Inconsistency in psychological resilience and social support with mental health in early adolescents: A multilevel response surface analysis approach.

BACKGROUND: Given the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health. METHODS: We used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis. RESULTS: The higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = -1.83, P < 0.001; depression: a1 = -2.44, P < 0.001; and perceived stress: a1 = -1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls' mental health (anxiety: a1 = -1.97, P < 0.001; depression: a1 = -2.71, P < 0.001; perceived stress: a1 = -1.23, P < 0.001). LIMITATIONS: The cross-sectional study design limited the inference of causal relationships between variables. CONCLUSIONS: These results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.

Anxiety in adolescents and subsequent risk of suicidal behavior: A systematic review and meta-analysis.

BACKGROUND: Suicide is a major public health concern, and anxiety is a prevalent developmental challenge in adolescents closely linked to suicidal behavior. This study aimed to assess the association between anxiety in adolescents and subsequent risk of suicidal behavior through a meta-analysis, offering crucial insights for suicide prevention. METHODS: Six bibliographic databases were comprehensively searched to clarify the association between adolescents anxiety and subsequent risk of suicidal behavior. We used a fixed-effects model to determine the total pooled effect size estimate and reported odds ratios and the corresponding 95 % confidence intervals. Subgroup analysis, sensitivity analysis and publication bias analysis were conducted with Stata version 15.1. RESULTS: The findings revealed a significant association between anxiety in adolescents and subsequent suicidal behavior (OR = 2.33, 95 % CI [2.00, 2.71]). Subgroup analyses indicated differences in mean effect size estimates based on clinical diagnoses and self-reported measures used to assess anxiety. The correlation strength between adolescent anxiety and subsequent suicidal behavior increased with a longer follow-up period. Furthermore, adolescents anxiety was associated with increased risk of subsequent suicidal ideation (OR = 1.97, 95 % CI [1.72, 2.25]) and attempts (OR = 3.56, 95 % CI [2.49, 5.07]). Finally, boys (OR = 2.41, 95 % CI [1.67, 3.47]) with anxiety had a greater risk of subsequent suicidal behavior than girls (OR = 2.02, 95 % CI [1.47, 2.78]). CONCLUSION: This study revealed that adolescents anxiety increases the risk of suicidal behavior, including suicidal ideation and attempts. Consequently, there is a critical need for timely interventions tailored to adolescents with anxiety to prevent future instances of suicide.

Multi-level factors associated with psychological resilience in the face of adverse childhood experiences among Chinese early adolescents.

BACKGROUND: Adverse childhood experiences (ACEs) are pervasive and exert enduring negative effects on health throughout one's life. A better understanding of resilience among adolescents with ACEs exposure is crucial to enhance their mental health; however, comprehensive and multifaceted analyses of its associated factors are limited. OBJECTIVE: This study aimed to investigate multi-level correlates of psychological resilience in Chinese early adolescents exposed to ACEs. PARTICIPANTS AND SETTING: In a sample of 5724 middle school students, 65.5 % (n = 3749; 49.1 % females; Mage = 13.57, SD = 0.96) reported ACEs during their primary school period and were finally included in this study. METHOD: Both linear regression and network models were conducted to explore correlates of capacity- and outcome-oriented resilience at the individual (i.e., five personality traits, emotional release, and loneliness), family (i.e., family support and relationships with the mother and father), and school levels (i.e., peer support, teacher support, and relationships with classmates and teachers). RESULTS: Linear regression analysis revealed that all correlates were associated with capacity- (ß ranged from -0.271 to 0.503, PFDR < 0.001 for all) and outcome-oriented resilience (ß ranged from -0.516 to 0.229, PFDR < 0.001 for all). Similarly, network analysis revealed that neuroticism, conscientiousness, loneliness, emotional release, extraversion, and the relationship with the mother were directly associated with both capacity- (weights ranged from 0.029 to 0.179) and outcome-oriented resilience (weights ranged from 0.024 to 0.396). However, openness, peer and family support, and relationships with classmates and teachers were directly associated with capacity-oriented resilience (weights ranged from 0.020 to 0.201). CONCLUSIONS: This study identified the shared and unique associated factors for capacity- and outcome-oriented resilience in the face of ACEs and demonstrated the complex interactions between these factors, which can guide tailored interventions to enhance resilience among Chinese early adolescents with ACEs exposure. Further longitudinal studies may endeavor to confirm our results.

