The links between parenting, self-esteem, and depressive symptoms: a meta-analysis

INTRODUCTION

Framed by attachment and cognitive theories, the current meta-analysis tested the direct and indirect links among parenting dimensions (parental support, authoritative control, psychological control, and behavioral control), self-esteem, and depressive symptoms for children and adolescents.

METHODS

Based on 53 studies, and 74 independent samples, the present study used One-Stage Meta-analytic Structural Equation Modeling (OSMASEM) to investigate these links, including testing a mediation effect by self-esteem between parental support-, authoritative control-, psychological control-, behavioral control-, and depressive symptoms. It also tested for potential moderation effects by several variables.

RESULTS

The evidence indicated that parental support (β = .29), authoritative control (β = .23), and behavioral control (β = .07) are positive correlates of self-esteem, while psychological control (β = -.26) is a negative one. It also found that self-esteem was negatively associated with depressive symptoms (β range: -.49 to -.53). Furthermore, parental support (β = -0.14), authoritative control (β = -0.10), and behavioral control (β = -0.05) are negative correlates of depressive symptoms, while psychological control is a positive correlate (β = .11). OSMASEM also provided evidence that parental support, authoritative control, psychological control, and behavioral control are indirectly associated with depressive symptoms, via self-esteem.

CONCLUSION

Parenting dimensions are associated with depressive symptoms both directly and indirectly. That is, self-esteem partially mediates the relationships between parental support, authoritative control, psychological control, and behavioral control with depressive symptoms. Furthermore, OSMASEM moderator tests provided evidence of several significant moderators, including age, sex, parenting measurement, and self-esteem measurement.

The impact of video game playing on Chinese adolescents' academic achievement: Evidence from a moderated multi-mediation model

Internet access for adolescents is becoming more prevalent around the world. Although video game playing has been verified to be negatively related to adolescent academic achievement, the mechanisms underlying this relationship are also unknown. Using a nationally representative sample of adolescents from the China Education Panel Survey (2014-2015), this study aims to explore the parallel mediation roles of self-educational expectation and learning attitude in the link between video game playing and academic achievement, and whether the direct and indirect effects are moderated by parent-child relationship. The results indicate that video game playing in adolescents is both directly and indirectly related to their academic achievement, and self-educational expectation and learning attitude partially mediate this association. Moreover, the results reveal that parent-child relationship moderates the direct association between video game playing and academic achievement as well as the indirect association of video game playing on academic achievement via self-educational expectation, respectively. By showing empirical evidence for the usefulness of social cognitive theory to adolescents' academics in the Internet Age, our research provides a supplement to existing literature.

The prevalence and its associated factors of psychological stress among middle school students in China: pooled evidence from a systematic scoping review

Psychological issues are of significant concern in present-day society, as poor mental well-being results in depression and suicidal behavior. Understanding the current situation of psychological stress among secondary school students will help policy makers to formulate targeted measures to help them cope with stress, and at the same time evaluate the effectiveness of the existing policies to address the shortcomings and enhance the diversification of interventions. The main purpose of this review was to map the existing evidence on the prevalence and levels of psychological stress among adolescents in China, and to identify the associated risk factors. This review strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was performed spanning Web of Science, PubMed, and Scopus databases. Studies involving only humans and full text in English were selected. Selection was limited to samples from mainland China, Hong Kong, Macau, and Taiwan. Variables were extracted, exploring the factors that affected the mental wellness of Chinese middle school students. A final 15 articles and 1 report were included. The findings revealed psychological stress is prevalent among Chinese middle school population, with the degree of prevalence from low to severe stress levels. Three dimensions of psychological stress affecting Chinese secondary school students: school, family and lifestyle. Within the school, the factors included academic stress, peer relationships etc. Family-related factors were comprised of parent-child relationship, parents' mental health status etc. Lastly, lifestyle-related factors included poor diet, sedentary and inactivity etc. Our findings suggest that policy makers should reduce the excessive emphasis on examination results and focus on the all-round development of students, and that schools should organize a variety of extra-curricular activities to reduce students' stress. Parents should create a harmonious family atmosphere to minimize conflicts and maintain close communication with teachers.

Systematic Review Registration

OSF; https://doi.org/10.17605/OSF.IO/HEFCP.

