Social And Psychological Effects Of Early-life Stress On Child And Adolescent Depressive Symptom And The Underlying Mechanism

Objective: To understand the present situation of depression and childhood maltreatmentof adolescents in Wuhan City, Hubei Province, and to explore the relationship of childhoodmaltreatment and depression as well as the social and psychological factors, so as toprovide scientific basis for improving the quality of mental health of children andadolescents.Methods: The sample of the study was drawn from six schools selected by cross-sectionalin Wuhan City. Half of the schools were key schools, the rest were ordinary schools. Eachkind of schools was made up of one primary school, one junior high school and one seniorhigh school, respectively. The students aged9to18years were selected by randomlycluster sampling. The questionnaire which we used was included the general information,Children’s Depression Inventory, Personal Report of Childhood Abuse and relatedsocial/psychological survey. The total of data was analyzed by SPSS17.0, includingdescriptive statistics, t test, Chi-square test, ANOVAand multi-analysis. Structural equationmodel was performed using Amos v18.0.Results: Total of2950students were investigated and the available sample included2888students, with692in the primary school,1137in junior high school and1059in seniorhigh school, respectively. The ratio of male to female was1.22:1.①Adolescent depressivesymptom:14.3%students had depressive symptoms, and the average scores of CDI were higher in15years old and senior high school.②Childhood maltreatment: Childhoodmaltreatment was reported by51.9%students. The students aged13to15years and injunior high school had the peak scores of PRCA. There were no significant genderdifferences in CDI and PRCA scores.③Different types of childhood maltreatment (CM):emotional abuse gained larger percentage than other types. Except neglect, boysexperienced more CM than girls. Age and grade group had difference in types of CMexcept sexual abuse.④The relationship between adolescent depression and childhoodmaltreatment (CM): there was more CM in depressive symptom group. Depressivestudents had more different types of CM except sexual abuse. Moreover, CM and itsdifferent types may increase the risk of depressive symptoms.⑤Social/psychologicalfactors: students in depressive symptom group and childhood maltreatment group gainedhigher scores of the variable such as neuroticism (N), psychoticism (P), negativeattributional style. In contrast, the scores of variables including extraversion (E),self-esteem, positive attributional style and social support were lower in depressivesymptom group and childhood maltreatment group.⑥Multi-analysis in childhoodmaltreatment, depressive symptom and influence factors: The positive correlation betweendepressive symptom and childhood maltreatment and personality’s N, P variables, negativeattributional style. Meanwhile, it took negative correlation to E, self-esteem, positiveattributional style and social support. Above factors play different roles betweendepression and childhood maltreatment by direct or indirect effects.Conclusion: The incidence of adolescent depressive symptom and childhood maltreatmentin Wuhan were on the high side, and there were differences between gender, age and grade.Social/psychological factors such as personality, self-esteem, attributional style and socialsupport play important roles between adolescent depression and childhood maltreatment.Therefore, we should enhance adolescent mental health education, from a social andpsychological point of view, to promote the development of adolescent physical and mentalhealth through various levels and dimensions.