Effects Of Specific Types Of Coping Styles On The Relationship Between Childhood Maltreatment And Dep-19ressive Symptom Among Medical Students:The Role Of Sex

ObjectiveWe investigated the mediating effects of different coping styles on the relationship between childhood maltreatment and depressive symptoms among medical students,as well as the role of sex in the mediated pathways.MethodsThis study selected two medical schools in Hefei and Anqing from November 2019 to December 2019 to conduct a baseline survey,collect 7623 valid questionnaires,and conduct a follow-up survey from May 2020 to June 2020,there are 6879 valid questionnaires.Excluding those who were depressed in the baseline survey,a total of5504 people were included in the analysis.The Childhood Trauma Questionnaire(CTQ),the Copying Style Questionnaire(CSQ)and the Center for Epidemiologic Studies-Depression(CES-D)were used to evaluate the experience of childhood maltreatment,coping styles and depressive symptoms,respectively,in medical students.Use Epi Data 3.1 to establish a database,and SPSS 23.0 to perform descriptive analysis of the data;use Spearman to analyze the correlations between childhood maltreatment,multiple coping styles and depressive symptoms;adjust age,sex,urban/rural,only child status,parents’ education level,economic status of family,through the Bootstrap program and PROCESS software,the mediation effect of various coping styles in childhood maltreatment and medical students’ depressive symptoms was tested.ResultsSpearman correlation analysis showed that childhood maltreatment was negatively related to problem solving and help seeking(P<0.001),and positively related to self-blame,fantasy,problem avoidance,rationalization,and depressive symptoms(P<0.001).Problem solving and help seeking were negatively related to depressive symptoms(P<0.001),and self-blame,fantasy,problem avoidance,and rationalization were positively related to depressive symptoms(P<0.001).After adjusting for factors such as age,sex,urban/rural,only child status,parents’ education level,economic status of family,etc.,Bootstrap test results show that among the total population,the coping styles of problem solving,self-blame,help seeking and fantasy play a mediating role in the association between childhood maltreatment and depressive symptoms.The estimated effect of childhood maltreatment on the occurrence of depressive symptoms could be explained by the mediation of problem solving,self-blame,help seeking and fantasy,whose ratio of roles came to 8.38%,13.95%,3.55%,and 2.32%,respectively.For boys,adjust age,urban/rural,only child status,parents’ education level,economic status of family,the coping styles of problem solving,self-blame,and problem avoidance played a mediating role in the association between childhood maltreatment and depressive symptoms,with mediation effect ratio of 9.76%,11.16% and 9.92%;After adjusting for factors such as age,urban/rural,only child status,parents’ education level,economic status of family,mediating effects of problem-solving,self-blame,help-seeking,and fantasy coping styles in the above association are respectively 7.73%,14.41%,4.12% and 2.65%.In the association of emotional abuse,physical abuse,sexual abuse,emotional neglect,physical neglect and depressive symptoms,different coping styles play a certain mediating effect.ConclusionsThe findings illustrate the need to focus on coping styles and to employ sex-specific methods to effectively help college students reduce depressive symptoms associated with childhood maltreatment.