An Ethnic Minority Perspective: Association Between Negative Life Events and Depressive Symptoms in Yi Adolescents in China

Qingqing Xiao; Xiaozhen Song; Shoukang Zou; Ying Wang; Tuge Waqi; Li Yin

doi:10.30773/pi.2024.0303

Psychiatry Investig > Volume 22(4); 2025 > Article

Xiao, Song, Zou, Wang, Waqi, and Yin: An Ethnic Minority Perspective: Association Between Negative Life Events and Depressive Symptoms in Yi Adolescents in China

Original Article

Psychiatry Investigation 2025;22(4):405-411.

Published online: April 11, 2025

DOI: https://doi.org/10.30773/pi.2024.0303

An Ethnic Minority Perspective: Association Between Negative Life Events and Depressive Symptoms in Yi Adolescents in China

Qingqing Xiao^1,²

, Xiaozhen Song^1,²

, Shoukang Zou³

, Ying Wang^2,⁴

, Tuge Waqi⁵

, Li Yin¹

¹Mental Health Center, West China Hospital, Sichuan University, Chengdu, China

²West China School of Nursing, Sichuan University, Chengdu, China

³The Fourth People’s Hospital of Chengdu, Chengdu, China

⁴Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China

⁵The People’s Hospital of Zhaojue, Liangshan Yi Autonomous Prefecture, China

Correspondence: Li Yin, PhD Mental Health Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu 610041, China Tel: +86-18980606720, E-mail: yli009@163.com

Received October 7, 2024 Revised December 24, 2024 Accepted January 24, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

This study explored whether anxiety and core self-evaluation mediate the relationship between negative life events and depressive symptoms in adolescents of the Yi ethnic minority in China.

Methods

In this cross-sectional study, a convenience sample of 627 Yi adolescents 10-19 years old (252 males, 40.2%) from primary, middle and high schools in Liangshan Prefecture in China completed the Adolescent Self-Rating Life Events Checklist (ASLEC) to report on negative life events, the Second Edition of the Beck Depression Inventory (BDI-II) to report on depressive symptoms, the Core Self-Evaluations Scale (CSES) to describe core self-evaluation, and the Screen for Child Anxiety-Related Emotional Disorders (SCARED) to report anxiety symptoms.

Results

In Pearson correlation analysis, total score and dimension subscores on the ASLEC correlated positively with total score and dimension subscores on the SCARED survey as well as with total score on the BDI. Total ASLEC score and dimension subscores correlated negatively with total CSES score. Mediation analysis indicated that negative life events affected depressive symptoms directly, as well as indirectly via core self-evaluation (mediating effect was 0.087; 95% confidence interval [CI], 0.063-0.113; p<0.001). The chain-mediated pathway effect was significant (mediating effect was 0.017; 95% CI, 0.011-0.026; p<0.001).

Conclusion

Yi adolescents in Liangshan Prefecture show certain prevalence of anxiety and depression, and they score relatively low on core self-evaluation. In this ethnic group, negative life events can affect depressive symptoms directly as well as indirectly through chain-mediated effects of anxiety and core self-evaluation.

Keywords: Life events, Anxiety, Core self-evaluation, Depressive symptoms, Yi adolescents

INTRODUCTION

China is a large, multiethnic country home to 56 ethnic groups [1]. Han Chinese make up more than 90% of the total population, and the sixth largest ethnic group is the Yi minority, which lives primarily within Liangshan Prefecture [2]. Adolescents growing up in this prefecture face the challenges of adverse economic conditions [3] and one of the highest prevalences of AIDS in the country [4], which together with the stresses and trauma of the recent COVID-19 pandemic [5], they may be particularly prone to anxiety, depression, insomnia and other mental health problems [6].

