The association between serum orexin-A levels and sleep quality in pregnant women.

OBJECTIVE/BACKGROUND: Orexin has been shown to regulate the sleep-wake cycle, and it may play a major role in the pathogenesis of sleep disorders; however, its role in sleep disorders in pregnant women remains unclear. We aimed to assess the relationship between serum orexin-A (OXA) levels and sleep quality in pregnant women. PATIENTS/METHODS: This study comprised 214 enrolled pregnant women (poor sleep quality, n = 125; no poor sleep quality, n = 89). We assessed participants' sleep quality and depression and anxiety levels. OXA levels were measured using enzyme-linked immunosorbent assay. RESULTS: Women in the poor sleep quality group showed higher serum OXA levels (0.33[0.3] vs. 0.27[0.11], P < 0.001) than those in the no poor sleep quality group. Binary regression analysis showed that the higher the OXA levels (odds ratio [OR] 1.385, 95% CI [confidence interval] 1.160-1.655) and Zung Self-Rating Anxiety Scale scores (OR 1.073, 95% CI 1.009-1.140), the greater the risk of sleep quality in pregnant women. First-trimester OXA levels differed significantly from those in the second and third trimesters (P < 0.05). CONCLUSION: Serum OXA levels were higher in pregnant women with poor sleep quality than in those without poor sleep quality. OXA levels were also higher in the second and third trimesters than in the first trimester.

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

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

Adolescent resilience and mobile phone addiction in Henan Province of China: Impacts of chain mediating, coping style.

BACKGROUND: As mobile phone use grows, so it brings benefits and risks. As an important part of adolescents healthy growth, resilience plays an indispensable role. Thus, it is important to identify when mobile phone use of an adolescent becomes an addiction. This study proposed to explore the effects of adolescent resilience on mobile phone addiction, and tested the mediating role of coping style and depression, anxiety, and stress (DASS) on phone addiction among 2,268 adolescents in the Henan province, China. METHODS: The adolescents were surveyed via an online questionnaire, a mobile phone addiction index (MPAI), a depression, anxiety, and stress scale with 21 items (DASS-21), the Resilience Scale for Chinese Adolescents (RSCA), and the Simplified coping style questionnaire (SCSQ), and we used structural equation modeling to examine the correlations and moderation effects. All data analyses were performed using SPSS 26.0 and Amos 23.0. RESULTS: The results show that adolescences resilience were negatively related to negative coping, DASS, and mobile phone addiction; both coping style and DASS could mediate the relationship between adolescent resilience and mobile phone addiction among Chinese adolescents. The relationship between adolescent resilience and mobile phone addiction in Chinese adolescents was mediated by the chain of coping styles and DASS. CONCLUSIONS: There is a negative relationship which exists between resilience and mobile phone addiction in this population. In addition, stress, anxiety, depression, and coping style significantly influence the risk of adolescent mobile phone addiction and play an intermediary role in Chinese adolescent resilience and mobile phone addiction.

Depression and Cognition Mediate the Effect of Self-Perceptions of Aging Over Frailty Among Older Adults Living in the Community in China.

Objectives: The aims of the study were first to investigate the association between self-perceptions of aging and frailty and second to determine whether self-perceptions of aging affects frailty via depressive symptoms and cognitive status among older adults living in the community in China. Methods: Among 850 older adults who participated in this cross-sectional study, 822 older adults made valid responses to Tilburg Frailty Indicator, Brief Aging Perceptions Questionnaire, UCLA loneliness scale-8, Mini-Mental State Examination, and Patient Health Questionnaire-9 between March to December 2019. The possible pathways of self-perceptions of aging affecting frailty were analyzed based on the structural equation modeling analysis. Results: A total of 21.53% of older adults reported frailty. Correlation analyses showed that higher degrees of frailty were related to greater loneliness, more depressive symptoms, more negative self-perceptions of aging, worse locomotive function, and cognitive status (r = 0.267, r = 0.440, r = 0.481, r = 0.451, r = -0.337; p < 0.001). Multiple regression analysis showed that loneliness, depressive symptoms, self-perceptions of aging, locomotive function, and cognitive status were the five factors to be entered the regression equation, and the variance of joint explanation was 46.60%. SPA had a direct effect on frailty (ß = 0.306 and p < 0.001), and SPA indirectly affects frailty by independently affecting depressive symptoms (ß = 0.391, 95% CI [0.027, 0.061], and p < 0.001) or cognitive status (ß = 0.148, 95% CI [0.009, 0.024], and p < 0.001) of older adults. Conclusion: These findings help explain the potential psychological mechanisms through which SPA impacts frailty and may aid community healthcare providers in China in identifying individuals at high risk of frailty. The results suggest that health staff should help older adults improve their perspectives on aging, alleviate or prevent depressive symptoms, and improve cognitive status to delay the progress of frailty and promote healthy aging.

