Background Parenting styles are significantly associated with self-harm (SH) in adolescents. Nevertheless, little is known about the mechanism underlying this association. This study primarily aimed to evaluate the potential mediating role of impulsivity in the association between parenting styles and SH in Chinese adolescents. Methods Self-administered questionnaires were used to conduct a survey among a sample population consisting of 3146 adolescents in southwest China. Logistic regression analyses were performed to evaluate the association between parenting styles, impulsivity, and SH. A path model investigation further examined the mediating role of impulsivity in terms of the association between parenting styles and SH. Results The age range of participants was 10 to 17 years old. The prevalence of SH was 47.0% (95% CI: 36.3–58.0%). Impulsivity, less paternal emotional warmth, maternal over-protection, and rejection were significantly associated with SH. The path model identified impulsivity as a salient mediator, accounting for 23.4% of the total association between parenting styles and SH. The hypothesized path model indicated differences in the parenting styles of fathers and mothers: Impulsivity played a significant mediating role, though only in respect to the maternal over-protection and rejection paths. Conclusions For Chinese children and adolescents who experience a harsher maternal parenting style, impulsivity-centered intervention measures might be effective in reducing SH related to parenting styles.
Background A significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC). Existing literature suggests that resilience might be a mediator in this association. However, this hypothesis has not been effectively discussed. The major aim of our study is to analyze the possible mediation of resilience in SH-SI association in Chinese LBC. Methods A population-based clustering sampling survey of 2619 LBC was conducted in southwestern China Yunnan province. Self-developed structured questionnaire was used to collect relevant information. Univariate and multivariate Logistic regression models were applied to estimate the associations between SH and SI, resilience and SI, and SH and resilience. Path analysis was adopted to measure the mediation of resilience, as well as its 5 dimensions, in the association between SH and SI. A subgroup analysis was further done to explore the mediation of resilience in the associations between SH severity and SI, SH repetition and SI, among self-harmed LBC. Results Compared with LBC who reported no SH behaviors, the odds ratio (OR) for SI was 3.37 (95% CI: 2.63–4.31) among self-harmed LBC. Based on the path model, resilience significantly mediated a quarter of the total association between SH and SI. Among the 5 dimensions of resilience, emotion regulation, interpersonal assistance, and family support were the strongest mediators. Subgroup analysis revealed that, the mediation of resilience was only significant for SH severity and SI. Conclusions Resilience played as a prominent mediator in SH-SI association among Chinese LBC. Resilience-centered intervention measures could be considered to reduce suicidal risk of this disadvantageous group.
Bipolar disorder (BD) is associated with a higher risk of self-harm (SH) when compared with depression. Therefore, it is reasonable to suspect that the state of mania or hypomania may independently contribute to increased SH risk. However, for hypomania, its association with SH remains less known. We intend to investigate this hypothesis in a large sample of Chinese children and adolescents with depressive symptoms. Based on a two-stage simple random cluster sampling method with probability proportionate to sample size (PPS) design, a total of 4,858 children and adolescents aged between 10 and 17 years were surveyed in southwestern China, Yunnan Province, by using self-administered questionnaires. Among them, 1,577 respondents with depressive symptoms were screened out and included in the final analysis. Descriptive statistics were calculated to illustrate the major characteristics of the study subjects. Multivariate logistic regression models were fitted to evaluate the adjusted association between hypomanic symptoms and SH. The prevalence of SH in children and adolescents with depressive symptoms was 63.92% (95% CI: 58.70–69.00%). The two hypomanic factors, which measure “active/elated” (factor I) and “risk-taking/irritable” (factor II), were significantly and discordantly associated with SH: after adjustment, every one-point increase in factor I and factor II scores was associated with 0.94-fold (95% CI: 0.91–0.97) and 1.25-fold (95% CI: 1.15–1.36) of odds ratio (OR) in SH prevalence. Further analyses based on quartiles of the two factors revealed a more prominent dose–response relationship between factor II and SH prevalence, SH repetition, and SH severity. The results of this study may suggest that, for hypomanic children and adolescents, individuals with elevated factor II score are probably of greater urgency for SH intervention. Major limitations of this study include inability of causal inference, risk of information bias, and limited results extrapolation.
Objectives Accumulating evidences suggested that serum C-reactive protein (CRP) was associated with the survival of bladder cancer patients. However, incongruent findings have been reported. Methods We comprehensively searched PubMed, Embase, and Web of science through August 2020 in order to find all eligible studies on the association between CRP and the overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS) of bladder cancer patients. The pooled hazard ratios (HRs) together with their 95% confidence intervals (CIs) were estimated by fixed-effect model if the heterogeneity was low, and random-effect model if the heterogeneity was high. A series of subgroup meta-analysis were performed with regard to the specific characteristics of study design. Results Thirteen eligible studies were included in this meta-analysis. The pooled results of 8 included studies revealed that an elevated CRP was associated with poor OS (HR = 2.24, 95% CI: 1.16–4.34) and CSS (HR = 1.53 95% CI: 1.36–1.72) of bladder cancer. Besides, the combined results of 3 included studies also indicated an inferior DFS for bladder cancer patients of elevated CRP level (HR = 2.07, 95% CI: 1.24–3.35). Subgroup analyses supported the robust association between elevated CRP and CSS. Conclusions These findings suggested that bladder cancer patients reported increase serum CRP had inferior prognostic outcomes.
Background: Parenting styles were positively associated with self-harm (SH) in adolescents. Nevertheless, little is known concerning the mechanism behind this association. This study primarily aims to evaluate the potential mediation of impulsivity in the association between parenting styles and SH in Chinese adolescents. Methods: A population-based sample of 3146 adolescents in southwest China were surveyed by using self-administered questionnaires. Logistic regression analyses were used to measure the association between parenting styles and SH. Path model further examined mediation of impulsivity in this association. Results: The prevalence of SH was 47.0% (95% CI: 36.3%-58.0%). Impulsivity and mother’s over-protection were significantly associated with SH. Impulsivity showed a salient mediation, accounting for 23.4% of the total association. Parenting styles of father and mother showed disparate roles in the hypothesized path model. Conclusions: Our major findings suggested that, for Chinese adolescents with harsher maternal parenting style, impulsivity-centered intervention measures might be effective in reducing parenting style related SH.
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