中国学校卫生

Focus on the intergenerational transmission of adverse childhood experiences

TANG Jie, HU Bin, LIN Weiquan

2025, 46(10): 1369-1371. doi: 10.16835/j.cnki.1000-9817.2025309

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Adverse childhood experiences (ACEs) constitute a significant environmental risk factor for various physical and mental health issues. In recent years, the intergenerational health effects of ACEs have gradually become a research focus. The article reviews and analyzes the prevalence of ACEs, and their intergenerational health impacts, and the underlying biological and socio-psychological mechanisms. It calls for strengthening relevant research on the transformation of mechanisms, methods and practices, so as to provide a scientific basis for the ongoing optimization of policies aimed at improving children's growth environments.

Analysis and implications of the curriculum objectives in the U.S. National Health Education Standards (2024)

HAN Yuxin, GUO Zhaoxia

2025, 46(10): 1372-1375. doi: 10.16835/j.cnki.1000-9817.2025302

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The development of effective school health education in the key to enhancing students' health literacy. In 2024, the United States issued the National Health Education Standards (NHES) (3rd Edition), which established a goal system centered on health literacy. Its features included a hierarchical, continuous and holistic design of the standards, an emphasis on skills-based health education, a focus on overall health and well-being, and promotion of a diversified evaluation system. Through a textual analysis of the U.S. NHES (2024), four insights have been gained: integrating health literacy into the core competencies of disciplines to develop localized health education standards; creating a health education knowledge graph based on backward design to improve content structure; deepening the "disciplinary penetration + thematic education +" model, emphasizing students' deep participation and performance in implementation; and improving the health education evaluation system by using digital and intelligent technologies for precise intervention.These efforts aim to promote students' holistic development and advance educational modernization.

Network analysis of the relationship of bullying victimization with anxiety and depressive symptoms among adolescents

XIONG Yuxiang, PAN Shuibo, LIN Jinfeng, WEI Qiaoyue, WU Junduan

2025, 46(10): 1376-1380. doi: 10.16835/j.cnki.1000-9817.2025290

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Objective To identify the core symptoms and bridge symptoms in the network structure among adolescents bullying victimization, anxiety and depressive symptoms, and to explore the interrelationships among these three variables, so as to provide a basis for the precise prevention of bullying behaviors and the improvement of adolescents' psychological health conditions. Methods From October to November 2023, a stratified cluster random sampling method was employed to select 4 759 middle and high school students from four cities in Guangxi: Beihai, Guigang, Hechi, and Laibin. The Chinese version of the Olweus Bully/Victim Questionnaire (OBVQ) was used to assess bullying victimization among adolescents, while the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) were utilized to assess anxiety and depressive symptoms, respectively. The Bootnet package (version 1.6) in R software (version 4.4.1) was used to construct a network structure and analyze the associations between bullying victimization, anxiety symptoms and depressive symptoms among adolescents. Results The reporting rates of depressive symptoms, anxiety symptoms, and bullying victimization among adolescents in Guangxi were 24.67%, 16.33%, and 16.58%, respectively. Network analysis revealed that the node with the highest expected influence was "property being taken or damaged", with a standardized expected influence (EI) index of 2.09. The top two nodes in terms of bridge expected influence were "thoughts of self-harm or suicide" and "irritability", with standardized bridge expected influence (BEI) indices of 2.15 and 1.27, respectively. The stronger associations were observed between the node "property being taken or damaged" and the nodes "physical attacks such as hitting, kicking, pushing, or shoving" and "ridiculed due to accent", with edge weights of 0.43 and 0.35, respectively. Conclusion Targeting preventive measures against the symptoms with the highest expected influence and bridge expected influence in the network of bullying victimization, anxiety and depressive symptoms among adolescents may be an effective approach to reduce the negative impact of bullying victimization, anxiety and depressive symptoms on adolescents.

Meta-analysis of the relationship between maternal adverse childhood experiences and offspring maladaptive social behaviors

XIAO Lüman, NIE Xiaofei, KE Li, JIANG Shiying, LIU Bing

2025, 46(10): 1381-1386. doi: 10.16835/j.cnki.1000-9817.2025289

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Objective To systematically evaluate the association between maternal adverse childhood experiences (ACEs) and offspring social behavior, so as to provide a theoretical basis for further research on intergenerational social behavioral development. Methods Relevant research literature about maternal ACEs and the development of children's maladaptive social behaviors were collected, from China National Knowledge Infrastructure (CNKI), VIP, Wanfang, SinoMed, PubMed, Web of Science, Cochrane Library, Embase and SpringLink databases, covering the period from the inception of each database to May 2025. The Chinese database matched and searched through three groups of keywords: "Pregnant women" "Mothers" and "Women"; "Bad childhood experience" "Bad early experience" and "Bad adolescent experience"; "Children" "Teenagers" "Children's behavior" "Children's development" "Teenagers' behavior" "Internalized behavior" and "Externalized behavior". The English database was searched by three groups of keywords: "Female" "Pregnant women" "Mothers"; "Adverse childhood experiences" "Adverse early childhood experiences" "Adverse experiences of adolescent"; "Child behavior" "Child development" "Adolescent behavior" "Internalized behaviors" "Externalized behaviors". The selected literature was evaluated for quality and data extraction, with OR and 95%CI as effect indicators. Stata 16.0 software was used for heterogeneity testing, subgroup analysis, and publication bias analysis. Results A total of 14 studies involving 64 302 mother-child pairs were included. The Meta-analysis results showed a significant correlation between maternal ACEs and both offspring maladaptive internalized behaviors (OR=1.75, 95%CI=1.42-2.15, P < 0.01) and externalized behaviors (OR=1.82, 95%CI=1.51-2.20, P < 0.01). The results of subgroup analyses showed that in different regions[internalized behaviors: domestic, foreign OR(95%CI)=2.03(1.49-2.76), 1.55(1.19-2.03); externalized behaviors: domestic, foreign OR(95%CI)=2.41(1.52-3.82), 1.65(1.36-2.01)], study type[internalized behaviors: cohort study, cross-sectional study OR(95%CI)=1.64(1.34-2.00), 1.85(1.30-2.65); externalized behaviors: cohort study, cross-sectional study OR(95%CI)=1.76(1.46-2.12), 2.12(1.40-3.20)], sample size [internalized behaviors: ≥4 000, < 4 000 pairs OR(95%CI)=1.69(1.13-2.55), 1.77(1.41-2.24); externalized behaviors: ≥3 000, < 3 000 pairs OR(95%CI)=1.72(1.37-2.17), 2.13(1.44-3.15)], there were significant and positive association between mothers' ACEs and children's internalizing and externalizing behaviors (all P < 0.05). Conclusion A substantial positive association exists between maternal ACEs and the development of offspring maladaptive internalized and externalized behaviors, but the result needs to be continued to be validated by more research.

Association between left-behind status and health risk behaviors among adolescents