Bisphenol AF exposure synergistically increases the risk for suicidality among early adolescents with child maltreatment: A prospective cohort study.

BACKGROUND: Child maltreatment (CM) is correlated with suicidality risk among adolescents. Additionally, exposure to bisphenol AF (BPAF) may increase this risk. However, the combined effect of CM and BPAF exposure remains unknown and should be further investigated. METHODS: In this study, 1,475 early adolescents (mean age = 12.48 years) from the Chinese Early Adolescents Cohort were enrolled. Data were collected at three time points with an interval of 12 months between 2019 and 2021. Participants' history of CM and suicidality (including suicidal ideation and suicidal attempts) were evaluated using a self-report questionnaire. Blood samples were obtained from participants to measure serum BPAF concentrations at baseline. Group-based trajectory modeling was employed to identify different developmental trajectories of suicidality across the three waves. After adjusting for potential confounders, the association between CM and BPAF exposure on suicidal ideation and suicidal attempts was assessed using logistic regression and Poisson regression analyses. RESULTS: Participants with CM were associated with a risk of one- and two-year incident suicidality (all ps < 0.05), and BPAF levels were positively associated with two-year incident suicidal ideation (adjusted OR = 1.68, 95% CI: 1.13-2.50). Additionally, middle and high levels of BPAF exposure synergistically increase the risk for one- and two-year incident suicidal ideation among participants with CM (adjusted ORs = 2.00-3.83). Similarly, participants exposed to high-level BPAF as well as CM were at a greater risk of one- and two-year incident suicidal attempts than those with low-level BPAF exposure and no CM (adjusted incidence rate ratio [IRRs] = 2.82-4.34). Moreover, compared with participants with a low developmental trajectory of suicidality across the three waves, high BPAF exposure exhibited a significant synergistic effect on participants with CM in the persistently high suicidal ideation trajectory and the increasing suicidal attempts trajectory (all ps < 0.05). Sex subgroup analysis revealed that females were more susceptible to the synergistic effect of BPAF and CM exposure on suicidality than males. CONCLUSIONS: Environmental factors and the psychological status of individuals may synergistically increase their susceptibility to suicidality. These results offer novel insights into enhancing our understanding of suicidality among adolescents.

Longitudinal and Reciprocal Effects in the Association Between School Bullying and Homicidal Ideation During Early Adolescence.

Several cross-sectional studies indicated a positive association between school bullying and homicidal ideation during early adolescence. However, few longitudinal studies investigated this association. This study examined whether a bi-directional relationship exists within the longitudinal association between bullying victimization or bullying perpetration and homicidal ideation among early adolescents using a Random Intercept Cross-Lagged Panel Model. A total of 1611 early adolescents (39.5% girls; Mage = 12.50 years, SD = 0.50) were recruited from the Chinese Early Adolescents Cohort study. Data on bullying victimization, bullying perpetration, and homicidal ideation collected during three time points (September 2019, September 2020, and September 2021) were used. Bullying victimization showed a significant positive association with homicidal ideation at the between-person level. Bullying victimization and bullying perpetration had a bi-directional relationship with homicidal ideation at the within-person level. Additionally, this study considered the impact of biological sex-based differences and bullying types on adolescents' homicidal ideation. Based on these findings, school bullying might exhibit unique reciprocal associations with homicidal ideation.

Social-ecological perspective on the suicidal behaviour factors of early adolescents in China: a network analysis.

