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Open Access 01-12-2019 | Research article

Mental health and its influencing factors among left-behind children in South China: a cross-sectional study

Authors: Xiu Zhang, Mengjie Li, Li Guo, Yanna Zhu

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

With rapid development of China’s economy, there were over 68.7 million left-behind children (LBC) in China whose mental health has become a problem of public concern. The present cross-sectional study aimed to investigate the status of mental health and its associated factors of LBC aged 3–16 years old in both rural and urban areas.

Methods

A total of 4187 children (aged 3–16), including 1471 LBC and 2716 non-left-behind children (NLBC), were recruited from 50 communities (22 in urban areas and 28 in rural areas) in Guangdong, China in August, 2014. The mental health problems were assessed using the Strength and Difficulties Questionnaire (SDQ).

Results

No statistically significant difference of SDQ subscales scores about difficulties were found between LBC and NLBC on the whole participants as well as in rural areas or in urban areas within the same age group after adjustments were made (all p > 0.05). However, compared with NLBC in the same areas, urban LBC tended to have higher prosocial behaviours scores, while rural LBC had the lowest prosocial behaviours scores not only in the whole age group but also in different age subgroups (p < 0.05). Besides, compared with urban LBC, rural LBC were not worse in SDQ subscales scores except for prosocial behaviour at 7–9 age group (p = 0.003). Furthermore, higher paternal educational level and longer duration of parental absence, were associated with less difficulties in both rural and urban LBC. Besides, shorter duration of talk per-time but higher communication frequency were associated with less difficulties in rural LBC.

Conclusions

The present study demonstrated that in general, no difference of mental health problems were found between LBC and NLBC. Besides, longer duration of parental absence, shorter duration of talk per time but more communication frequency, and higher paternal educational level tend to have better development of mental health. The findings reinforce the importance of the stability of caregivers and the effective parent-child communication for Chinese rural LBC.

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Duan CR, Lai MH, Qin M. The Research on the demographic trends of Left-behind Children in rural China since the 21st century. China Youth Study. 2017;06:52–60. https://doi.org/10.19633/j.cnki.11-2579/d.2017.06.009.CrossRef

Duan CR, Yang G. The left-behind children in rural China. Population Research. 2008;32(03):15–25.

Tao XW, Guan HY, Zhao YR, Fan ZY. Mental health among left-behind preschool-aged children: preliminary survey of its status and associated risk factors in rural China. J INT MED RES. 2014;42(1):120–9. https://doi.org/10.1177/0300060513503922.CrossRefPubMed

Cheng J, Sun YH. Depression and anxiety among left-behind children in China: a systematic review. Child Care Health Dev. 2015;41(4):515–23. https://doi.org/10.1111/cch.12221.CrossRefPubMed

Wang LM, Mesman J. Child development in the face of rural-to-urban migration in China: a meta-analytic review. Psychol Sci. 2015;10(6):813–31. https://doi.org/10.1177/1745691615600145.CrossRef

Zhao J, Liu X, Wang M. Parent–child cohesion, friend companionship and left-behind children's emotional adaptation in rural China. Child Abuse Negl. 2015;48:190–9. https://doi.org/10.1016/j.chiabu.2015.07.005.CrossRefPubMed

Dai Q, Chu RX. Anxiety, happiness and self-esteem of western Chinese left-behind children. Child Abuse Negl. 2016. https://doi.org/10.1016/j.chiabu.2016.08.002.CrossRef

Kobak R, Madsen S: Disruptions in attachment bonds: Implications for theory, research, and clinical intervention. In Handbook of attachment: Theory, research, and clinical applications. Edited by Cassidy J, Shaver PR. New York, NY, US: Guilford Press; 2008:23–47.

Wu YL, Zhao X, Ding XX, Yang HY, Qian ZZ, Feng F, et al. A prospective study of psychological resilience and depression among left-behind children in China. J HEALTH PSYCHOL. 2017;22(5):627-636. https://doi.org/10.1177/1359105315610811.CrossRef

10.

Jia ZB, Tian WH. Loneliness of left-behind children: a cross-sectional survey in a sample of rural China. Child Care Health Dev. 2010;36(6):812–7. https://doi.org/10.1111/j.1365-2214.2010.01110.x.CrossRefPubMed

11.

Givaudan M, Pick S. Children left behind: how to mitigate the effects and facilitate emotional and psychosocial development: supportive community networks can diminish the negative effects of parental migration. Child Abuse Negl. 2013;37(12):1080–90. https://doi.org/10.1016/j.chiabu.2013.10.019.CrossRefPubMed

12.