Contributions of Multilevel Family Factors to Emotional and Behavioral Problems among Children with Oppositional Defiant Disorder in China

Oppositional defiant disorder (ODD) is one of the most prevalent childhood mental health disorders and is extremely affected by family factors. However, limited studies have addressed the issue from the perspective of family systems. The current study examines the associations between multilevel family factors (i.e., family cohesion/ adaptability at system level, mother-child and father-child attachment at a dyadic level, and child self-esteem at an individual level) and emotional and behavioral problems among children with ODD in China. The participants were 256 Chinese children with ODD and their parents and class master teachers. A multiple-informant approach and structural equation model were used. The results revealed that system level factors (family cohesion/adaptability) were associated with child emotional and behavior problems indirectly through factors at the dyadic level (mother-child attachment) and the individual level (child self-esteem) in sequence. Mother-child, but not father-child, attachment, mediated the linkage between family cohesion/adaptability and the emotional problems of children with ODD. Moreover, child self-esteem mediated the association between mother-child attachment and child emotional and behavioral problems. The findings of the present study underscored that multilevel family factors are uniquely related to emotional and behavioral problems in children with ODD.

Comparison of three machine learning models to predict suicidal ideation and depression among Chinese adolescents: A cross-sectional study

BACKGROUND

Machine learning (ML) algorithms based on various clinicodemographic, psychometric, and biographic factors have been used to predict depression, suicidal ideation, and suicide attempt in adolescents, but there is still a need for more accurate and efficient models for screening the general adolescent population. In this study, we compared various ML methods to identify a model that most accurately predicts suicidal ideation and level of depression in a large cohort of school-aged adolescents.

METHODS

Ten psychological scale scores and 20 sociodemographic parameters were collected from 10,243 Chinese adolescents in the first or second year of middle school and high school. These variables were then included in a random forest (RF) model, support vector machine (SVM) model, and decision tree model for factor screening, dichotomous prediction of suicidal ideation (yes/no), and trichotomous prediction of depression (no depression, mild-moderate depression, or major depression).

RESULTS

The RF model demonstrated greater accuracy for predicting suicidal ideation (mean accuracy (ACC) = 87.3 %, SD = 3.2 %, area under curve (AUC) = 92.4 %) and depressive status (ACC = 84.0 %, SD = 2.8 %, AUC = 90.1 %) than SVM and decision tree models. We have also used the RF model to predict adolescents with both depression and suicidal ideation with satisfactory results. Significant differences were found in several sociodemographic parameters and scale scores among classification groups and differences in six factors between sexes.

CONCLUSIONS

This RF model may prove valuable for predicting suicidal ideation, depression, and non-suicidal self-injury among the general population of Chinese adolescents.

Psychosocial Problems and Condomless Anal Sex among Transgender Women in Two Cities of China: Study Based on the Syndemic Framework

Studies examining the association between psychosocial problems and condomless anal sex (CAS) among transgender women (TGW) are rare. In this study, close attention was paid to the effect of co-occurring psychosocial problems on sexual risk behaviors. A cross-sectional study, including 247 TGW, was conducted in Kunming and Shenyang, China. The prevalence of condomless anal sex among TGW in the previous 6 months was 30.8%. Most of the psychosocial factors were associated with one another in bivariate logistic regression models. Low self-esteem (ORm = 2.99, 95% CI = 1.25-7.18), sexual compulsivity (ORm = 2.13, 95% CI = 1.13-4.00), and intimate partner violence (ORm = 2.21, 95% CI = 1.19-4.11) were discovered to be related to condomless anal sex in the multivariate regression model. No significant interactive effects of the syndemic factors on condomless anal sex were detected. More programmatic and effective HIV prevention interventions targeting psychosocial problems are required to reduce HIV infection within the population.

Associations of parent-adolescent relationship and self-esteem with emotional and behavioral problems among Chinese adolescents

BACKGROUND

This study aimed at exploring the associations of parent-adolescent relationship and self-esteem with emotional and behavioral problems (EBPs) among Chinese adolescents using a large-scale nationally questionnaire survey data from China.

