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Wang H, Wang Z, Li X, Liu J. Characteristics and risk factors of Health-Related Risky behaviors in adolescents with Depression. Child Adolesc Psychiatry Ment Health 2024; 18:34. [PMID: 38500185 PMCID: PMC10949750 DOI: 10.1186/s13034-024-00722-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/24/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGOUND To explore the characteristics and risk factors for health-related risky behaviours (HRRBs) in adolescents with depression. METHODS A total of 136 adolescents aged 12-18 years who met the diagnostic criteria for depression, and 272 healthy controls. All the subjects were assessed with the Adolescent Health-Related Risky Behavior Inventory (AHRBI), and the AHRBI scores of the two groups were compared with the Mann-Whitney U test. The depression group was assessed with the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Childhood Trauma Questionnaire (CTQ), Cognitive Emotion Regulation Questionnaire (CERQ), Egna Minnen av Barndoms Uppfostran (EMBU), and Family Adaptability and Cohesion Scale (FACES II-CV). Spearman correlation analysis and multiple linear regression were used to explore the risk factors for HRRBs in adolescents with depression. RESULTS The AHRBI total score and five-factor scores of self-injury and suicide (SS), aggression and violence (AV), rule-breaking (RB), smoking and drinking (SD), and health-compromising behavior (HCB) in the depression group were higher than those in the control group. The severity of anxiety, catastrophizing, cognitive emotional regulation strategy (self-blame and blaming of others), the frequency of depression, physical neglect, and sexual abuse all increased the risk of HRRBs in adolescents with depression, and paternal emotional warmth and understanding had protective effects. CONCLUSION First, depressed adolescents exhibited significantly more HRRBs than healthy adolescents. Second, there are many risk factors for HRRBs in adolescents with depression, and the risk factors for different types of HRRBs are also different.
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Affiliation(s)
- Hui Wang
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhixiong Wang
- Peking University HuiLongGuan Clinical Medical School, Bejing Huilongguan Hospital, Bejing, China
| | - Xue Li
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jing Liu
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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Modeste-James A, Fitzgerald T, Stewart E, De Jesus D, Canuto M, Guzman M, Mateo J, D’lppolito M, Lundgren L. The Intersections Between Sexual Orientation, Latine Ethnicity, Social Determinants of Health, and Lifetime Suicide Attempts in a Sample Being Assessed for Entry to Co-Occurring Mental Health and Substance Use Disorder Treatment. J Prim Care Community Health 2024; 15:21501319241240425. [PMID: 38511864 PMCID: PMC10958810 DOI: 10.1177/21501319241240425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE Few studies have examined the relationship between the intersections of lesbian, gay, and bisexual (LGB) sexual orientation, Latine ethnicity, and lifetime suicide attempts in Latine individuals with substance use disorder. This study examines this intersection and controls for social determinants of health, mental health disorder symptoms, and substance use disorder symptoms in a sample of Latine adults entering treatment for co-occurring disorders. METHOD Bivariate statistics and multivariate logistic regression were used to analyze assessment data (n = 360) from a bilingual/bicultural integrated behavioral health system serving Latine communities in Massachusetts to examine the relationship between sexual orientation, Latine ethnicity, and history of lifetime suicide attempts. We controlled for social determinants of health, mental health disorders, and substance use disorder (SUD) factors significantly associated with lifetime suicide attempts at the bivariate level. RESULTS Over 27% of the sample and 35% of Puerto Ricans (PR) reported lifetime suicide attempts. The logistic regression identified that PR clients were 78% more likely to have attempted suicide in a lifetime compared to non-PR clients. Clients identifying as LGB were 3.2 times more likely to report having attempted suicide in their lifetime compared to heterosexual clients. Unemployed clients were 2.4 times more likely to report having attempted suicide in their lifetime compared to employed clients. CONCLUSION Findings identify high rates of lifetime suicide attempts among LGBs and PRs entering SUD treatment. Targeted outreach and treatment efforts designed to address intersectionality for this underserved population are needed.
