{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:53:33Z","timestamp":1789750413664,"version":"4.0.1"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014175","name":"Shanghai Municipal Health and Family Planning Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014175","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019978","name":"Shanghai Pudong New Area Health Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019978","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>The two-child policy has been implemented in China since 2016 and has attracted the attention of the world. Adolescents may face huge psychological challenges in the process of changing family structures and relationships. To date, no mental health survey of adolescents from two-child families has been conducted. We investigated the prevalence and risk factors for childhood trauma, anxiety, and depression in two-child families in a statistically representative sample of Chinese senior high school students from Shanghai. A total of 426 participants were randomly selected from 1,059 students of four senior high schools in different districts of Shanghai. The childhood trauma questionnaire-short form (CTQ-SF), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used as the screening tools. We found that the overall prevalence of childhood trauma, anxiety, and depression among senior high school students in two-child families was 46.70% (95% CI, 39.93\u201353.47%), 22.17% (95% CI, 16.53\u201327.81%), and 35.85% (95% CI, 29.34\u201342.36%), respectively. The two-child families was an important factor associated childhood trauma, emotional neglect, and physical neglect (\u03c7<jats:sup>2<\/jats:sup> = 5.984, <jats:italic>p<\/jats:italic> = 0.014; \u03c7<jats:sup>2<\/jats:sup> = 4.071, <jats:italic>p<\/jats:italic> = 0.044; \u03c7<jats:sup>2<\/jats:sup> = 4.202, <jats:italic>p<\/jats:italic> = 0.040). Ranking in two-child families was a risk factor for childhood trauma (\u03b2 = \u22120.135, <jats:italic>p<\/jats:italic> = 0.048). Parental preference was a significantly correlated with physical abuse, physical neglect, anxiety, and depression (\u03b2 = \u22121.581 to 0.088, <jats:italic>p<\/jats:italic> &amp;lt; 0.05). Meanwhile, emotional abuse, physical abuse, emotional neglect, and physical neglect of participants in the two groups were positively correlated with anxiety and depression (<jats:italic>r<\/jats:italic> = 0.195\u20130.478, <jats:italic>p<\/jats:italic> &amp;lt; 0.05). There was a significant relationship between sexual abuse and anxiety symptoms in the one-child family group (<jats:italic>r<\/jats:italic> = 0.161, <jats:italic>p<\/jats:italic> &amp;lt; 0.05). The findings suggest that the overall prevalence of childhood trauma, anxiety and depression among adolescents from two-child families in China was high. The two-child families and family ranking are important factors associated childhood trauma, while parental preference is related to anxiety and depression. These results highlight an urgent need to be addressed by adolescents' mental health service providers and policy-makers.<\/jats:p>","DOI":"10.3389\/fpsyt.2022.782087","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T09:09:12Z","timestamp":1647594552000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Prevalence and Contributing Factors of Childhood Trauma, Anxiety, and Depression Among Adolescents From Two-Child Families in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Jie","family":"Tong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazhan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manji","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"104249","DOI":"10.1016\/j.chiabu.2019.104249","article-title":"Prevalence of adverse childhood experiences (ACE) in the Czech Republic","volume":"102","author":"Velem\u00ednsk\u00fd","year":"2020","journal-title":"Child Abuse Negl."},{"key":"B2","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1111\/jcpp.13294","article-title":"A randomised controlled trial of a relationship-focussed mobile phone application for improving adolescents' mental health","volume":"61","author":"O'Dea","year":"2020","journal-title":"J Child Psychol Psychiatry."},{"key":"B3","unstructured":"2021"},{"key":"B4","unstructured":"2017"},{"key":"B5","doi-asserted-by":"publisher","first-page":"895","DOI":"10.3389\/fpsyt.2019.00895","article-title":"Specialized therapeutic assessment-based recovery-focused treatment for young people with self-harm: pilot study","volume":"10","author":"English","year":"2019","journal-title":"Front Psychiatry."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1186\/s12889-021-11367-7","article-title":"The effect of the universal two-child policy on medical insurance funds with a rapidly ageing population: evidence from China's urban and rural residents' medical insurance","volume":"21","author":"Zhang","year":"2021","journal-title":"BMC Public Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"785","DOI":"10.16050\/j.cnki.issn1674-6309.2017.07.012","article-title":"Meta-analysis on the Mental Health Status among Children and Adolescents in China","volume":"39","author":"Ding","year":"2017","journal-title":"JoNMU"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1007\/s10802-021-00826-9","article-title":"The impact of academic achievement and parental practices on depressive symptom trajectories among chinese adolescents","volume":"49","author":"Qin","year":"2021","journal-title":"Res Child Adolesc Psychopathol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/jcpp.13445","article-title":"Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals","volume":"63","author":"Li","year":"2022","journal-title":"J Child Psychol Psychiatry."