Association of Child Sexual Abuse Victimization and Murderous Behaviors and the Mediating Role of Psychological Adjustment among College Students in China.

A history of child sexual abuse (CSA) is associated with a variety of psychological issues and conduct disorders in adolescents. However, little is known about the association between CSA and its characteristics and murderous behaviors in young adults. The purpose of this study was to examine this relationship and explore the mediating effect of psychological adjustment (PA). A cross-sectional study was conducted with 4034 college students in Anhui Province, China. The participants were invited to complete self-report questionnaires regarding the history of CSA, self-perceived PA and murderous behaviors. PA was evaluated by two of the most important indicators: resilience and emotional release. Mediation analyses were computed via parallel mediation models. Of the participants, 14.1% reported experiencing CSA. After controlling for potential confounders, CSA victimization was robustly and positively associated with murderous ideation (OR: 2.36, 95% CI: 1.77-3.14), murderous plans (OR: 4.02, 95% CI: 2.63-6.12), murderous preparation (OR: 3.87, 95% CI: 2.37-6.31), and murderous attempts (OR: 5.35, 95% CI: 3.11-9.21). CSA victimization that was persistent and of the combined contact or noncontact types greatly increased the risk of murderous behaviors. A dose-response relationship was observed between the duration of experienced CSA and murderous behaviors. Furthermore, the results of the mediation analysis revealed that PA partially mediated the relationship between CSA victimization and murderous behaviors. Therefore, PA protects against the development of murderous behaviors in abused individuals. These findings have important implications for the prevention and intervention of murderous behaviors in adolescents who experienced CSA, highlighting the importance of considering PA as a protective role in this relationship.

Gestational bisphenol A exposure advances puberty onset in female offspring: Critical time window identification.

Increasing evidence shows that the early onset of puberty in female offspring may be caused by maternal prenatal exposure to bisphenol A (BPA) during pregnancy; however, the critical time window of maternal prenatal BPA exposure remains unknown. Here, we identify the critical time window of gestational BPA exposure that induces early onset of puberty in female offspring. Pregnant CD-1 mice were gavaged with BPA (8 mg/kg) daily during the early gestational stage (GD1-GD6), middle gestational stage (GD7-GD12) or late gestational stage (GD13-GD18). We show that maternal BPA exposure during the early and middle gestational stages could advance the vaginal opening time and increase the serum levels of kisspeptin-10 and GnRH in the female offspring at PND 34. Mechanistically, maternal BPA exposure during early and middle gestation could significantly increase CpG island methylation in the Eed gene promoters but reduce the mRNA expression of Eed in the hypothalamus tissues of the female offspring. In conclusion, the critical period of maternal BPA exposure-induced early onset of puberty in female offspring is early and middle gestation; this BPA-induced early onset of puberty might be partly attributed to epigenetic programming of the Eed gene in the hypothalamus. This study provides important insights regarding the relationship and the mechanisms between BPA and offspring pubertal development.

Life Course Prevalence of Bullying among University Students in Mainland China: A Multi-university Study.

Little is known about the life course prevalence of bullying among university students. The current study examined the prevalence of bullying in different life periods among multi-university students. Our study included 4,034 university students from four types of universities. Participants self-reported four types of bullying (i.e., physical, verbal, relational, and cyber) with bullies and victims, and four periods (i.e., primary school or earlier, middle school, high school, and postsecondary education). Overall, the percentage of university students experiencing at least one type of bullying victimization (BV) and bullying perpetration (BP) during their lifetime was 59.7% and 31.6%, respectively; the percentage of the university students experiencing more than two types of BV and BP was 16.3% and 7.4%, respectively. The prevalence rates of each type of BV and BP were the highest in elementary school or earlier, and these rates decreased from elementary school or earlier to postsecondary education period. Four latent classes were identified for BV: low BV (73.8%), moderate BV (18.6%), secondary school BV (4.4%), and persistent BV (3.2%). Similarly, four classes for BP were identified: low BP (86.6%), primary school BP (8.1%), high school BP (1.5%), and persistent BP (3.8%). These findings may inform school health practice of bullying prevention by taking prevention programs, especially during elementary school or earlier period.

Relationships among adverse childhood experience patterns, psychological resilience, self-esteem and depressive symptoms in Chinese adolescents: A serial multiple mediation model.

