| Objective:Psychotic-like experiences(PLEs)are believed to have a significant correlation with the high risk of future mental disorders.The study of PLEs and its related risk factors in children is of great significance in preventing the occurrence of mental disorders.Most of the previous studies were limited to cross section and psychotic symptom-like experience of positive symptoms(delusions,auditory hallucinations),but often ignored negative symptoms,depressive symptom-like experience,and the long-term development trajectory of PLEs.This study adopts a mixed research method to provide more reliable basis and reference for the prevention and treatment of mental disorders.Methods:1.Altogether 1774 students from 5 secondary schools in the rural Xiangxi Region,Hunan Province were followed up for a three-year study.We used The Community Assessment of Psychic Experiences(CAPE)to measure psychotic-like experiences including positive,negative and depressive symptoms among those students.On the third year,the Trauma History Questionnaire(child version)was used to assess experiences of previous traumatic events,and the attachment relationship between adolescents and their parents or peers was assessed by using the short version of the Inventory of Parent and Peer Attachments(IPPA).The frequency rate of positive,depressive and negative symptoms of psychoticlike experience at each subclinical level between left-behind children and non-left-behind children was calculated.The t-test and chi-squared test were used to compare the differences of demographic sociological characteristics,childhood trauma questionnaire scores,and parental and peer attachment scale scores between left-behind children and non-leftbehind children.Single factor logistic regression was used to test the relationship between persistent psychotic-like experience with demographic risk factors,and multiple linear regression was used to explore the risk factors of psychotic-like experience among left-behind children.2.Through qualitative research,we conducted in-depth interviews with 14 freshman students who had left-behind experience and studied in the medical school of Jishou University,a social guidance teacher for leftbehind children,and a leader of the county women’s federation.By using phenomenological methods in qualitative research,we analyzed the collected data,and explored the protective factors of psychotic-like experience.Furthermore,we revealed the impact of left-behind children’s experience on the healthy growth of adolescents,and tried to explore how social support and other variables promote or hinder the mental and psychological health development of adolescents from the perspective of college students who had left-behind experience.Results:1.A total of 1265 adolescents have completed items of all assessments over the three waves with 41.5% had left-behind status.The prevalence rate of persistent positive,negative and depressive experience among the left-behind children is 21.7%,21.5% and 9.5% respectively,much higher than the non-left behind.In addition,left-behind children had a higher incidence of childhood trauma and suffered more serious harm,while the degree of peer attachment was lower;The score of the negative impact of childhood trauma experience of left-behind children was significantly higher than that of non-left-behind children(t=-2.89,p=0.004).There was no significant difference in the score of parental attachment between the two groups,but the score of peer attachment of left-behind children was significantly lower than that of non-left-behind children(t=2.43,p=0.015).Multiple logistic regression showed that left behind status was a risk factor for persistent negative symptoms(OR: 1.08,2.17,p=0.017)and persistent depressive symptoms(OR: 1.00,2.96,p=0.049).A higher attachment index reduced the likelihood of persistency of three subclinical symptoms,while a higher childhood trauma experience significantly increased the likelihood of persistent positive,negative,and depressive symptoms.2.The results of qualitative investigation showed that the pain caused by positive symptoms was generally low;Among the negative symptoms,"Do you feel that the whole day has passed,but you haven’t done anything?" experienced the highest frequency and degree of pain;Among the depressive symptoms,"Do you feel guilty?" experienced the highest frequency and degree of pain;When most respondents mentioned their feelings in childhood,they showed obvious negative emotions.Accepting and enduring left-behind experiences and traumatic experiences,pro-social relationships,good social support networks,and emotional regulation abilities were found to be the key to coping with psychotic-like experiences.Conclusion:The separation from parents has brought obvious negative psychological health effects to the psychotic-like experience of left-behind children,mainly manifested in the significant increase in the incidence of persistent psychotic symptoms,negative symptoms and depression-like experience.Given that these symptom-like experiences are high-risk subclinical symptoms that may develop into mental disorders,active screening of PLEs,negative symptoms,and depression-like experiences should be considered,and early intervention measures should be taken for left-behind children living in rural areas to reduce the occurrence of mental disorders.After entering the university,the interviewees with left-behind children’s experience did not adapt to their self-control ability and learning goals in a more autonomous daily routine;Most respondents mentioned that their parents worked hard,but their achievements were not satisfactory and they had a strong sense of guilt.It is of great significance to help college students who have experienced left-behind children adapt to campus life,reduce guilt and self-blame,learn to accept themselves,and improve their ability to bear for improving their mental health. |
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