Weiqing Jiang

Background: Few studies have simultaneously considered the impacts of parental labour migration and childhood maltreatment on psychosocial health.Objective: To estimate the complex associations of parental labour migration and childhood maltreatment with psychosocial health among adolescents and young adults in China.Method: This cross-sectional study was conducted among undergraduates aged 17 to 24 years from sixty colleges and universities across 10 provinces of China. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire-Short Form, and psychosocial health was measured using the Strengths and Difficulties Questionnaire (SDQ). Weighted linear mixed regression models, multiplicative interactions, and joint and mediation analyses were performed.Results: Of the 28,810 participants included (mean [SD] age, 19.87 [1.62] years), 12035 (41.8%) were male. In the fully adjusted model, participants who experienced parental migration were more likely to report higher levels of SDQ total difficulties (e.g. β = 0.16 [95% CI, 0.05 to 0.28]) compared with those with non-migrant parents. A positive association was found between the cumulative number of childhood maltreatment and SDQ total difficulties (β = 0.54 [95% CI, 0.49 to 0.60]), with a dose-response relationship observed for the levels of childhood maltreatment and SDQ total difficulties. Compared with individuals without exposure to both parental migration and childhood maltreatment, those exposed to both parental migration and at least 2 numbers of childhood maltreatment had the highest magnitude of psychosocial health difficulties (β = 1.12 [95% CI, 0.91 to 1.33]). Moreover, childhood maltreatment may partially mediate the association between parental migration and psychosocial health, with the mediation proportion being 58.8%.Conclusion: Exposure to parental labour migration or childhood maltreatment was positively associated with psychosocial health among adolescents and young adults. Parental migration and childhood maltreatment may jointly aggravate psychosocial health problems. These findings indicate the necessity of comprehensive interventions targeting adversity stressors to improve psychosocial health, especially for left-behind children experiencing maltreatment.

Background: To examine the independent association of adverse childhood experiences (ACEs) and lifestyle patterns with incident probable eating disorders among adolescents, and to explore whether healthy lifestyle affects incident probable eating disorders that vary by ACEs exposure levels.Methods: This longitudinal study included 7726 adolescents (mean [SD] age at baseline, 15.89 [0.60] years) without eating disorders at baseline. At baseline, we collected 11 ACE indicators and 6 healthy lifestyle behaviors (i.e., appropriate sleep duration, sufficient moderate‐to‐vigorous physical activity, less screen time, no smoking, no drinking, and a balanced diet). The Sick, Control, One, Fat, Food (SCOFF) questionnaire was used to measure probable eating disorders at baseline and at a 4‐month follow‐up. Generalized mixed logistic models, as well as stratified and joint analyzes, were performed, with mediation and interaction analyzes.Results: Among the included participants, 917 adolescents (11.87%) developed probable eating disorders during follow‐up. Accumulation of ACEs was independently associated with an increased risk of incident probable eating disorders (OR = 1.20, 95% CI: 1.14–1.27), even after adjusting for lifestyle behaviors. Conversely, a higher healthy lifestyle score was independently associated with a lower risk of incident probable eating disorders (OR = 0.82, 95% CI: 0.76–0.88). Stratified analyzes showed that adolescents with a favorable lifestyle had a consistently reduced risk of incident probable eating disorders compared with those with an unfavorable lifestyle, with the association particularly pronounced among those exposed to ACEs.Conclusions: The results highlight that reducing exposure to ACEs and encouraging healthy lifestyle behaviors may help prevent eating disorders among adolescents.

Background and aims: Gender nonconformity (GNC), which refers to an individual's expression of gender that does not align with the socially prescribed norms for their biological sex, may be associated with adverse behavioral problems, such as problematic smartphone use (PSU) and problematic internet use (PIU). This study examined the associations between GNC and PSU and GNC and PIU among Chinese adolescents.Methods: This cross-sectional study utilized data from the 2021 School-based Chinese Adolescents Health Survey, recruiting 23,054 eligible adolescents aged 11 to 21, with an average age of 14.9 (SD: 1.7) years from 504 classes in 84 public high schools across 7 cities in China. Gender nonconformity, PSU/PIU, and demographics were measured. Mixed-effect linear regression models were performed.Results: Among the participants (51.0% male), 5.3% reported high GNC and 26.9% reported moderate GNC. After adjusting for covariates, high GNC was significantly and positively associated with PSU (Β = 1.11, 95% CI = 0.49–1.72) and PIU severity (Β = 2.16, 95% CI = 1.40–2.93). Stratified analyses indicated that the associations between GNC and PSU differed between males and females, with a significant association observed only among male students (Β = 1.91, 95% CI = 0.97–2.86).Discussion and conclusions: GNC is positively associated with the severity of PSU and PIU among Chinese adolescents, with male gender-nonconforming adolescents being more vulnerable to PSU. These results highlight the importance of implementing education on gender expression diversity in schools to create an inclusive school environment, which may potentially help prevent PSU and PIU among gender-nonconforming adolescents.