METHODS

Obtained from China Family Panel Studies (CFPS) 2018, the research data involved 2400 adolescents aged 10-15. Multiple linear regression analysis and the PROCESS macro were used for examining the mediating effect of self-esteem on the associations of parent-adolescent relationship with EBPs.

RESULTS

After controlling the potential confounding factors, parent-adolescent relationship and self-esteem were significantly associated with EBPs (P < 0.01). Correlation analysis results showed that parent-adolescent relationship (r = -0.116, P < 0.01) and self-esteem (r = -0.209, P < 0.01) were negatively correlated with EBPs. Self-esteem partially mediated the associations of parent-adolescent relationship with EBPs among Chinese adolescents.

LIMITATIONS

The cross-sectional design limited the ability to make causal inferences.

CONCLUSIONS

Positive parent-adolescent relationship and high self-esteem contributed to fewer EBPs of adolescents. Parent-adolescent relationship predicted EBPs partially mediated by self-esteem. Establishing positive parent-adolescent relationship and improving individual self-esteem may thus be promising targets for intervention in adolescents with EBPs.

Parental psychological control and adolescents depression during the COVID-19 pandemic: the mediating and moderating effect of self-concept clarity and mindfulness

During the COVID-19 pandemic, the mental health state of adolescents had caused widespread concern, especially the various problems caused by the relationship between adolescents and their parents in the long isolation at home. Based on the mindfulness reperceiving model and Rogers's Self-theory, this study aimed to explore the roles of adolescents' self-concept clarity and mindfulness level in the relationship between parental psychological control and adolescent depression. A total of 1,100 junior high school students from China completed the questionnaires regarding parental psychological control, depression, self-concept clarity, and mindfulness. Moderated mediation analyses suggest that parental psychological control affects adolescent depression via self-concept clarity. The association between parental psychological control and depression is moderated by self-concept clarity. The effect was stronger among adolescents with high mindfulness levels than those with low. This study suggests that it is necessary to consider both parental factors and adolescents' factors in the future. The interventions on self-concept or mindfulness may ameliorate adolescent mental problems more effectively.

Parental migration status moderates the link between parent-child relationship and children's well-being through psychological distress

The effects of parental migration on the well-being of left-behind children (LBC) are varied. Several studies demonstrated that parental migration reduces children's psychological health but other research showed contradictory results. This study sought to clarify this issue by examining the mediating role of psychological distress and the moderating role of parental migration status in the association between the parent-child relationship and children's psychological distress. A total of 743 LBC and 688 non-LBC self-reported their parent-child relationship, psychological distress, and well-being. Findings showed that psychological distress mediated the association between parent-child relationship and children's well-being. This denotes that greater parent-child relationship results into lowered levels of psychological distress, and in turn, increases children's emotional, psychological, and social well-being. Moreover, the link between parent-child relationship and psychological distress was found to be contingent to parental migration status. Specifically, the negative association between parent-child relationship and psychological distress was especially strong among LBC in contrast to non- LBC. This implies that children with higher quality relationships with their parents tend to exhibit decreased severity of psychological distress symptoms, especially in children whose parents are working overseas. These results underscore the dynamic role of parent-child relationship in the well-being of LBC, and suggest ways to develop intervention programs that include cultivating skills in managing psychological distress and improving the emotional, psychological, and social well-being of LBC.

Parents’ Response to Children’s Performance and Children’s Self-Esteem: Parent–Child Relationship and Friendship Quality as Mediators

Previous research has revealed that parents’ success-oriented response to children’s performance promotes children’s self-esteem, while failure-oriented response damages their self-esteem. However, the potential mediating mechanisms are unclear. Therefore, the present study investigated whether parent–child relationship and friendship quality mediated the relation between parents’ response to children’s performance and children’s self-esteem. For this purpose, 859 children in Central China completed the Parents’ Response to Children’s Performance Scale, Buchanan Scale of Closeness to Parents (CPS), Friendship Quality Questionnaire (simplified version), and Self-Perception Profile tests. Structural equation modeling (SEM) revealed that: (1) parents’ success-oriented response was positively associated with parent–child relationship, friendship quality, and children’s self-esteem. Parents’ failure-oriented response was negatively associated with parent–child relationship and children’s self-esteem, but it was positively associated with friendship quality. (2) Parent–child relationship and friendship quality were identified as the serial mediators between parents’ success- or failure-oriented response and children’s self-esteem. These findings suggest that parents’ failure-oriented response should be reduced and parents’ success-oriented response should be increased to develop children’s self-esteem and establish a sound social network system for children.

Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study

BACKGROUND

The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched.

OBJECTIVE

We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents.

METHODS

A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as △) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent-adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of △SFUI with △CES-D and the association of △EFUI with △CES-D were tested using hierarchical regression models.

RESULTS

The association between △SFUI and △CES-D was partially mediated by △mother-adolescent conflict (mediation effect size 5.11%, P=.02) and △social nonconfidence (mediation effect size 20.97%, P<.001) but partially suppressed by △friendship quality, △perceived family support, and △perceived friend support, with suppression effects of -0.011 (P=.003), -0.009 (P=.003), and -0.022 (P<.001), respectively. The association between △EFUI and △CES-D was partially mediated by △social nonconfidence (mediation effect size 30.65%, P<.001) but partially suppressed by △perceived family support and △perceived friend support, with suppression effects of -0.036 (P<.001) and -0.039 (P<.001), respectively.

CONCLUSIONS

The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother-adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents.

The syndemic condition of psychosocial problems related to depression among sexually transmitted infections patients

BACKGROUND

The prevalence of depression in sexually transmitted infections (STIs) patients is much higher than general public. However, studies focusing on comprehensive psychosocial effects on depression among STIs patients are limited. This study aimed to examine association of multiple psychosocial syndemic conditions with depression among STIs patients in Shanghai, China.

METHODS

We conducted a cross-sectional study and recruited 910 STIs patients from Shanghai Skin Disease Hospital. Participants self-reported their demographics and themselves completed the scales of depression, self-esteem, loneliness, social support, entrapment, defeat and interpersonal needs. Logistic regressions were performed to detect the possible contributing psychosocial factors for depression and to verify the syndemic conditions of psychosocial problems.

RESULTS

Of the STIs patient sample, the prevalence of depression was 17.9%. Multivariable analysis showed low-level self-esteem (odds ratio [ORm]: 2.18, 95% CI [1.19-4.00]) and social support (ORm: 2.18, 95% CI [1.37-3.46]), high-level entrapment (ORm: 6.31, 95% CI [3.75-10.62]) and defeat (ORm: 2.60, 95% CI [1.51-4.48]) increased the risk of depression. Psychosocial syndemic conditions magnified effect in fusing depression (adjusted odds ratio [AOR]: 11.94, 95% CI [7.70-18.53]). Participants with more than 4 psychosocial problems were about 22 times more likely to have depression (AOR: 22.12, 95% CI [13.19-37.09]).

CONCLUSIONS

The psychosocial problems syndemic magnifying the risk of depression was confirmed and psychosocial interventions to prevent depression is needed among STIs patients.

Study problems and depressive symptoms in adolescents during the COVID-19 outbreak: poor parent-child relationship as a vulnerability

BACKGROUND

Little is known about the prevalence of and risk factors for adolescent mental health problems during the COVID-19 outbreak. We aimed to investigate the prevalence of depressive symptoms, their association with study-relevant problems, and the moderating effect of parent-child relationship among Chinese adolescents during the school closures.

METHODS

We performed a cross-sectional analysis with data collected in middle and high schools in Taizhou, China. Students completed an online survey between April 16 and May 14, 2020. Depressive symptoms were assessed using the Children's Depression Inventory. Three types of study problems were recorded, including having difficulty in studying at home, dislike of remote learning, and excessive screen entertainment time. Parental relationships were categorized into good or normal relationship and poor relationship. Linear regression and logistic regression analyses were conducted to investigate the associations between study-relevant problems and depressive symptoms.

RESULTS

Using data from 6435 adolescents, we found that the prevalence of depressive symptoms was 17.7%. All the study problem measures were associated with more severe depressive symptoms. There was a moderating effect of the parental relationship on the associations between study problems and depressive symptoms. The association between number of study problems and depressive symptoms was stronger in adolescents with a poor parent-child relationship (regression coefficient 4.34 [95% CI 2.97, 5.72]) than those with a good or normal relationship (2.55 [2.35, 2.75]), p for interaction 0.002, on multivariable adjustment.