Background: In early adolescence, youth are highly prone to suicidal behaviours. Identifying modifiable risk factors during this critical phase is a priority to inform effective suicide prevention strategies. Aims: To explore the risk and protective factors of suicidal behaviours (ie, suicidal ideation, plans and attempts) in early adolescence in China using a social-ecological perspective. Methods: Using data from the cross-sectional project 'Healthy and Risky Behaviours Among Middle School Students in Anhui Province, China', stratified random cluster sampling was used to select 5724 middle school students who had completed self-report questionnaires in November 2020. Network analysis was employed to examine the correlates of suicidal ideation, plans and attempts at four levels, namely individual (sex, academic performance, serious physical illness/disability, history of self-harm, depression, impulsivity, sleep problems, resilience), family (family economic status, relationship with mother, relationship with father, family violence, childhood abuse, parental mental illness), school (relationship with teachers, relationship with classmates, school-bullying victimisation and perpetration) and social (social support, satisfaction with society). Results: In total, 37.9%, 19.0% and 5.5% of the students reported suicidal ideation, plans and attempts in the past 6 months, respectively. The estimated network revealed that suicidal ideation, plans and attempts were collectively associated with a history of self-harm, sleep problems, childhood abuse, school bullying and victimisation. Centrality analysis indicated that the most influential nodes in the network were history of self-harm and childhood abuse. Notably, the network also showed unique correlates of suicidal ideation (sex, weight=0.60; impulsivity, weight=0.24; family violence, weight=0.17; relationship with teachers, weight=-0.03; school-bullying perpetration, weight=0.22), suicidal plans (social support, weight=-0.15) and suicidal attempts (relationship with mother, weight=-0.10; parental mental illness, weight=0.61). Conclusions: This study identified the correlates of suicidal ideation, plans and attempts, and provided practical implications for suicide prevention for young adolescents in China. Firstly, this study highlighted the importance of joint interventions across multiple departments. Secondly, the common risk factors of suicidal ideation, plans and attempts were elucidated. Thirdly, this study proposed target interventions to address the unique influencing factors of suicidal ideation, plans and attempts.

Bidirectional relationship between borderline personality features and depressive symptoms in early adolescence: A school-based cohort study.

Depressive symptoms is a public health concern worldwide, and adolescents may experience more depressive symptoms. Although the relationship between borderline personality features (BPFs) disorder and depressive symptoms has been established, it is unclear whether the longitudinal relationship between them is unidirectional or bidirectional and whether these symptoms are different between boys and girls. In this study, Chinese adolescents (1608 total and separately 972 for boys and 636 girls) were enrolled between September 2019 and September 2021, and we analyzed the data using a cross-lagged model. The results suggested a bidirectional relationship between BPFs and depressive symptoms in boys (ß = 0.191 and 0.117, P < 0.001). However, in girls, depressive symptoms were predicted based on BPFs (ß = 0.225, P < 0.001), whereas BPFs were not predicted based on depressive symptoms (ß = 0.035, P = 0.535). The findings suggest that borderline personality traits and depressive symptoms are only bilaterally associated in girls, which also provides important evidence for the treatment and prevention of adolescent BPFs and depressive symptoms.

Association Between Child Maltreatment and Aggression in Chinese Early Adolescents: The Mediating Role of Irritability.

Child maltreatment (CM) is a major global public health issue, and a strong association exists between CM and aggression. However, the underlying mechanism of this association has not been understood to date. The objective of this study was to explore the mediating role of irritability in the association between CM and aggression in Chinese early adolescents. A cross-sectional study was conducted using a self-report questionnaire to evaluate the levels of CM, aggression, and irritability in 5,724 middle school students from the Anhui Province, China. Structural equation modeling was used to test the hypothesis of the mediating effect of irritability on the relationship between CM and aggression. We further investigated gender differences in this association using multiple group analyses. CM was positively related to both irritability and aggression, and irritability was positively associated with aggression (p < .01). The mediating effects of irritability between CM and aggression were significant (ß = .107, 95% confidence intervals [CI]: 0.077-0.133, p < .05). Males had a higher indirect effect size of the pathway from CM to aggression via irritability compared with females. Overall, irritability was a crucial mediator in the relationship between CM and aggression in Chinese adolescents, and males were more prone to engage in aggression compared with females through the pathway of irritability. Therefore, early irritability characteristics should be carefully monitored in adolescents, and they should be provided adequate support to acquire critical emotion regulation skills.

Vitamin D and depressive symptoms in an early adolescent cohort.

