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Open Access Medical Psychology Issue
Self-aggressive behaviors exacerbate depressive mood among college students with anger-in: a 6-month follow-up study
Journal of Army Medical University 2026, 48(13): 1908-1918
Published: 15 July 2026
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Objective

Depressive mood has a relatively high incidence rate among college students, and has become a prominent issue affecting the mental health and adaptive development of this group. Anger-in is a potential influencing factor for depression, but its longitudinal predictive effect on depressive mood and the underlying mechanism remain unclear. This study aims to explore the predictive effect of anger-in on depressive mood among college students, clarify the mediating mechanism of self-aggression, and provide a scientific basis for the prevention and intervention of depressive mood among college students.

Methods

A prospective cohort design was adopted to conduct baseline surveys (T1 in November 2024) and 6-month follow-up surveys (T2 in April 2025) among 781 college students from 2 universities in Chongqing (Army Medical University and Chongqing Second Normal University). Patients’ health questionnaire depression scale-9 item (PHQ-9), Buss-Perry aggression questionnaire-Chinese version (AQ-CV), and the state-trait anger expression inventory 2(STAXI-Ⅱ) were used to measure the levels of depressive mood, self-aggression, and anger-in, respectively. Spearman correlation analysis was performed for data analysis, a cross-lagged model was constructed using Mplus 8.3, and the mediating effect was tested using the Bootstrap procedure.

Results

① Female college students had higher anger-in scores. Those aged ≤22 years, unmarried, and undergraduates showed higher anger-in and self-aggression scores. Female students, those aged >22 years, and graduate students exhibited higher levels of depressive mood. ② In the 6-month follow-up study on depressive mood, self-aggression, and anger-in among college students, the results revealed that the scores of anger-in (Z=4.44, P<0.001) and depressive mood (Z=11.98, P<0.001) were significantly increased, while the scores of self-aggression showed no significant difference. ③ At T1 and T2, there were significant positive correlations among anger-in, self-aggression, and depressive mood (r=0.31 to 0.54, P<0.01). ④ The cross-lagged model showed that T1 anger-in could positively predict T2 depressive mood (β=0.16, P<0.001). ⑤ The longitudinal mediation model demonstrated that self-aggression played a partial mediating role in the prediction of T2 depressive mood by T1 anger-in (β=0.13, 95%CI: 0.09 to 0.18, P<0.001), and the total indirect effect of the chain mediation accounted for 48.55% of the total effect, while the direct predictive effect of T1 anger-in accounted for 51.45% of the total effect.

Conclusion

Anger-in can positively predict depressive mood among college students, with self-aggression playing a mediating role in this process. This suggests that in mental health work for college students, attention should be paid to the tendency of anger-in, and the prevention and alleviation of depressive mood can be achieved through guiding rational emotional expression and reducing self-aggressive behaviors.

Open Access Medical Psychology Issue
Impact of ideal levels on depressive symptoms among high school students and mediating role of frustration tolerance: a prospective cohort study
Journal of Army Medical University 2026, 48(7): 936-945
Published: 15 April 2026
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Objective

The mental health problems among senior high school students require urgent attention in recent years. Ideal level, as an essential psychological quality, its long-term impact on depressive emotions remains unclear, and the mediating role of frustration tolerance between these 2 factors still lacks prospective evidence. This study aims to determine the predictive effect of ideal level on depressive symptoms and the mediating mechanism of frustration tolerance among high school students in Chongqing.

Methods

This study adopted a prospective cohort design. A total of 308 high school students from 3 high schools in Chongqing were surveyed at 3 time points: T1 (November 2024), T2 (May 2025), and T3 (November 2025). Revised Contemporary Adolescent Ideal Questionnaire, Frustration Tolerance Scale for Students, and Patient Health Questionnaire-9 were used to assess the levels of ideal, frustration tolerance, and depressive symptoms, respectively. Descriptive analysis, correlation analysis, cross-lagged analysis, and structural equation modeling were performed on the questionnaire data.