Indeed, difficult living conditions have led many parents to leave Liangshan in search of work in more prosperous parts of the country, giving rise to “left behind” children who must be raised by other family members [7]. A comparative analysis of Yi and Han young people 9-18 years old found that the ethnic minority showed significantly higher rates of anxiety (29.9% vs. 14.8%), depression (36.1% vs. 20.6%), and comorbid anxiety and depression (20.6% vs. 9.9%), and they suffered a significantly higher rate of online bullying (27.4% vs. 15.3%) [8]. Understanding how a negative growth environment affects depressive symptoms in Yi adolescents may improve our ability to identify those at higher risk of worse outcomes and to target interventions accordingly. The same is true of understanding depression among adolescents in general, yet this problem has been less studied in the Yi minority.

Negative life events are known to increase risk of depression [9] and we wanted to go further by clarifying the mechanism. Adolescent life events mainly refer to negative life events experienced by adolescents in school and family life. When faced with conflicts between classmates or families, academic pressure, and punishment from teachers and parents, they are unable to rationally seek solutions to problems, which can easily lead to negative emotions such as depression and anxiety [10]. Core self-evaluation as a stable personality trait reflecting selfassessment of one’s ability [11]. This trait actually comprises four personality traits of self-esteem, general self-efficacy, mental control source, and neuroticism [12]. Higher core self-evaluation is associated with greater control over one’s life [13] and milder frustration in the face of negative events [14]. A study of more than 11,500 primary and secondary schools in China reported that core self-evaluation mediates the relationship between depression and suicidal ideation [15]. On the one hand, in Liangshan Yi Autonomous Prefecture, excessive interference and protection by some parents manifest as excessive restrictions on their children’s social circles and excessive academic expectations [16]; on the other hand, some left behind adolescents receive little love from their parents and feel lonely and insecure, which may experience poor social adaptation and cause them to lose themselves and confidence and has a lower selfevaluation [17].

Based on this, our study hypothesizes that negative life events influence depression symptoms not only directly but also indirectly, with anxiety and core self-evaluation mediating the indirect influence. The specific assumptions are as follows. The conceptual model of this study is shown in Figure 1.

Assumption 1: Negative life events among Yi ethnic adolescents are positively correlated with depressive symptoms.

Assumption 2: Anxiety plays a mediating role in the relationship between negative life events and depressive symptoms, that is, negative life events affect depressive symptoms by influencing anxiety levels.

Assumption 3: Core self-evaluation plays a mediating role in the relationship between negative life events and depressive symptoms, that is, negative life events affect depressive symptoms by influencing the level of core self-evaluation.

Assumption 4: Anxiety and core self-evaluation have a chain mediated effect on the relationship between negative life events and depressive symptoms, that is, there is a chain mediated pathway of negative life events → anxiety → core self-evaluation → depressive symptoms.

METHODS

Participants

This cross-sectional study, which was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (No: 2020-1049), involved a convenience sample of Yi adolescents in Liangshan Prefecture in China, who were surveyed once between January 2022 and March 2022. All participants and their legal guardians provided informed consent before enrollment. According to Kendall’s sample size estimation method [18], the sample size is taken as 5-10 times the number of independent variables. This study has a total of 18 independent variables, with an estimated sample size of 10 times the number of independent variables. Considering the possibility of invalid questionnaires, the sample size is increased by 20%, and the calculated sample size is 225 cases. Referring to relevant literature [16,19], this study defines the age range of adolescents as 10-19 years old.

Measures

Sociodemographic characteristics

A self-administered questionnaire was established to collect sociodemographic data, including gender, age, religious belief, average daily sleep time, and exercise time.

Adolescent Self-Rating Life Events Checklist

The Adolescent Self-Rating Life Events Checklist (ASLEC) [20] was used to assess the frequency and intensity of negative life events during the past 12 months that may have affected the respondent psychologically. The survey consists of 27 items across six subscales, including interpersonal relationships, study pressure, punishment, sense of loss, healthy adaptation, and other factors. The participants responded to each item on a six-point Likert scale from 0 (did not occur) to 5 (extremely severe), with higher scores indicating greater stress. In this study, the Cronbach value of the ASLEC scale was 0.8492.

