The Relationship Between Traumatic Events And Anxiety,Depression,and Stress In Left-Behind Middle School Students

Objectives: To understand the occurrence of traumatic events and levels of anxiety,depression,and stress among left-behind middle school students in China;to study the relationship between traumatic events and anxiety,depression,and stress among left-behind middle school students in order to understand their psychological status and existing problems.Methods: This study is a cross-sectional study,which uses a combination of typical sampling and multi-stage cluster sampling methods.Five provinces are randomly selected from the seven provinces with a concentrated distribution of left-behind children,and one county is selected from each province.In each county,one ordinary junior high school,one ordinary high school,and one vocational secondary school are selected as research sites.A total of 7724 left-behind students from the 15 selected schools were surveyed.The students’ personal basic information,family intimacy,and growth environment were investigated through self-reported questionnaires,while traumatic events,anxiety,depression,and stress were measured using standardized scales.Binary logistic regression and path analysis were used to explore the relationship between traumatic events and anxiety,depression,and stress.Result:(1)The incidence of traumatic events among left-behind middle school students is 54.0%,with boys higher than girls(55.9% vs.52.3%).The top three events in terms of incidence are "seeing someone being beaten,insulted,or seriously injured outside"(21.5%),"being severely beaten,pushed,or kicked at home"(18.2%),and "seeing a dead person"(13.9%);(2)41.1% of left-behind middle school students have symptoms of anxiety,with a higher proportion of moderate to severe anxiety,at 19.4% and 13.1%respectively.33.3% of students have symptoms of depression,with a higher proportion of mild to moderate depression,at 12.9% and 14.5% respectively.17.0%of left-behind middle school students have symptoms of stress,with a higher proportion of mild to moderate stress,at 7.9% and 5.6% respectively.When stratified by gender,the levels of anxiety,depression,and stress in girls are higher than those in boys(43.5% vs.41.1%,34.4% vs.31.9%,18.5% vs.15.3%);(3)The number of traumatic events experienced by left-behind middle school students is significantly positively correlated with their levels of anxiety,depression,and stress(r=0.33,P<0.01;r=0.32,P<0.01;r=0.32,P<0.01).The frequency of contact with their father/mother during their time left-behind is significantly negatively correlated with their levels of anxiety,depression,and stress(father: r=-0.17,P<0.01;r=-0.19,P<0.01;r=-0.18,P<0.01;mother: r=-0.11,P<0.01;r=-0.12,P<0.01;r=-0.11,P<0.01).The earliest age of being left-behind is significantly negatively correlated with their levels of anxiety,depression,and stress(r=-0.07,P<0.01;r=-0.07,P<0.01;r=-0.07,P<0.01),while the cumulative years of being left-behind are significantly positively correlated with their levels of anxiety,depression,and stress(r=0.08,P<0.01;r=0.07,P<0.01;r=0.06,P<0.01);(4)The experience of being left behind(frequency of contact with father/mother during the left-behind period,age at which they were first left behind,and cumulative years of being left behind)has a direct effect on the overall levels of anxiety,depression,and stress(β=0.181,P<0.01),and an indirect effect through the number of traumatic events experienced on the overall levels of anxiety,depression,and stress(β=0.058,P<0.01),with a total effect of 0.460.Further analysis shows that the experience of being left behind has a direct effect on levels of anxiety(β=0.181,P<0.01),depression(β=0.196,P<0.01),and stress(β=0.196,P<0.01),and an indirect effect through experiencing traumatic events on levels of anxiety(β=0.089,P<0.01),depression(β=0.079,P<0.01),and stress(β=0.069,P<0.01).Conclusion: Traumatic events are more prevalent among left-behind middle school students in China,which affects their anxiety,depression,and stress levels.Among them,female students have higher levels of anxiety,depression,and stress than male students,and left-behind students who have experienced traumatic events have even higher levels of anxiety,depression,and stress.Traumatic events are related to leftbehind experiences,anxiety,depression,and stress levels,and play a mediating role between left-behind experiences and anxiety,depression,and stress levels.