The Impact of Adolescent Resilience on Mobile Phone Addiction During COVID-19 Normalization and Flooding in China: A Chain Mediating.

Natural disasters cause long-term psychological problems and increase substance use in some adults. However, it is unclear whether disasters also lead to these problems in adolescents. We hypothesized the influence of adolescent resilience on mobile phone addiction during the normalization of COVID-19 and flooding. We tested the mediating role of coping style and depression, anxiety, and stress (DASS) on phone addiction among 1,751 adolescents in the Henan Province in China. The adolescents were surveyed via an online questionnaire, and we used structural equation modeling to examine the correlations and moderation effects. The results show that coping style and DASS could mediate the relationship between adolescent resilience and mobile phone addiction among Chinese adolescents. A chain of coping styles and DASS mediated the relationship between adolescent resilience and mobile phone addiction in Chinese adolescents.

Factors Influencing Aggressive Adolescent Behavior: An Analysis Using the Decision Tree Method.

Aggression among adolescents is a significant public health concern worldwide. To safeguard adolescents' physical and mental health, controlling the incidence of aggressive behavior and its triggers and drivers is necessary. Different risk factors in each environment drive adolescent aggression. These factors are interconnected, making the environment an ecosystem of aggression. This study aims to analyze the factors that influence adolescents' aggressive behavior and provide a basis for formulating measures to reduce such behavior in the future. This multicenter cross-sectional study was conducted in five middle schools in Lingbao City. The participants were junior high school students aged 11-15 years. Data were analyzed from January to March 2020 using the decision tree analysis method. The aggressive behavior scale, adolescent emotion regulation scale, family intimacy and adaptation scale, parental education participation scale, and a simple parenting style questionnaire were used for the investigation. Of the 581 participants, 25.5% demonstrated a tendency for aggressive behavior, while the remaining did not. The decision tree analysis showed that the incidence of adolescent aggression was the highest (54.8%) when the maternal overprotective score was greater than or equal to 17, the adolescent had low emotional control, and the mother's intelligence score was higher than 30. The decision tree model reflects the influencing factors of adolescent aggressive behavior from multiple levels and provides a reference for formulating effective intervention measures to control such behavior and its influencing factors.

Interaction between Sirtuin 1 (SIRT1) polymorphisms and childhood maltreatment on aggression risk in Chinese male adolescents.

BACKGROUND: Aggressive behavior is a highly prevalent and serious public health problem among adolescents. However, the etiology and pathogenesis of aggressive behavior remain unclear. Childhood maltreatment is an acknowledged factor for aggressive behavior. SIRT1 is closely related to the occurrence and development of psychiatric disorders. We aimed to reveal the interactive effect between SIRT1 and childhood maltreatment on aggressive behavior among Chinese adolescents. METHODS: Aggressive behavior and childhood maltreatment were evaluated by the Buss and Warren's Aggression Questionnaire (BWAQ) and short form Childhood Trauma Questionnaire (CTQ-SF), respectively. This study comprised 436 aggression cases and 435 controls. Four SIRT1 tagSNPs were selected for genotyping. Interaction between SIRT1 and childhood maltreatment was estimated by logistic regression models. RESULTS: Individuals carrying SIRT1 rs4746720 minor allele and TAAC haplotype derived from SIRT1 variants was associated with reduced aggression risk when childhood maltreatment occurred (all P < 0.01). An antagonistic additive interaction between SIRT1 rs4746720 and childhood maltreatment on aggressive behavior (S = 0.421; 95%CI: 0.234 to 0.758) was further testified. No main effect of the SIRT1 SNPs or the haplotype block was observed (all P > 0.05). LIMITATIONS: Since participants were only males, our findings were unable to be directly extended to females. Cross-sectional design, self-reported measurements and limited sample size were adopted. CONCLUSION: This study provides the first evidence of SIRT1 × childhood maltreatment interaction on aggressive behavior in male adolescents. The minor allele of SIRT1 rs4746720 presents a protective effect on combination with childhood maltreatment on the risk of aggressive behavior.

