A Case-Control Study Of Parenting Styles,Childhood Trauma,and Life Events In Adolescents With Depression

Objectives:To understanding the basic socio-demographic information and mental health status of adolescents with depression and healthy adolescents who come to psychiatric clinics,to explore the relationship between parenting styles,childhood trauma,and life events of adolescent depression.Methods:The case group was from the outpatient and inpatient department of the First Affiliated Hospital of Kunming Medical University,who fit the diagnosis of depression,the control group was randomly selected middle school students with the PHQ-9 score is below 10.Using the self-made general case report form,social demography questionnaire,the Barratt impulsiveness scale-Chinese versions(BIS-CV),the Chinese version of Buss&Perry aggression questionnaire(AQ-CV),the Childhood Trauma Questionnaire(CTQ),the Adolescent self-rating life events check-list(ASLEC)and the Short-Egna Minnen av Barndoms Uppoforstran(s-EMBU),both the case group and the control group were tested.The demographic information and study variables of case group and control group were analyzed by SPSS software,including descriptive statistics,difference analysis and logistic regression.In addition,a structural equation modeling(SEM)of MPLUS7.4 was used to explore the relationship between parenting styles,childhood trauma,life events and adolescent depression.Results:1.A comparative analysis of the case group and the control group found that,in the case group,57.9%were in day school,while in the control group,92.5%were in residential school.Only children accounted for 47.1%in the case group and 34.6%in the control group.In the case group,77.8%of the parents were married,while in the control group,86.9%were married.Alcohol consumption accounted for 49.3%in the case group and only 22.9%in the control group.Lack of physical exercise accounted for 66.5%in the case group and only 46.8%in the control group.In the case group,28.1%and 16.7%were in bad relationship with their classmates and family members,while in the control group,respectively,accounted for 1.6%and 0.7%.In the case group,80.5%felt loneliness frequently or always,while in the control group,only 0.9%.2.After controlling the influencing factors of depression,the risk of depression decreased with age and remained a protective factor.Boarding(OR=0.122)was a protective factor.High school students(OR=3.772)was a risk factor of depression.The risk of depression increased by 55.6%for additional hour spent online per day in the past week(OR=1.556).Often or always feeling lonely(OR=9.634)and experiencing more negative life events(OR=9.634)can increasing the risk of depression.The warmth given by the parents(OR=9.634)became a protective factor against the disease.3.The childhood trauma(r=0.699),the life events(r=0.695),the parental rejection(r=0.545)and the parental over projection(r=0.382)was positively correlated with depression among adolescents.The parental warmth(r=-0.527)has a negative correlated with depression among adolescents.The childhood trauma(r=-0.669),the life events(r=-0.451)and the parental rejection(r=-0.451)was negatively correlated with the warmth given by the parents,but not with parental overprotection(r=-0.208).The highest correlation was between parental rejection and childhood trauma(r=-0.704).4.By establishing structural equation Modeling(SEM),we found that the three dimensions of Parenting styles(parental rejection,parental warmth,and parental overprotection)were responsible for the depressive effects,The proportion of total indirect effects of the childhood trauma and the life events was 100.4%,80.1%and 93.5%in rejection,warmth and over projection from parents,respectively,of which the mediating effects of the childhood trauma accounted for 54.8%,44.8%and 46.1%of the total effects,the mediating effects of the life events accounted for 19.8%,0.6%and 21.2%of the total effects,The common mediating effects of the childhood trauma and the life events accounted for 25.9%,34.5%and 26.2%of the total effects,respectively.By comparison,it was found that the childhood trauma of the three models played a greater role than the life events,while in the model of parental rejection,the childhood trauma played the most important role.Conclusions:1.Through comparative analysis,we found that in the case group,day reading was more dominant,while in the control group,it was more residential.The only-child ratio in case group was higher than that in control group.The proportion of parents were married in the case group was lower than that in the control group.The proportion of drinking in the case group was higher than that in the control group.The lack of physical exercise in case group was more than that in control group.The proportion of those who had bad relationship with classmates,family members and who often or always felt lonely in the csae group was much higher than the control group.2.The results of path analysis showed that childhood trauma and life events played a full mediating role between parental rejection and over protection,and played a partial mediating role in parental warmth.3.Depressive disorders in adolescents are associated with poor parenting styles,childhood trauma,and life events,Parental choices such as rejection or over protection are associated with the onset of adolescent depression.At the same time,child trauma and life events have mediating effect on the relationship between bad parenting styles and adolescent depression.