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DiFiore G, Wood S, Jenssen BP, Fiks AG, Mayne SL. Cumulative Health Vulnerabilities Among Adolescents by Age and Neighborhood Opportunity. Pediatrics 2023; 152:e2023062657. [PMID: 37974515 PMCID: PMC10774653 DOI: 10.1542/peds.2023-062657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Early detection of health vulnerabilities in adolescents is integral to promoting healthy behaviors into adulthood. Our objective was to quantify the prevalence of health vulnerabilities among adolescents and examine differences by age and neighborhood opportunity. METHODS In a cross-sectional analysis of electronic health record data for adolescents aged 13 to 18 years with preventive visits in a large pediatric primary care network between September 2021 and September 2022, we examined 5 health vulnerabilities: Tobacco use, substance use, firearm access, condomless intercourse, and depressive symptoms. Health vulnerabilities were assessed via self-reported adolescent health questionnaire and the validated Patient Health Questionnaire-Modified. Prevalence of health vulnerabilities were calculated alone and in combination, and compared by age and by quintile of neighborhood Child Opportunity Index (COI) score. Multivariable logistic regression estimated associations of neighborhood COI with reporting ≥2 health vulnerabilities. RESULTS Among 40 197 adolescents (57.7% aged 13-15 years, 66.3% living in "high"/"very high" COI neighborhoods), 29.7% reported at least 1 health vulnerability and 7.9% reported ≥2 vulnerabilities. Cumulative health vulnerabilities were more prevalent among older adolescents and adolescents from lower opportunity neighborhoods. In adjusted models, lower COI was associated with 65% higher odds of having ≥2 vulnerabilities (odds ratio 1.65, 95% confidence interval 1.43-1.91) compared with adolescents from the highest COI quintile. CONCLUSIONS Understanding the relationship between health vulnerabilities and neighborhood opportunities among adolescents may allow pediatric primary care providers and health systems to offer more tailored community support services and transdiagnostic specialized care navigation to address the health needs of teens with multiple vulnerabilities.
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Affiliation(s)
| | - Sarah Wood
- Clinical Futures and PolicyLab
- The Craig Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Department of Pediatrics, Perelman School of Medicine
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brian P. Jenssen
- Clinical Futures and PolicyLab
- The Department of Pediatrics, Perelman School of Medicine
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexander G. Fiks
- Clinical Futures and PolicyLab
- The Craig Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Department of Pediatrics, Perelman School of Medicine
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stephanie L. Mayne
- Clinical Futures and PolicyLab
- The Department of Pediatrics, Perelman School of Medicine
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Marcantonio TL, Nielsen KE, Haikalis M, Leone RM, Woerner J, Neilson EC, Schipani-McLaughlin AM. Hey ChatGPT, Let's Talk About Sexual Consent. JOURNAL OF SEX RESEARCH 2023:1-12. [PMID: 37707442 PMCID: PMC10937333 DOI: 10.1080/00224499.2023.2254772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Access to sexual health education, such as education on sexual consent, is limited in the US. Artificial intelligence (AI), such as ChatGPT, provides a potential opportunity to increase access to sexual consent information and education. However, what ChatGPT knows about sexual consent and if this aligns with the current evidence-based literature on sexual consent is unclear. The goal of this research commentary was to explore what ChatGPT knows about sexual consent with a focus on: 1) the definition of consent, 2) how consent could be communicated, and 3) the impact that substances have on consent. We also examined the reliability of ChatGPT's responses by having three different researchers ask ChatGPT the same set of questions. Across our questions, ChatGPT provided similar and comprehensive responses that discussed key features of consent - that consent is freely given or reversible. ChatGPT provided examples of different verbal and nonverbal cues people can use to communicate and interpret consent and discussed the ways that substances can impact consent communication. Overall, ChatGPT could be a potential resource for educators and young people who seek information about sexual consent; however, we should proceed with caution. ChatGPT is not a replacement for an educator but rather a way to increase access to education.
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Affiliation(s)
- Tiffany L Marcantonio
- Department of Health Science, College of Human Environmental Sciences, University of Alabama
| | - Karen E Nielsen
- Population Health Science, School of Public Health, Georgia State University
| | - Michelle Haikalis
- Department of Behavioral and Social Sciences, School of Public Health, Center for Alcohol and Addiction Studies, Brown University
| | - Ruschelle M Leone
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University
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Wiener SJ, Porter JJ, Paydar-Darian N, Monuteaux MC, Hudgins JD. Emergency Care Utilization for Mental and Sexual Health Concerns Among Adolescents Following Sexual Assault: A Retrospective Cohort Study. J Adolesc Health 2023; 73:486-493. [PMID: 37294253 DOI: 10.1016/j.jadohealth.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE This study aimed to explore the health outcomes of adolescent survivors of sexual assault, as measured by subsequent emergency department (ED) utilization for mental and sexual health concerns. METHODS This retrospective cohort study used the Pediatric Health Information System (PHIS) database. We included patients aged 11-18 years seen at a PHIS hospital with a primary diagnosis of sexual assault. The control group included age- and sex-matched patients seen for an injury. Participants were followed in PHIS for 3-10 years; subsequent ED visits for suicidality, sexually transmitted infection, pelvic inflammatory disease (PID), or pregnancy were identified, and likelihoods of each were compared using Cox proportional hazards models. RESULTS The study population included 19,706 patients. ED return visit rates in the sexual assault and control groups were 7.9% versus 4.1% for suicidality, 1.8% versus 1.4% for sexually transmitted infection, 2.2% versus 0.8% for PID, and 1.7% versus 1.0% for pregnancy, respectively. Compared to controls, sexual assault patients were significantly more likely to return to the ED for suicidality throughout the follow-up period, with the highest hazard ratio of 6.31 (95% confidence interval 4.46-8.94) during the first 4 months. Sexual assault patients also had higher likelihood of returning for PID (hazard ratio 3.80, 95% confidence interval 3.07-4.71) throughout the follow-up period. DISCUSSION Adolescents seen in the ED for sexual assault were significantly more likely to return to the ED for suicidality and sexual health concerns, highlighting the need for increased allocation of research and clinical resources to improve their care.
