The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study

PLOS ONE, Dec 2019

Background In China, a growing number of adolescents have experienced traumatic events that have resulted in PTSD (post-traumatic stress disorder). Post-traumatic symptoms are common psychological problems in adolescents who have experienced traumatic events. However, existing studies tend to focus on the factors influencing PTSD, such as the response styles and social support, and studies on the relationships between parenting style, resilience and post-traumatic symptoms are still rare. Objectives To analyze the relationships between parenting style, resilience and post-traumatic symptoms among adolescents in China. Methods A cross-sectional survey was conducted from June to December 2013 in the Liaoning Province, China. N = 5765 adolescents (aged 12 to 18 years old) were ultimately chosen to participate. The Chinese version of the Essen Trauma Inventory for Kids and Juveniles (ETI-KJ), a modified version of the Parental Authority Questionnaire, and the Chinese Resilience Scale were used to estimate the post-traumatic symptoms, parenting style, and resilience, respectively. Pearson’s correlations, multiple linear regression analyses and structural equation modeling (SEM) were applied to analyze the data. Results Of the adolescents, 39.76% (N = 2292) had been exposed to traumatic events during their lives. The prevalence of probable PTSD at the time of the interview (one-month-prevalence) was 12.65%. Parenting style and resilience were significantly associated with post-traumatic symptoms. According to the SEM, parenting style had a significant direct effect on resilience (0.70, P<0.01) and post-traumatic symptoms (-0.15, P<0.05), and resilience had a significant direct effect on the post-traumatic symptoms (-0.43, P<0.01). Furthermore, parenting style had a significant indirect effect (-0.43×0.70 = -0.30. P<0.01) on the post-traumatic symptoms through resilience. The SEM significantly explained 49% of the variance in resilience and 30% of the variance in post-traumatic symptoms. Conclusions Parenting style and resilience have significant effects on adolescents’ post-traumatic symptoms. Schools and social-related departments could share knowledge on the impact of parenting style with parents enabling them to improve their own parenting style and their children’s resilience and ability to respond effectively to traumatic events.

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The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study

October The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study Yanxue Zhai 0 1 Kun Liu 0 1 Lin Zhang 0 1 Han Gao 0 1 Zhuo Chen 0 1 Siyi Du 0 1 Lili Zhang 0 1 Yu Guo 0 1 0 Editor: Christian Schmahl, Central Institute of Mental Health , GERMANY 1 1 College of Nursing, Liaoning Medical University , Jinzhou, Liaoning , People's Republic of China, 2 College of Basic Medical Sciences, Liaoning Medical University , Jinzhou, Liaoning , People's Republic of China In China, a growing number of adolescents have experienced traumatic events that have resulted in PTSD (post-traumatic stress disorder). Post-traumatic symptoms are common psychological problems in adolescents who have experienced traumatic events. However, existing studies tend to focus on the factors influencing PTSD, such as the response styles and social support, and studies on the relationships between parenting style, resilience and post-traumatic symptoms are still rare. - To analyze the relationships between parenting style, resilience and post-traumatic symptoms among adolescents in China. A cross-sectional survey was conducted from June to December 2013 in the Liaoning Province, China. N = 5765 adolescents (aged 12 to 18 years old) were ultimately chosen to participate. The Chinese version of the Essen Trauma Inventory for Kids and Juveniles (ETIKJ), a modified version of the Parental Authority Questionnaire, and the Chinese Resilience Scale were used to estimate the post-traumatic symptoms, parenting style, and resilience, respectively. Pearson’s correlations, multiple linear regression analyses and structural equation modeling (SEM) were applied to analyze the data. Of the adolescents, 39.76% (N = 2292) had been exposed to traumatic events during their lives. The prevalence of probable PTSD at the time of the interview (one-month-prevalence) was 12.65%. Parenting style and resilience were significantly associated with posttraumatic symptoms. According to the SEM, parenting style had a significant direct effect on resilience (0.70, P<0.01) and post-traumatic symptoms (-0.15, P<0.05), and resilience had a significant direct effect on the post-traumatic symptoms (-0.43, P<0.01). Furthermore, parenting style had a significant indirect effect (-0.43×0.70 = -0.30. P<0.01) on the post-traumatic symptoms through resilience. The SEM significantly explained 49% of the variance in resilience and 30% of the variance in post-traumatic symptoms. Parenting style and resilience have significant effects on adolescents’ post-traumatic symptoms. Schools and social-related departments could share knowledge on the impact of parenting style with parents enabling them to improve their own parenting style and their children’s resilience and ability to respond effectively to traumatic events. PTSD is a commonly occurring disorder that often has a duration of many years and it is frequently associated with exposure to multiple traumatic events [1]. In school-aged children in Palestine, 54.7% have experienced at least one traumatic event in their lifetime, and the prevalence of PTSD is 34.1% [2]. The prevalence of PTSD among young people (14–24 years old) in Germany is 1.5% [3], and it is 8.08% [4] among adolescents (12–17 years old) in America. In China, an increasing number of publications focused on PTSD in adolescents after the 2008 Sichuan earthquake because adolescents tend to be more vulnerable. According to one investigation [5], five months after the earthquake, the prevalence of PTSD in adolescents in the earthquake districts was 46.61% and decreased to 13.3% at 18 months after the earthquake. Substantial research has focused on adolescents in the Sichuan Province, but much less research has been performed on other regions in China. Not only can natural disasters cause PTSD, other life-threatening events (wars, serious accidents, severe diseases, physical abuse, etc.) could also lead to PTSD. Therefore, research on adolescents in the regions outside of the earthquake districts is also important. PTSD has become an increasing public health problem worldwide. Hence, systematic community and population-based studies should be advocated to investigate the severity and process of post-traumatic reactions among adolescents [6–7]. Resilience is a psychological function whereby individuals recover after experiencing adversity or traumatic events using a successful response to a self-adjusting mechanism [8–9]. It is an effective protective factor when people experience detrimental events [10]. Research in the United States has shown that resilience has a significant negative effect on post-traumatic symptoms [11]. Moreover, it was revealed that, because of their resilience, many individuals do not have mental disorders despite their exposure to traumatic events [12]. Furthermore, there have been many studies on the influence of resilience and its effect on mental health; these (...truncated)


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Yanxue Zhai, Kun Liu, Lin Zhang, Han Gao, Zhuo Chen, Siyi Du, Lili Zhang, Yu Guo. The Relationship between Post-Traumatic Symptoms, Parenting Style, and Resilience among Adolescents in Liaoning, China: A Cross-Sectional Study, PLOS ONE, 2015, 10, DOI: 10.1371/journal.pone.0141102