WANG Chengchen, HOU Hao, DAI Xingyu, YANG Bingxiang, ZHOU Yang

2025, 46(10): 1387-1391. doi: 10.16835/j.cnki.1000-9817.2025297

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Objective To examine the association between the left-behind status and health risk behaviors (HRB) among adolescents, so as to provide empirical evidence for identifying high-risk groups and developing intervention measures for HRB. Methods From October to November 2023, by using a combination of convenient sampling and cluster sampling, 14 964 adolescents from 6 schools in a county-level city in Hubei Province (3 junior high schools and 3 senior high schools) and 7 schools in a county-level city in Hunan Province (all junior high schools) were selected as the research subjects. The adolescents were divided into non-left-behind, father-absent, mother-absent, and both parents absent groups based on their left-behind status. A self-designed adolescent HRB questionnaire was utilized to investigate the prevalence of 12 types of HRBs and their co-existence among the subjects. Multifactorial Logistic regression and unordered multinomial Logistic regression analyses were used to explore the association between the left-behind status of adolescents and the occurrence of individual HRBs as well as the co-existence of multiple HRBs. Results After controlling for gender, age, only child, and subjective socioeconomic status, the results of the multiple factor Logistic regression analysis showed that having father in absence for working was positively associated with screen use long time on school days (OR=1.15, 95%CI=1.05-1.26) and rest days (OR=1.16, 95%CI=1.06-1.26); having mother in absence for working was significantly associated with increased risks of smoking (OR=1.68, 95%CI=1.22-2.32), spending long time on screen during school days (OR=1.19, 95%CI=1.00-1.41)and rest days (OR=1.36, 95%CI=1.16-1.59), skipping breakfast (OR=1.20, 95%CI=1.03-1.39), skipping dinner (OR=1.20, 95%CI=1.01-1.43), not eating fruit (OR=1.34, 95%CI=1.12-1.61), and consuming sugar-sweetened beverages (OR=1.30, 95%CI=1.09-1.55); having both parents in absence for working was positively associated with screen use on rest days (OR=1.51, 95%CI=1.38-1.65), skipping dinner (OR=1.15, 95%CI=1.04-1.27), not eating fruit (OR=1.80, 95%CI=1.62-1.99), and non-suicidal self-injury (OR=1.16, 95%CI=1.04-1.29), and negatively associated with fast food consumption (OR=0.72, 95%CI=0.65-0.79)(all P < 0.05).The results of unordered multiclass Logistic regression analysis showed that mother absence for working was associated with an increased risk of moderate and high co-occurrence of HRBs (OR=1.25, 95%CI=1.06-1.47; OR=1.67, 95%CI=1.30-2.13), both parents absence for working was also positively correlated with a high co-occurrence risk of HRBs (OR=1.29, 95%CI=1.11-1.50) (all P < 0.05). Conclusion Father absence for working is only related to adolescents' screen time, while adolescents with mother absence or both parents absent for working are priority groups for HRB prevention.

Correlation of blind box consumption and non-suicidal self-injury among middle school students

LEI Lin, ZHANG Yi, HU Bin, WANG Hongyan, LUO Jinshuo, YAN Zidan, TANG Jie

2025, 46(10): 1392-1395. doi: 10.16835/j.cnki.1000-9817.2025293

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Objective To explore the correlation between blind box consumption and non-suicidal self-injury(NSSI) among middle school students, so as to provide new theoretical insights for the prevention of NSSI. Methods Using stratified random cluster sampling method, 2 807 middle school students aged 11-19 years old were selected from Hunan and Gansu provinces from November 2024 to March 2025. The blind box consumption questionnaire and Functional Assessment of Self-mutilation Scale were administered to collect data on students' blind box consumption frequency, as well as NSSI behavior. The χ² test was used to compare differences in the distribution of NSSI across different groups. Multivariate Logistic regression analysis was performed to infer the correlation and gender differences. Results A total of 15.3% of middle school students reported having at least one NSSI incident in the past year, among which the reported rates of occasional NSSI (1-4 times) and repeated NSSI (≥5 times) were 5.5% and 9.8% respectively. The results of univariate analysis showed that there was statistically significant different in NSSI distribution among groups with different blind box consumption frequencies (χ²=55.72, P < 0.05). After adjusting for confounding factors such as age, gender, school stage, family type, discipline style, pocket money, impulsiveness and emotion management, the results of multiple Logistic regression models showed that compared with the group without blind box consumption, the risks of "occasional NSSI" and "repeated NSSI" were higher in the group with blind box consumption (OR=1.54, 1.66), and the frequency of blind box consumption(continous variable) was positively correlated with the risks of "occasional NSSI" and "repeated NSSI" among middle school students (OR=1.26, 1.34)(all P < 0.05).After gender stratification, the consumption behavior of blind boxes and the frequency of blind box consumption (continuous variable) of boys and girls were associated with "repeated NSSI"(boys: OR=1.61, 1.32, girls: OR=1.65, 1.35), and only in the male group was a correlation between blind box consumption and "occasional NSSI" observed (OR=2.27) (all P < 0.05). Conclusion Blind box consumption may be related to NSSI among middle school students, and there are gender differences in its correlation with NSSI among middle school students.

Association between mental health status and adverse childhood experiences among sexual minority college students in Guangxi

DONG Mingming, WEN Junshang, HUANG Dongping, LIU Hui, LIANG Ran

2025, 46(10): 1396-1400. doi: 10.16835/j.cnki.1000-9817.2025308

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Objective To explore the association between mental health status and adverse childhood experiences (ACEs) among sexual minority college students, so as to provide a scientific basis for mental health education and health promotion in universities. Methods From January to February 2024, convenience and cluster sampling methods were used to select 1 792 college students from 11 colleges in Guangxi. A self-reporting method was applied to identify 476 sexual minority individuals. The Symptom Check-List 90 (SCL-90) and the Simplified Chinese Adverse Childhood Experiences International Questionnaire (SC-ACE-IQ) were employed to assess mental health and ACEs. Multivariate Logistic regression analysis was conducted to examine the associations. Results The detection rates of all psychological issues among sexual minority college students in Guangxi were significantly higher than those of non-sexual minority college students (χ²=56.01-91.39, all P < 0.01). Except for physical neglect, bullying, and community violence, sexual minority students exhibited higher reporting rates of other ACEs types compared to non-sexual minority students (χ²=4.52-13.34, all P < 0.05). The total ACEs score for college students was 1.00 (1.00, 2.00), while the SCL-90 total score was 96.00 (113.00, 160.00). Spearman correlation analysis revealed a positive correlation between ACEs total scores and SCL-90 total scores (r=0.29, P < 0.05). Additionally, all ACEs subscales, including emotional neglect, physical neglect, emotional abuse, sexual abuse, parental loss, domestic violence, and community violence were positively correlated with corresponding SCL-90 subscale scores (r=0.05-0.22, all P < 0.05). Multivariate Logistic regression analysis showed that family violence increased the risk of mental health issues for sexual minority students (OR=1.61, 95%CI=1.26-2.09); emotional neglect (OR=1.05, 95%CI=1.00-1.10), physical neglect (OR=1.20, 95%CI=1.06-1.35), sexual abuse (OR=1.49, 95%CI=1.15-1.93) increased mental health risks for non-sexual minority students (all P < 0.05). The cumulative effects of ACEs were all statistically significant in the total sample and both subgroups (all P < 0.05). Conclusion Mental health status among sexual minority college students in Guangxi is associated with ACEs, and their well-being requires active attention

Impact of milk and egg supplementation on body composition and bone mineral density of rural primary school students in Yunnan Province

ZHANG Yan, ZHANG Wenbin, GONG Weiyan, SONG Chao, ZHOU Ying, DING Caicui, YUAN Fan, CHEN Zheng, QIU Yujie, LIU Ailing

2025, 46(10): 1401-1405. doi: 10.16835/j.cnki.1000-9817.2025288

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Objective To investigate the impact of milk and egg supplementation on body composition and bone mineral density of rural primary school students in Yunnan Province, so as to provide a reference for developing targeted nutritional intervention strategies. Methods In December 2023, a cluster sampling method was adopted to select students from grades one to three in four primary schools each from Jinggu and Shidian countys of Yunnan Province, as the intervention group (662 students). Additionally, two boarding primary schools were selected from each county based on the principle of matching scale and student numbers as the control group (455 students). Starting from April 2023, the intervention group received 200 mL milk and 50 g eggs during the break on school days for 8 months, while the control group maintained their usual diet behavior. Body composition was measured by using bioelectrical impedance analysis, and distal radial bone mineral density was assessed via dual-energy X-ray absorptiometry in April and December 2023. The intervention effects were analyzed by using a difference-in-differences approach. Results The final measurements of body fat percentage, skeletal muscle mass and fat-free mass of the intervention group and the control group of primary school students were significantly higher than the baseline values, and the net effect of milk and egg intervention on these body composition indicators was not statistically significant (P>0.05, both before and after adjustment). In contrast, bone mineral density increased significantly by 0.02 g/cm² in the intervention group. The net intervention effect on bone mineral density was statistically significant (β=0.02, 95%CI=0.00-0.04), and remained significant after model adjustment (β=0.02, 95%CI=0.00-0.04) (both P < 0.05). Subgroup analysis showed statistically significant effects of the intervention among girls (β=0.02, 95%CI=0.00-0.04), day students (β=0.04, 95%CI=0.01-0.07), and students with normal nutritional status (β=0.02, 95%CI=0.00-0.04) (all P < 0.05). No significant effect of milk and egg supplementation was observed on body composition indicators (all P < 0.05). Conclusions Milk and egg supplementation can improve bone mineral density among rural primary school students in Yunnan Province. It is recommended that rural school-aged children should increase intake of milk and eggs to support growth and development.

