| ObjectiveTo explore epidemiological character of Left-behind Children's (LBC) anxiety and depression and the psychopathology, develop and testify the Situation- Inhibition-Evaluation-Resilience Model for LBC's anxiety and depression, and construct Resilience Development Program and confirm its efficacy to LBC's anxiety and depression preliminary.Methods:1) Surveyed countryside LBC of 0-15 years old in whole Hunan province, and stratified sampled and investigated 1312 children in grade 4 and grade 8 with SCARED and DSRSC. Compared the difference of anxiety and depression, among LBC (527), children with history of being left behind for more than one year but who at intake were already living with at least one parent (ELB: 102), children were being left-behind at intake but the duration was less than one year (NLB: 38), and controls(CON: 645), among children groups with different kind caregiver, and analyzed the sex difference and age difference of anxiety and depression.2) Investigated LBC (190) and CON (588) of 9-15 years old (11.9±1.6 years old) with The Screen for Child Anxiety Related Emotional Disorders (SCARED), Depression Self-rating Scale for Children (DSRSC), Adolescent Self-rating Life Event Checklist (ASLEC), Social Support Rating Scale for Children and Adolescents (SSRS-CA), Parental Bonding Instrument (PBI), Adolescent Attachment Questionnaire (AAQ), Social Economic status Questionnaires (SES), Behavioral Inhibition Scale (BIS), Cognitive Style Questionnaire for Adolescents (CSQ-A), Children Simple Coping Style Questionnaire (CSCSQ), Resilience Scale (RS). Explored the association among the above evaluated situation factors, behavioral inhibition, cognitive, resilience and anxiety/depression. Constructed pathway model with regression analyses and testified it with Structural Equation Model.3) Formulated Resilience Development Program, and performed the program to intervene 29 LBC with anxiety and depression, compared the assessment of preliminary test, posttest and 3-month follow up test between intervention group, partnership group and blank controller.Results1) Of the 0-15 years old children in Hunan province, 27% were LBC, 6% were ELB, and 3% were NLB. LBC and NLB tended to have more anxiety and depression than CON (p<.01) and ELB tended to have higher depression than CON (p<.05). Compared with controls, LBC had higher detected ratio in anxiety disorder (37% vs. 25%), depression disorder (22% vs. 17%), and comorbidity anxiety and depression (16% vs. 10%). Within LBC, Children raised by a relative caregiver (RLC) had higher anxiety than children raised by a non-relative caregiver (NLC) (F=5.9, p=.015), female LBC had higher anxiety and depression than male LBC (t=2.0-3.9, p<.05), LBC in juvenile tended to have more social phobia, school phobia and less separation anxiety (t=2.0-4.8, p<.05).2) The longer of the duration of LBC tended to have higher anxiety and depression (r=.28-.38, p<.01), and earlier onset of LBC tended to have higher depression (r=-.39,p<.01), while the onset of being LBC during 5-7 years old affected their anxiety worst. Compared with controllers, LBC tended to report more negative life events, less social support, lower social-economic status (SES) of caregiver, lower care by caregiver than that of CON (t=1.98-5.03, p<.05,cohen's d =. 15-.36). However, there was not significant difference in the point of the behavioral inhibition, negative cognitive style, resilience between LBC and CON except for LBC tended to have more negative coping style and less positive coping style (t=1.97-2.98,p<.05). Social support, higher SES of parents and caregiver, higher family education involvement of teachers, and higher resilience were the collective protective factors of anxiety and depression (r=-.17- -.54, p<.05) . Moreover, the concerning (or care) of parents and caregiver tended to contribute to ease LBC's anxiety significantly (r = -.27- -.40, p<.05), but the over-control of parents tended to aggravate LBC's anxiety significantly (r = .27, p<.05). There were similar psychopathology of anxiety and depression. The "Situation-Inhibition-Evaluation- Resilience" pathway model, which stemmed from regression analyses, had acceptable fitness coefficients. However, it should be necessary to further explore and testify the model, especially its ecological validity.3) The Resilience Development Program for LBC could contribute to develop LBC's resilience and relieve their anxiety and depression. The effects of the program to developing resilience, reducing anxiety and depression were noteworthy (effect size of the posttest vs. preliminary test: Cohen's d =.56-1.81) and durative (effect size of the 3-month follow-up vs. preliminary test: Cohen's d =.72-1.91).ConclusionThe issue of LBC's anxiety and depression have been the public problem in Hunan province. Environment factors and behavioral inhibition affected anxiety and depression directly and indirectly. Cognitive and resilience acted on as mediator or moderator or both of them between environment, behavioral inhibition and anxiety and depression. Negative cognition triggered and aggravated anxiety and depression via negative coping style, and resilience safeguarded and restored anxiety and depression. The Situation-Inhibition-Evaluation-Resilience Model could illustrate psychopathology of LBC's anxiety and depression acceptably. The Resilience Development Program could contribute to develop LBC's resilience and ease their anxiety and depression.
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