Screen for Child Anxiety-Related Emotional Disorders

The Screen for Child Anxiety-Related Emotional Disorders (SCARED) is a self-reported measure of anxiety disorder symptoms over the past month in children and adolescents aged 8-18 years [21]. It contains 41 items that are rated on a 3-point scale: almost never (0), sometimes (1), and often (2). There are 5 subscales that measure different anxiety symptoms that par-allel anxiety disorders classified in the DSM, including panic/somatic symptoms, generalized anxiety, separation anxiety, social anxiety, and school phobia [22]. The SCARED has demonstrated adequate psychometric properties in both clinical and nonclinical samples [23]. The SCARED has moderate to high internal consistency (alpha=0.43-0.89) and test-retest reliability (intraclass correlation coefficients=0.46-0.77 over 2 weeks and 0.24-0.67 over 12 weeks) [24].

The Chinese version of the Core Self-Evaluations Scale

The Chinese version of the Core Self-Evaluations Scale (CSES) was translated by Chunyu et al. [25] and used to evaluate the core self-evaluation of adolescents. The 10 items include four subfactors: self-esteem, generalized self-efficacy, locus of control, and emotional stability. The responses to each item are on a five-point scale, where 1 means “strongly disagree,” 2 means “disagree,” 3 means “neutral,” 4 means “agree,” and 5 means “strongly agree [15].” A higher total score indicates a higher level of core self-evaluation. The Cronbach’s α coefficient of the CSES in Chinese adolescent students was 0.89 [26].

Second Edition of the Beck Depression Inventory

The Beck Depression Inventory (BDI) is a favored screening instrument for adolescent depression [27], and its revised form is known as the BDI-II. The BDI-II is a self-rating instrument comprising 21 items with four response options (0-3) to assess the severity of depression [28], such as weight loss, irritability, hopelessness, suicide ideation, self-guilt and a lack of energy during the previous two weeks [29]. The total score ranges from 0 to 63, and higher scores indicate more severe depression. The severity of depression can be categorized into minimal depression (scores of 0-13), mild depression (scores of 14-19), moderate depression (scores of 20-28), and severe depression (scores of 29-63) [30]. The BDI-II scale has been shown to have good internal reliability, consistency, and validity [27]. The Cronbach’s α coefficient of the scale was 0.89, and the test-retest reliability was 0.93 among adolescents in China [31].

Data collection and data quality control methods

Questionnaires were administered on-line through the Wenjuanxing portal (www.wjx.cn). After obtaining the approval of the primary, middle, and high schools in the study, we asked teachers in charge of classes to send parents the questionnaire link via parent WeChat groups. If parents agree to investigate their children, reply “agree” in the WeChat group. Then the child could use his or her own phone or a parent’s phone to complete the questionnaires. Before they could proceed to the questionnaires, they had to read a description of the study and its objectives, which also mentioned that participation was voluntary and anonymous. Children who indicated their consent to participate were allowed to proceed to the questionnaire items. Encourage participants to answer honestly, fill out the questionnaire alone, parents will not know their specific content, and inform them of their right to withdraw from the survey at any time. To ensure data quality, questionnaires that were completed in less than 200 seconds were excluded, based on the criterion that each question should take at least 2 seconds to answer [32].

Statistical analysis

All the statistical analyses were performed in SPSS 21.0 (IBM Corp.). Sociodemographics were expressed as frequencies and percentages (%), and the scores of the ASLEC, SCARED, CSES, and BDI were described as the means±standard deviations. Pearson correlation was used to test correlations between variables. Structural equation models were constructed via Amos 24.0 (IBM Corp.) to test the mediating effects of anxiety and core self-evaluation on negative life events and depression. The test level (α) was 0.05.

RESULTS

Of the total potential study population of Yi children and adolescents whose parents were approached, we sent questionnaire links to them and received surveys from 687. After eliminating 60 surveys because they were incomplete or featured the same response for all items, we included 627 surveys in the final analysis, corresponding to an effective response rate of 91.3%. The average age of the 627 respondents (252 males, 40.2%) was 15.65±2.26 years (range, 10-19). Just under half of respondents (294, 46.9%) stated that they do not have religious beliefs, and just over half (372, 59.3%) reported sleeping longer than 7 hours per day on average. Just over half (369, 58.9%) reported engaging in exercise for shorter than 1 hour daily.