Association of dietary behaviors, physical activity and altitude with nutritional status among children and adolescents

ZHANG Dengcheng, JIANG Jianuo, CHEN Li, PUBU Zhuoma, TAN Liming, ZHANG Xiuhong, YANG Tian, DONG Ziqi, QIN Yang, LU Zhenting, MA Jun, DONG Yanhui

2025, 46(10): 1411-1415. doi: 10.16835/j.cnki.1000-9817.2025246

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Objective To analyze the association between altitudes and nutritional status of children and adolescents, and to explore the moderating effects of dietary behaviors and physical activity, so as to provide a scientific basis for developing lifestyle interventions tailored to local conditions. Methods From September to November 2023, physical examinations and questionnaire surveys were conducted among children and adolescents aged 7-17 in two autonomous regions, Inner Mongolia and Xizang, with a final sample of 156 511 participants by the stratified cluster random sampling method. Height and weight were measured to calculate body mass index (BMI). Sociodemographic characteristics, dietary behaviors, and physical activity were collected via questionnaires, while the altitude of each participant's school was obtained using Amap. Logistic regression was performed to examine the relationship between altitudes and nutritional status. Interaction terms and stratified analyses were applied to assess the moderating effects of dietary behaviors and physical activity. Restricted cubic spline (RCS) were used for visualization. Results In 2023, the prevalence of wasting and overweight/obesity among children and adolescents in Xizang were 9.7% and 9.0%, respectively, compared to 2.9% and 22.0% in Inner Mongolia. Logistic regression analysis results showed that for every 1 km increase in altitude, the risk of wasting increased, while the risk of overweight/obesity decreased (OR=1.43, 0.19, both P < 0.05). The results of the stratified analysis showed that compared to those living at altitudes < 1 km, children and adolescents with healthy diets showed no significant association between altitudes (1- < 2 and 2- < 3 km) and wasting (OR=1.22, 0.75, both P>0.05), whereas significant associations were observed at 3- < 4 and ≥4 km altitudes (OR=2.25, 2.89, both P < 0.05). In contrast, unhealthy dietary groups showed statistically significant associations across altitudes (OR=1.18-4.04, all P < 0.05), consistent with RCS results. No moderating effects were observed for physical activity on the altitude-wasting association or for dietary behaviors and physical activity combined on the altitude-overweight/obesity association (P_interaction=0.63, 0.10, 0.53). Conclusion Healthy dietary behaviors play a critical role in improving the nutritional status of children and adolescents and reducing regional disparities, providing a scientific foundation for public health policy formulation and implementation.

Intervention effect of building social networks with medical backgrounds on college students' knowledge, attitudes, and practices in the HIV prevention and treatment

XIANG Jing, LIU Tao, TAO Hui

2025, 46(10): 1406-1410. doi: 10.16835/j.cnki.1000-9817.2025300

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Objective To evaluate the structural communication advantages of peers with medical background in social networks and their intervention effects on college students' knowledge, attitudes, and practices (KAP) levels in the prevention and control of human immunodeficiency virus (HIV), so as to provide theoretical support and practical pathways for structured health communication. Methods From April to June in 2025, 367 undergraduates were selected by stratified cluster random sampling in Nankai University. A multimodal strategy was employed to construct students' social networks. Fifty peer nodes were selected through a four-step screening process: betweenness centrality ≥0.3, eigenvector centrality ≥P₉₀, serving as student leader for at least one year, being mentioned ≥2 times in classroom interactions and information exchanges, with a total of five rounds, each lasting five days. Peer leaders daily pushed five Micromessage (knowledge points, interactive topics, or videos) through WeChat/QQ groups. KAP scale scores for AIDS prevention and treatment were measured before and after the intervention, and intervention effectiveness and predictive factors were analyzed using paired t-tests and Logistic regression analysis. Results After the intervention, the total KAP score for AIDS prevention and treatment increased from (65.86±6.58) to (71.27±4.90) (t=-12.84, P < 0.01). The intermediary centrality (0.51±0.09) in the medical group was significantly higher than the non-medical group (0.34±0.12) (t=3.18, P < 0.01), with an average daily peak transmission rate of 8.71 people, and the network modularity increased from 0.39 to 0.47 (ΔQ=0.09, P < 0.01). The interaction between structural advantages and medical background significantly predicted KAP improvement (OR=4.21, 95%CI=1.89-9.38, P < 0.05). Conclusions Professional peers have significant structural communication advantages in HIV prevention and treatment interventions in colleges and universities. It is recommended to optimize sub-node screening strategies by combining network structure and professional background.

Systematic review and Meta-analysis of intervention effects and maintenance of school-based sexual abuse prevention programs

DONG Ziyao, MA Yihan, WANG Guoqing, WU Shouyuan, GONG Wenjie

2025, 46(10): 1416-1421. doi: 10.16835/j.cnki.1000-9817.2025294

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Objective To explore effects and maintenance of school-based sexual abuse prevention programs for minors, so as to provide scientific evidences for optimizing intervention design and policy-making. Methods Six Chinese and English databases were searched, including CNKI, Wanfang Database, Medline (via PubMed), Embase, Cochrane Library and Web of Science, with the time frame set from database inception to December 31, 2024. Studies on school-based sexual abuse prevention programs for minors were selected, and data on knowledge, attitudes and skills related to sexual abuse prevention were extracted. Meta-analysis was performed using Stata 17. Results A total of 26 studies were included. The Meta-analysis results showed that school-based sexual abuse prevention programs improved participants' knowledge (SMD=1.24, 95%CI=0.96-1.52), attitudes (SMD=0.62, 95%CI=0.19-1.04) and skills (SMD=0.66, 95%CI=0.50-0.83) (all P < 0.01). During the overall follow-up, the maintenance rates for knowledge, attitudes, and skills were 0.97(95%CI=0.95-1.00), 0.99(95%CI=0.95-1.04) and 1.01(95%CI=0.99-1.04), respectively, with no statistically significant differences (all P>0.05). However, knowledge retention declined significantly when follow-up exceeded three months (R=0.91, 95%CI=0.83-0.99, P < 0.01), while skills retention (R=0.94, 95%CI=0.87-1.02, P=0.23) remained higher than knowledge and attitudes (R=0.98, 95%CI=0.96-1.00, P=0.13), demonstrating stronger long-term effects. Conclusion School-based sexual abuse prevention programs are effective in enhancing participants' knowledge, attitudes and skills, but the intervention effects diminish over time, particularly in knowledge retention.

Association of parent-child connectedness and peers' romantic behaviors with romantic relationships of secondary vocational school students

XU Simin, ZUO Xiayun, FANG Yuhang, YU Chunyan, LIAN Qiguo, LOU Chaohua, ZHENG Yujia, TU Xiaowen

2025, 46(10): 1422-1426. doi: 10.16835/j.cnki.1000-9817.2025304

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Objective To explore the association between parent-child connectedness and romantic relationships of secondary vocational school students and the moderating effect of peers' romantic behavior, providing scientific basis for family and school health education. Methods From March to April 2021, 2 426 students from six secondary vocational and technical schools in Shanghai and Shaanxi Province were selected to conduct the survey by combining convenience sampling and cluster sampling.Electronic questionnaires were used to collect data on students' family characteristics, oneself and peer romantic behaviors, and parent-child bonding. The t-test was employed for inter-group comparisons, and binary Logistic regression analysis was conducted to examine the relationship between parent-child bonding levels, peer romantic behavior, and the romantic behavior of secondary vocational students. Results The mother-child connection (2.63±0.77) was higher than that of father-child connection (2.48±0.78), with statistically significant difference (t=6.83, P < 0.01). Multivariable Logistic regression showed that overall father-child connectedness was negatively associated with students' romantic relationships(OR=0.86, 95%CI=0.76-0.97, P=0.02)and was only associated to girls' romantic relationships when stratified by gender(OR=0.79, 95%CI=0.66-0.93, P=0.01). Peers' romantic relationships were positively associated with students' romantic relationships (OR=3.19-5.12, all P < 0.01), and there was a moderating effect of the association between maternal connectedness and boys' romantic relationships (OR=1.67, 95%CI=1.05-2.66, P=0.03). Among boys without romantic peers, mother-child connectedness was negatively associated with their romantic relationships (OR=0.60, 95%CI=0.36-0.99, P < 0.05). In the total sample of Shanghai and girls of Shaanxi, father-child connectedness was negatively correlated with the romantic relationships of secondary vocational school students (OR=0.84, 0.65, 95%CI=0.71-1.00, 0.50-0.85, both P < 0.05). Peer romantic relationships exhibited a negative moderating effect on the influence of mother-child connectedness on the romantic relationships of males in Shanghai (OR=1.91, 95%CI=1.03-3.57, P < 0.05). Conclusions The father-daughter connectedness is negatively correlated with girls' romantic behavior, and peer romantic behavior weakens the correlation between mother-child connectedness and boys' romantic behavior. Efforts should be made to enhance the parent-child connectedness of secondary vocational students and their ability to cope with peer influence, providing proper guidance for adolescents' heterosexual interactions.

