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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 12 - 2024 |
doi: 10.3389/fpubh.2024.1422242
This article is part of the Research Topic Youth Mental Health, Particularly in Asian Populations View all 27 articles
The reciprocal relationship between depressive symptoms and deliberate self-harm among Chinese rural adolescents: a cross-lagged panel analysis
Provisionally accepted- 1 Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
- 2 Sichuan University, Chengdu, China
- 3 Research Center for Palliative Care, Sichuan University, Chengdu, China
- 4 West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
- 5 University of Texas at San Antonio, San Antonio, Texas, United States
- 6 Department of Sociology, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, Texas, United States
- 7 Department of Palliative care, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- 8 West China Fourth Hospital of Sichuan University, Chengdu, Sichuan Province, China
- 9 West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
- 10 Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, Sichuan Province, China
- 11 Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
Methods: A 2-year panel study was conducted among 1,840 adolescents aged 10-18 attending rural junior and senior high schools in Sichuan Province, China. The Center for Epidemiologic Studies-Depression Scale (CES-D) and a global measure of self-reported deliberate self-harm were utilized to examine the relationship between depressive symptoms and deliberate self-harm using both classic and random intercept cross-lagged panel models. Multi-group comparisons were carried out for the gender, pubertal stage, and academic performance subgroups. Results: Positive and statistically significant correlations were found between depressive symptoms and deliberate self-harm both within and across the three waves of the panel survey, after adjusting for covariates, among rural adolescents in western China (Range: 0.05-0.28, p < 0.05). As anticipated, depressive symptoms positively predicted later deliberate self-harm, which in turn reciprocally predicted subsequent depressive symptoms, both between and within individuals. While the cross-lagged effects were invariant by gender and academic performance, the effect of baseline depressive symptoms on later deliberate self-harm was stronger for adolescents in the early pubertal stage (β = 0.19, 95% Confidence Interval: 0.08 to 0.30) than for those in the middle-to-late pubertal stage (β = 0.13, 95% CI: 0.06 to 0.19). Conclusions: There is a causal and reciprocal relationship between depressive symptoms and deliberate self-harm among rural adolescents in China. Not only does this finding lend further credence to a growing body of research on adolescents’ self-harming behaviors but also informs early intervention strategies aimed at improving behavioral health of rural adolescents in western China.
Keywords: Depressive symptom, self-harm, adolescents, Mental Health, behavioral health, Cross-lagged panel model, multi-group analysis
Received: 23 Apr 2024; Accepted: 31 Oct 2024.
Copyright: © 2024 Liu, Xu, Jiang, Peng, Ji, Yang, Zhang, Li, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiaolan Liu, Sichuan University, Chengdu, China
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