BACKGROUND: To explore the cross-sectional and longitudinal association between vitamin D and depressive symptoms across early adolescence. METHODS: This longitudinal study included 1607 early adolescents [mean (s.d.) age, 12.49 years; 972 (60.5%) males] from the Chinese Early Adolescents Cohort, recruited from a middle school in Anhui Province and followed up annually (2019-2021). Serum 25(OH)D levels were measured in both 2019 and 2021. Self-reports on depression were assessed at each of three time points from 2019 to 2021. RESULTS: In the whole sample, higher baseline serum 25(OH)D levels were linked with a lower risk of cumulative incident depression within two-year follow-ups (adjusted RR = 0.97, 95% CI 0.94-0.99) and the increasing trajectory of depression symptoms across the three waves (adjusted RR = 0.97, 95% CI 0.95-0.99). Baseline vitamin D deficiency (VDD) (adjusted RR = 1.50, 95% CI 1.10-2.05) were associated with an increased risk for the increasing trajectory of depression symptoms across the three waves. Remitted VDD was positively related to one dichotomous depression symptoms across three waves (adjusted OR 2.15, 95% CI 1.15-4.01). The above-mentioned significant association was also found in males. Additionally, baseline VDD (adjusted OR 1.59, 95% CI 1.04-2.44) and persistent VDD (adjusted OR 1.58, 95% CI 1.02-2.60) were linked to an increased risk of having two dichotomous depression symptoms only in males. CONCLUSIONS: Our results highlight a prospective association between baseline vitamin D and depression risk in early adolescents. Additionally, a male-specific association between vitamin D and depression risk was observed. Our findings support a potential beneficial effect of vitamin D supplementation in reducing depression risk in early adolescents.

Longitudinal trajectories of sleep quality in correlation with maltreatment in early childhood: A cohort of Chinese early adolescents.

BACKGROUND: Child maltreatment may lead to sleep disturbance during the critical period of child development. Our study examined the effect of maltreatment in early childhood on trajectories of sleep quality among early adolescents. METHODS: The study included 1611 participants (mean ± standard deviation age at baseline: 12.5 ± 0.5 years) from a middle school in southeastern China. Of these participants, 60.5 % were males. Information on early childhood maltreatment during pre-seventh grade was obtained through a self-report questionnaire at baseline, and sleep quality was collected at baseline and during follow-up. We used a group-based trajectory model to characterize trajectories of sleep quality. RESULTS: The study identified four trajectories of sleep quality, namely the low sleep score group (25.0 %), the moderate-low sleep score group (51.0 %), the moderate-increasing sleep score (17.0 %), and the high-decreasing sleep score (7.0 %) group. After adjusting for covariates, the findings revealed that emotional abuse and physical abuse were associated with an increased risk of developing new-onset sleep disturbances in early adolescents. Particularly, emotional abuse (incidence rate ratio = 1.71, 95 % confidence interval: 1.08-2.71) significantly increased the risk of belonging to the high-decreasing sleep score group. Moreover, there existed a dose-response relationship between early childhood maltreatment and sleep quality trajectories, with a higher number of maltreatment types in early childhood correlating with a greater risk of belonging to the high-decreasing sleep score group. CONCLUSIONS: The findings of our study provide compelling evidence indicating that specific types and cumulative maltreatment during early childhood contribute to sleep disturbances among early adolescents. The study findings highlight the significance of preventing and reducing early childhood maltreatment to enhance sleep quality during early adolescence.

Vitamin D and suicidality: a Chinese early adolescent cohort and Mendelian randomization study.

AIMS: Previous cross-sectional and case-control studies have proposed that decreased vitamin D levels are positively correlated with the risk of suicidality in adults. However, limited studies have examined the association between vitamin D and suicidality in adolescents. This study aimed to investigate the relationship between serum vitamin D and suicidality risk among early adolescents. METHODS: Data were obtained from a Chinese early adolescent cohort. In this cohort, seventh-grade students from a middle school in Anhui Province were invited to voluntarily participate in the baseline assessments and provide peripheral blood samples (in September 2019). The participants were followed up annually (in September 2020 and September 2021). Serum 25-hydroxyvitamin D [25(OH)D] and vitamin D-related single-nucleotide polymorphisms at baseline were measured in November 2021. Traditional observational and Mendelian randomization (MR) analyses were performed to examine the relationship between serum 25(OH)D at baseline and the risk of baseline and incident suicidality (i.e., suicidal ideation [SI], plans and attempts). RESULTS: Traditional observational analysis did not reveal a significant linear or non-linear association of serum 25(OH)D concentration with the risks of baseline and 2-year incident suicidality in the total sample (P > .05 for all). Sex-stratified analysis revealed a non-linear association between the 25(OH)D concentration and the risk of baseline SI in women (Poverall = .002; Pnon-linear = .001). Moreover, the risk of baseline SI in the 25(OH) insufficiency group was lower than that in the 25(OH) deficiency group in the total sample (odds ratio [OR] = 0.69, 95% confidence interval [CI] = 0.51-0.92, P = .012). This difference remained significant in women (OR = 0.59, 95% CI = 0.40-0.87, P = .008) but not in men (OR = 0.78, 95% CI = 0.53-1.15, P = .205). Additionally, both linear and non-linear MR analyses did not support the causal effect of serum 25(OH)D concentration on the risk of baseline, 1-year and 2-year incident suicidality (P > .05 for all). CONCLUSIONS: This study could not confirm the causal effect of vitamin D on suicidality risk among Chinese early adolescents. Future studies must confirm these findings with a large sample size.

