltreatment was assessed using Childhood Trauma Questionnaire, a 28-item Short Form (CTQ-SF). Single nucleotide polymorphism (SNP) of the IL1B gene was determined using a SNaPshot method. Correlation of rs16944 gene polymorphism with response to treatment was analyzed using Unphased 3.0.13 software. The main and interactive effects of SNP and childhood maltreatment on the antidepressant treatment were analyzed using Logistic regression analysis.

RESULTSNo significant difference of gender, age, year of education, family history, episode time, and antidepressant agents was detected between the remitters and non-remitters. Association analysis has found that the SNP rs16944 in the IL1B AA genotype carriers antidepressant response was poorer (χ2=3.931, P=0.047). No significant difference was detected in the CTQ scores between the two groups. Genetic and environmental interaction analysis has demonstrated a significant correlation between rs16944 AA genotype and childhood maltreatment and poorer response to antidepressant treatment.

CONCLUSIONThe SNP rs16944 in the IL1B gene and its interaction with childhood maltreatment may influence the effect of antidepressant treatment for patients with MDD.

Adolescent ; Adult ; Antidepressive Agents ; therapeutic use ; Child Abuse ; psychology ; Depressive Disorder, Major ; drug therapy ; genetics ; psychology ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Gene Frequency ; Genotype ; Humans ; Interleukin-1beta ; genetics ; Logistic Models ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Polymorphism, Single Nucleotide ; Young Adult

PURPOSE: The purpose of this study is to test a model linking infant health problem, mother's depression and marital relationship to infant abuse. METHODS: This study employed a cross-sectional survey design. Data were collected from 2009 Data of Index Studies for Korean Children and Adolescents Development. Survey data from 1,060 infants and their mothers (including infant health status and infant physical illness scale, depression scale, marital relationship scale, and child abuse scale) were used to test the model. The model was tested using path analysis techniques within structural equation modeling. RESULTS: The model fit indices suggested that the original hypothesized model adequately fit the data (chi2 = .33, df = 5, p = .84, Tucker-Lewis Index = 1.04, Comparative Fit Index = 1.00, Root Mean Square Error of Approximation = .00). Infant health problem and mother's depression had a negative direct effect on marital relationship, which in turn had a direct negative effect on infant abuse. Infant health problems directly affected infant abuse and also influenced infant abuse indirectly through the marital relationship. Mother's depression had significant direct effects on infant abuse and also influenced infant abuse indirectly through the marital relationship. CONCLUSION: The findings from this study demonstrate the fundamental importance of infant health as linked to the mother's mental health, and marital relationship and increasing the quality of marital relationship may be the key to infant abuse prevention.
Adult ; Child Abuse/*psychology/statistics & numerical data ; Cross-Sectional Studies ; Depressive Disorder/epidemiology/*psychology ; Female ; *Health Status ; Humans ; Infant ; Infant Welfare/*psychology/statistics & numerical data ; Marriage/*psychology/statistics & numerical data ; Middle Aged ; Models, Psychological ; Mothers/*psychology ; Questionnaires ; Republic of Korea/epidemiology

The purpose of the present study was to develop a Korean version of the trauma symptom checklist for children (TSCC) and to examine its reliability and validity for screening posttraumatic stress symptoms. A normative group of 405 children and adolescents aged 8 to 16 yr participated in the study. A test-retest procedure was conducted with 76 participants from the normative group after 4 weeks. In the traumatized group, 73 children and adolescents of the same age from the Child Sexual Abuse Treatment Center were included. Good internal consistency (Cronbach's alpha) for the total scale (0.95, ranging 0.79-0.85 on the clinical scales) and test-retest reliability for the total scale (r=0.91, ranging 0.71-0.87 on the clinical scales) were found. Confirmatory 6-factor analysis explained 51.1% of the variance. Other measures such as concurrent or discriminative validity were also shown to be satisfactory. In conclusion, the Korean version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable of identifying trauma symptoms among children and adolescents who have self-reported experiencing trauma or for whom clinicians have identified traumatic experiences.
Adolescent ; Analysis of Variance ; Anxiety ; Asian Continental Ancestry Group ; Checklist/*methods ; Child ; Child Abuse, Sexual/psychology ; Depression/psychology ; Female ; Humans ; Male ; Mental Disorders/diagnosis/psychology ; Observer Variation ; *Psychology, Adolescent ; Psychometrics ; Questionnaires ; Reproducibility of Results ; Republic of Korea ; Stress Disorders, Post-Traumatic/diagnosis/*psychology

Children deserve a childhood free from abuse, where their basic physical, intellectual, emotional and social needs are met. Child abuse is defined as any act of omission or commission by a parent or guardian that would endanger or impair the child's physical or emotional well-being, or that is judged by a mixture of community values and professionals to be inappropriate. A total of 247 cases of suspected child abuse in Singapore was investigated in 2012. Physical abuse, sexual abuse, and physical neglect or emotional abuse accounted for 60%, 30% and 10% of these cases, respectively. Primary care providers play an important role in the early detection and referral of child abuse cases, which enable timely intervention to ensure the well-being of the child and prevent further abuse. Hospitals and other medical centres form the largest source of referrals of suspected child abuse.
Child ; Child Abuse ; diagnosis ; legislation & jurisprudence ; prevention & control ; Child Welfare ; Humans ; Parent-Child Relations ; legislation & jurisprudence ; Parents ; psychology ; Risk Factors

PURPOSE: This quasi-experimental study was performed to evaluate the effectiveness of an early nursing intervention program to support mothers of children aged 0-3 yr living in poverty. METHODS: In this study, mothers who received financial support from the government were recruited from one city and assigned to an intervention group (24) and comparison group (18). They completed a baseline questionnaire about depression, child rearing burden, agreement on physical punishment, and child temperament. Also, Denver II screening of the children was performed by the researcher. Mothers in the intervention group received a home visit intervention every two weeks for three months. At 3-months post-baseline, questionnaire and Denver II screening were reused to compare these two groups. RESULTS: Mother's depression, child rearing burden, agreement on physical punishment, and child temperament were not significantly different between the two groups. However, the percentage of depression declined only in the intervention group. Mothers in the intervention group showed higher Home Observation for Measurement of the Environment (HOME) scores than mothers in the comparison group. CONCLUSION: The findings of the study show that this nursing intervention is an effective parenting program. The early nursing program for mothers with infant and toddlers in poverty is effective in promoting HOME, the child rearing home environment.
Adult ; Child Abuse ; *Child Rearing ; Child, Preschool ; Depression ; Female ; Humans ; Infant ; Infant, Newborn ; Interviews as Topic ; Male ; Mother-Child Relations ; Mothers/*psychology ; Nursing Methodology Research ; Parenting ; *Poverty ; Program Evaluation ; Questionnaires ; Social Support