In Pearson correlation analysis, total score and dimension subscores on the ASLEC correlated positively with total scores and dimension subscores on the SCARED survey, as well as with total score on the BDI. Conversely, total score and dimension subscores on the ASLEC correlated negatively with total score on the CSES. The total score and dimension subscores on the SCARED survey correlated positively with the total BDI score, but negatively with total score and subscores on the CSES. Total CSES score correlated negatively with total BDI score (Table 1).

We performed structural equation modeling to assess whether self-reported levels of anxiety and core self-evaluation mediated the observed relationship between negative life events and depressive symptoms in our sample (Figure 2). Mediation effect testing indicated a direct effect of negative life events on depression as well as indirect effects, through up to three different pathways (Table 2): one in which: ASLEC-SCAREDBDI, another in which ASLEC-CSES-BDI and a third in which ASLEC-SCARED-CSES-BDI. While the first pathway turned out not to be significant, the second one was significant, indicating an indirect effect of negative life events on depression through core self-evaluation (mediating effect was 0.087; 95% confidence interval [CI], 0.063-0.113; p<0.001). The third pathway was also significant, indicating an indirect effect through the chain-mediated effect of anxiety and core selfevaluation (mediating effect was 0.017; 95% CI, 0.011-0.026; p<0.001). The effect size associated with the second pathway was significantly greater than that associated with the third pathway (mediating effect was 0.070; 95% CI, 0.047-0.095; p<0.001). Both these pathways were associated with significantly greater effect sizes than the first one.

DISCUSSION

In multi-ethnic countries, due to historical changes and social development, ethnic minority students face dual issues of ethnic integration and cultural identity [33]. Due to cultural differences, parents of different ethnic groups also have different ways of raising their children. In depth research on the psychological characteristics and mechanisms of psychological development of ethnic minority adolescents can better understand and explain the special paths and laws of psychological development of ethnic minority adolescents and provide reference for other multi-ethnic countries in the world.

We analyzed a population of adolescents subjected to numerous environmental stresses because of the history and economic underdevelopment in Liangshan Prefecture in order to understand how negative life events influence the risk and severity of depressive symptoms. Our results suggest that such events can influence depression directly but also indirectly, acting via chain mediating effects of anxiety and core self-evaluation. Our findings may help screen Yi adolescents for risk of depression, which may help develop preventive programs and therapeutic interventions. Our results may also help clarify the links between negative life events and depression in other ethnic minority adolescent populations.

Relationship between exposure to negative life events and depressive symptoms

In our sample, exposure to negative life events positively predicted more severe depressive symptoms. This result is consistent with previous studies of young people in Japan, South Korea, and the Netherlands [34-36]. These findings can be explained through the interaction between diathetic factors and stress factors [37]. Diathesis refers to an individual’s suscep-tibility to depressive emotions as a result of unclear self-concept, negative coping strategies, negative cognitive evaluations, and other psychological factors. Stress factors may include daily stress and sudden changes. Exacerbating the relationship between diathesis and stress factors is the fact that long-term exposure to an adverse living environment may lower one’s threshold for perceiving negative life events, making the individual more susceptible to depression. Previous research has documented numerous adverse circumstances in which Yi adolescents in Liangshan grow up, including relatively high prevalence of domestic violence [38], shortage of qualified teachers and limited collaboration between schools and parents [7] and long-term separation from parents [39], as well as negative life events typical of young people around the world, such as dislike of school, stresses of romantic relationships, and difficulties with teachers [39].

Mediating role of core self-evaluation

In our sample, exposure to negative life events affected depressive symptoms indirectly through core self-evaluation. Specifically, exposure to negative life events was positively associated with low level core self-evaluation, which further increased adolescents’ depression. Previous research with different ethnic groups growing up under more or less difficult circumstances suggests a strong association between negative life events and negative core self-evaluation [15]. Adolescents experiencing more negative life events are more likely to have lower self-esteem, self-efficacy, and internal locus of control, as well as greater emotional instability [40]. Depressed people have distorted cognitive schemata and view threats or stressors more negatively, leading them to take more negative decisions and engage more in more negative behaviors [41]. Conversely, adolescents with high levels of core self-evaluations are convinced of their ability to cope with immediate risks and are more likely to take active approaches to defusing crises [42]. When adolescents have high core self-evaluation, their emotional states tend to be positive and stable, which may protect them from anxiety and depression [43].