Relationship between emotional intelligence and job well-being in Chinese clinical nurses: multiple mediating effects of empathy and communication satisfaction.

BACKGROUND: Nursing work is associated with great pressure, and nurses are often overwhelmed. Therefore, correct emotional regulation is essential to improve nurses' job well-being and promote better engagement in nursing work. The purpose of this study was to establish a structural model to estimate the impact of Chinese clinical nurses' emotional intelligence on job well-being, using multiple intermediaries to explain the internal mechanisms underlying the relationship. METHODS: This was a cross-sectional study of 1475 registered nurses from a Chinese hospital who provided responses to emotional intelligence, empathy, communication satisfaction, and job well-being scales. Path analysis using a multiple mediation model was performed using AMOS 23.0. RESULTS: Among all clinical nurses who participated in the survey, 1475 (98.33 %) completed the questionnaire. The nurses' job well-being score was 83.61 ± 12.63. There was a significant positive correlation between job well-being and communication satisfaction, emotional intelligence, and empathy ability (r = 0.346-0.570, P < 0.001). Empathy and communication satisfaction partially mediated the relationship between emotional intelligence and job well-being, with effect sizes of 0.047 and 0.227, respectively. The chain mediating effect of empathy and communication satisfaction had a value of 0.045. CONCLUSIONS: It is recommended that hospital managers take actions to improve nurses' emotional intelligence level, and conduct professional psychological training to improve nurses' empathy and communication satisfaction, and ultimately improve their job well-being.

Relationship between emotional intelligence and job well-being in Chinese Registered Nurses: Mediating effect of communication satisfaction.

AIM: To explore the relationship between emotional intelligence and job well-being among Chinese Registered Nurses, and the mediating role of communication satisfaction in the relationship. DESIGN: A descriptive cross-sectional study design was employed. METHODS: Random sampling was adopted. The study was conducted from September to December 2019, and 1,475 Registered Nurses from a Chinese hospital provided responses to Wong and Law's emotional intelligence scale, communication satisfaction scale, job well-being scale and general information questionnaire. SPSS25.0 software was used to calculate means, standard deviations and correlations, and AMOS 21.0 software was used to establish the structural equation model. RESULTS: The emotional intelligence, communication satisfaction and job well-being of Registered Nurses in China were related to positional rank, work department, monthly income, years of service, night shift work distribution and intensity of work. There were positive correlations among emotional intelligence, communication satisfaction and job well-being. Communication satisfaction partly mediated the relationship between emotional intelligence and job well-being. Improving the level of emotional intelligence and communication satisfaction should be an important strategy to improve nurses' job well-being. Therefore, nursing managers could carry out targeted training on emotional intelligence management and communication between nurses and patients and pay attention to the spiritual needs of nurses and provide psychological guidance on a regular basis.

Specific effects of neglect and physical abuse on adolescent aggressive behaviors by gender: A multicenter study in rural China.

BACKGROUND: Neglect and physical abuse may be typical risk factors for aggressive behavior in adolescents. However, findings on their specific effects and sex differences are still unclear. This study aimed to examine the specific effects of neglect and physical abuse on adolescent aggressive behaviors and to further explore the potential sex-specific effect. METHODS: A multicenter school-based survey was conducted in rural China. A total of 15,957 students aged 11-20 years completed self-report questionnaires to record aggressive behaviors, neglect and physical abuse, and other related information. Participants were grouped into those who experienced none, one of, or both neglect and physical abuse for statistical analyses. RESULTS: Of the participants, 37.0% experienced both neglect and physical abuse, 30.0% experienced neglect only, and 9.8% experienced physical abuse only. Higher risk for physical aggression (OR=1.24, 95% CI=1.06-1.45), and lower risk for verbal aggression (OR=0.83, 95% CI=0.72-0.94) and hostility (OR=0.81, 95% CI=0.69-0.94) were found in the physical abuse only group as compared to the neglect only group. No sex difference was found between neglect or physical abuse and general aggressive behaviors (P>0.05), except that females were more likely to exert physical aggression than males when exposed to neglect and physical abuse (P<0.05). LIMITATIONS: Cross-sectional design, retrospective self-report data, and not including other maltreatment subtypes. CONCLUSIONS: Neglect and physical abuse may each have distinct sensitivity for different subtypes of aggression. Targeted treatment for diverse aggressive symptoms is suggested, and strategies to prevent both neglect and physical abuse across gender would yield comprehensive benefits.