Adverse childhood experiences (ACEs) and adolescent depression are both prevalent social problems that can increase the risk of several negative health consequences throughout life. The original definition of ACEs misdirects the focus of intervention efforts for ACEs to only family dysfunction and parenting practices. We used a broader definition of ACEs and a latent class analysis (LCA) model to examine ACE patterns, aiming to overcome the shortcomings of cumulative and single adversity approaches based on the special social context of China. The data were derived from a middle school in Huaibei City of Anhui Province in 2019 and 2020, which was a prospective study involving 1687 junior high school students. At the initial evaluation (T1), ACEs, psychological resilience, self-esteem, and depressive symptoms were assessed by the students. At Time 2 (T2), the depressive symptoms of students were assessed. LCA and mediation analyses were conducted with Mplus version 8.2. The LCA identified the following three heterogeneous ACE classes: "low adversity" (36.4%), "moderate adversity" (44.2%), and "high adversity" (19.4%). The mediation analysis showed that the ACE patterns affected depressive symptoms through the following two mediation paths only in the moderate but not in the high adversity class: self-esteem alone and a path combining psychological resilience and self-esteem. Psychological resilience separately did not mediate the association between ACE patterns and depressive symptoms. To reduce depressive symptoms, interventions for students with ACEs need to improve self-esteem through many channels.

Bidirectional associations among school bullying, depressive symptoms and sleep problems in adolescents: A cross-lagged longitudinal approach.

BACKGROUND: Adolescence is a life stage with a high risk of depression, sleep disorders and school bullying. The aim of this study is to examine the longitudinal relationships between school bullying (bullying victimization and bullying perpetration), depressive symptoms and sleep problems among adolescents and to consider whether the direct pathways vary by gender. METHODS: The study included 1687 7th grade students (60.4% boys) recruited from a middle school in southeastern China. We collected self-reports of school bullying, depressive symptoms and sleep problems from 2019 (T1) and 2020 (T2) among adolescents. A series of gender-specified cross-lagged paths in a structural equation model was used for the primary analysis. RESULTS: The models revealed evidence for bidirectional associations between school bullying, depressive symptoms and sleep problems. Among girls, higher bullying perpetration at T1 predicted fewer sleep problems and depressive symptoms at T2, while bullying victimization significantly predicted poor quality of sleep and severe depressive symptoms. Furthermore, sleep problems at T1 positively predicted bullying perpetration and victimization at T2 in boys but not in girls. For both boys and girls, severe depressive symptoms significantly predicted more victimization and sleep problems, and sleep problems were positively associated with depressive symptoms. LIMITATIONS: The sample is unrepresentative, as it is from only one middle school. CONCLUSIONS: Our findings highlight that school bullying, depressive symptoms and sleep problems were interrelated across time and that acknowledging gender differences is important.

Childhood abuse and borderline personality disorder features in Chinese undergraduates: the role of self-esteem and resilience.

BACKGROUND: Although childhood abuse is considered to be related to borderline personality disorder (BPD), few studies have elaborated on the mediating role of self-esteem and resilience in it. Thus, the present study aimed to explore the potential mediating role of resilience and self-esteem between childhood abuse and BPD. METHODS: This cross-sectional study was conducted with 4034 college students in Anhui Province, China. Participants were asked to complete Chinese versions of the following instruments: Childhood Trauma Questionnaire-Short Form (CTQ-SF), Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Connor-Davidson Resilience Scale (CD-RISC), and Rosenberg Self-Esteem Scale (RSES). Structural equation modeling (SEM) was used to test the mediation effects. RESULTS: Resilience and self-esteem were found to be mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately; however, when all three types of childhood abuse were entered into the model simultaneously, neither the indirect effects nor direct effects of physical abuse or sexual abuse were found to be significant, only the association between emotional abuse and BPD features was partially mediated by resilience and self-esteem. CONCLUSIONS: Self-esteem and resilience mediate the links between childhood abuse and BPD features, and emotional abuse is uniquely associated with BPD features.

Childhood Separation From Parents and Self-Harm in Adolescence: A Cross-Sectional Study in Mainland China.

As the prevalence of self-harm among adolescents in Chinese escalates, finding out the potential risk factors associated with self-harm behaviors has aroused much attention. This study aims to explore the association between parent-child separation and series of self-harm (SH) subtypes among Chinese adolescents. We survey a total of 4,928 middle school students aged from 12 to 18 years at school. Parent-child separation was investigated from four dimensions-occurrence of parental separation, separation status, age at first separation and duration of separation. Self-harm series are deemed as five subtypes-highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviors with latent damage and psychological self-harm. Multivariate logistic regression is used to explore the associations between parent-child separation and different subtypes of self-harm among adolescents. Paternal separation is associated with each type of self-harm whilst maternal separation is not correlated with highly lethal self-harm. Except for highly lethal self-harm, the other four subtypes of self-harm demonstrate a relation with both length of paternal separation and maternal separation with aOR ranging from 1.02 to 1.06. Individuals who suffer parental separation prior to the age of three were at a higher risk for four types of less-lethal self-harm. The association of parent-child separation with self-harm deserves our attention, and future research is needed to identify the underlying mechanisms.