Chain mediating role of anxiety and core self-evaluation

Ethnic minorities in Liangshan Yi Autonomous Prefecture in China faced various social problems such as severe poverty, limited access to resources and opportunities, and rampant crime over the past century [44]. In this region, parents tend to have lower education levels and often have to work outside the home for extended periods of time. These can make it challenging for them to closely monitor their children’s behavior and might contribute to lower levels of social control over adolescents [45]. Our results are consistent with the diathesisstress model of anxiety [46], which stipulates that external stress events interact with personality to produce anxiety [47,48]. Indeed, adolescents affected by life events are more likely to experience anxiety. Adolescents have immature concepts of self, so when they face pressure from study and interpersonal relationships, they lack proper guidance from their elders, are prone to tension and anxiety, and are unable to evaluate themselves rationally. This reduces their core self-evaluation, increasing risk of depression [40]. For example, the combination of individual vulnerability (anxious solitude) and interpersonal adversity (peer exclusion) predicted depressive symptoms in children over time in young people [49].

Suggestions for schools, and families

To ensure the healthy futures of the youth in China, both school- and home-based interventions that need to prevent depression among adolescents. Based on the psychological vulnerability of Yi ethnic youth, the schools should provide diversified educational support, character building, mental health care, and humanistic emotional support to create a more fair and high-quality quality education environment for Yi ethnic adolescents in Liangshan Prefecture. Parents should provide a warm family environment, pay attention to their children’s emotional changes in a timely manner, provide correct guidance, correct negative cognition, and reduce the occurrence of depression.

Limitations

Our results should be interpreted with caution in light of several limitations. One is potential bias in our sample, which was recruited based on convenience and came from only Liangshan Prefecture, which is nevertheless home to the largest Yi population in the country. The generalizability of our results to other Yi populations remains to be clarified. Another limitation is our exclusive reliance on self-report, which may increase risk of reporting bias due to, for example, feelings of guilt or shame. Moreover, online surveys may have limitations such as inaccuracy and difficulty in limiting the sources of respondents. Future work should seek to verify our findings by cross-correlating self-report with reports of teachers, parents, and other family members. It should also perform longitudinal assessments and face-to-face surveys to verify whether negative life events and associated changes in anxiety and core self-evaluation cause depression.

Conclusions

Our cross-sectional study suggests that anxiety and core self-evaluation exert chain mediating effects on the relationship between negative life events and depressive symptoms in Yi adolescents. Our findings may help guide preventive training and therapeutic interventions to relieve anxiety and enhance core self-evaluation in order to strengthen the resistance and resilience of young people against negative life events.

Notes

Availability of Data and Material

The datasets generated or analyzed during the study are available from the corresponding author on reasonable request.

Conflicts of Interest

The authors have no potential conflicts of interest to disclose.

Author Contributions

Conceptualization: all authors. Data curation: Qingqing Xiao, Xiaozhen Song. Formal analysis: Qingqing Xiao, Xiaozhen Song, Shoukang Zou. Funding acquisition: Xiaozhen Song, Li Yin. Investigation: all authors. Methodology: all authors. Project administration: Qingqing Xiao, Xiaozhen Song, Li Yin. Supervision: Li Yin. Writing—original draft: Qingqing Xiao, Xiaozhen Song. Writing—review& editing: Li Yin.

Funding Statement

This research was funded by the Investigation and Intervention on Mental Health of Children and Adolescents with AIDS in Zhaojue County (No. HX-H2108203).

Acknowledgments

The authors are grateful to all participants for their contributions.

Figure 1.

Conceptual model.

Figure 2.

Final model path diagram and its standardized regression coefficients. ASLEC, Adolescent Self-Rating Life Events Checklist; SCARED, Screen for Child Anxiety-Related Emotional Disorders; CSES, Core Self-Evaluations Scale; BDI, Beck Depression Inventory.