Longitudinal correlates of bullying victimization among Chinese early adolescents: A cross-lagged panel network analysis.

BACKGROUND: Bullying victimization is a major public health issue often faced by adolescents. This highlights the need to identify the relevant risk factors to inform intervention. Based on the ecological systems theory and applied cross-lagged panel network analysis, this study explored the longitudinal correlates of bullying victimization among Chinese early adolescents. METHODS: A total of 1686 early adolescents (60.4 % were boys) from the Chinese Early Adolescent Cohort study were included in this study. Bullying victimization and its associated factors were assessed using the self-report questionnaires, which was administered from 2019 (T1), 2021 (T2), and 2022 (T3). The longitudinal relationships between bullying victimization and its correlates were examined using a cross-lagged panel network analysis. RESULTS: 27.0 %, 14.9 %, and 13.2 % of the participants reported being bullied by peers at T1, T2, and T3, respectively. The temporal network suggested that individual-level (sex, depression, and anxiety), family-level (child abuse), school-level (satisfaction with classmates), and social-level (satisfaction with society) factors were associated with bullying victimization. The node with the greatest centrality strength was anxiety. Notably, relationship with teachers and classmates were the unique nodes in the T2 → T3 replication network. LIMITATIONS: The sample is unrepresentative, as it is from only one middle school. CONCLUSIONS: The findings provide important insights into bullying victimization prevention and intervention among Chinese early adolescents: 1) highlighting the importance of joint interventions across multiple departments; 2) focusing on the most central factors of bullying victimization; and 3) considering the effect of time when exploring the correlates of bullying victimization.

Involvement in bullying and sleep disorders in Chinese early adolescents.

Background: School bullying may cause sleep disorders in early adolescents. Here, we determined the relationship between school bullying (considering all the features of bullying involvement) and sleep disorders, which are the common problems in Chinese early adolescents. Materials and methods: We conducted a questionnaire survey among 5,724 middle school students from Xuancheng, Hefei, and Huaibei cities in Anhui province, China. The self-report questionnaires included the Olweus Bully/Victim Questionnaire and Pittsburgh Sleep Quality Index. We used latent class analysis to identify the potential subgroups of bullying behavior. Logistic regression analysis was used to investigate the association between school bullying and sleep disorders. Results: Active participants in bullying interactions, including the bullies and victims, reported higher levels of sleep disorders compared with the non-active participants [Bully: physical (aOR = 2.62), verbal (aOR = 1.73), relational (aOR = 1.80), and cyber (aOR = 2.08); Victim: physical (aOR = 2.42), verbal (aOR = 2.59), relational (aOR = 2.61), and cyber (aOR = 2.81)]. A dose-response relationship was observed between the number of school bullying types and sleep disorders. In the context of bullying roles, bully-victims had the highest risk of reporting sleep disorders (aOR = 3.07, 95% CI: 2.55-3.69). We identified four potential categories of school bullying behaviors: low involvement in bullying, verbal and relational victims, medium bully-victims, and high bully-victims, and the highest frequency of sleep disorders was observed in the high bully-victims group (aOR = 4.12, 95% CI: 2.94-5.76). Conclusion: Our findings indicate a positive correlation between bullying roles and sleep disorders in early adolescents. Therefore, targeted intervention for sleep disorders should include an evaluation of bullying experiences.

Childhood maltreatment and homicidal ideation among Chinese early adolescents: The serial mediating role of borderline personality features and aggression.