Difference in the relationship between childhood sexual abuse and sexual orientation among college students / 中国学校卫生

Objective@#This study aimed to explore the relationship between childhood sexual abuse (CSA) and sexual orientation among college students, and to explore possible sex difference.@*Methods@#By using multi-stage stratified cluster sampling method, 4 034 students were selected from 4 college schools. Self-made questionnaire was used to collect the demographic information, CSA experiences and sexual orientation. Logistic regression models were conducted to examine sex differences in the relationship between different types and timing of CSA and sexual orientation.@*Results@#The reporting rates of heterosexual, homosexual, bisexual and asexual orientation of college students were 93.2%, 0.7%, 3.7% and 2.4%, respectively. For males, contact CSA (OR=14.70, 95%CI=5.73-37.72), both contact and noncontact CSA (OR=4.33,95%CI=1.91-9.84) in elementary school or earlier were associated with sexual orientaion. non-contact CSA (OR=4.20, 95%CI=2.21-7.98), both contact and noncontact CSA (OR=3.57, 95%CI=1.65-7.70) in middle school were related to sexual orientation. However, for females, non-contact CSA (OR=1.78, 95%CI=1.02-3.13) and both contact and non-contact CSA (OR=3.13, 95%CI=1.35-7.23) in elementary school or earlier were associated with sexual orientation.@*Conclusion@#CSA experiences are associated with sexual orientation in sex-specific manner, with significant stronger association among males.

Association between sexual abuse victimization during the life course and suicidal behaviors in male and female college students in China: Timing, duration, types and patterns.

BACKGROUND: A certain link between sexual abuse (SA) victimization and suicidal behaviors has been confirmed, but it remains unclear whether this association varies with regard to SA characteristics and gender. METHODS: Participants were 4034 college students drawn from a cross-sectional study conducted in Hefei, China. Gender-stratified latent class analysis (LCA) and logistic regression models were used to examine the relationships between timing, duration, types and patterns of SA victimization and suicidal behaviors. RESULTS: For the males, SA in the elementary school or earlier period was associated with suicidal ideation (OR: 3.29, 95%CI: 2.20-5.38), plans (OR: 3.44, 95% CI: 1.54-7.77) and preparations (OR:3.05, 95% CI: 1.19-7.74). All types of SA were significantly associated with the four types of suicidal behaviors. Dose-response relationship and cumulative effect were found between duration, types of SA victimization and suicidal behaviors. Three latent classes of SA victimization were identified for males and females, respectively. For males, the "moderate SA" class and "persistent SA" class were associated with the four types of suicidal behaviors. For the females, SA during the university period was associated with suicidal ideation (OR: 2.47, 95% CI: 1.24-4.93). Only suicidal ideation was associated with the "moderate SA" class. LIMITATIONS: The cross-sectional survey design did not allow to conclude any causality. CONCLUSIONS: The relationship between SA victimization and suicidal behaviors varies in terms of SA victimization characteristics and the relationships were stronger in males than in females.

[Dietary literacy questionaire for school-age children's daily diet providers and its reliability and validity].