Parents' awareness and willingness regarding human papillomavirus and vaccination for male primary and secondary school students in Bao'an District, Shenzhen

LU Fangfang, LIN Mingfeng, QIAN Miaofang, ZHANG Min, NI Xiuxian

2025, 46(10): 1432-1436. doi: 10.16835/j.cnki.1000-9817.2025295

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Objective To explore parents' knowledge, vaccination attitude, and willingness influencing factors of human papillomavirus (HPV) and its vaccine for male primary and secondary school students, so as to provide a scientific basis for formulating targeted health education strategies and promoting the popularization of boys HPV vaccination. Methods From March 3 to 14, 2025, a stratified cluster random sampling method was used to select 912 parents of boys in primary and secondary school in Bao'an District, Shenzhen for a questionnaire survey. Data on their demographic characteristics, HPV-related knowledge and its vaccine, vaccination attitude, and willingness were collected. Univariate analysis was performed by using the χ² test or t-test, and binary Logistic regression model was used to analyze related factors of HPV vaccine vaccination willingness. Results The total awareness rate of parents' knowledge related to HPV and its vaccine was 35.75%, among which the awareness rates of boys vaccine types (6.36%), optimal age (21.16%), and optimal vaccination period (31.25%) were the lowest. The scores of parents' knowledge and attitude related to HPV and its vaccine were (4.31±2.66) and (3.82±0.63). About 64.25% of parents expressed willingness to have boys vaccinated against HPV. The scores of knowledge and attitude related to HPV and its vaccine of parents with vaccination willingness (4.86±2.55, 4.02±0.58) were higher than those of parents without vaccination willingness (3.34±2.57, 3.46±0.55), and the differences were statistically significant (t=8.59, 13.96, both P < 0.01). Logistic analysis showed that parents without raising daughters had a lower willingness to vaccinate boys against HPV (OR=0.49, 95%CI=0.35-0.70); for each 1 increase in parents' knowledge score related to HPV and its vaccine, the vaccination willingness increased by 9.0% (OR=1.09, 95%CI=1.01-1.17); parents who were worried about boys' infection risk (OR=1.50, 95%CI=1.08-2.08) and parents who had their children vaccinated against HPV even if their classmates were not vaccinated (OR=3.68, 95%CI=2.73-4.94) had higher willingness to vaccinate boys against HPV(all P < 0.05). Conclusions Parents of boys in primary and secondary schools of Bao'an District, Shenzhen have low scores of knowledge related to HPV and its vaccine.While parents show strong willingness to vaccinate boys against HPV, limited knowledge may hinder both the sustained growth of vaccination intentions and the actual implementation of vaccination practices.

Cross-lagged analysis of academic procrastination, negative emotions and self-control, and smartphone addiction among college students

WANG Wenting, SONG Jinqiu, ZHANG Zhonglou

2025, 46(10): 1427-1431. doi: 10.16835/j.cnki.1000-9817.2025305

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Objective To explore the causal relationship between academic procrastination, negative emotions, self-control, and smartphone addiction among college students, so as to provide theoretical reference for promoting their mental health and academic achievement. Methods A multi-stage cluster random sampling method was used to select 452 first-year students from a university in Guangzhou as the research subjects. Procrastination Assessment Scale- Student (PASS), The Depression Anxiety Stress Scale (DASS-21), Self Control Scale, and Short Version of the Smartphone Addiction Scale (SAS-SV) were used as measurement tools. Three questionnaire surveys were completed in October 2024 (T1), February 2025 (T2), and May 2025 (T3). Coss-lagged models were utilized to analyze the causal relationship between academic procrastination, negative emotions, self-control, and smartphone addiction. Results The SAS-SV scale for college students showed an average score of (40.52±1.96), with 43.1% of freshmen exhibiting smartphone addiction.Positive correlations were observed between academic procrastination, negative emotions, and smartphone addiction across different time points, while self-control exhibited negative correlations with these three variables (r=0.30-0.62, -0.72 to -0.34, all P < 0.05). Cross-lagged model results indicated that academic procrastination and negative emotions at T1 and T2 positively predicted smartphone addiction at T2 and T3 (T1→T2, β=0.22, 0.35; T2→T3, β=0.21, 0.24; all P < 0.05). Self-control negatively predicted smartphone addiction (T1→T2, β=-0.32; T2→T3, β=-0.26; both P < 0.05). In reverse-causality regression models, smartphone addiction at T1 and T2 positively predicted academic procrastination and negative emotions at T2 and T3 (T1→T2, β=0.09, 0.24; T2→T3, β=0.10, 0.35; all P < 0.05), but no statistically significant predictions were found for self-control (T1→T2, β=-0.04; T2→T3, β=-0.03; both P>0.05). Conclusion Academic procrastination and negative emotions exhibit bidirectional causality with smartphone addiction among college students, while self-control unidirectionally predicts smartphone addiction.

Random forest model combined with LASSO regression to analyze the influencing factors of aggressive behavior among high school students

LI Yaxin, HU Qibi, WANG Xingyu, LIU Xin, CHANG Hongjuan

2025, 46(10): 1437-1442. doi: 10.16835/j.cnki.1000-9817.2025292

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Objective To analyze the influencing factors of aggressive behaviors in high school students, rank the importance of relevant variables with visual presentation, so as to provide new references for developing intervention strategies. Methods In December 2024, a convenience sampling method was used to select 5 330 students from 5 high schools in Wuhan for an online questionnaire survey. The survey included the Buss-Perry Aggression Questionnaire (BPAQ), Interaction Anxiety Scale (IAS), Emotion Regulation Ability Scale, Inventory of Parent and Peer Attachment (IPPA), and a self-designed general information questionnaire. Variables were screened using LASSO regression, followed by multivariate Logistic regression analysis. The Random Forest model was then employed to rank and visualize variable importance. Results Univariate analysis and LASSO regression results indicated that gender, emotion regulation capability, paternal attachment quality, maternal attachment quality, maternal parenting style, paternal parenting style, parenting consistency, monthly household income per capita, school climate, relationship with classmates, interaction anxiety, and academic ranking were all significant variables (all P < 0.01). Multivariate Logistic regression analysis identified the following as influencing factors of aggressive behaviors in high school students: emotional management ability (OR=0.38, 95%CI=0.34-0.43), gender (OR=0.83, 95%CI=0.75-0.93), mother attachment quality (OR=0.89, 95%CI=0.74-1.07), father attachment quality (OR=0.76, 95%CI=0.66-0.87), interaction anxiousness (OR=1.58, 95%CI=1.40-1.78), consistency of parenting styles of parents (OR=1.40, 95%CI=1.21-1.62), school atmosphere (OR=1.50, 95%CI=1.14-1.98), academic performance ranking (upper-middle: OR=0.76, 95%CI=0.61-0.93; middle: OR=0.70, 95%CI=0.57-0.86) were the influencing factors of aggressive behavior in high school students (all P < 0.05). The results of Random Forest showed that emotional management ability was the most important factor affecting aggressive behavior in high school students. Conclusion Emotion regulation capability is identified as the core predictor of adolescent aggressive behaviors, which can significantly reduce the incidence of aggressive behaviors through enhanced emotion management.