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Affiliation(s)
- Susan J Wiener
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
| | - John J Porter
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
| | | | - Michael C Monuteaux
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Joel D Hudgins
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
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Robinson MS, England M, Luthy KE, Peterson NE. HPV Infection and Vaccination: A Question and Answer Guide for School Nurses. NASN Sch Nurse 2023; 38:134-144. [PMID: 36757046 DOI: 10.1177/1942602x221146758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
School nurses frequently interact with school-age children and their parents/guardians regarding vaccinations. As a trusted source of information, the school nurse is in a unique position to share vaccine information with parents/guardians and school-age children that may dispel myths and, consequently, improve vaccination rates. Nevertheless, some parents/guardians are still reluctant to vaccinate their school-age children against Human Papilloma Virus (HPV) for a variety of reasons. Common barriers to HPV vaccination include a lack of understanding of the vaccine's purpose, concerns regarding the vaccine's safety, and insufficient recommendation from healthcare workers. However, school nurses have many duties in addition to ensuring vaccine compliance. School nurses may have difficulty remaining up-to-date on evidence-based answers to parents'/guardians' questions about HPV vaccine. Therefore, the purpose of this article is to provide school nurses with a quick reference question and answer guide to parents'/guardians' common HPV-related vaccination questions.
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Wen X, Ding R, Guo C, Zheng X. Association between childhood sexual abuse and early sexual debut among Chinese adolescents: The role of sexual and reproductive health education. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 4:909128. [PMID: 36755898 PMCID: PMC9900103 DOI: 10.3389/frph.2022.909128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/29/2022] [Indexed: 01/24/2023] Open
Abstract
Background Despite accumulating evidence of the long-term impacts of childhood sexual abuse (CSA), few studies have investigated the association between CSA and early sexual debut among adolescents. In this study, we examine the relationship between CSA and early initiation of sexual intercourse among Chinese youth, and the role of school-based sex education in this association, based on a nationally representative survey. Methods Data were collected from the Survey of Youth Access to Reproductive Health in China (YARHC) conducted in 2009. Multivariable logistic regression models were used to investigate the association between CSA experience and early sexual debut, and the interaction terms between sexual and reproductive health education and CSA were included to examine the role of education in the association between CSA and early sexual debut. Results Among 4,907 sexually experienced youth, 1,062 (21.6%) made their early sexual debut. After adjusting for sociodemographic characteristics, it was found that CSA experience was significantly associated with early sexual debut, with an adjusted odds ratio of 3.13 (95% CI: 1.67-5.87). Receiving any type of sexuality education (reproductive health, sexually transmitted disease (STD) and HIV prevention, or contraception use) was not associated with a decreased risk of early sexual debut. Conclusion Our results indicate a greater risk of early sexual debut among Chinese adolescents with a history of CSA, and only 46.7% sexually experienced youth had received prior sex education, which suggested an inadequacy of school-based sexuality education. To reduce this risk, targeted intervention with timely and adequate sexuality education for both early starters of sexual intercourse and CSA victims is warranted in China.