OBJECTIVE: Development of dietary literacy questionnaire for school-age children's diet providers and evaluation of its reliability and validity. METHODS: Based on the main theoretical basis of dietary literacy definition, a pool of dietary literacy questionnaires for school-age children's daily diet providers was prepared by expert group discussion through the Delphi method. The initial scale was formed by method such as expert panel discussions. A stratified cluster sampling method was used to investigate the daily dietary providers of 1137 urban and rural children in Hefei in November 2018. The t-test and Pearson correlation coefficient were used to analyze the decision value, correlation analysis and internal consistency analysis. The structural equation model was constructed to evaluate the structural validity of the questionnaire. One week after the interval, 90 school-age children's daily diet providers using random sampling were retested, and the test-retest reliability was analyzed. The reliability of the questionnaire was evaluated using Cronbach'α, Guttman coefficient, and structural validity. Further analysis of the differences in the educational level of children's diet providers and the scores of urban and rural questionnaires. RESULTS: A total of 1043 valid questionnaires were returned. 894(85. 7%) were children's parents and 128(12. 3%) were children's grandparents or maternal grandparents. After expert group discussion, the questionnaire preliminarily identified four first-level indicators to provide attitudes, actions, skills and environment for daily dietary providers about children's meals. The average authority coefficient of experts was 0. 87. The study finally retained 30 items, including the four dimensions of attitudes, actions, skills and environment provided by the daily diet providers of school-age children to the children's diet. The cumulative variance contribution rate was 52. 470%. The Cronbach' α coefficient of the questionnaire was 0. 874, the split-half reliability was 0. 813, and the test-retest reliability was 0. 878. Structural equation model fitting index: χ~2/df=2. 28, RMSEA=0. 042, NFI=0. 841, GFI=0. 927, AGFI=0. 912, RFI=0. 821, IFI=0. 904, TLI=0. 891, CFI=0. 903. In addition, the differences in scores of different education levels, urban and rural questionnaires and different dietary behaviors of children were statistically significant(P<0. 05), and the questionnaires had good discriminant validity. CONCLUSION: The reliability and validity of the dietary literacy questionnaire for school-age children's daily diet providers is good, and it can provide reference for evaluating the dietary quality of school-age children's dietary providers.

Sensitive periods for the effect of bullying victimization on suicidal behaviors among university students in China: The roles of timing and chronicity.

OBJECTIVE: To examine whether timing and chronicity of bullying victimization (BV) play a significant role in linking exposure to BV to suicidal behaviors in university students. METHODS: A multistage stratification sampling method was used to select a sample of 4034 university students (18-23 years, mean age 20.38±1.35 years, 41.9% female). We used latent class analysis and developmental-stage-based characterizations of BV timing and chronicity to explore the sensitive periods for the effect of BV on suicidal behaviors. RESULTS: The prevalence rates of suicidal ideation, plans and attempts among our study participants were 9.9%, 3.0% and 1.3%, respectively. BV during primary school (OR = 2.12, 95% CI: 1.55-2.90) and secondary school (OR = 2.65, 95% CI: 1.80-3.90) was associated with suicidal ideation among university students. We identified four classes of life-course BV experiences (low BV, 73.8%; moderate BV, 18.6%; secondary school BV, 4.4% and persistent BV, 3.2%). Persistent BV was associated with 2.50 times (95% CI: 1.56-3.98), 2.98 times (95% CI: 1.48-6.02), and 6.13 times (95% CI: 2.48-15.14) higher risk of suicide ideation, plans, and attempts, respectively. Both moderate BV (OR = 1.75, 95% CI: 1.35-2.26) and secondary school BV (OR=2.01, 95% CI: 1.29-3.12) were positively correlated with suicidal ideation. Furthermore, there was a dose-response relationship between the number of periods of BV and suicidal behaviors. LIMITATIONS: This study was a cross-sectional study based on self-reported measures, especially BV experiences in each school stage. CONCLUSIONS: This study identifies sensitive periods for the effect of BV on suicidal behaviors among university students in China.

The association between childhood physical disability or long-term health problems and depression among adolescents in China: Mediating effect of childhood maltreatment.

BACKGROUND: Increasing evidence has suggested that childhood maltreatment might mediate the association between physical disability or chronic illness and depression among adolescents. We sought to identify whether childhood maltreatment mediated the relationship between physical disability or long-term health problems and depression in Chinese adolescents. METHOD: A total of 5726 middle and high school students aged 12-18 years old were chosen to participant in this study. Participants completed the self-reported questionnaire on childhood physical or long-term health problems, childhood maltreatment and depression. RESULTS: The results showed that there were significant differences of childhood maltreatment, depression between adolescents with childhood physical disability or long-term health problems and those without. Physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect mediated the association between childhood physical disability or long-term health problems and depression accounting for 8.7%, 20.6%, 14.5%, 16.3% and 14.7% of the total effect of physical disability or long-term health problems on depression in each single mediator model respectively, whereas the indirect effect of emotional abuse and sexual abuse in the association between physical disability or long-term health problems and depression explained 15.6% and 8.0% of the total effect in a multiple mediation model respectively. CONCLUSION: Childhood physical disability or long-term health problems was associated with the increased risk for depression, and the associations between childhood physical disability and long-term health problems and depression were partially mediated by childhood maltreatment experiences. Childhood maltreatment exposure should be considered to prevent depression among adolescents with childhood physical disability or long-term health problems.

Association between different stages of precollege school bullying and murder-related psychological behaviors among college students in Anhui Province, China.