Analysis of the current situation and influencing factors of comorbidity of depressive and anxiety symptoms among middle school students in Chongqing

LI Xia, XIONG Ying, YANG Siwei, ZHANG Jing, PENG Chang, LI Mengfen, WANG Hong

2025, 46(10): 1443-1448. doi: 10.16835/j.cnki.1000-9817.2025266

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Objective To understand the current situation and influencing factors of comorbidity of depressive and anxiety symptoms among middle school students in Chongqing, so as to provide a scientific basis for formulating a comprehensive strategy for the co-prevention of multiple diseases among middle school students. Methods From September to December 2024, 12 327 middle school students were selected from 6 districts and counties in Chongqing by the combination of stratified cluster sampling and convenience sampling method. The current status of depressive and anxiety symptoms was investigated by using the Center for Epidemiological Survey-Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7). The Chi-squared test was used to compare the differences between groups with comorbidity of depressive and anxiety symptoms, multivariate Logistic regression analysis was used to analyze its related factors, and a nomogram prediction model was drawn. Results The detection rates of depressive symptoms, anxiety symptoms and comorbidity among middle school students in Chongqing were 26.34%, 34.55% and 21.16%, respectively. Among them, the detection rates of the three types of symptoms in girls (29.80%, 40.99%, 25.15%) were all higher than those in boys (23.22%, 28.73%, 17.55%) (χ²=68.61, 204.23, 106.51, all P < 0.01). Statistical significance was observed in the distribution of depressive and anxious symptoms among middle school students across different gender, academic stage, school district, family type, physical activity levels, parental discipline, smoking, alcohol consumption, sleep deprivation, excessive screen time, Internet addiction, and bullying (χ²=14.49-991.46, all P < 0.01). Multivariate Logistic regression analysis showed that compared with junior high school students, ordinary high school students had a higher risk of comorbidity (OR=2.71, 95%CI=2.41-3.05); girls (OR=2.17, 95%CI=1.95-2.40), non-core family (OR=1.20, 95%CI=1.08-1.32), and good neighborhood (OR=1.16, 95%CI=1.02-1.30), campus bullying (OR=4.88, 95%CI=4.32-5.50), Internet addiction (OR=4.77, 95%CI=3.41-6.68), parental beating and scolding (OR=3.18, 95%CI=2.72-3.71), alcohol consumption (OR=2.10, 95%CI=1.86-2.37), and insufficient sleep (OR=1.73, 95%CI=1.54-1.95) had higher risks with comorbidity of depression and anxiety symptoms (all P < 0.05). A nomogram prediction model was constructed based on significant variables shows that C-index=0.75 (AUC=0.75, 95%CI=0.74-0.76, P < 0.05), and the model had good predictive performance. Conclusions The current situation of comorbidity of depressive and anxiety symptoms among middle school students in Chongqing is not optimistic. The nomograms can be used to effectively predict the risk of comorbidity of depressive and anxiety symptoms in middle school students.

Coexistence and related factors of malnutrition and depressive symptoms among middle school students in Inner Mongolia Autonomous Region

WU Nan, YANG Tian, ZHANG Xiuhong, MA Caixia, GAO Sheng

2025, 46(10): 1449-1453. doi: 10.16835/j.cnki.1000-9817.2025314

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Objective To understand the current status of malnutrition, depressive symptoms, and their coexistence among middle school students, so as to provide references for exploring the "comorbidity-common cause-common prevention" model for these conditions. Methods In September 2023, a stratified random cluster sampling method was adopted to select 88 594 students from junior high schools, regular high schools, and vocational high schools in 12 leagues/cities (covering 103 banners/counties) of Inner Mongolia Autonomous Region. Physical examinations were conducted to collect data on malnutrition, and the Center for Epidemiologic Studies Depression (CES-D) Scale was used to assess depressive symptoms. The Chi-square test and multivariate linear stepwise regression analysis were employed to analyze the related factors of malnutrition, depressive symptoms, and their coexistence. Results In 2023, the detection rates of malnutrition, depressive symptoms, and their coexistence among middle school students in Inner Mongolia were 4.60%, 21.85%, and 0.90%, respectively. There were statistically significant differences in the detection rates of malnutrition, depressive symptoms, and their coexistence among middle school students of different genders, monitoring sites (except for malnutrition), and school stages (χ²=4.95-817.39, all P < 0.05). The results of the multivariate Logistic regression analysis showed that high school students, drink sugar-sweetened beverages ≥1 time per day and those with Internet addiction had higher risk of coexisting malnutrition and depressive symptoms [OR(95%CI)=1.38 (1.04-1.83), 1.46 (1.20-1.78), 2.28 (1.90-2.74), respectively, all P < 0.05]. The risk of coexistence was lower among female students, those who ate fresh fruits at least once a day, those who engaged in moderate-to-vigorous physical activity for ≥1 time/day, those who engaged in moderate-to-vigorous physical activity for ≥1 hour/day on ≥5 days/week, those who did not use cough syrup without therapeutic need, those who did not use sedative-hypnotic drugs without medical advice, and non-drinking students [OR(95%CI)=0.84 (0.73-0.98), 0.77 (0.66-0.89), 0.82 (0.68-0.98), 0.66 (0.53-0.80), 0.57 (0.41-0.78), 0.63 (0.53-0.72), respectively, all P < 0.05]. Conclusions The occurrence of undernutrition, depressive symptoms, and their coexistence among middle school students in Inner Mongolia can't be ignored. Schools, the government and society should implement a strategy aimed at concurrent prevention of multiple conditions through comprehensive interventions.

Longitudinal study on the associations between sleep problems and non-suicidal self-injury behaviors in college students

LIAO Wenna, SUN Yongpeng, KONG Fanxu, LUO Xianghan

2025, 46(10): 1454-1458. doi: 10.16835/j.cnki.1000-9817.2025303

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Objective To explore the longitudinal relationships between sleep problems and non-suicidal self-injury (NSSI) behaviors in college students, so as to provide a theoretical basis for the prevention and intervention of NSSI. Methods In October 2023 (T1), a total of 1 009 college students from two provincial colleges in Guangdong were selected by using a combination of convenience sampling and stratified cluster random sampling for a 1-year follow-up survey (October 2024, T2). The students were assessed by using the Insomnia Severity Index(ISI), Non-restorative Sleep Scale(NRSS), Epworth Sleepiness Scale (ESS), and Adolescent Non-suicidal Self-injury Assessment Questionnaire(ANSAQ). Data analysis was performed using McNemar's test and Logistic regression. Results The detection rate of NSSI behaviors was 18.83% at T1 and decreased to 7.73% at T2, with a statistically significant difference (χ²=66.24, P < 0.01). The trajectories of NSSI behaviors were divided into persistent group (4.06%), new-onset group (3.67%), remission group (14.77%), and resistance group (77.50%). Logistic regression analysis showed that sleep less than 7 hours per day at night, insomnia (mild, moderate-to-severe), non-restorative sleep (moderate, severe), daytime sleepiness, and weekly nightmare frequency (1-2, ≥3 times) were associated with NSSI behaviors at T1 (OR=5.02, 2.39, 5.51, 3.47, 9.70, 2.36, 2.63, 4.74, all P < 0.01). Insomnia (mild, moderate-to-severe), severe non-restorative sleep, daytime sleepiness, and weekly nightmares ≥3 times at T1 all increased the risk of NSSI behaviors at T2 (OR=1.76, 4.15, 4.05, 1.88, 5.63, all P < 0.05). Moderate-to-severe insomnia, severe non-restorative sleep, daytime sleepiness, and weekly nightmares ≥3 times at T1 increased the risk of belong to the new-onset NSSI group (OR=5.05, 3.37, 2.08, 5.86, all P < 0.05). Conclusions Insomnia, non-restorative sleep, daytime sleepiness, and frequent nightmares are important risk factors for NSSI behaviors among college students. Early assessment and intervention of sleep problems may be an important strategy for the prevention and treatment of NSSI.