CONCLUSIONS

Study problems due to school closures were particularly problematic for adolescents who had poor parent-child relationships. Public health initiatives could help students to adjust study habits and improve parent-child relationships, thereby protecting against the development of depression.

The Influence of Pubertal Development on Adolescent Depression: The Mediating Effects of Negative Physical Self and Interpersonal Stress

The current study examined the influence of pubertal development stage on depression and its psychosocial mechanisms in a non-clinical population of 502 adolescents (244 boys and 258 girls) in China, graded 5 to 8. Results indicated that (1) pubertal development was positively correlated with depression, negative physical self and interpersonal stress. (2) There is a significant gender by pubertal development interaction on the measure of academic self-concept, which is accounted for by decreased academic self in boys but not in girls as a function of pubertal development. (3) Mediation analyses show that increased depression in late compared to pre- puberty is partly mediated by the enhancement of negative physical self and interpersonal stress. These findings suggest that the late stage of puberty is coupled by a higher risk of depression in adolescents partly through increased negative physical self and interpersonal stress.

Early estimated glomerular filtration rate and depression in kidney transplantation recipients: a longitudinal study

Depression is a common psychological problem in kidney transplantation (KT) recipients and affects long-term graft outcomes. Estimated glomerular filtration rate (eGFR) as a commonly used indicator of renal function plays a vital role in follow-up detection after KT. The aim of this study is to observe the change of early eGFR within 3 months after KT and to explore the correlation between eGFR and depression before and after transplantation. The Self-rating Depression Scale was used to evaluate depression. Among 135 patients with KT, 128 patients completed the longitudinal study. We used a one-way repeated-measures analysis of variance to analyze eGFR and a generalized estimating equation model to examine the relationship between depression and eGFR in KT recipients with pre-transplant and 30, 60, 90 days post-transplant. The mean eGFR of KT recipients at four time-points was 5.97 ± 4.83, 72.84 ± 26.06, 79.06 ± 26.45 and 81.79 ± 25.62, respectively. The results demonstrated that eGFR kept steady at 60 days and 90 days post-transplant; depression was significantly associated with eGFR. Earlier identification and treatment of depression in KT recipients may be essential to promote their recovery of early renal function.

Psychosocial risk factors associated with depressive symptoms among adolescents in secondary schools in mainland china: A systematic review and meta-analysis

BACKGROUND

The objective of the study is to systematically estimate the effect size of psychosocial risk factors for depressive symptoms among adolescents in secondary schools in mainland China.

METHOD

A literature search was conducted in both English and Chinese databases. This meta-analysis used a random-effects model to estimate the effect size.

RESULTS

Fifteen psychosocial risk factors were identified in a total of 164 articles. The results revealed the absolute value of effect size ranging from 0.16 to 0.43. Among them, poor parent-child communication (r = 0.43), negative life events (r = 0.40), academic pressure (r = 0.40), abuse (r = 0.33), poor family functioning (r = 0.33), bullying (r = 0.32), and poor family cohesion (r = 0.32) were associated with depression with a medium to large effect. Moderator analysis shows that grade, study quality, mean age, and gender were significant moderators of at least one factor for depression.

LIMITATIONS

Limitations included the heterogeneity which is largely unexplained, and the inability to investigate the interactions of different factors and to determine the direction of causal relationships between psychosocial factors and depression in the present meta-analysis.

CONCLUSIONS

This study suggests that family-related factors and school-related factors may be significantly associated with depressive symptoms in Chinese secondary school students. Further research is needed to develop effective strategies to modify these factors in depression prevention programmes.

Effect of perceived organizational support on suicidal ideation of young employees: The mediator role of self-esteem

This study aimed to explore the relationships among perceived organizational support, self-esteem, and suicidal ideation of young employees. A total of 447 unmarried employees completed the survey of perceived organizational support, Rosenberg self-esteem scale, and suicide ideation scale. The results revealed that perceived organizational support, self-esteem, and suicidal ideation were significantly correlated with each other. Stepwise regression analysis and path analysis both indicated that self-esteem partially mediated the effect of perceived organizational support on suicidal ideation.