Li Q, Zhong Y, Chen K, Zhong Z, Pan J. Identifying risk factors for child neglect in rural areas of western China. Child Care Health Dev. 2015;41(6):895–902. https://doi.org/10.1111/cch.12283.CrossRefPubMed

13.

Yang TT, Li CC, Zhou CC, Jiang S, Chu J, Medina A, et al. Parental migration and smoking behavior of left-behind children: evidence from a survey in rural Anhui, China. INT J EQUITY HEALTH. 2016;15(1):127. https://doi.org/10.1186/s12939-016-0416-7.CrossRefPubMedPubMedCentral

14.

Jiang S, Chu J, Li CC, Medina A, Hu QW. Liu Jet al.: alcohol consumption is higher among left-behind Chinese children whose parents leave rural areas to work. Acta Paediatr. 2015;104(12):1298–304. https://doi.org/10.1111/apa.13163.CrossRefPubMed

15.

Wang X, Ling L, Su H, Cheng J, Jin L, Sun Y. Self-concept of left-behind children in China: a systematic review of the literature. Child Care Health Dev. 2015;41(3):346–55. https://doi.org/10.1111/cch.12172.CrossRefPubMed

16.

Nianli Z, Fangfang X. Analysis the influence of parenting absent on rural young Children’s social development. Studies in Preschool Education. 2012;11:26–30.

17.

Zhao X, Chen J, Chen MC, Lv XL, Jiang YH, Sun YH. Left-behind children in rural China experience higher levels of anxiety and poorer living conditions. Acta Paediatr. 2014;103(6):665–70. https://doi.org/10.1111/apa.12602.CrossRefPubMed

18.

Fan F, Su L, Gill MK, Birmaher B. Emotional and behavioral problems of Chinese left-behind children: a preliminary study. Soc Psychiatry Psychiatr Epidemiol. 2010;45(6):655–64. https://doi.org/10.1007/s00127-009-0107-4.CrossRefPubMed

19.

Liu ZK, Li XY, Ge XJ. Left too early: the effects of age at separation from parents on Chinese rural children's symptoms of anxiety and depression. Am J Public Health. 2009;99(11):2049–54. https://doi.org/10.2105/AJPH.2008.150474.CrossRefPubMedPubMedCentral

20.

Ge Y, Se J, Zhang J. Research on relationship among internet-addiction, personality traits and mental health of urban left-behind children. Glob J Health Sci. 2014;7(4):60–9. https://doi.org/10.5539/gjhs.v7n4p60.CrossRefPubMedPubMedCentral

21.

Ni YY, Zhang JX. How to determine permissible error δ value properly when computing sample sizes in hypothesis tests. The Journal of Evidence-based Medicine. 2011;11(06):370–2.

22.

General Principles of the Civil Law of the People's Republic of China (2009 Amendment): Standing Committee of the National People's Congress; 2009.

23.

International Ethical Guidelines for Health-related Research Involving Humans. Fourth edition. Geneva: Council for International Organizations of Medical Sciences (CIOMS); 2016.

24.

Goodman R. The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581–6.CrossRef

25.

Du YS, Kou JH, Coghill D. The validity, reliability and normative scores of the parent, teacher and self report versions of the strengths and difficulties questionnaire in China. Child Adolesc Psychiatry Ment Health. 2008;2(1):8. https://doi.org/10.1186/1753-2000-2-8.CrossRefPubMedPubMedCentral

26.

Liu SK, Chen YL, Shang CY, Lin CH, Liu YC, Gau SS. Psychometric properties of the Chinese version of strength and difficulties questionnaire. COMPR PSYCHIAT. 2013;54(6):720–30. https://doi.org/10.1016/j.comppsych.2013.01.002.CrossRefPubMed

27.

WHO G: Technical consultation on indicators of adolescent health.; 2014.

28.

Arnett JJ. Adolescent storm and stress, reconsidered. AM PSYCHOL. 1999;54(5):317–26.CrossRef

29.

Attar-Schwartz S, Tan JP, Buchanan A, Flouri E, Griggs J. Grandparenting and adolescent adjustment in two-parent biological, lone-parent, and step-families. J Fam Psychol. 2009;23(1):67–75. https://doi.org/10.1037/a0014383.CrossRefPubMed

30.

Aronoff J. Parental nurturance in the standard cross-cultural sample. Cross-Cult Res. 2012;46(4):315–47. https://doi.org/10.1177/1069397112450851.CrossRef

31.

