The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China
Abstract Background Prior research on the mental well-being of adolescents has shown conflicting findings regarding the impact of only-child status. This study uses Propensity Score Matching (PSM) to control for confounding variables and investigate the impact of only-child status on the psychologic...
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2025-06-01
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| Online Access: | https://doi.org/10.1186/s12889-025-23383-y |
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| author | Jinlong He Yunling Zhong Yuqin Song Jing Luo Cen Lin Yuhang Wu Lu Pan Yu Cen Jiayu Zhao Shiya Gou Nianjie Wang Yao Wang Lei Tang Jiaming Luo |
| author_facet | Jinlong He Yunling Zhong Yuqin Song Jing Luo Cen Lin Yuhang Wu Lu Pan Yu Cen Jiayu Zhao Shiya Gou Nianjie Wang Yao Wang Lei Tang Jiaming Luo |
| author_sort | Jinlong He |
| collection | DOAJ |
| description | Abstract Background Prior research on the mental well-being of adolescents has shown conflicting findings regarding the impact of only-child status. This study uses Propensity Score Matching (PSM) to control for confounding variables and investigate the impact of only-child status on the psychological health of adolescents. Methods A multi-center cluster sampling approach included 7,359 students from 33 middle schools in Western China. The Depression, Anxiety, and Stress Scale-21 (DASS-21), the Childhood Psychological Abuse and Neglect Scale (CPANS), the Pittsburgh Sleep Quality Index (PSQI), the Chinese iteration of the Barratt Impulsiveness Scale (BIS-11), and the Chinese version of the Positive and Negative Affect Scale for Children (PANAS-C) were utilized to assess the adolescents’ emotions, sleep, psychological abuse, and neglect. PSM was employed to address confounding variables. Univariate analysis used t-tests, chi-square tests, and Wilcoxon rank-sum tests, while multivariate analysis used GLM to compare DASS-21, PSQI, and PANAS-C scores. Results After PSM, 980 only-child and 980 non-only-child adolescents were included. Only-child adolescents showed significantly lower levels of depression, stress, emotional neglect, and negative affect. Further scrutiny of the mean ranks of these dimensions indicated that the only-child group yielded lower scores. In the GLM analysis, after adjusting for neglect, no significant associations were observed (all p > 0.05). However, post adjustments for psychological abuse, the only-child group also recorded lower scores in depression, stress, and negative affect. Conclusions This study reveals that the only-child adolescents possibly showing better psychological well-being overall in western China. This study’s findings suggest that, during adolescent development, families and society should pay greater attention to the mental health of non-only children. |
| format | Article |
| id | doaj-art-e7fc9b9191114b5fbc09b5e4dad6532f |
| institution | OA Journals |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj-art-e7fc9b9191114b5fbc09b5e4dad6532f2025-08-20T02:31:00ZengBMCBMC Public Health1471-24582025-06-0125111310.1186/s12889-025-23383-yThe impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western ChinaJinlong He0Yunling Zhong1Yuqin Song2Jing Luo3Cen Lin4Yuhang Wu5Lu Pan6Yu Cen7Jiayu Zhao8Shiya Gou9Nianjie Wang10Yao Wang11Lei Tang12Jiaming Luo13Mental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeMental Health Center, Affiliated Hospital of North Sichuan Medical CollegeAbstract Background Prior research on the mental well-being of adolescents has shown conflicting findings regarding the impact of only-child status. This study uses Propensity Score Matching (PSM) to control for confounding variables and investigate the impact of only-child status on the psychological health of adolescents. Methods A multi-center cluster sampling approach included 7,359 students from 33 middle schools in Western China. The Depression, Anxiety, and Stress Scale-21 (DASS-21), the Childhood Psychological Abuse and Neglect Scale (CPANS), the Pittsburgh Sleep Quality Index (PSQI), the Chinese iteration of the Barratt Impulsiveness Scale (BIS-11), and the Chinese version of the Positive and Negative Affect Scale for Children (PANAS-C) were utilized to assess the adolescents’ emotions, sleep, psychological abuse, and neglect. PSM was employed to address confounding variables. Univariate analysis used t-tests, chi-square tests, and Wilcoxon rank-sum tests, while multivariate analysis used GLM to compare DASS-21, PSQI, and PANAS-C scores. Results After PSM, 980 only-child and 980 non-only-child adolescents were included. Only-child adolescents showed significantly lower levels of depression, stress, emotional neglect, and negative affect. Further scrutiny of the mean ranks of these dimensions indicated that the only-child group yielded lower scores. In the GLM analysis, after adjusting for neglect, no significant associations were observed (all p > 0.05). However, post adjustments for psychological abuse, the only-child group also recorded lower scores in depression, stress, and negative affect. Conclusions This study reveals that the only-child adolescents possibly showing better psychological well-being overall in western China. This study’s findings suggest that, during adolescent development, families and society should pay greater attention to the mental health of non-only children.https://doi.org/10.1186/s12889-025-23383-yAdolescentsOnly childMental healthDepressive disorderPropensity score |
| spellingShingle | Jinlong He Yunling Zhong Yuqin Song Jing Luo Cen Lin Yuhang Wu Lu Pan Yu Cen Jiayu Zhao Shiya Gou Nianjie Wang Yao Wang Lei Tang Jiaming Luo The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China BMC Public Health Adolescents Only child Mental health Depressive disorder Propensity score |
| title | The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China |
| title_full | The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China |
| title_fullStr | The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China |
| title_full_unstemmed | The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China |
| title_short | The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China |
| title_sort | impact of only child status on adolescent mental health a multi center cross sectional study using propensity score matching in western china |
| topic | Adolescents Only child Mental health Depressive disorder Propensity score |
| url | https://doi.org/10.1186/s12889-025-23383-y |
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