| Objective Left-behind children in rural areas is a special vulnerable group in China at present,because of long-term left-behind children,they are prone to variety adverse psychological outcomes.However,in recent years,studies have found that some school-age left-behind children still have resilience development,while there are few studies on the psychological resilience of preschool children,and the influencing factors and mechanisms of their resilience development are still unclear.This study will explore the factors influencing the resilient development of pre-school left-behind children from multiple dimensions,such as age,type of left-behind children,child neglect,emotional regulation and family function.At the same time,functional magnetic resonance technology was combined to explore the activity and connection characteristics of brain functions under different resilience states,so as to deeply understand the neurological mechanism of children's psychological resilience,and provide a broader idea for promoting children's psychological health.Methods(1)A cross-sectional study design was conducted.Children under the age of 6 were included in the study from Feixi,Changfeng,Funan and Qianshan counties of Anhui Province.This research adopts the methods of concentrated and household survey,and conducts questionnaire survey through face-to-face interview.The contents of the survey include: basic information of children,basic information of parents and families,left-behind status of children,psychological resilience of children,child neglect,emotional regulation,child anxiety,anxiety and depression with foster children,and family function.(2)Resting state f MRI study.Taking Anhui Children's Hospital as the research site,50 left-behind children of preschool age were selected.The research contents included general investigation,psychological resilience assessment and resting-state f MRI.(3)Statistical analysis: SPSS 23.0(SPSS Inc.)was used for statistical analysis of the data.The univariate analysis of children's psychological resilience used two independent samples t test,analysis of variance or chi-square test.The correlation between resilience score and emotion regulation,neglect and anxiety was analyzed by Pearson correlation analysis.Multiple linear regression model and binary Logistic regression model were used to analyze the influencing factors of psychological resilience.Metlab(R2013b)software was used to analyze the resting state f MRI data.DPARSF 5.0 software was used for data preprocessing.REST V1.8 software to extract the amygdala ALFF value,two independent samples t-test or analysis of variance were used to compare between groups.The amygdala was selected as the region of interest for seed sites,and the whole brain and Pearson correlation analysis to each voxel of time series.Results A total of 2546 rural children under 6 years old were investigated in this study,including 615 children aged from 6 to 18 months,568 children aged from18 to 36 months,and 1363 children aged from 3 to 6 years.Among 1,023 left-behind children(40.18%),266(26.00%)had resilience development,with 52(30.95%)under 18 months of age,89(37.87%)between 18 and 36 months of age,and 125(20.16%)between 3 and 6 years of age.(1)Children under 18 months of age: Multiple linear regression showed that high monthly family income and persuasion education were protective factors for children's initiative,while reprimanding and scolding parenting style and anxiety about raising children were risk factors for initiative.The protective factors of attachment/relationship were non-left-behind,higher family monthly income,higher educational level of mother,persuasion education and reprimanded parenting style,and the risk factors of attachment/relationship were caregiver's anxiety.Non-left-behind children,higher family monthly income,persuasion education and scolding parenting style were the protective factors of the total protective factors,non-only-child and caregiver's anxiety were the risk factors of the total protective factors of children's psychological resilience.Logistic regression analysis model showed that higher family monthly income(OR=0.650,95%CI:0.496-0.852),persuasion(OR=0.483,95%CI: 0.337-0.692)and reprimanding(OR=0.382,95%CI: 0.205-0.709)parenting were the protective factors for low psychological resilience of children under 18 months of age,while maternal passive smoking and caregiver's anxiety(OR=3.064,95%CI: 1.509-6.224)were the risk factors for low psychological resilience of children.