# The correlation between different types of negative life events and the mental health status of Han ethnic adolescents in Sichuan Province

## TL;DR

This study explores how different negative life events affect the mental health of Han ethnic adolescents in Sichuan, finding that interpersonal stress and adaptation problems are key risk factors.

## Contribution

The study identifies specific types of negative life events that uniquely impact mental health outcomes in adolescents, using a large sample and mediation analysis.

## Key findings

- Interpersonal stress and adaptation problems are significant risk factors for anxiety, depression, and suicidal ideation.
- Sleep and core self-evaluation act as protective factors and mediate the effects of negative life events on mental health.
- Academic stress and punishment are linked to specific mental health issues like anxiety and depression.

## Abstract

Although many studies have shown a significant association between negative life events and mental health problems among adolescents, few studies have explored whether there are differences in the impact of different types of negative life events on mental health problems among adolescents. We hope to further explore and analyze this issue through a cross-sectional study of Han ethnic adolescents in Sichuan Province.

Cluster sampling was adopted to analyze anxiety symptoms, depressive symptoms and suicidal ideation and their influencing factors among 9,982 students from 4 middle schools in Sichuan Province, western China. We used the Adolescent Life Events Scale to evaluate the negative life events experienced by adolescent students in the past year. we use the Generalized Structural Equation Model (GSEM) to calculate the chain mediation effect between the negative life events and mental health status. The influence of different negative life events on different mental health problems was explored through binary logistic regression.

A higher level of core self-evaluation was a protective factor for anxiety symptoms, depressive symptoms and suicidal ideation among adolescent students. Adequate sleep was a protective factor for depressive symptoms and suicidal ideation among adolescent students. Vocational high school education and sufficient exercise were the protective factors for anxiety symptoms among adolescent students. After controlling for gender, age, school type, and exercise, sleep and core self-evaluation exhibited a significant chain mediating effect in the relationship between negative life events and anxiety symptoms/depressive symptoms (effect value: 0.0131, p<0.001, 95% CI: 0.0086- 0.0177; effect value:0.0116, p<0.001, 95% CI: 0.0076- 0.0155). For negative life events, interpersonal stress and adaptation problem were risk factors for anxiety symptoms, depressive symptoms and suicidal ideation among adolescent students (OR = 1.179, p<0.001, 95% CI 1.149–1.209; OR = 1.187, p<0.001, 95% CI 1.153–1.222; OR = 1.074, p<0.001, 95% CI 1.048–1.100; OR = 1.163, p<0.001, 95% CI 1.128–1.199; OR = 1.229, p<0.001, 95% CI 1.188–1.271; OR = 1.044, p=0.002, 95% CI 1.016–1.073). Loss was a risk factor for depressive symptoms and suicidal ideation among adolescent students (OR = 1.050, p<0.001, 95% CI 1.022–1.079; OR = 1.030, p=0.009, 95% CI 1.008–1.054). Punishment was the risk factor for depressive symptoms among adolescent students (OR = 1.037, p=0.012, 95% CI 1.008–1.067). Academic stress was the risk factor for anxiety symptoms among adolescent students (OR = 1.077, p<0.001, 95% CI 1.051–1.104).

Sleep and core self-evaluation are important mediating factors in the relationship between negative life events and mental health status. Interpersonal stress and adaptation problem in negative life events were the main risk factors for mental health problems among adolescent students. We expect to provide data to support the early prevention and intervention of mental health problems among adolescents. Special attention should be given to the mental health status of adolescent students with interpersonal relationship problems and maladaptation.