Association of depressive and anxiety symptoms with physical activity patterns in boarding and non-boarding high school students

WANG Chen, LI Aiqin, LUO Shuaicheng, XIN Jian, YANG Maolin, ZHU Juncheng

2025, 46(10): 1459-1464. doi: 10.16835/j.cnki.1000-9817.2025307

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Objective To examine differences in depressive and anxiety symptoms between boarding and non-boarding high school students and their associations with physical activity (PA) patterns, so as to provide evidence to inform adolescent mental-health promotion. Methods From October to December 2024, a convenience sample of 11 782 students aged 15-18 years was recruited from 36 schools in Nanchang, Ganzhou, and Shangrao of Jiangxi Province. Depressive and anxiety symptoms and PA were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and International Physical Activity Questionary Short Form (IPAQ-SF). Logistic regression model was used to examine associations between PA patterns, depressive and anxiety symptoms among boarding and non-boarding students. Results The detection rates of depressive symptoms were 45.7% and 46.4% among boarding and non-boarding students, respectively; for anxiety symptoms, the corresponding rates were 43.0% and 46.7%. Boarding and non-boarding students differed significantly in smoking status, screen time, sleep duration, sedentary time, daily vegetable intake, and napping (χ²=16.74-664.17, all P < 0.01). Across PA pattern groups, the detection rates of depressive and anxiety symptoms differed significantly between boarding and non-boarding students (χ_depression²=23.85, χ_anxiety²=22.78, both P < 0.01). Adjusted for confounding factors, Logistic regression analysis of high school students showed that compared with the not meeting PA recommendations, both the concentrated and regular PA pattern were associated with lower odds of depressive symptoms [OR(95%CI)=0.83(0.70-0.98), 0.90(0.83-0.98)]; and the concentrated pattern was also associated with lower odds of anxiety symptoms [OR(95%CI)=0.78(0.65-0.92)], and the association of anxiety symptoms in concentrated boarding students was consistent with that of the overall group [OR(95%CI)=0.71(0.52-0.98)] (all P < 0.05). Conclusions There is a correlation of different physical activity patterns with depressive and anxiety symptoms among boarding and non-boarding high school students. Schools should ensure students engage in regular physical activity and work to increase overall activity volume.

Association between pubertal timing and depressive symptoms among high school students in Suzhou City

HU Jiale, ZHANG Liye, LING Ruizhe, HAN Di, WANG Xi, HU Jia, SHEN Hui

2025, 46(10): 1469-1473. doi: 10.16835/j.cnki.1000-9817.2025315

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Objective To investigate the relationship between pubertal timing and depressive symptoms among high school students in Suzhou, so as to provide scientific evidence for promoting adolescents mental health. Methods From October 2023 to January 2024, 3 369 students were selected from 20 high schools in Suzhou using stratified cluster random sampling method. Physical examinations and questionnaire surveys were conducted. The Preece & Baines growth Model 1 was used to calculate the age at take-off of height velocity (ATO) and age at peak height velocity (APHV), categorizing students into three groups: early pubertal timing group (< P₁₅), on-time group (P₁₅-P₈₅), and delayed group (>P₈₅). Binary Logistic regression was used to analyze its association with depressive symptoms. Results The ATO for male and female high school students in Suzhou was (9.35±1.23) and (8.12±1.52) years old, respectively. The mean APHV was (12.35±0.74) years old for boys and (10.91±0.82) years old for girls. The overall prevalence of depressive symptoms was 34.22%, with no statistically significant gender difference (χ²=0.42, P=0.52). Significant differences in depressive symptom prevalence were observed across grade levels, breakfast frequency, weekly days of moderate-to-vigorous physical activity, daily sleep duration, history of school bullying, and the presence of Internet addiction (χ²=5.03-69.21, all P < 0.05). After adjusting for age, body mass index, region, boarding status, breakfast frequency, weekly moderate-to-vigorous physical activity days, sleep duration, campus bullying, and presence of Internet addiction, Logistic regression analysis revealed that when ATO was used to evaluate pubertal timing, the risk of depressive symptoms in the delayed group of boys was 1.65 times that of the on-time group (95%CI=1.24-2.19); when APHV was used to evaluate pubertal timing, the risks of depressive symptoms in the early pubertal timing group and delayed group of boys were 1.43 times (95%CI=1.07-1.91) and 1.41 times (95%CI=1.05-1.88) of that of the on-time group, respectively (all P < 0.05). No statistically significant associations were found among females (all P>0.05). Conclusion The prevalence of depressive symptoms among high school students in Suzhou is relatively high, and both early and delayed puberty timing in boys are associated with depressive symptoms.

Association of takeaway consumption and sedentary behavior with emotional symptoms among freshman students

YAO Zhiyuan, WEI Ruihong, WANG Xinyue, JIANG Linlin, WAN Yuhui

2025, 46(10): 1474-1477. doi: 10.16835/j.cnki.1000-9817.2025291

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Objective To investigate the assocation of sedentary behavior among college students on psychological health issues, such as depressive, anxiety, and stress symptoms, and to analyze the moderating role of takeaway consumption behavior in the context, in order to provide a scientific basis for reducing emotional symptoms among college students. Methods A stratified cluster sampling method was employed to conduct a questionnaire on 3 427 first-year students of a higher education institution in Hefei of Anhui Province from May to June 2021. The study variables included demographic characteristics, sedentary time, takeaway consumption behavior, and emotional (symptoms depressive, anxiety, and stress symptoms). The Spearman correlation analysis was used to analyze the association between variables, and linear regression analysis was used to analyze the association between takeaway consumption behavior and depressive, anxiety and stress symptoms among college students with sedentary time. Results Both sedentary time and takeaway consumption behavior were positively correlated with depressive, anxiety and stress symptoms among college students (r=0.10, 0.10, 0.10; 0.10, 0.11, 0.11, all P < 0.05). The results of linear regression analysis showed that the interaction term between takeaway consumption behavior and sedentary time was positively correlated with symptoms of depressive, anxiety, and stress symptoms among college students (depression: β=0.04, anxiety: β=0.04, stress: β=0.04, all P < 0.05). The results of the simple slope test demonstrated that regardless of the level of takeaway consumption behavior, sedentary time was positively correlated with the depressive symptoms of college students; compared with low takeaway consumption behavior, high takeaway consumption behavior (β=0.77, P < 0.01) enhanced the association between sedentary time and depressive symptoms among college students. In addition, under the condition of high takeaway consumption behavior, sedentary time was positively correlated with the anxiety and stress symptoms of college students (anxiety: β=0.64; stress: β=0.71, both P < 0.01); while under the condition of low takeaway consumption behavior, sedentary time was not related to the anxiety and stress symptoms of college students (β=0.17, 0.22, both P>0.05). Conclusions Sedentary behavior is related to a the emotional symptoms of depressive, anxiety, and stress among college students. Takeaway consumption behavior may exacerbate this impact.

Association of sleep and circadian rhythm disruption with co-occurring depressive and anxiety symptoms among primary and secondary school students

YE Sheng, YANG Yue, LU Xuelei, JIN Heyue, LI Juntong, LIU Hui, LIU Li

2025, 46(10): 1478-1483. doi: 10.16835/j.cnki.1000-9817.2025287

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Objective To investigate the association of sleep and circadian rhythm disruption indicators (including chronotype, sleep duration, and social jetlag) with co-occurring depressive and anxiety symptoms among primary and secondary school students, so as to provide a reference for promoting their mental health. Methods In October 2023, a total of 15 944 primary and secondary school students were recruited from Nanjing, using a stratified cluster random sampling method. The Morning and Evening Questionnaire-5, Center for Epidemiological Studies Depression, and Generalized Anxiety Disorder-7 were used for the survey. Chi-square test was employed for intergroup comparisons, and Logistic regression model was applied to analyze the independent and joint effects of sleep-related factors on comorbid symptoms of depressive and anxiety among primary and middle school students. Results The prevalence of co-occurring depressive and anxiety symptoms among primary and secondary school students in Nanjing was 16.9%. After adjusting for covariates, Logistic regression analysis revealed significant independent associations between evening chronotype (OR=6.55, 95%CI=5.59-7.68), insufficient sleep duration (OR=3.05, 95%CI=2.60-3.59), and social jetlag ≥2 h (OR=2.09, 95%CI=1.85-2.37) with comorbid symptoms of depressive and anxiety among students (all P < 0.05). Concurrent of evening chronotype and insufficient sleep (OR=7.54, 95%CI=3.55-16.01), as well as evening chronotype and social jetlag ≥2 h (OR=4.18, 95%CI=3.01-5.81), were associated with an increased risk of co-occurring depressive and anxiety symptoms (both P < 0.05). In the female and high school student subgroups, the combination of evening chronotype and insufficient sleep or social jetlag ≥2 h showed stronger joint effects on co-occurring depressive and anxiety symptoms [OR(95%CI)=8.46(3.25-22.04) and 15.90(3.66-69.08); 7.87(4.90-12.65) and 4.85(3.10-7.59), respectively; all P < 0.05]. Conclusions Evening chronotype, insufficient sleep, and social jetlag≥2 h may serve as risk factors for comorbid symptoms of depressive and anxiety in school-aged populations. Paying attention to the coexistence of multiple sleep-related risk factors may help mitigate the occurrence of emotional disorders in this demographic.

