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Sci.","Behavioral Sciences"],"abstract":"<jats:p>Depressive symptoms are highly prevalent among university students, yet the psychosocial correlates linking exposure to potentially traumatic or severe adverse events with depressive symptoms remain incompletely understood. This study examined the association between traumatic event exposure and depressive symptoms among Chinese university freshmen, focusing on the mediating role of interpersonal difficulties and the moderating role of only-child status. A cross-sectional survey was conducted among 8079 freshmen from three universities in Shandong Province, China. Depressive symptoms were measured using the PHQ-9, traumatic event exposure was assessed using the Severe Traumatic Events Questionnaire, and interpersonal difficulties were evaluated using the Comprehensive Diagnostic Scale of Interpersonal Relationships. Mediation and moderated mediation analyses were performed using Hayes\u2019 PROCESS macro (Model 15), controlling for sex, age, and residence. Results showed that traumatic event exposure was positively associated with depressive symptoms (\u03b2 = 0.194, 95% CI [0.169\u20130.221]). A statistically significant indirect association through interpersonal difficulties was observed (indirect effect = 0.110, 95% bootstrap CI [0.097\u20130.124]). Only-child status moderated both the direct association between traumatic event exposure and depressive symptoms and the association between interpersonal difficulties and depressive symptoms. These findings suggest that interpersonal difficulties may represent an important factor associated with the relationship between traumatic event exposure and depressive symptoms, and that only-child status may influence the strength of these associations among university students.<\/jats:p>","DOI":"10.3390\/bs16071243","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:17:52Z","timestamp":1784647072000},"page":"1243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Traumatic Event Exposure and Depressive Symptoms Among Chinese University Freshmen: A Conditional Process Analysis of Interpersonal Difficulties and Only-Child Status"],"prefix":"10.3390","volume":"16","author":[{"given":"Fengting","family":"Wang","sequence":"first","affiliation":[{"name":"School of Mental Health, Jining Medical University, Jining 272013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Hu","sequence":"additional","affiliation":[{"name":"School of Mental Health, Jining Medical University, Jining 272013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangziye","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Public Health, Jining Medical University, Jining 272013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Public Health, Jining Medical University, Jining 272013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhicheng","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Jining Medical University, Jining 272067, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2007-4693","authenticated-orcid":false,"given":"Xue","family":"Chong","sequence":"additional","affiliation":[{"name":"School of Public Health, Jining Medical University, Jining 272013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9586-0906","authenticated-orcid":false,"given":"Shuang","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Shandong Second Medical University, Weifang 261053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanchen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Faculty of Computer Science, Dalhousie University, Halifax, NS B3H 4R2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Faculty of Agricultural Business, Dalhousie University, Halifax, NS B3H 4R2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuqin","family":"Mu","sequence":"additional","affiliation":[{"name":"School of Mental Health, Jining Medical University, Jining 272013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Qiao","sequence":"additional","affiliation":[{"name":"School of Public Health, Jining Medical University, Jining 272013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5059-3743","authenticated-orcid":false,"given":"Min","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Jining Medical University, Jining 272013, China"},{"name":"Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2379","DOI":"10.1017\/S0033291717001064","article-title":"Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: A test of the stress sensitization hypothesis","volume":"47","author":"Bandoli","year":"2017","journal-title":"Psychological Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1002\/jclp.22163","article-title":"An investigation of depression, trauma history, 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