Bowlby J. Attachment and loss, volume II separation: anxiety and anger. 3rd ed. Hazell Watson & Viney Ltd: Great Britian; 1981.

32.

Baltes PB. Theoretical propositions of life-span Developmental Psychology: on the dynamics between growth and decline. Dev Psychobiol. 1987;23(5):611–26. https://doi.org/10.1037/0012-1649.23.5.611.CrossRef

33.

Veríssimo M, Santos AJ, Fernandes C, Shin NN, Vaughn BE. Associations Between Attachment Security and Social Competence in Preschool Children. Merrill-Palmer Quarterly. 2014;1(60):80–99. https://doi.org/10.13110/merrpalmquar1982.60.1.0080.CrossRef

34.

Bandura A: Social-Learning Theory of Identificatory Processes. In Handbook of Socialization Theory and Research. Edited by Goslin DA: Rand McNally & Company; 1969:213–262.

35.

Tamis-LeMonda CS, Shannon JD, Cabrera NJ, Lamb ME. Fathers and mothers at play with their 2- and 3-year-olds: contributions to language and cognitive development. Child Dev. 2004;75(6):1806–20. https://doi.org/10.1111/j.1467-8624.2004.00818.x.CrossRefPubMed

36.

Engle PL, Breaux C: Fathers' involvement with children: perspectives from developing countries. Soc Policy Rep 1998, 11(1):1–21. doi:https://doi.org/10.1002/j.2379-3988.1998.tb00007.x.

37.

Xiaowei L, Xiaoyu W. Father Involvement and Children's Social Competence: Mediating effects of maternal parenting self-efficacy. J Beijing Normal University (Social Sciences). 2017;05:49–58.

38.

Maken ZH, Nasir II, Zahid A, Zulfiqar A, Munib A. Hassan Fet al.: factors influencing father's antenatal and perinatal involvement in maternal health care. J Matern Fetal Neonatal Med. 2018;31(19):2569–75. https://doi.org/10.1080/14767058.2017.1347920.CrossRefPubMed

39.

McMunn A, Martin P, Kelly Y, Sacker A. Fathers' involvement: correlates and consequences for child Socioemotional behavior in the United Kingdom. J Fam Issues. 2017;38(8):1109–31. https://doi.org/10.1177/0192513X15622415.CrossRefPubMed

40.

Yan RS. Research on achievement motivation and self-adjustment strategy of young educated women. China Adult Education. 2015;02:76–7.

41.

Helmerhorst KOW, Riksen-Walraven JMA, Fukkink RG, Tavecchio LWC, Gevers Deynoot-Schaub MJJM. Effects of the caregiver interaction profile training on caregiver–child interactions in Dutch child care centers: a randomized controlled trial. CHILD YOUTH CARE FOR. 2017;46(3):413–36. https://doi.org/10.1007/s10566-016-9383-9.CrossRef

42.

RB MC, Groark CJ, Hawk BN, Julian MM, Merz EC, Rosas JM, et al. Early Caregiver-Child Interaction and Children's Development: Lessons from the St. Petersburg-USA Orphanage Intervention Research Project. Clin Child Fam Psychol Rev. 2019;22(2):208–224. https://doi.org/10.1007/s10567-018-0270-9.CrossRef

43.

Raikes H. Relationship duration in infant care: time with a high-ability teacher and infant-teacher attachment. Early Child Res Q. 1993;8(3):309–25. https://doi.org/10.1016/S0885-2006(05)80070-5.CrossRef

44.

Howes C, Hamilton CE. Children's relationships with child care teachers: stability and concordance with parental attachments. Child Dev. 1992;63(4):867–78.CrossRef

45.

Marcovitch S, Goldberg S, Gold A, Washington J, Wasson C, Krekewich K, et al. Determinants of behavioral problems in Romanian children adapted in Ontario. Int J Behav Dev. 1997;20:17–31. https://doi.org/10.1080/016502597385414.CrossRef

46.

Guang Y, Feng Z, Yang G, Yang Y, Wang L. Dai Qet al.: depressive symptoms and negative life events: what psycho-social factors protect or harm left-behind children in China? BMC PSYCHIATRY. 2017;17(1):402–18. https://doi.org/10.1186/s12888-017-1554-1.CrossRefPubMedPubMedCentral

Title: Mental health and its influencing factors among left-behind children in South China: a cross-sectional study
Authors: Xiu Zhang
Mengjie Li
Li Guo
Yanna Zhu
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-8066-5

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Mental health and its influencing factors among left-behind children in South China: a cross-sectional study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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