Mediating Effect Of Self-esteem On The Relationship Between Left-behind Experience And Obsessive Compulsive Symptoms Among College Students

Objective To investigate the prevalence of obsessive-compulsive symptoms(OCS)among college students,explore the relationship between left-behind experience and OCS,and further to examine the mediating effects of self-esteem on relationship between left-behind experience and OCS,so that to provide theoretical basis for the prevention and intervention of OCS among college students.Methods Based on the geographical distribution of Anhui Province.The stratified cluster sampling method was conducted in our study,and selected three cities of Suzhou(Northern Anhui),Hefei(Central Anhui)and Maanshan(Southern Anhui)as survey sites.At each city,one university was selected,and a total of 3 universities.Different colleges were selected in each university,and the selected colleges were clustered into the sample.A total of 4 145 college students were selected to conduct a questionnaire survey.The Obsessive-Compulsive Inventory-Revised(OCI-R),Rosenberg Self-Esteem Scale(RSES),Self-Rating Depression Scale(SDS)and Left-behind basic situation questionnaire were used to measure OCS,self-esteem,depressive symptoms and left-behind experience.Epi Data 3.1 and SPSS 23.0 software were used to establish a data-base and analyze data.The level of OCS scores of college students were compared between left-behind experience and non-left-behind experience by using Independent-samples t-test.Chi-square test was used to compare the prevalence of OCS among college students in different socio-demographic characteristics.Binary Logistic regressions models were applied to examine the influential factors related to OCS.Spearman correlation analysis was used to analyze the correlation between left-behind experience and self-esteem,OCS.Pearson correlation analysis was used to analyze the correlation between self-esteem and OCS.Bootstrap method and PROCESS software were used to examine the mediating effects.Results Of 4145 participants,there are 1001 college students had OCS,the detection rate for OCS were 24.1%.There was no significant difference in the scores of OCS between gender among college students(P(29)0.05).The scores of OCS of rural college students(14.50±10.69)were significantly higher than those of urban college students(13.06±10.55),and the difference was statistically significant(P<0.001).There was no significant different in the scores OCS between only-child(13.63±10.53)and non-only-child(14.28±10.73)college students(P(29)0.05).Furthermore,Scores of OCS for the college students with left-behind experience were higher than those non-left-behind experience(14.77±10.66)vs(13.23±10.61),(P<0.001).The analysis of the influencing factors of OCS indicates that college students with left-behind experience(OR=1.202,95%CI:1.024~1.412),smoking(OR=1.517,95%CI:1.115 ~ 2.065)and depressive symptoms(OR=2.525,95%CI: 2.146 ~ 2.971)had a higher risk of OCS.In addition,high self-esteem(OR=0.485,95%CI: 0.387~0.608)and middle self-esteem(OR=0.616,95%CI: 0.518 ~ 0.733)of college students had lower risk of OCS.Spearman correlation analysis showed that the left-behind experience was positively correlated with the scores of OCS(r=0.086,P<0.01),and negatively correlated with the scores of self-esteem(r=-0.111,P<0.01).Pearson correlation analysis showed that the scores of self-esteem was negatively correlated with the scores of OCS(r=-0.287,P<0.01).The results of Bootstrap mediation test showed that when self-esteem was included in the analysis model as a single factors,the results demonstrate that self-esteem had a significant mediating effect on the relationship between left-behind experience and OCS of college students.The mediation effects was 0.6675,95%CI did not contain 0(0.4753~0.8743),and the ratio of mediation effects to total effect was 43.3%.After controlling for confounding factors,the mediation effect was still significant,the mediation effects was 0.2635,95%CI did not contain 0(0.1349~0.4056),and the effect ration was 22.6%?Conclusions OCS was common mental health problems among college students.Left-behind experience was a risk factor for OCS.Self-esteem play a mediating role in correlation between Left-behind experience and OCS.Improving self-esteem will be beneficial to prevent and control the OCS of college students who have left-behind experience.