The Mediating Effects of Stress and Coping on Depression Among Adolescents in China

AIMS: To explore gender differences in Chinese adolescent depression related to the mediating effects of stress and coping. METHODS: The data were collected using a cross-sectional design from a multisite follow-up investigation of adolescent physical and psychological study carried out in China. The study population consisted of 17,622 students aged from 11 to 22 years of age in junior high, senior high schools, and colleges/universities from eight large cities in China. RESULTS: Overall, 44.3% of the sample reported depression during the past week. Male adolescents were more likely to have depression than female counterparts (46.8% versus 41.7%), especially those aged <15 and >17 years of age. Overall, stress in boys was statistically higher than that of girls. Boys experienced high levels of stress from school, family, health, and romantic domains, while girls suffered a higher level of peer stress. A multivariate logistic regression model showed that a high level of total stress was significantly associated with increased risk for depression, while peer stress and positive coping style were protective factors for depression in both boys and girls in China. CONCLUSIONS: Unlike their Western counterparts, Chinese boys suffered more depression than girls, which is partly due to more stressful life events and less positive coping style. Our study has important implications for health officers and public health professionals to pay much attention to the relationship between stress and coping style in prevention on adolescent depression.