The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China.

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

BMC Public Health Pub Date : 2025-06-07 DOI:10.1186/s12889-025-23383-y

Jinlong He, Yunling Zhong, Yuqin Song, Jing Luo, Cen Lin, Yuhang Wu, Lu Pan, Yu Cen, Jiayu Zhao, Shiya Gou, Nianjie Wang, Yao Wang, Lei Tang, Jiaming Luo

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引用次数: 0

Abstract

Background: Prior research on the mental well-being of adolescents has shown conflicting findings regarding the impact of only-child status. This study uses Propensity Score Matching (PSM) to control for confounding variables and investigate the impact of only-child status on the psychological health of adolescents.

Methods: A multi-center cluster sampling approach included 7,359 students from 33 middle schools in Western China. The Depression, Anxiety, and Stress Scale-21 (DASS-21), the Childhood Psychological Abuse and Neglect Scale (CPANS), the Pittsburgh Sleep Quality Index (PSQI), the Chinese iteration of the Barratt Impulsiveness Scale (BIS-11), and the Chinese version of the Positive and Negative Affect Scale for Children (PANAS-C) were utilized to assess the adolescents' emotions, sleep, psychological abuse, and neglect. PSM was employed to address confounding variables. Univariate analysis used t-tests, chi-square tests, and Wilcoxon rank-sum tests, while multivariate analysis used GLM to compare DASS-21, PSQI, and PANAS-C scores.

Results: After PSM, 980 only-child and 980 non-only-child adolescents were included. Only-child adolescents showed significantly lower levels of depression, stress, emotional neglect, and negative affect. Further scrutiny of the mean ranks of these dimensions indicated that the only-child group yielded lower scores. In the GLM analysis, after adjusting for neglect, no significant associations were observed (all p > 0.05). However, post adjustments for psychological abuse, the only-child group also recorded lower scores in depression, stress, and negative affect.

Conclusions: This study reveals that the only-child adolescents possibly showing better psychological well-being overall in western China. This study's findings suggest that, during adolescent development, families and society should pay greater attention to the mental health of non-only children.

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中国西部地区独生子女身份对青少年心理健康的影响：一项多中心横断面研究

背景：关于独生子女身份对青少年心理健康的影响，先前的研究显示了相互矛盾的结果。本研究采用倾向得分匹配（PSM）来控制混杂变量，探讨独生子女身份对青少年心理健康的影响。方法：采用多中心整群抽样方法，对西部地区33所中学的7359名学生进行调查。采用抑郁、焦虑和压力量表-21 （DASS-21）、儿童心理虐待和忽视量表（CPANS）、匹兹堡睡眠质量指数（PSQI）、中国版Barratt冲动量表（BIS-11）和中国版儿童积极和消极情绪量表（PANAS-C）对青少年的情绪、睡眠、心理虐待和忽视进行评估。采用PSM处理混杂变量。单因素分析采用t检验、卡方检验和Wilcoxon秩和检验，多因素分析采用GLM比较DASS-21、PSQI和PANAS-C评分。结果：经PSM后，共纳入980名独生子女和980名非独生子女青少年。独生子女青少年表现出较低的抑郁、压力、情绪忽视和消极情绪水平。进一步研究这些维度的平均排名表明，独生子女组的得分较低。在GLM分析中，在对忽视进行调整后，没有观察到显著的关联（均p < 0.05）。然而，在心理虐待的岗位调整中，独生子女组在抑郁、压力和负面影响方面的得分也较低。结论：本研究揭示了西部地区独生子女青少年的整体心理健康状况可能较好。本研究结果提示，在青少年发展过程中，家庭和社会应更加关注非独生子女的心理健康。

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来源期刊

BMC Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

4.40%

发文量

2108

审稿时长

1 months

期刊介绍： BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.