Micro-ribonucleic acid-23a-3p prevents the onset of type 2 diabetes mellitus by suppressing the activation of nucleotide-binding oligomerization-like receptor family pyrin domain containing 3 inflammatory bodies-caused pyroptosis through negatively regulating NIMA-related kinase 7.

AIMS/INTRODUCTION: Micro-ribonucleic acids (miRNAs) possess crucial functions in governing metabolisms associated with type 2 diabetes mellitus. This study aimed to investigate the role of miR-23a-3p in pyroptosis caused by nucleotide-binding oligomerization-like receptor family pyrin domain containing 3 (NLRP3) inflammatory body activation, thereby reducing the occurrence of type 2 diabetes mellitus. MATERIALS AND METHODS: miR-23a-3p and NIMA-related kinase 7 (NEK7) expression in type 2 diabetes mellitus patients and rat models was examined. Dual-luciferase reporter gene experiments were used to verify the targeting relationship between miR-23a-3p and NEK7. Bone marrow-derived macrophages were transfected with miR-23a-3p mimic, miR-23a-3p inhibitor or short hairpin NEK7 and were treated with a specific activator of NLRP3 inflammatory body (lipopolysaccharide + adenosine-5'-triphosphate) to evaluate expression of NEK7, miR-23a-3p, gasdermin D p30, pro-caspase-1 and caspase-1 in cells, and interleukin-1ß and tumor necrosis factor-α in supernatant. Type 2 diabetes mellitus rat models were used to observe the influences of miR-23a-3p, NEK7 and NLRP3 inflammatory body on pyroptosis and type 2 diabetes mellitus in vivo. RESULTS: NEK7 was overexpressed, whereas miR-23a-3p was underexpressed in patients and rat models with type 2 diabetes mellitus. NEK7 was a target gene of miR-23a-3p. After the addition of lipopolysaccharide + adenosine-5'-triphosphate in bone marrow-derived macrophages, the expression of miR-23a-3p subsequently declined. Furthermore, the addition of lipopolysaccharide + adenosine-5'-triphosphate elevated NEK7, NLRP3, pro-caspase-1, cle-caspase-1 and gasdermin D p30 expressions in bone marrow-derived macrophages, and enhanced levels of interleukin-1ß and tumor necrosis factor-α in the supernatant, accompanied with conspicuous cell pyroptosis, which was reversed after miR-23a-3p overexpression and NEK7 silencing. miR-23a-3p overexpression alleviated liver and kidney damage in type 2 diabetes mellitus rats, and reduced NLRP3-induced pyroptosis. CONCLUSIONS: Targeting NEK7 by miR-23a-3p could reduce NLRP3-induced pyroptosis, and assuage liver and kidney injuries in type 2 diabetes mellitus rats.

The Mediating Role of Cognitive Emotion Regulation in BIS/BAS Sensitivities, Depression, and Anxiety Among Community-Dwelling Older Adults in China.

BACKGROUND: The behavioral inhibition system (BIS) and behavioral activation system (BAS), which primarily underlie emotions and behaviors, are associated with depression and anxiety. However, the reasons behind these associations require further exploration. OBJECTIVE: This study aims to examine the mediating effects of cognitive emotion regulation between BIS/BAS and depression/anxiety among community-dwelling elderly Chinese. METHODS: A cross-sectional survey was conducted with a sample of 836 elderly individuals. Structural equation modeling was used to determine relationships among BIS/BAS, cognitive emotion regulation, and depression/anxiety. RESULTS: Participants reporting higher BIS sensitivity were more likely to use maladaptive cognitive emotion regulation strategies, which were in turn associated with higher rates of depression and anxiety. BAS sensitivity was more likely to lead to adaptive cognitive emotion regulation strategies, which resulted in lower levels of depression and anxiety. CONCLUSION: Our findings suggest that incorporating emotional regulation in interventions targeting BIS/BAS sensitivities may enhance the accuracy and efficiency of these treatments for depression and anxiety.

Reactive Aggression Affects Response Inhibition to Angry Expressions in Adolescents: An Event-Related Potential Study Using the Emotional Go/No-Go Paradigm.