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Affiliation(s)
- Xu Wen
- College of Biochemical Engineering, Beijing Union University, Beijing, China
| | - Ruoxi Ding
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Chao Guo
- APEC Health Science Academy, Peking University, Beijing, China
| | - Xiaoying Zheng
- APEC Health Science Academy, Peking University, Beijing, China,Correspondence: Xiaoying Zheng
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Bentivegna F, Patalay P. The impact of sexual violence in mid-adolescence on mental health: a UK population-based longitudinal study. Lancet Psychiatry 2022; 9:874-883. [PMID: 36206779 PMCID: PMC9630148 DOI: 10.1016/s2215-0366(22)00271-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND A large gender gap appears in internalising mental health conditions during adolescence, with higher rates in girls than boys. There is little high-quality longitudinal population-based research investigating the role of sexual violence experiences, which are disproportionately experienced by girls. We aimed to estimate the effects of sexual violence experienced in mid-adolescence on mental health outcomes. METHODS In this study, we used data from the longitudinal UK Millennium Cohort Study, a large nationally representative cohort of children born in the UK in 2000-02, for participants with information available at age 17 years on sexual violence in the past year (eg, sexual assault or unwelcome sexual approach), mental health outcomes (eg, completion of the Kessler Psychological Distress K6 scale in the past 30 days, self-harm in the past year, and lifetime attempted suicide). Multivariable confounder adjusted regressions and propensity matching approaches were used, and population attributable fractions (PAFs) were calculated. FINDINGS We included 5119 girls and 4852 boys (8063 [80·8%] of whom were White) in the full analysis sample. In the fully adjusted model, compared with no sexual violence, sexual violence was associated with greater mean psychological distress in girls (mean difference 2·09 [95% CI 1·51-2·68]) and boys (2·56 [1·59-3·53]), higher risk of high psychological distress in girls (risk ratio [RR] 1·65 [95% CI 1·37-2·00]) and boys (1·55 [1·00-2·40]), higher risk of self-harm in girls (RR 1·79 [1·52-2·10]) and boys (RR 2·16 [1·63-2·84]), and higher risk of attempted suicide in girls (RR 1·75 [1·26-2·41]) and boys (RR 2·73 [1·59-4·67]). PAF estimates suggest that, in a hypothetical scenario with no sexual violence, the prevalence of adverse mental health outcomes at age 17 years would be 3·7-10·5% lower in boys and 14·0-18·7% lower in girls than the prevalence in this cohort. INTERPRETATION Reductions in sexual violence via policy and societal changes would benefit the mental health of adolescents and might contribute to narrowing the gender gap in internalising mental ill health. Clinicians and others working to support adolescents should be aware that sexual violence has a widespread, gendered nature and an impact on mental health. FUNDING UK Medical Research Council.
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Affiliation(s)
- Francesca Bentivegna
- UCL Institute of Education, Department of Psychology and Human Development; University College London, London, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies, Social Research Institute; University College London, London, UK; MRC Unit for Lifelong Health and Ageing; University College London, London, UK.
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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Shim J, Baek J, Han S. Factors Related to Sexual Intercourse Among Korean Middle and High School Students. Front Public Health 2022; 10:924489. [PMID: 35875024 PMCID: PMC9304745 DOI: 10.3389/fpubh.2022.924489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Social interest in sexual intercourse among teenagers is increasing in Korea. This study aimed to identify factors related to sexual intercourse among adolescents. Methods This is a secondary analysis study using data from the 2020 Korea Youth Risk Behavior Survey, with information regarding 54,948 middle school and high school students in Korea having been analyzed. Demographics, health behavior, and mental health characteristics were included. Data evaluation involved chi-square test and binary multivariable logistic regression analysis. Results For middle school students, sexual intercourse was related to their housing type [Odds Ratio (OR) = 10.698], smoking (OR = 5.165) and drinking (OR = 2.229) experience, suicide attempt (OR = 1.920), gender (OR = 1.632), loneliness (OR = 1.501), sadness and despair (OR = 1.493), year level (OR = 1.457), happiness (OR = 0.772), sleep status (OR = 0.716), economic status (OR = 0.705). For high school students, sexual intercourse was related to their smoking experience (OR = 4.746), housing type (OR = 3.661), drinking experience (OR = 2.840), drug use (OR = 2.511), suicide attempt (OR = 2.071), year level (OR = 1.989), sadness and despair (OR = 1.506), gender (OR = 1.429), suicide plan (OR = 1.402), loneliness (OR = 1.270), academic performance (OR = 1.165), happiness (OR = 0.865), subjective health status (OR = 0.814), and economic status (OR = 0.727). However, sleep status was statistically significant for middle school students, but not for high school students. Academic performance, drug use, suicide plan, and subjective health status were statistically significant in high school students, but not in middle school students. Conclusion A program that can directly mediate these factors must be prepared. When conducting sex education for adolescents, mental health-related factors must also be considered.