},{"key":"B10","first-page":"8","article-title":"Implementation of China's population policy","volume":"1","author":"Qian","year":"1983","journal-title":"China Popul Newsl."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.1016\/S0140-6736(16)31405-2","article-title":"The effects of China's universal two-child policy","volume":"388","author":"Zeng","year":"2016","journal-title":"Lancet."},{"key":"B12","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1126\/science.358.6361.283","article-title":"Analysis of China's one-child policy sparks uproar","volume":"358","author":"Hvistendahl","year":"2017","journal-title":"Science."},{"key":"B13","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1186\/s12916-020-01714-7","article-title":"The trend of caesarean birth rate changes in China after 'universal two-child policy' era: a population-based study in 2013-2018","volume":"18","author":"Yan","year":"2020","journal-title":"BMC Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1186\/s12888-019-2307-0","article-title":"Population-based surveys and interventions for mental health literacy in China during 1997-2018: a scoping review","volume":"19","author":"Lu","year":"2019","journal-title":"BMC Psychiatry."},{"key":"B15","doi-asserted-by":"publisher","first-page":"36","DOI":"10.19738\/j.cnki.psy.2019.16.018","article-title":"Investigation on the psychological status of the elderly children under the New policy of comprehensive two children","volume":"14","author":"Gu","year":"2019","journal-title":"Psychiatr Danub."},{"key":"B16","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1037\/a0036990","article-title":"Sibling relationship patterns and their associations with child competence and problem behavior","volume":"28","author":"Buist","year":"2014","journal-title":"J Fam Psychol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1177\/016502549601900309","article-title":"Transitions and tuming points in developmental psychopathology; As applied to the age span between childhood and midadulthood","volume":"9","author":"Rutter","year":"1996","journal-title":"Int J Behav Dev."},{"key":"B18","doi-asserted-by":"publisher","first-page":"3089","DOI":"10.1001\/jama.286.24.3089","article-title":"Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study","volume":"286","author":"Dube","year":"2001","journal-title":"JAMA."},{"key":"B19","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1007\/s00787-014-0621-0","article-title":"Child maltreatment and psychological symptoms in a Portuguese adult community sample: the harmful effects of emotional abuse","volume":"24","author":"Dias","year":"2015","journal-title":"Eur Child Adolesc Psychiatry."},{"key":"B20","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.schres.2010.12.010","article-title":"Psychotic symptoms in young adults exposed to childhood trauma\u2013a 20 year follow-up study","volume":"127","author":"Galletly","year":"2011","journal-title":"Schizophr Res."},{"key":"B21","doi-asserted-by":"publisher","first-page":"462","DOI":"10.11817\/j.issn.1672-7347.2020.190699","article-title":"Major depressive disorder with childhood trauma:Clinical characteristics, biological mechanism, and therapeutic implications","volume":"45","author":"Guo","year":"2020","journal-title":"Zhong Nan Da Xue Xue Bao Yi Xue Ban."},{"key":"B22","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1177\/1524838016659878","article-title":"The sibling relationship in the context of child maltreatment: what do we know? What are the directions for the future?","volume":"19","author":"Katz","year":"2018","journal-title":"Trauma Violence Abuse"},{"key":"B23","doi-asserted-by":"publisher","first-page":"l4680","DOI":"10.1136\/bmj.l4680","article-title":"Association of China's universal two child policy with changes in births and birth related health factors: national, descriptive comparative study","volume":"366","author":"Li","year":"2019","journal-title":"BMJ."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1002\/sim.4780091208","article-title":"Test statistics and sample size formulae for comparative binomial trials with null hypothesis of non-zero risk difference or non-unity relative risk","volume":"9","author":"Farrington","year":"1990","journal-title":"Stat Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"2223","DOI":"10.1001\/jama.2018.6360","article-title":"Randomization in clinical trials: permuted blocks and stratification","volume":"319","author":"Broglio","year":"2018","journal-title":"JAMA."},{"key":"B26","volume-title":"Childhood Trauma Questionnaire: A Retrospective Self-Report Manual","author":"Bernstein","year":"1998"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1176\/ajp.151.8.1132","article-title":"Initial reliability and validity of a new retrospective measure of child abuse and neglect","volume":"151","author":"Bernstein","year":"1994","journal-title":"Am J Psychiatry."},{"key":"B28","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/S0145-2134(02)00541-0","article-title":"Development and validation of a brief screening version of the Childhood Trauma Questionnaire","volume":"27","author":"Bernstein","year":"2003","journal-title":"Child Abuse Negl."