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
{"title":"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","authors":"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","doi":"10.1186/s12889-025-23383-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2140"},"PeriodicalIF":3.6000,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144823/pdf/","citationCount":"0","resultStr":"{\"title\":\"The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China.\",\"authors\":\"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\",\"doi\":\"10.1186/s12889-025-23383-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":9039,\"journal\":{\"name\":\"BMC Public Health\",\"volume\":\"25 1\",\"pages\":\"2140\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-06-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144823/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Public Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12889-025-23383-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12889-025-23383-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China.
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.
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.
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