Perceived academic stress and depressive symptoms among Chinese adolescents: A moderated mediation analysis of overweight status

Guo

et al. 2023

Front. Public Health

ObjectiveThe purpose of this study was to explore the relationship between academic stress, school bullying and self-harm behaviors among Chinese middle school students and to further explore the impact of anxiety and depression on this relationship.MethodsThe students (aged 12–16 years) in a middle school in Changsha city were invited to respond to a questionnaire through an online platform. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess the severity of anxiety and depressive symptoms, respectively. The experience of being bullied, academic stress, and self-harm behaviors were assessed using several questions on the basis of previous studies.ResultsA total of 1,313 middle school students completed the study, and 3.40% and 4.10% of them reported suicide attempts (SAs) and non-suicidal self-injury (NSSI), respectively. Univariate logistic regression analysis revealed that anxiety symptoms (OR = 1.23, 95% CI: 1.18–1.28; OR = 1.25, 95% CI: 1.19–1.31), depressive symptoms (OR = 1.20, 95% CI: 1.16–1.25; OR = 1.26, 95% CI: 1.20–1.31), school bullying (OR = 3.8, 95% CI: 2.11–6.89; OR = 2.76, 95% CI: 1.39–5.47), and academic stress (OR = 2.20, 95% CI: 1.27–3.80; OR = 3.80, 95% CI: 1.20–7.25) were common factors of NSSI and SAs. In addition, depressive symptoms showed a mediating effect on the association of school bullying and academic stress with SAs or NSSI, and anxiety symptoms showed a mediating effect on the association of school bullying and academic stress with NSSI only.ConclusionAppropriate strategies are needed to reduce academic pressure and prevent school bullying. Meanwhile, negative emotions such as depression and anxiety should be evaluated and intervened in to prevent self-harm behaviors among middle school students.

Section: Academic Stressmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of academic stress and school bullying on self-harm behaviors among Chinese middle school students: The mediation effect of depression and anxiety

Guo

et al. 2023

Front. Public Health

Journal Community Psychology

“…This includes five items that ask students to report the frequency (numbers 1–5 indicate every day to no days) of the following feelings in the last 7 days: frustration, depression, unhappiness, meaninglessness, and sadness. This short version scale has demonstrated good reliability in Chinese adolescents and is widely used by researchers (Fu et al, 2021; Jiang & Dong, 2020). Mental health was measured using the factor score after principal component factor analysis of the five items, with higher numbers indicating fewer depressive symptoms or better mental health.…”

Section: Methodsmentioning

confidence: 99%

Early and continuing grandparental care and middle school students' educational and mental health outcomes in China

Hong

Zeng

2022

Several recent studies have examined the relationship between grandparents and grandchildren, but few have examined the effects of early and continuing grandparental care on children's development in China. Using data from the China Education Panel Survey, this study examines the effects of early and continuing care, in which grandparents serve as primary caregivers on middle school students' educational (measured by academic performance and cognitive scores) and mental health (depression score) outcomes. Using multilevel analyses and robustness tests, the results show that for urban and rural students, students cared for by their grandparents showed no disadvantages in their educational outcomes. For rural students who received grandparental care in early childhood or adolescence academically outperformed those who received only parental care. Urban and rural students who received only grandparental care in early childhood and adolescence show worse mental health outcomes. These results challenge the prevailing belief that grandparent caregiving can harm grandchildren's school preparation and cognitive abilities.

“…Depressive symptoms CDI-Short Form (Kovacs, 1985) Academic stress had a positive association with depressive symptoms, with a 1-point increase in academic stress associated with a 0.12-point (95% CI 0.09-0.14) increase in depressive symptoms (standardised coefficient = 0.25, p<0.001). (Fu et al, 2022) Single parental expectations item Depressive symptoms CES-D (Radloff, 1977a) Academic stress had a direct positive association with depressive symptoms (unstandardised coefficient = 0.44, p<0.001) (Guo et al, 2014) ERI-S Depressive symptoms CES-DC (Chinese version) (Li et al, 2010) A high level of school-related stress was associated with increased odds of experiencing depressive symptoms in comparison to students with low levels of school-related stress (OR = 5.38, 95 CI%: 4.19-6.91).…”

Section: Narrative Synthesis Depressionmentioning

confidence: 99%

The association between academic pressure and adolescent mental health problems: A systematic review

Steare

Munoz

Sullivan

et al. 2023

Preprint

Background: Academic pressure is a potential contributor to adolescent mental health problems, but international evidence on this association has never been synthesised. Methods: We conducted the first systematic review on the association between academic pressure and adolescent depression, anxiety, self-harm, suicidality, suicide attempts and suicide. We searched MEDLINE, PsycINFO, ERIC and Web of Science (core collection) up to November 24, 2022, for studies of school-going children or adolescents, which measured academic pressure or timing within the school year as the exposure and depression, anxiety, self-harm, or suicidal ideation, attempts or suicide as outcomes. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used narrative synthesis to summarise the evidence. The review was prospectively registered with PROSPERO (CRD42021232702). Results: We included 52 studies primarily from Asia (n=26) and Europe (n=20). Most studies assessed mixed anxiety and depressive symptoms (n=20) or depressive symptoms (n=19). Forty-eight studies found evidence of a positive association between academic pressure or timing within the school year and at least one mental health outcome. Limitations: Most studies were cross-sectional (n=39), adjusted for a narrow range of confounders or had other limitations which limited the strength of causal inferences. Conclusions: We found evidence that academic pressure is a potential candidate for public health interventions which could prevent adolescent mental health problems. Large population-based cohort studies are needed to investigate whether academic pressure is a causal risk factor that should be targeted in school- and policy-based interventions.