Association of balanced time perspective and social jetlag with depressive symptom among junior high school students

WAN Xiaoke, WEI Ke, WANG Zhouyan, CHEN Gen, PENG Chang, WANG Hong

2025, 46(10): 1465-1468. doi: 10.16835/j.cnki.1000-9817.2025249

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Objective To explore the mediating role of balanced time perspective in the relationship between social jetlag and depressive symptom among junior high school students, so as to privide a basis for improving their mental health. Methods In October 2024, a method of combining convenient sampling with cluster sampling was used to select 3 438 junior high school students from two districts(Yubei District and Kaizhou District) in Chongqing. The Center for Epidemiological Studies Depression Scale (CES-D), Munich Chronotype Questionnaire (MCTQ), and Balanced Time Perspective Inventory (BTPI) were administered for the survey. Statistical analyses included t-test, ANOVA, and Spearman correlation analysis, and conduct a mediation effect analysis using the Process program. Results The mean score of depressive symptom among junior high school students was 15.00(9.00, 23.00), social jetlag was 1.18(0.72, 1.83) hours, and balanced time perspective score was -0.18(-2.82, 2.93). Social jetlag among junior high school students was positively correlated with depressive symptom score (r=0.17), while balanced time perspective was negatively correlated with social jetlag (r=-0.15) and depressive symptom score (r=-0.68) (all P < 0.01). Mediation analysis showed that balanced time perspective partially mediated the relationship between social jetlag and depressive symptom (β=0.68, P < 0.01) among junior high school students, accounting for 53.97% of the total effect. Conclusions Social jetlag of junior high school students influences depressive symptoms by affecting balanced time perspective. Efforts should be made to improve adolescents' balanced time perspective for reducing the impact of social jetlag on depressive symptom.

Association between body mass index and physical fitness index of freshman students in Ningxia universities

ZHU Huarui, LIU Jing, NIU Gentian, ZHANG Yanhong, DU Pengying, MA Weiping, YANG Yang, ZHANG Ling

2025, 46(10): 1484-1488. doi: 10.16835/j.cnki.1000-9817.2025312

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Objective To understand current state of physical health levels of first-year students in different body mass index (BMI) categories in Ningxia universities, and to explore the correlation between BMI and physical fitness index (PFI), so as to provide a reference for enhancing physical health levels of university students. Methods In November 2024, physical fitness test data from 16 631 first-year students across four universities in Yinchuan City, Ningxia from 2019 to 2023 were collected by adopting convenience and stratified cluster random sampling methods. The PFI was calculated using the Z-score of the physical fitness test results, and a nonlinear quadratic model was established via least squares regression to examine the relationship between BMI and PFI among university students. Results The BMI for males was (21.69±3.53)kg/m², while for females was (20.78±2.94)kg/m². The composite score for males physical fitness (69.86±9.25) was lower than that for females (72.24±8.15), with a statistically significant difference (t=-17.54, P < 0.01). Moreover, the failure rates of various physical fitness indicators (vital capacity, sit-and-reach, standing long jump, pull-ups/1-minute sit-ups, 1 000 m/800 m run) were higher among males than females (χ²=103.48, 72.45, 14.38, 5 134.85, 188.89, all P < 0.01). Comparisons across BMI categories revealed that among males, the normal weight group outperformed other groups in the 50 m sprint, standing long jump, 1 000 m sprint, composite score, and PFI (F=89.17, 113.90, 179.02, 573.35, 593.08); among female students, the normal weight group outperformed other groups in the 50 m sprint, sit-and-reach, 800 m run, composite score, and PFI (F=10.67, 19.58, 96.45, 294.05, 183.45) (all P < 0.01). The relationship between BMI and PFI among first-year students exhibited a parabolic change trend, students with a moderate BMI demonstrated higher PFI, and as BMI increased, PFI decreased (all P < 0.01). Conclusions The physical health level of male students in Ningxia universities is lower than that of female students. There is a correlation between BMI classification and PFI. Tailored intervention measures should be implemented according to the physical characteristics of students across different genders and BMI classifications to enhance university students' physical health.

Relationship between 24-hour activity behavior and body composition among primary and secondary school students

WANG Rongjia, LI Hongjuan, WU Baoai, GAO Yanhui

2025, 46(10): 1489-1492. doi: 10.16835/j.cnki.1000-9817.2025301

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Objective To investigate the association between 24-hour activity behavior and body composition among primary and secondary school students using compositional data analysis method, so as to provide scientific guidance for optimizing daily activity allocation and improving physical health. Methods In June 2021, following the principle of random cluster sampling, 349 primary and middle school students were selected by lottery method from Taiyuan City, Shanxi Province. Compositional multiple regression analysis was conducted to examine the relationship between different 24-hour activity behaviors and body composition indicators. The isotemporal substitution model was adopted to examine the quantitative effects of substituting 10 or 20 minutes among activity behaviors on body composition. Results In girls, sedentary behavior (SB) time was negatively correlated with fat-free mass (FFM) (β=-4.81); in boys, moderate-to-vigorous physical activity (MVPA) time was positively correlated with FFM (β=7.01), while light physical activity (LPA) time was negatively correlated with FFM (β=-9.26) and positively correlated with body fat percentage (FAT%) (β=0.09) (all P < 0.01). Isocaloric substitution analysis revealed that replacing the same duration of MVPA with SB, sleep (SL), or LPA for 10 or 20 minutes produced significantly greater adverse effects compared to the beneficial effects of MVPA substitution. Replacing MVPA with LPA for 10 minutes resulted in 1.01% increase in FAT% and 0.91% decrease in reverse substitution for boys; replacing MVPA with SB or SL for 10 minutes resulted in a decrease of 1.10 kg and 1.16 kg in FFM for boys, 0.81 kg and 0.74 kg for girls, and reverse substitution increased by 0.92 and 0.97 kg, 0.65 and 0.58 kg, respectively (all P < 0.05). When LPA, SB or SL were replaced with MVPA for 20 minutes, the trend of change were basically consistent (all P < 0.05). Conclusions Activity behaviors of 24-hour are associated with body composition among primary and secondary school students. MVPA is the primary influential component.

Analysis of food poisoning event by type F Clostridium perfringens in a school

YU Kuangming, PENG Jian, YANG Suqing, FANG Yezhen, HUANG Shiwang, JIANG Siqing, WANG Shujing, JIN Yihui

2025, 46(10): 1493-1497. doi: 10.16835/j.cnki.1000-9817.2025296

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Objective To understand the epidemiological and etiological characteristics of food poisoning event occurred in a school in Hangzhou, Zhejiang, so as to provide reference for the scientific management of related emergencies. Methods By determining the nature of the event through epidemiological investigation, a case-control study was carried out to spot suspicious food in May 2024. The hygienic investigation was conducted to find out possible pollution links and factors, patients and canteen practitioners' anal swab, canteen retention samples, catering link daub and other specimens were collected, for rapid pathogen screening. And the suspected pathogen Clostridium perfringens (CP) were isolated and identified according to the screening results, and toxin gene detection and whole genome sequencing and cluster analysis of CP isolated strains were carried out. Results The incident resulted in 45 people experiencing gastrointestinal symptoms, such as diarrhea and abdominal pain. The suspicious food was tomato scrambled eggs and corn ribs provided by the student canteen for lunch on May 29. A hygiene investigation found that there was a risk of contamination in the food processing, preparation and storage. A total of 46 anal swabs and 10 canteen retention samples were positive for CP 16 S, 59 strains of CP were isolated from 27 samples, 10 cases and 1 practitioner isolate were positive for CPE (cpe) (F mode), and their whole genome evolution analysis was conducted based on the same source. Conclusions The food poisoning event is caused by CP infection carrying CPE (cpe) (F mode), and the possible sources of outbreak are the carriers of the CP by employees. It is recommended that cafeteria staff strengthen training on common foodborne diseases and conduct regular monitoring of pathogens.