Little is known about the relationship between precollege school bullying and murder-related psychological behaviors. The present study aims to examine that relationship in Chinese college students using a cross-sectional study. Self-report data were collected from 4034 college students in Anhui Province using a proportional stratified cluster sampling method. Four types of school bullying (i.e., physical, verbal, relational, and cyber) with bullies and victims and two periods (i.e., primary and secondary) were measured. The prevalence rates of murderous ideation, plans, preparation, and attempts were 6.9%, 2.5%, 1.8%, 1.4%, respectively. Different stages of precollege cyber bullying were associated with murder-related psychological behaviors for both bullies (primary: AORs = 2.78 to 15.67; secondary: AORs = 2.43 to 9.99; both periods: AORs = 2.26 to 14.04) and victims (primary: AORs = 2.87 to 16.57; secondary: AORs = 1.89 to 4.49; both periods: AORs = 3.68 to 21.48). A dose-response relationship was found, such that college students with a bullying perpetration index of two types and more were more likely to have murder-related psychological behaviors than those who were not bullied. Notably, both primary and secondary school bullying, especially cyber forms, were more likely to be associated with murder-related psychological behaviors. Therefore, it is necessary to develop school bullying preventive measures beginning in primary school.

Mediating role of adult attachment in childhood abuse and borderline personality disorder in college students / 中国学校卫生

Objective@#To explore the relationship between childhood abuse, adult attachment and borderline personality disorder (BPD) in college students, and to provide reference for promoting the physical and mental health of college students.@*Methods@#We selected undergraduate students from four colleges in Hefei, a total of 4 034 college students were surveyed by the childhood trauma questionnaire short form(CTQ-SF), the state adult attachment measure (SAAM) and the Personality Diagnostic Questionnaire(PDQ).@*Results@#BPD was found in 4.2% of subjects, 4.5% of males and 3.7% of females. The score of BPD in non-single-parent families was lower than that in single-parent families, in families with average family economic status was lower than that in families with poor and good family economic status, and in families with medium father education level was lower than that in fathers with low and high education level(Z=-2.30, 29.25, 9.63, P<0.05). Childhood abuse, avoidant attachment and anxious attachment positively predicted BPD(β=0.21, 0.10, 0.23, P<0.01), secure attachment negatively predicted BPD(β=-0.15, P<0.01). Adult attachment played a partial mediating role in the effects of childhood abuse on BPD, with the mediating effect accounting for 16.7% of the total effect.@*Conclusion@#Adult attachment plays a mediating role in the effects of childhood abuse on BPD.

Association between adverse childhood experiences and adolescent depression: a Meta-analysis / 中国学校卫生

Objective@#To summarize the existing cohort study evidence between adverse childhood experience(ACEs) and adolescent depression, to explore the influence of ACEs on adolescent depression, so as to provide evidence for the prevention of adolescent depression.@*Methods@#Chinese and English literatures on the cohort study on the correlation between ACEs and adolescent depression published by WanFang, VIP databases, CNKI, CBM, PubMed and Web of Science were searched. We only selected orginal articles that their either reported on Chinese and English retrieval words of "adverse childhood experiences" "ACE" "abuse" "maltreat" "mistreat" "neglect" "bully" "bullying" "family dysfunction" "family violence" "adversities" "trauma" "victimization" "victim" "adverse events" "adverse experiences" "longitudinal" "follow-up" "prospective" "cohort" "depression" "depressive". Meta-analysis was performed on the literatures that met the inclusion criteria, and statistical analysis was conducted using Stata software.@*Results@#Twelve references (11 in English and 1 in Chinese) were included in the Meta-analysis, and the results showed that ACEs were positively correlated with adolescent depression (pooled OR=1.75，95%CI=1.43-2.15). Among them, The effect of neglect was most prominent (pooled OR=2.42, 95%CI=1.31-4.46) while the influence of abuse was least strong (pooled OR=1.77, 95%CI=1.25-2.52). The pooled odds ratio associated with bully was 2.09 with the 95% confidence intervals from 1.38 to 3.16. The pooled odds ratio of boys is greater than girls(boys: pooled OR=3.77, 95%CI=2.31-6.15; girls: pooled OR=1.44, 95%CI=1.04-2.01). Funnel plot and Egger test suggested publication bias in the included literatures, and the sensitivity analysis indicated that the meta analysis results were relatively stable.@*Conclusion@#The adverse childhood exprience is positively associated with adolescent depression.Adolescent depression is strongly affected by neglected,and is least affected by abuse.