Although it is well established that response inhibition to angry expressions is impaired among reactively aggressive adolescents, the cognitive processes underlying this effect remain unclear. The main goal of our study was to investigate the time course of response inhibition to angry expressions in reactively aggressive adolescents compared to controls. In total, 23 reactively aggressive adolescents and 23 control adolescents were recruited to participate in an event-related potential (ERP) study measuring response inhibition to angry expressions with an emotional Go/No-go paradigm. The results showed that when presented angry or happy expressions, reactively aggressive adolescents showed a smaller No-go P3 effect than the control group. These results indicate that response inhibition to angry expressions in reactively aggressive adolescents is impaired at the later stage of the actual inhibitory control. The characteristics of response inhibition to happy expressions in reactively aggressive adolescents are similar to those in response to angry expressions.

Association of Internet Addiction With Nonsuicidal Self-injury Among Adolescents in China.

Importance: Both nonsuicidal self-injury (NSSI), defined as the direct, deliberate damage of one's body tissue without suicidal intent, and internet addiction among adolescents are public health concerns. However, the possible association of NSSI with internet addiction is not well understood. Objective: To examine the occurrence of internet addiction with NSSI and any sex differences among Chinese adolescents. Design, Setting, and Participants: A multicenter, cross-sectional, survey study was conducted from February 18 to October 15, 2015, among adolescents aged 11 to 20 years from 343 classes in 45 public high schools across 5 provinces of China. Data analysis was performed from August 1, 2018, to March 1, 2019. Exposures: Possible internet addiction and internet addiction. Main Outcomes and Measures: Less-frequent (1-4 times) NSSI and more-frequent (≥5 times) NSSI were surveyed using the Chinese version of the Functional Assessment of Self-Mutilation. Results: A total of 15 623 students (8043 male [51.5%] and 7580 female [48.5%]) aged 11 to 20 years (mean [SD] age, 15.1 [1.8] years) participated. Of these, 4670 participants (29.9%) met the criteria for possible internet addiction and 509 participants (3.3%) met the criteria for internet addiction. A total of 2667 students (17.1%) engaged in less-frequent NSSI, while 1798 students (11.5%) engaged in more-frequent NSSI in the 12 months preceding the survey. Both possible internet addiction and internet addiction were associated with less-frequent or more-frequent NSSI. The adjusted odds ratios were 1.29 (95% CI, 1.17-1.42) for possible internet addiction and 1.41 (95% CI, 1.11-1.80) for internet addiction for less-frequent NSSI; for more-frequent NSSI, the adjusted odds ratios were 1.75 (95% CI, 1.56-1.96) for possible internet addiction and 2.66 (95% CI, 2.10-3.38) for internet addiction. These associations were similarly observed among age groups of 11 to 14, 15 to 17, and 18 to 20 years. No sex disparities were found in the associations of internet addiction with NSSI, except among adolescents aged 11 to 14 years, where the odds ratios for possible internet addiction with less-frequent NSSI were higher in male adolescents (1.53; 95% CI, 1.25-1.88) than female adolescents (1.13; 95% CI, 0.90-1.47). Conclusion and Relevance: Internet addiction appears to be associated with NSSI, and the findings of this study suggest that the association was similar between male adolescents and female adolescents. These data suggest that evaluation of the risk of NSSI for adolescents in association with internet addiction may help health care professionals in developing preventive interventions for NSSI.

Power spectrum study of EEG resting-state in students with high trait anxiety / 中国学校卫生

Objective@#To investigats the specific changes of brain neuron oscillation in non-clinical high-trait anxiety college students by recording the resting state EEG of high and low trait anxiety subjects.@*Methods@#College students in a university were administered by using the S-TA Inventory, 27% of the number of people before and after the selection were divided into low-specific focus group (15) and high-trait anxiety group(15), based on the STAT score. After pre-processing, the data was divided into five frequency bands of δ(1-<4), θ(4-<8), α(8-<13), β(13-<30), γ(30-100)Hz and every electrode power value of those was calculated respectively. Correlation between power spectrum and trait anxiety scores was investigated.@*Results@#The high-trait anxiety group were in the frontal and central regions (t=3.47, 2.62) of the δ band, the frontal region (t=2.22) of the θ band, the frontal, central, right temporal, and posterior regions (t=2.77, 2.23, 3.65, 2.35) of the β band, the frontal, left temporal, central, right temporal, and posterior regions (t=2.83, 2.22, 2.64, 2.43, 2.09) of the γ band, than that in the low trait anxiety group. Furthermore, in central regions of the δ band; the frontal region of the θ band; the frontal, the central, and posterior regions of the β band; the frontal, left temporal, central, and posterior regions(r=-0.63, -0.51, -0.62, -0.53, -0.54, -0.59, -0.56, -0.55, -0.49) of the γ band, the correlation between trait anxiety scores and the power value were obvious negatively.@*Conclusion@#High trait anxiety college students have lower power spectrum than low trait anxiety college students. The degree of trait anxiety is related to the power spectrum. The changes of brain resting-state electrical signals in high-trait anxiety individuals may be related to the influence of trait anxiety on college students’ attention and working memory.