(2)Children aged from 18 to 36 months: Multiple linear regression showed that monthly family income,persuasion education and reprimanding style were protective factors for initiative,while child neglect was a risk factor for initiative.The mother's high education level,family monthly income,persuasion education and scolding were the protective factors of children's self-regulation,and child neglect was the risk factor of self-regulation.The protective factors of attachment/relationship were mother's high education level,family monthly income,non-left-behind,persuasion education and reprimanding style,and child neglect was the risk factor of attachment/relationship.The protective factors of the total protective factors were mother's high education level,family monthly income,non-left-behind,persuasion education and scolding,and child neglect was the risk factors of the total protective factors.Logistic regression analysis model showed that high family monthly income(OR=0.660,95%CI:0.503-0.865),non-left-behind(OR=0.667,95%CI:0.466-0.954),persuasion education(OR=0.610,95%CI: 0.392-0.950)and reprimanding(OR=0.440,95%CI: 0.263-0.738)were the protective factors for low mental resilience of children aged from 18 to 36 months.(3)Children aged from 3 to 6 years: Multiple linear regression showed that age was the protective factor for initiative.Reprimanding parenting style,caregiver's depression and child neglect were risk factors for initiative.In the emotional regulation strategies,the use of problem solving,alternative activities,cognitive reconstruction and venting were the protective factors of initiative,and the self-comfort strategy was the risk factor of initiative.Children's age,father's age and nuclear family type were the protective factors of preschool children's self-regulation,mother's age,caregiver's depression and child neglect were the risk factors of self-regulation,the alternative activities and cognitive reconstruction in emotion regulation strategy were the protective factors,and the venting was the risk factors.Father's age,mother pregnancy without disease and family income were the protective factors of the attachment/relationship factors,persuade education parenting and consistent parenting attitude were protective factors of attachment/factors,child neglect was risk factor of attachment/relationship,using alternative activities and problem solving strategies were protective factors of the attachment/relationship.Children's age,father's age and nuclear family type were the protective factors of the total protective factors,the risk factors were caregiver's depression,child neglect and self-comfort,alternative activities,cognitive reconstruction and problem solving were the protective factors.Logistic regression analysis model showed that father's age(OR=0.667,95%CI: 0.507-0.877),cognitive reconstruction(OR=0.582,95%CI: 0.446-0.758),alternative activities(OR=0.595,95%CI: 0.467-0.759)and problem solving(OR=0.557,95%CI: 0.443-0.699)were the protective factors for low psychological resilience of preschool children,and the risk factors for low mental resilience of preschool children were caregiver's depression(OR=1.523,95%CI: 1.006-2.304)and child neglect(OR=1.091,95%CI: 1.069-1.113).(4)Logistic regression analysis of the psychological resilience of left-behind preschool children showed that child neglect(OR=1.149,95%CI: 1.105-1.195)was the influencing factor of their low psychological resilience,and cognitive reconstruction(OR=0.582,95%CI: 0.372-0.909),self-comfort(OR=0.508,95%CI:0.299-0.863),problem solving(OR=0.586,95%CI: 0.397-0.865)and alternative activity(OR=0.662,95%CI: 0.446-0.984)strategies were the protective factors.(5)The rs-f MRI results of preschool left-behind children showed that,The ALFF values of Frontal_Sup_Medial_R and Frontal_Mid_L in the low psychological resilience group were lower than those in the normal psychological resilience group,and the difference were statistically significant(P<0.01).The functional connections between the right amygdala and Parietal_Inf_L,Cingulum_Mid_R,Temporal_Sup_L,Calcarine_R and Frontal_Mid_R were weakened.The functional connection between the left amygdala and Cingulum_Mid_L and Frontal_Mid_L were weakened,and the difference were statistically significant(P<0.01)Conclusions Rural left-behind children have neglect,anxiety and emotional regulation disorders,etc.While some children still have good psychological development.Children's age,child neglect,emotional regulation ability,parents and family environment may have influence on their resilience development,which need more attention of the whole society,and a variety of measures should be combined to guide and intervene to promote their healthy development.Resting-state f MRI study found that preschool left-behind children in different psychological resilience status,have different ALFF in the local area,bilateral amygdala functional connectivity are not unified,there may be a partial lateralization.Less activity in the frontal lobes and abnormal functional connections in the amygdala may be neurological basis of preschool left-behind children with lower psychological resilience. |
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