Results

① High school students demonstrated relatively high ideal levels, with a total score of 154. 28±13. 68, which remained stable over 1 year. The frustration tolerance scores were 61. 77±14. 39 at baseline and increased progressively to 65. 83±15. 68 after 1 year (P<0. 001). The depressive symptom scores were 1. 23±2. 45 at baseline and elevated significantly to 4. 79±4. 33 after 1 year (P<0. 001). The career ideal scores were higher in 16-year-old adolescents than in 15-year-old counterparts (P<0. 05), and the male students had higher total frustration tolerance scores than the female (P<0. 01). ② The ideal level was positively correlated with frustration tolerance (r=0. 17 to 0. 30, P<0. 01), and both were negatively correlated with depressive symptoms (r=-0. 23 to -0. 15, P<0. 01). ③ The results from the cross-lagged model indicated that ideal level positively predicted frustration tolerance levels at 6 months later (β =0. 10, P<0. 01). ④ Frustration tolerance played a fully mediating role between ideal level and depressive symptom scores (β=-0. 07, 95%CI: -0. 19 to -0. 02, P<0. 01), with the total indirect effect of the chain mediation accounting for 8. 24% of the total effect.

Conclusion

Ideal level in high school students positively predicts frustration tolerance, and frustration tolerance plays a fully mediating role between ideal level and depressive symptoms. It is recommended that families, schools, and communities seize the critical period of ideal formation to strengthen frustration tolerance training, thereby reducing depressive symptoms and laying a foundation for achieving national strategic goals.

Open Access Medical Psychology Issue
Moderate obedience enhances college students' creativity: an exploration based on dual dimension of benefit-avoidance structure and moderating effect of age and marital status
Journal of Army Medical University 2026, 48(5): 643-652
Published: 15 March 2026
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Objective

To revise and validate the Obedience Attitude Questionnaire for College Students (OAQ-CS), explore the sociological characteristics of obedience attitude, and preliminarily investigate the impact of obedience attitude on creativity.

Methods

Based on WANG Yuchao's 8-item obedience questionnaire, the revision was made according to the characteristics of college students. A cross-sectional observation was conducted on 4200 college students subjected with stratified cluster sampling from 3 institutions in Chongqing (Army Medical University, Chongqing University of Education, and Chongqing University). The participants were surveyed with the OAQ-CS and the College Students' Creativity Assessment Inventory (CSCAI). The obtained data were analyzed with item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing. Mann-Whitney U nonparametric test was used to observe the demographic differences of college students' obedience attitudes, Spearman correlation analysis was explored to analyze the correlation between variables, and stratified linear regression analysis was performed to explore the predictive factors of obedience attitude and creativity.

Results

① Item analysis revealed no items requiring deletion. EFA extracted 2 factors: self-interested obedience and harmavoidance obedience. CFA demonstrated good model fit (χ2/df=2.90, RMSEA=0.03, CFI=0.99, IFI=0.99, TLI=0.99). The scale exhibited strong internal consistency reliability (α=0.87 to 0.91). ② College students had high overall propensity for obedience (42.51±9.85, M=46), with harm-avoidance obedience score (21.34±5.48) higher than self-interested obedience score (21.17±5.34). Total obedience attitude and its dimensions showed significant positive correlations with creativity (rs=0.28 to 0.87, P<0.001). Males and the individuals aged ≤22 years scored higher than their counterparts in females and those aged >22 years individuals in both obedience attitude and its dimensions (all P<0.05). Age (β =-0.21, P<0.001) was a negative predictor of obedience attitude, while male (β=0.06, P<0.001), married (β=0.11, P<0.001), and graduate students (β=0.13, all P<0.001) were positive predictors. Male (β=0.04, P<0.01), graduate students (β=0.05, P<0.05), obedience attitude (β=0.44, P<0.001), and the interaction term between obedience attitude and age (β=0.05, P<0.05) positively predicted creativity, whereas the interaction term between obedience attitude and marital status (β=-0.04, P<0.05) was a negative predictor of creativity.