Correlation between aggression and self-acceptance, family intimacy and adaptability in college students / 中国学校卫生

Objective@#To understand the relationships between college students’ aggression and self-acceptance, family intimacy and adaptability, and to provide reference for college students’ aggression preventing and intervening.@*Methods@#Using general information questionnaire, Aggression Questionnaire, Self-acceptance Questionnaire and FACES II-CV, 984 college students from 3 colleges in Xinxiang, Henan province were surveyed by questionnaire.@*Results@#The total score of physical aggression, verbal aggression, indirect aggression and aggression in male students was higher than that of female students (t=7.17,4.21,2.05,3.63,P<0.05).The score of physical aggression of only children was higher than that of nononly children (t=2.39,P<0.05).The score of indirect attack of disciplined college students was higher than that of undisciplined college students (t=2.60,P<0.01).There were statistically significant differences in the total scores of indirect attack, hostility and attack among college students with different left-behind experiences (F=3.39,4.61, 3.37, P<0.01).There were statistically significant differences in the total scores of physical aggression, anger and aggression among college students by family income(F=5.70,3.94,3.37,P<0.01).Correlation analysis showed that the total score of college students’ aggression was positively correlated with self-acceptance, negatively correlated with actual family intimacy and actual family adaptability (r=0.37，-0.09，-0.07,P<0.01). Regression analysis showed that self-acceptance, gender, disciplinary action, left-behind experience and expected family adaptability showed significant associations with total score of college students’ aggression (P<0.05).@*Conclusion@#Self-acceptance and family closeness and adaptability are associated with aggressive behavior in college students. Schools should carry out targeted psychological health education on self-acceptance to ensure that college students maintain a reasonable level of self-acceptance, and family members should develop certain level of intimacy and adaptability, in order to reduce the occurrence of aggressive behavior of college students.

Genetic variants in oxytocin receptor gene (OXTR) and childhood physical abuse collaborate to modify the risk of aggression in chinese adolescents.

BACKGROUND: Accumulating evidence suggests that genetic and environmental factors may influence aggression susceptibility. However, the etiology of aggressive behavior remains unknown. Compared to some extensively studied candidate genes of aggression, very little is known about the OXTR gene. The objective of this study was to determine whether OXTR genetic variants were associated with aggression risk and whether these polymorphisms showed interactive effects with childhood maltreatment on aggression in Chinese adolescents. METHODS: A total of 996 participants including 488 cases and 488 controls were selected in our study. Aggression, childhood maltreatment were measured by self-reported questionnaire. Buccal cells were collected. Genotyping was performed using SNPscan. Logistic regressions were used to estimate both main effects of OXTR polymorphisms and the interactive effects with childhood maltreatment on aggressive behavior. RESULTS: Participants who carried the rs237885 TT genotypes in OXTR had a higher risk of aggression compared to those who carried GG or GT genotypes under the recessive model (OR=1.40, 95% CI, 1.04-1.89) after controlling for potential confounders. In addition, we also found that the polymorphism had a synergic additive interaction with childhood physical abuse on the aggression risk. LIMITATIONS: The subjects in the present study were only males, thus our findings and conclusions could not be generalized to females. CONCLUSIONS: The present study provides evidence that OXTR genetic variants may contribute to aggression susceptibility. Moreover, this is the first study reporting significant interactive effects of OXTR polymorphism and childhood physical abuse on aggressive behavior in Chinese adolescents.

Association of genetic variations in the serotonin and dopamine systems with aggressive behavior in the Chinese adolescent population: Single- and multiple-risk genetic variants.

