Loneliness, Internalizing and Externalizing Problems, and Suicidal Ideation Among Chinese Adolescents: A Longitudinal Mediation Analysis.

IF 5.5 2区医学 Q1 PEDIATRICS Journal of Adolescent Health Pub Date : 2024-10-04 DOI:10.1016/j.jadohealth.2024.08.010

Jingyi Wang, Yuting Yang, Yun Chen, Haijiang Lin, Tingting Wang, Ziyao Wang, Xiaoxiao Chen, Chaowei Fu

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Abstract

Purpose: Research indicates that loneliness and emotional and behavioral problems increase the risk of suicidal ideation in adolescents, but less is known about the distinct contributions of these problems. This study aimed to distinguish the pathways through which loneliness, internalizing problems, and externalizing problems contribute to suicidal ideation in Chinese adolescents.

Methods: We did a longitudinal mediation analysis with data collected at 3 time points (2021.05, 2021.10, and 2022.05) from 28 Taizhou high schools. Loneliness and suicidal ideation were assessed using the UCLA 3-Item Loneliness Scale and one suicide item from the Children's Depression Inventory, respectively. The Strength and Difficulties Questionnaire assessed internalizing (emotional and peer problems) and externalizing problems (conduct and hyperactivity problems). Structural equation modeling was used to construct complete longitudinal path models.

Results: Using data from 2,190 adolescents in junior and senior high schools, we found that loneliness, internalizing problems, and externalizing problems separately contributed to subsequent higher levels of suicidal ideation. Most notably, loneliness predicted worse subsequent internalizing problems (β = 0.279, p < .001) and externalizing problems (β = 0.159, p < .001), which in turn predicted more severe suicidal ideation (β = 0.019, p < .001; β = 0.018, p < .001). Loneliness also partially mediated the association between internalizing or externalizing problems and suicidal ideation.

Discussion: Loneliness, internalizing problems, and externalizing problems were strongly intertwined with suicidal ideation in adolescents. Public health initiatives could reduce loneliness and emotional and behavioral problems by implementing multifaceted interventions, thereby breaking the vicious circle and protecting against the development of suicidal ideation.

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中国青少年的孤独感、内化和外化问题以及自杀意念：纵向调解分析

研究目的研究表明，孤独感、情绪和行为问题会增加青少年自杀意念的风险，但人们对这些问题的不同作用却知之甚少。本研究旨在区分孤独感、内化问题和外化问题对中国青少年自杀倾向的影响途径：我们对28所台州高中在3个时间点（2021.05、2021.10和2022.05）收集的数据进行了纵向中介分析。孤独感和自杀意念分别使用加州大学洛杉矶分校孤独感三项目量表和儿童抑郁量表中的一个自杀项目进行评估。强度和困难问卷评估了内化问题（情绪和同伴问题）和外化问题（行为和多动问题）。结构方程模型用于构建完整的纵向路径模型：通过对2190名初中和高中青少年的数据进行分析，我们发现孤独感、内化问题和外化问题分别导致了青少年自杀倾向的增加。最值得注意的是，孤独感预示着更严重的内化问题（β = 0.279，p < .001）和外化问题（β = 0.159，p < .001），进而预示着更严重的自杀意念（β = 0.019，p < .001；β = 0.018，p < .001）。孤独感也在一定程度上介导了内化或外化问题与自杀意念之间的关联：讨论：孤独感、内化问题和外化问题与青少年自杀意念密切相关。公共卫生措施可以通过实施多方面的干预来减少孤独感以及情绪和行为问题，从而打破恶性循环，防止自杀意念的产生。

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来源期刊

Journal of Adolescent Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

10.40

自引率

3.90%

发文量

526

审稿时长

46 days

期刊介绍： The Journal of Adolescent Health is a scientific publication dedicated to enhancing the health and well-being of adolescents and young adults. Our Journal covers a broad range of research topics, spanning from the basic biological and behavioral sciences to public health and policy. We welcome a variety of contributions, including original research papers, concise reports, literature reviews, clinical case reports, opinion pieces, and letters to the editor. We encourage professionals from diverse disciplines such as Anthropology, Education, Ethics, Global Health, Health Services Research, Law, Medicine, Mental and Behavioral Health, Nursing, Nutrition, Psychology, Public Health and Policy, Social Work, Sociology, and Youth Development to share their expertise and contribute to our mission of promoting adolescent health. Moreover, we value the voices of young individuals, family and community members, and healthcare professionals, and encourage them to submit poetry, personal narratives, images, and other creative works that provide unique insights into the experiences of adolescents and young adults. By combining scientific peer-reviewed research with creative expressions, our Journal aims to create a comprehensive understanding of the challenges and opportunities in adolescent and young adult health.