The correlation between different types of negative life events and the mental health status of Han ethnic adolescents in Sichuan Province

Shoukang Zou¹Yangling Li²Wenli Tan³Meijiang Jin¹茂佳 冉¹Zhujun Wang¹Hang Zhang¹Hanmei Xu¹Yuanmei Tao¹Xian Tang⁴Ping Xiong⁵Huiping Huang⁶Ying Huang⁶Ling Li⁶Wenjuan Yang⁷Hongping Zeng⁸Liu Gui⁹Xiaosu Shen¹⁰Hongqin Zhao¹⁰Ying Chen¹¹Kangling Yao¹²Jingyi Zhao¹³Wenwen Han¹⁴Jingmiao Zhou¹⁴Jianmin Hou¹⁵Shikun Peng¹⁶Yadan Wang¹⁶Yunzhen Yang¹⁷Yi Feng¹⁸Lin Chen¹⁸Xiting Yang¹⁹Shuangshuang Li²⁰Xue Luo²⁰Yan Wang²⁰Li Yin^1*

• ¹Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
• ²Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China
• ³Chengdu Research Institute of Education Science, Chengdu, China
• ⁴Center for Disease Control and Prevention, Wuhou District, Chengdu, China
• ⁵Chengdu Engineering Technical Vocational School, Chengdu, China
• ⁶Sichuan Bright Foreign Language School, Emeishan, China
• ⁷Chengdu Shishi Jincheng Foreign Language School, Chengdu, China
• ⁸Sichuan Chengdu Zhonghe Vocational High School, Chengdu, China
• ⁹Chengdu Eldo Primary School, Chengdu, China
• ¹⁰Majiahe primary school of Chengdu, Chengdu, China
• ¹¹Chengdu Huaxi Primary School, Chengdu, China
• ¹²Shude Xiejin High School, Chengdu, China
• ¹³Chengdu Wuhou Experimental Middle School Primaey School, Chengdu, China
• ¹⁴Yinxing Primary School, Chengdu, China
• ¹⁵Southwest Jiaotong University Affiliated Middle School, Chengdu, China
• ¹⁶Tianfu No.4 High School, Chengdu, China
• ¹⁷Chengdu Primary School Affiliated To Beijing International Studies University, Chengdu, China
• ¹⁸Chengdu Shuangqing Primary School, Chengdu, China
• ¹⁹Chengdu Shayan Primary School, Chengdu, China
• ²⁰Chengdu Xin Qiao Primary School, Chengdu, China

Objectives: Although many studies have shown a significant association between negative life events and mental health problems among adolescents, few studies have explored whether there are differences in the impact of different types of negative life events on mental health problems among adolescents. We hope to further explore and analyze this issue through a cross-sectional study of Chinese adolescents. Methods: Cluster sampling was adopted to analyze anxiety symptoms, depressive symptoms and suicidal ideation and their influencing factors among 9,982 students from 4 middle schools in Sichuan Province, western China. we use the Generalized Structural Equation Model (GSEM) to calculate the chain mediation effect between the negative life events and mental health status. The influence of different negative life events on different mental health problems was explored through binary logistic regression. Results: After controlling for gender, age, school type, and exercise, sleep and core self-evaluation exhibited a significant chain mediating effect in the relationship between negative life events and anxiety symptoms/depressive symptoms (effect value: 0.0131, p<0.001, 95% CI: 0.0086-0.0177; effect value:0.0116, p<0.001, 95% CI: 0.0076-0.0155). For negative life events, interpersonal stress and adaptation problem were risk factors for anxiety symptoms, depressive symptoms and suicidal ideation among adolescent students (OR=1.179, p<0.001, 95% CI 1.149–1.209; OR=1.187, p<0.001, 95% CI 1.153–1.222; OR=1.074, p<0.001, 95% CI 1.048–1.100; OR=1.163, p<0.001, 95% CI 1.128–1.199; OR=1.229, p<0.001, 95% CI 1.188–1.271; OR=1.044, p=0.002, 95% CI 1.016–1.073). Loss was a risk factor for depressive symptoms and suicidal ideation among adolescent students (OR=1.050, p<0.001, 95% CI 1.022--1.079; OR=1.030, p=0.009, 95% CI 1.008--1.054). Punishment was the risk factor for depressive symptoms among adolescent students (OR=1.037, p=0.012, 95% CI 1.008--1.067). Academic stress was the risk factor for anxiety symptoms among adolescent students (OR=1.077, p<0.001, 95% CI 1.051-- 1.104). Conclusion: Sleep and core self-evaluation are important mediating factors in the relationship between negative life events and mental health status. Interpersonal stress and adaptation problem in negative life events were the main risk factors for mental health problems among adolescent students. Special attention should be given to the mental health status of adolescent students with interpersonal relationship problems and maladaptation.