Table 1.

Descriptive statistics and correlation analysis of variables

Variables	Mean±SD	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15
1. ASLEC	29.9±21.8	1.00
2. Interpersonal relationships	6.3±5.1	0.87^*	1.00
3. Study pressure	8.4±5.5	0.83^*	0.71^*	1.00
4. Punishment	5.4±6.1	0.86^*	0.65^*	0.60^*	1.00
5. Sense of loss	3.0±3.2	0.74^*	0.58^*	0.50^*	0.62^*	1.00
6. Healthy adaptation	4.5±3.8	0.85^*	0.70^*	0.72^*	0.64^*	0.55^*	1.00
7. Other factors	2.9±3.1	0.80^*	0.64^*	0.53^*	0.79^*	0.51^*	0.60^*	1.00
8. SCARED	32.6±22.7	0.36^*	0.38^*	0.37^*	0.21^*	0.24^*	0.37^*	0.23	1.00
9. Panic/somatic symptoms	8.1±7.2	0.35^*	0.35^*	0.32^*	0.22^*	0.24^*	0.35^*	0.24^*	0.96^*	1.00
10. Generalized anxiety	7.9±5.5	0.38^*	0.40^*	0.40^*	0.21^*	0.24^*	0.36^*	0.22^*	0.95^*	0.88^*	1.00
11. Separation anxiety	6.5±4.6	0.34^*	0.34^*	0.34^*	0.20^*	0.24^*	0.36^*	0.18^*	0.93^*	0.87^*	0.85^*	1.00
12. Social anxiety	7.3±4.5	0.27^*	0.32^*	0.31^*	0.13^*	0.16^*	0.27^*	0.14^*	0.90^*	0.81^*	0.84^*	0.79^*	1.00
13. School phobia	2.9±2.6	0.35^*	0.35^*	0.33^*	0.22^*	0.20^*	0.36^*	0.30^*	0.86^*	0.83^*	0.78^*	0.77^*	0.72^*	1.00
14. CSES	32.1±6.7	-0.47^*	-0.45^*	-0.42^*	-0.28^*	-0.30^*	-0.46^*	-0.38^*	-0.35^*	-0.34^*	-0.36^*	-0.29^*	-0.31^*	-0.36^*	1.00
15. BDI	14.3±10.8	0.54^*	0.52^*	0.42^*	0.39^*	0.36^*	0.51^*	0.46^*	0.26^*	0.27^*	0.26^*	0.20^*	0.19^*	0.28^*	-0.60^*	1.00

^* p<0.01.

ASLEC, Adolescent Self-Rating Life Events Checklist; SCARED, Screen for Child Anxiety-Related Emotional Disorders; CSES, Core Self-Evaluations Scale; BDI, Beck Depression Inventory; SD, standard deviation

Table 2.

Bootstrap analysis of significance test for mediating effects (standardized)

Path	Estimate	95% confidence interval		p
Path	Estimate	Lower limit	Upper limit	p
Path 1: ASLEC-SCARED-BDI	-0.004	-0.018	0.009	0.496
Path 2: ASLEC-CSES-BDI	0.087	0.063	0.113	<0.001
Path 3: ASLEC-SCARED-CSES-BDI	0.017	0.011	0.026	<0.001
Ratio 1: Path 1 effect/Total effect	-0.016	-0.066	0.034	0.498
Ratio 2: Path 2 effect/Total effect	0.327	0.241	0.413	<0.001
Ratio 3: Path 3 effect/Total effect	0.065	0.041	0.098	<0.001
Difference 1: (Path 1-Path 2) effect	-0.091	-0.123	-0.062	<0.001
Difference 2: (Path 1-Path 3) effect	-0.022	-0.038	-0.007	0.004
Difference 3: (Path 2-Path 3) effect	0.070	0.047	0.095	<0.001

ASLEC, Adolescent Self-Rating Life Events Checklist; SCARED, Screen for Child Anxiety-Related Emotional Disorders; CSES, Core Self-Evaluations Scale; BDI, Beck Depression Inventory

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