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Affiliation(s)
- Joohee Shim
- College of Nursing, Yeungnam University College, Daegu, South Korea
| | - Jihyun Baek
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
| | - Seungwoo Han
- Department of Emergency Medical Technology, Kyungil University, Gyeongsan, South Korea
- *Correspondence: Seungwoo Han
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Ren J, Qi X, Cao W, Wang Z, Guo Y, Gaoshan J, Liang X, Tang K. Early Sexual Initiation Is Associated with Suicide Attempts among Chinese Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073966. [PMID: 35409650 PMCID: PMC8997714 DOI: 10.3390/ijerph19073966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to investigate the association between early sexual initiation and suicide attempts (SAs) among Chinese young people. Our analysis included 9131 college students who had sexual experience from a national sample of 31 provincial administrative regions. Self-reported age at first intercourse was categorized as ≤15, 15–18, and ≥18 years, and the experience of SAs was recorded and analyzed. Compared with females whose sexual debut age was ≥18 years, those ≤15 years (defined as early sexual initiation) had higher odds of SAs in both the forced debut group (odds ratio (OR) 17.04, 95% confidence interval (CI) 4.87–59.66) and the voluntary debut group (OR 37.63, 95% CI 14.96–94.66). Early sexual initiators who lived in rural areas were more inclined to have SAs (female: OR 65.76, 95% CI 19.80–218.42; male: OR 15.39, 95% CI 1.64–144.19). Early sexual initiators who never had parent–child communication about sex were more likely to report having SAs (female: OR 37.81, 95% CI 12.28–116.46). Sexual debut during adolescence, particularly early sexual initiation, was a crucial risk factor for SAs among both sexes. Comprehensive sexuality education and smooth parental communication about sex will provide a supportive environment for young people and hence reduce the potential risks of SAs.
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Affiliation(s)
- Jianing Ren
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Xinran Qi
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- School of Nursing, Capital Medical University, Beijing 100069, China
| | - Wenzhen Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China;
| | - Zhicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Yueping Guo
- School of Journalism and Communication, Graduate School of Chinese Academy of Social Sciences, Beijing 102488, China;
| | - Junjian Gaoshan
- Department for Health, University of Bath, Bath BA2 7AY, UK;
| | - Xiao Liang
- China Family Planning Association, Beijing 100035, China;
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- Correspondence:
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Hou H, Zhang C, Tang J, Wang J, Xu J, Zhou Q, Yan W, Gao X, Wang W. Childhood Experiences and Psychological Distress: Can Benevolent Childhood Experiences Counteract the Negative Effects of Adverse Childhood Experiences? Front Psychol 2022; 13:800871. [PMID: 35282200 PMCID: PMC8914177 DOI: 10.3389/fpsyg.2022.800871] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Childhood experiences can exert a huge impact on adult psychological conditions. Previous studies have confirmed the effects of adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) on psychological distress (e.g., stress, depression, and suicidal ideation) separately, but few studies explored a combined effect of ACEs and BCEs on psychological distress. The aim of this study was to explore a combined effect of ACEs and BCEs on psychological distress among Chinese undergraduates. Methods Participants were undergraduates aged 17–24 years (N = 1,816) and completed a self-reported questionnaire. A series of regression analyses were conducted to examine the association between childhood experiences and psychological distress. Results A total of 65.7% of undergraduates had BCEs, 27.1% of undergraduates had ACEs, and 12.9% of undergraduates had ACEs and BCEs simultaneously. Logistic regression analysis indicated that undergraduates who experienced high ACEs were more likely to have a high risk of psychological distress [odds ratio (ORs) = 1.46, 1.84, and 3.15 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively], while undergraduates who experienced High BCEs were less likely to have psychological distress (ORs = 0.33, 0.22, and 0.32 for uncertainty stress, depressive symptoms, and suicidal ideation, respectively) compared with Low-Both group. The combined effect of ACEs and BCEs (High-Both group) could also play as a protective factor in uncertainty stress (OR = 0.56) and depressive symptoms (OR = 0.47). Conclusion Our findings suggested that ACEs and BCEs could not only predict the psychological distress independently, but also BCEs could counteract the negative effect of ACEs in psychological problems. There is an even greater need to identify and support the victims of ACEs and to increase BCEs in early childhood.
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Affiliation(s)
- Hao Hou
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Caochen Zhang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jie Tang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jingjing Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jiaqi Xu
- School of Medical Technology, Xuzhou Medical University, Xuzhou, China
| | - Qin Zhou
- The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wenjun Yan
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xiuyin Gao
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, China
- *Correspondence: Wei Wang,
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