Association of metabolic score for insulin resistance with bone mineral content and bone metabolic markers among adolescents

LIU Jianxi, SHI Longkai, CHEN Linlin, XU Yingli, DING Wenqing

2025, 46(10): 1498-1502. doi: 10.16835/j.cnki.1000-9817.2025299

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Objective To investigate the relationship of metabolic score for insulin resistance (METS-IR) with bone mineral content (BMC) and bone metabolic markers levels among adolescents, so as to provide a scientific foundation for the early identification and prevention of bone-related diseases. Methods From 2017 to 2019 and 2023, a total of 1 414 adolescents aged 12-18 years from Yinchuan were selected using a method combining convenient sampling with stratified cluster random sampling. The data of basic information, body mass index, BMC, serum osteocalcin (OC), type Ⅰ collagen cross-linked C-terminal peptide (CTX) and calcium (Ca), METS-IR among adolescents were obtained by questionnaire survey, physical measurement and laboratory examination, and METS-IR was divided into four groups Q1-Q4 according to P₂₅, P₅₀ and P₇₅. Logistic regression models combined with restricted cubic splines were employed to analyze the relationship between METS-IR and low BMC as well as low bone metabolic markers. The receiver operating characteristic (ROC) curve was used to evaluate METS-IR effectiveness in diagnosing low BMC. Results The levels of BMC, OC, CTX, Ca and METS-IR in the surveyed adolescents were (2.66±0.52)kg, (20.49±13.77)ng/mL, (2 460.89±1 818.96)pg/mL, (2.47±0.67)mmol/L, 30.63±7.58. After adjusting for gender, age and physical activity level, METS-IR in Q4 group had a reduced risk of low BMC and low CTX [OR (95%CI)=0.03(0.01-0.07), 0.45(0.32-0.65)] and an elevated risk of low OC [OR (95%CI)=1.85(1.28-2.67)], compared with the Q1 group (all P < 0.05). Gender-stratified analyses revealed similar trends for both males and females (all P < 0.05). Non-linear dose-response relationships were observed between METS-IR and low BMC (P_{total trend} < 0.01, P_{non-linearity}=0.01), as well as low OC (P_{total trend} < 0.01, P_{non-linearity}=0.01), while a linear relationship was detected with low CTX (P_{total trend} < 0.01, P_{non-linearity}=0.72). ROC curves revealed that METS-IR had the best diagnostic performance for low BMC (AUC=0.85, 95%CI=0.82-0.88, P < 0.01). Conclusions Higher METS-IR score is linked to reduced risk of low BMC and CTX but increase risk of low OC among adolescents. These findings suggest METS-IR is a reliable indicator for assessing BMC and early predicting bone health risk among adolescents.

Association between light at night and ocular biometric parameters among preschool children

HUANG Axiang, ZHANG Yizheng, TONG Haojie, TAO Fangbiao

2025, 46(10): 1506-1510. doi: 10.16835/j.cnki.1000-9817.2025311

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Abstract:
Objective To explore the association between light at night (LAN) of different intensities and ocular biometric parameters among preschool children, so as to provide a reference for optimizing strategies for myopia prevention and control. Methods From November 2024 to January 2025, a cross-sectional study was conducted among 369 preschool children from one kindergarten in Quanzhou City, Fujian Province. Questionnaire survey and eye examination were performed, and portable light sensors were used to collect LAN exposure data. Spearman correlation analysis was used to examine the associations between the duration of LAN exposure at different intensities and ocular biometric parameters. Generalized linear model was employed to explore the relationships between LAN duration at various intensities and ocular biometric parameters, while restricted cubic spline was used to investigate potential nonlinear associations. Results The spherical equivalent (SE), axial length (AL), and axial length/corneal radius of curvature (AL/CR) for preschool children were 0.38 (-0.13, 0.63) diopters, 22.35 (21.86, 22.88) mm, and 2.86 (2.82, 2.90), respectively. The median daily duration (interquartile ranges) of LAN exposure at intensities of 0, >0-100, >100-300, and >300 lx were 6.09(5.31, 6.74), 1.74(1.13, 2.42), 0.06(0.00, 0.26), 0.00(0.00, 0.00)h/d, respectively. The generalized linear model showed that for every additional hour of LAN at >100-300 lx, the AL/CR increased by 0.26 (95%CI=0.01-0.52); for every additional hour of LAN at >300 lx, AL/CR increased by 0.32 (95%CI=0.05-0.59) (both P < 0.05). No statistically significant associations were observed between SE or AL and LAN exposure at any of the intensity levels (0, >0-100, >100-300, and >300 lx) (all P>0.05). The restricted cubic spline model revealed that, except for the nonlinear relationship between LAN duration and AL at >100-300 lx (P=0.02), all other light intensity levels showed linear correlations between LAN duration and preschool children's SE, AL, and AL/CR (both P>0.05). Time-of-day subgroup analysis revealed that during school days, for every additional hour of LAN at >100-300 lx and over 300 lx, AL/CR increased by 0.18 (95%CI=0.01-0.35) and 0.22 (95%CI=0.03-0.41), respectively (both P < 0.05). However, weekend exposure showed no statistically significant association (all P>0.05). Conclusion Higher intensity of LAN is associated with increased AL/CR, and reducing exposure to LAN may have a potential protective effect on the visual health of preschool children.

Research progress on the association between inflammatory factors and myopia

FENG Mian, XU Shaojun, SU Yu, TAO Fangbiao

2025, 46(10): 1503-1505. doi: 10.16835/j.cnki.1000-9817.2025306

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The etiology and pathogenesis of myopia among children and adolescents remain unclear. As crucial regulatory mediators in the body, inflammatory cytokines have drawn increasing attention for their potential role in the onset and progression of myopia. The study examines the relationship between systemic inflammation and intraocular inflammation and myopia, explores the inflammatory mechanisms underlying myopia development, and discusses intervention strategies targeting related signaling pathways for myopia treatment. It aims to provide new insights for the prevention and control of myopia in children and adolescents.

Research progress on the application of artificial intelligence technology in mental health services among children and adolescents

ZHANG Ludan, LI Yaoyao, LI Qiurong, LU Jinkui, NIU Zhining

2025, 46(10): 1511-1515. doi: 10.16835/j.cnki.1000-9817.2025310

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The application of artificial intelligence (AI) technology in the field of mental health is becoming increasingly extensive and in-depth. As digital natives, children and adolescents are experiencing a significant shift in the prevention, identification, and intervention of their mental health issues: transitioning from traditional models to intelligent and digital approaches. At present, the mental health status of children and adolescents in China is not optimistic, with emotional disorders such as depression and anxiety showing a trend toward younger onset. However, the traditional mental health service model faces multiple challenges, including a shortage of professionals, low service accessibility, and difficulties in early identification. The study systematically reviews the current application status of AI technology in the mental health field of children and adolescents, including the latest progress in screening, assessment, intervention, and treatment; deeply analyzes the key challenges currently faced; and proposes suggestions for promoting the deep integration of AI technology and mental health services for children and adolescents, providing theoretical support and practical guidance for the intelligent, precise, and inclusive development of mental health services.

Research progress on the impact of abuse on mental health of children and interventions

ZHOU Dandan, LI Changling

2025, 46(10): 1516-1520. doi: 10.16835/j.cnki.1000-9817.2025313

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Abuse severely violates children's fundamental rights to survival, development, and protection, representing an urgent public health issue that demands immediate attention. Children are particularly vulnerable to abuse and constitute a high-risk group due to their increasing psychological needs, limited expressive abilities, and inadequate social support. The article systematically examines the impact of child abuse on mental health, and elaborates on the main types and implementation effects of current intervention approaches from two dimensions: preventive and therapeutic interventions. By strengthening top-level design, developing tailored tools, and implementing adaptive measures, it aims to establish a scientific and efficient child abuse prevention and treatment system.

Current Issue 2025 Vol. 46, No. 10

Current Issue
2025 Vol. 46, No. 10