BACKGROUND: Genetic predisposition is an important factor leading to aggressive behavior. However, the relationship between genetic polymorphisms and aggressive behavior has not been elucidated. METHODS: We identified candidate genes located in the dopaminergic and serotonin system (DRD3, DRD4, and FEV) that had been previously reported to be associated with aggressive behavior. We investigated 14 tag single-nucleotide polymorphisms (SNPs) using a multi-analytic strategy combining logistic regression (LR) and classification and regression tree (CART) to explore higher-order interactions between these SNPs and aggressive behavior in 318 patients and 558 controls. RESULTS: Both LR and CART analyses suggested that the rs16859448 polymorphism is the strongest individual factor associated with aggressive behavior risk. In CART analysis, individuals carrying the combined genotypes of rs16859448TT/GT-rs11246228CT/TT-rs3773679TT had the highest risk, while rs16859448GG-rs2134655CT had the lowest risk (OR = 5.25, 95% CI: 2.53-10.86). CONCLUSION: This study adds to the growing evidence on the association of single- and multiple-risk variants in DRD3, DRD4, and FEV with aggressive behavior in Chinese adolescents. However, the aggressive behavior scale used to diagnose aggression in this study did not account for comorbid conditions; therefore, further studies are needed to confirm our observations.

Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China.

BACKGROUND: Non-suicidal self-injury (NSSI) is a highly prevalent and serious public health problem among adolescents worldwide. However, to date there were no studies assessing the prevalence of NSSI defined by suggested DSM-5 criteria among Chinese adolescents. We aimed to conduct a nationwide survey to explore the prevalence of and risk factors for NSSI among school-based adolescents in rural China. METHODS: A total sample of 15,623 adolescents in rural China were enrolled by using a multistage sampling method. Data was collected by self-report questionnaires including demographic characteristics, neglect, maltreatment, loneliness, resilience, social support and emotional management ability. NSSI was defined by suggested DSM-5 criteria, according to which the engagement in self-injury took place more than 5 times a year. Multinomial logistic regression models were used to estimate the association between risk factors and NSSI. RESULTS: There were 12.2% of adolescents (n = 1908) met the suggested DSM-5 criteria. Approximately 29% reported a history of NSSI at least once during the last year. Significant differences were found in several demographic factors including gender, ethnicity, grade, and family structure between adolescents with and without experiencing NSSI. The top three NSSI behaviors among adolescents with NSSI experience were hitting self, pinching, and pulling hair, with a prevalence rate of 16.7%, 14.1% and 11.2%, respectively. Female, Han ethnicity, fathers' education level, neglect, maltreatment, loneliness, social support, suicidal behaviors and emotional management ability were significantly associated with NSSI by multivariate analysis. No significant relationship was found between resilience and risk of NSSI. LIMITATION: The DSM-5 has proposed 6 groups of criteria for NSSI, we only used criteria on frequency given its more accepted feasibility and pragmatic application. Consequently, it may different from other prevalence that estimated by other criteria. CONCLUSION: To the best of our knowledge, this is the first study reporting prevalence of NSSI defined by suggested DSM-5 criteria among adolescent in rural China. In comparison to finding from the similar samples of adolescents, Chinese rural adolescents seem to have a relative higher prevalence. The potential risk factors for NSSI include female, father's education, Han ethnicity, psychosocial factors and suicide behaviors. More evidence for further understanding of context of the occurrence, improving access to health care utilization, and identifying the role of psychosocial factors and family relationship, is needed for the prevention and management of NSSI.

A comparative analysis of suicide attempts in left-behind children and non-left-behind children in rural China.

To estimate the prevalence of suicide attempts and explore the shared and unique factors influencing suicide risk in left-behind children (LBC) and non-left-behind children (NLBC) in rural China, this study collected data using a multi-stage cluster random sampling method from 13,952 children including 6,034 LBC and 7,918 NLBC. Sociodemographic characteristics, suicide attempts, neglect and physical abuse, negative life events, and loneliness were measured by self-reported questionnaires. Data were analyzed using logistic regression models. Gender and mother's education level were unique influential factors for NLBC while family structure type was a unique influential factor for LBC. The study provides two novel findings regarding NLBC specifically: 1. Children with optimal family socioeconomic status are more likely to report suicide attempts (odds ratio OR = 1)than are those in the general children population, OR 0.52 (95% CI: 0.39-0.70), and 2. Children with higher mother's education level are subject to higher suicide rates in high school, OR 1.67 (95% CI: 1.13-2.46), and post-secondary education, OR 2.14 (95% CI: 1.37-3.37). The unique characteristics of LBC and NLBC in China suggest that investigating risk factors and determining the factors that might be targeted in intervention programs are urgently needed currently.