},{"key":"B29","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3321\/j.issn:1673-8225.2005.20.052","article-title":"Reliability and validity of the Chinese version of childhood trauma questionnaire","volume":"9","author":"Zhao","year":"2005","journal-title":"Chin J Clin Rehabil."},{"key":"B30","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1097\/00004583-199703000-00012","article-title":"Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population","volume":"36","author":"Bernstein","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry."},{"key":"B31","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/S0033-3182(71)71479-0","article-title":"A rating instrument for anxiety disorders","volume":"12","author":"Zung","year":"1971","journal-title":"Psychosomatics."},{"key":"B32","first-page":"301","article-title":"Reliability and validity of revised self rating Anxiety Scale","volume":"20","author":"Tao","year":"1994","journal-title":"Chin J Nerv Mental Dis."},{"key":"B33","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1001\/archpsyc.1965.01720310065008","article-title":"A self-rating depression scale","volume":"12","author":"Zung","year":"1965","journal-title":"Arch Gen Psychiatry."},{"key":"B34","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1177\/089198879400700404","article-title":"The Zung self-rating depression scale: screening for depression among the Hong Kong Chinese elderly","volume":"7","author":"Lee","year":"1994","journal-title":"J Geriatr Psychiatry Neurol."},{"key":"B35","unstructured":"2008"},{"key":"B36","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1016\/j.jaac.2010.05.017","article-title":"Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication\u2013Adolescet Supplement (NCS-A)","volume":"49","author":"Merikangas","year":"2010","journal-title":"J Am Acad Child Adolesc Psychiatry."},{"key":"B37","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3390\/children7060057","article-title":"Family Socioeconomic status and exposure to childhood trauma: racial differences","volume":"7","author":"Assari","year":"2020","journal-title":"Children"},{"key":"B38","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.1177\/0886260509354516","article-title":"Family conflict and childhood aggression: the role of child anxiety","volume":"25","author":"Tanaka","year":"2010","journal-title":"J Interpers Violence."},{"key":"B39","doi-asserted-by":"publisher","first-page":"673","DOI":"10.3389\/fpsyt.2018.00673","article-title":"Childhood trauma and sleep among young adults with a history of depression: a daily diary study","volume":"9","author":"Hamilton","year":"2018","journal-title":"Front Psychiatry."},{"key":"B40","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1007\/s10802-020-00749-x","article-title":"Family processes and child psychopathology: a between- and within-family\/child analysis","volume":"49","author":"Lin","year":"2021","journal-title":"Res Child Adolesc Psychopathol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1542\/peds.2012-3801","article-title":"Association of sibling aggression with child and adolescent mental health","volume":"132","author":"Tucker","year":"2013","journal-title":"Pediatrics."},{"key":"B42","doi-asserted-by":"publisher","first-page":"S134","DOI":"10.1016\/j.jadohealth.2019.11.268","article-title":"Developing trauma-informed health education: understanding the intersection of childhood adversity, mental health, and substance use amongst alternative teens","volume":"66","author":"Stalgaitis","year":"2020","journal-title":"J Adolesc Health."},{"key":"B43","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s40429-020-00320-0","article-title":"Parental and family factors associated with problematic gaming and problematic internet use in adolescents: a systematic literature review","volume":"7","author":"Nielsen","year":"2020","journal-title":"Curr Addict Rep"},{"key":"B44","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1375\/twin.9.2.240","article-title":"How long do the consequences of parental preference last: a study of twins from pregnancy to young adulthood","volume":"9","author":"Trias","year":"2006","journal-title":"Twin Res Hum Genet."},{"key":"B45","doi-asserted-by":"publisher","first-page":"104361","DOI":"10.1016\/j.chiabu.2020.104361","article-title":"Child maltreatment and depression: a meta-analysis of studies using the Childhood Trauma Questionnaire","volume":"102","author":"Humphreys","year":"2020","journal-title":"Child Abuse Negl."},{"key":"B46","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jad.2017.02.009","article-title":"The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: the mediating role of cognitive emotion regulation strategies","volume":"213","author":"Huh","year":"2017","journal-title":"J Affect Disord."},{"key":"B47","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1080\/10538712.2018.1425944","article-title":"Prevalence of childhood sexual abuse in china: a meta-analysis","volume":"27","author":"Ma","year":"2018","journal-title":"J Child Sex Abus."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.782087\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T09:09:26Z","timestamp":1647594566000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.782087\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,18]]},"references-count":47,"alternative-id":["10.3389\/fpsyt.2022.782087"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2022.782087","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,18]]},"article-number":"782087"}}