A large body of evidence linked childhood maltreatment (CM) to juvenile violence and delinquent behavior. However, little is known about the association between CM and homicidal ideation in early adolescents. This study aimed to examine that relationship and to explore the serial mediating role of borderline personality features (BPF) and aggression in that relationship in a large sample of early adolescents. A total of 5724 early adolescents (mean age: 13.5 years) were recruited from three middle schools in Anhui Province, China. The participants were invited to complete self-report questionnaires regarding their history of CM, BPF, aggression, and homicidal ideation. Mediation analyses were evaluated using structural equation modeling. A total of 669 participants (11.7%) reported homicidal ideation in the past 6 months. CM victimization was positively associated with homicidal ideation after adjusting for covariates. Furthermore, the serial mediation analysis showed a significant indirect effect of CM on homicidal ideation through BPF and subsequent aggression. Exposure to maltreatment in childhood is likely to manifest BPF and subsequently higher levels of aggression, which in turn are related to increased homicidal ideation. These findings suggest the need for early intervention for BPF and aggression in early adolescents exposed to CM to prevent the development of homicidal ideation.

Enhancing de novo ceramide synthesis induced by bisphenol A exposure aggravates metabolic derangement during obesity.

OBJECTIVE: Exposure to bisphenol A (BPA) has been shown to increase the prevalence of obesity and its related insulin resistance (IR). Ceramide is a sphingolipid known to facilitate the production of proinflammatory cytokines and subsequently exacerbate inflammation and IR during the progression of obesity. Here, we investigated the effects of BPA exposure on ceramide de novo synthesis and whether increased ceramides aggravate adipose tissue (AT) inflammation and obesity-related IR. METHODS: A population-based case-control study was conducted to explore the relationship between BPA exposure and IR and the potential role of ceramide in AT in obesity. Next, we used mice reared on a normal chow diet (NCD) or a high-fat diet (HFD) to verify the results from the population study and then investigated the role of ceramides in low-level BPA exposure with HFD-induced IR and AT inflammation in mice treated with or without myriocin (an inhibitor of the rate-limiting enzyme in de novo ceramide synthesis). RESULTS: BPA levels are higher in obese individuals and are significantly associated with AT inflammation and IR. Specific subtypes of ceramides mediated the associations between BPA and obesity, obesity-related IR and AT inflammation in the obesity group. In animal experiments, BPA exposure facilitated ceramide accumulation in AT, activated PKCζ, promoted AT inflammation, increased the expression and secretion of proinflammatory cytokines via the JNK/NF-κB pathway, and lowered insulin sensitivity by disrupting IRS1-PI3K-AKT signaling in mice fed a HFD. Myriocin suppressed BPA-induced AT inflammation and IR. CONCLUSION: These findings indicate that BPA aggravates obesity-induced IR, which is partly via increased de novo synthesis of ceramides and subsequent promotion of AT inflammation. Ceramide synthesis could be a potential target for the prevention of environmental BPA exposure-related metabolic diseases.

Bidirectional association between sleep quality or duration and aggressive behaviour in early adolescents: A cross-lagged longitudinal study.

BACKGROUND: Several cross-sectional studies have suggested a strongly positive link between sleep and aggressive behaviour; however, longitudinal studies reporting the relationship between sleep and aggressive behaviour are lacking. This study aimed to examine whether a bidirectional relationship exists between sleep quality or duration and aggressive behaviour in early adolescents. METHODS: A total of 1579 early adolescents (60.9 % boys) from the Chinese Early Adolescents Cohort study were included in this study. Data on sleep quality, sleep duration and aggressive behaviour collected at two time points (September 2019 and September 2021) were used, and the bidirectional relationship between sleep quality or duration and aggressive behaviour was examined using a cross-lagged model. RESULTS: The results revealed a bidirectional relationship between low sleep quality and highly aggressive behaviour. A shorter sleep duration did not predict highly aggressive behaviour, whereas only highly aggressive behaviour predicted a shorter sleep duration. CONCLUSIONS: Sleep quality and aggressive behaviour were interrelated over time among adolescents. However, sleep duration did not predict aggressive behaviour, suggesting that sleep quality, instead of sleep duration, should be the primary target for managing aggressive behaviour.

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.