Conclusion

Our revised OAQ-CS has good reliability and validity. College students display a high obedience tendency. Older individuals exhibit lower obedience and males higher than females. Moderate obedience, encompassing both self-interested and harmavoidance dimensions, is conducive to creativity enhancement.

Issue
Effect of parent-child alienation on epression among surface ship officers and soldiers: mediating role of resilience
Journal of Army Medical University 2024, 46(14): 1626-1632
Published: 30 July 2024
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Objective

To investigate the effect of parent-child alienation on depression in surface ship officers and soldiers based on the theory of "diathesis-stress", and the mediating role of resilience between parent-child alienation and depression in them.

Methods

A cross-sectional study was conducted on 599 officers and soldiers from a surface ship unit. The participants were surveyed with inventory of alienation toward parents, connor-davidson resilience scale and patient health questionnaire-9 to obtain and analyze their demographic-military characteristics of their depression scores. The participants with depression scores ≥5 were recruited as the subjects, and Spearman correlation analysis was used to explore the correlation among parent-child alienation, resilience and depression. On the basis of hierarchical regression analysis, AMOS software was used to establish a structural equation modelling of intermediary effects.

Results

The depression score was 1(0, 4) in the participants, and the depression scores of those with service length ≥11 years were comparatively higher than those with shorter length. Our results indicated that parent-child alienation was positive correlated with depression (r=0.451, P < 0.001), while resilience was negatively correlated with depression and parent-child alienation (r=-0.412, -0.407, P < 0.001). Regression analysis revealed that parent-child alienation had a direct positive predictive value for depression (β=0.574, P < 0.001), and resilience showed a negative predictive value for depression (β=-0.211, P < 0.01). Model analysis displayed that resilience had a significant mediating role in the effect of parent-child alienation on depression among these surface ship officers and soldiers, with an effect value of 0.088, and accounting for 15.86% of the total effect.

Conclusion

Parent-child alienation has a significant influence on depression among surface ship officers and soldiers, with resilience playing a partial mediating role.

Issue
Relationship between stress and insomnia in plateau soldiers: mediating role of parent-child alienation and moderating role of expressive suppression
Journal of Army Medical University 2024, 46(14): 1633-1639
Published: 30 July 2024
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Objective

To investigate the influence of stress on insomnia among plateau soldiers, and explore the mediating role of parent-child alienation and the moderating role of emotion regulation strategies in this relationship.

Methods

A cross-sectional study design was adopted in this study. Our Self-designed General Information Questionnaire, Plateau Soldiers Stressor Scale, Insomnia Severity Index, Inventory of Alienation towards Parents, and Emotion Regulation Scale were employed to survey 2 065 plateau soldiers at an average altitude of 4 200 m. With aid of SPSS 26.0 statistics, descriptive analysis, correlation analysis and regression analysis were applied to analyze stress status, parent-child alienation, insomnia and emotion regulation in the participants, and then a structural equation model was established.

Results

① The scores of stress, parent-child alienation and insomnia were significantly higher in the participants who were older, well educated (P < 0.01) and were or had been in a marital relationship (married, divorced, or widowed)(P < 0.001) than those without above conditions.② Significant pairwise positive correlations were observed among stress, parent-child alienation, insomnia, cognitive reappraisal, and expressive suppression (r=0.08~0.61, P < 0.001).③ Stress and expressive suppression could positively predict parent-child alienation (β=0.14~0.43, P < 0.001), and stress, parent-child alienation and expressive suppression could positively predict insomnia (β=0.04~0.25, P < 0.01). Cognitive reappraisal could not significantly predict parent-child alienation or insomnia.④Parent-child alienation towards parents partially mediated the relationship between stress and insomnia, with a mediation effect accounting for 7.29% of the total effect.⑤ Expressive suppression moderated the impact of stress on insomnia (β=-0.01, P < 0.001), and the higher expressive suppression level mitigated the adverse effect of stress on insomnia when compared with the lower expressive suppression level.

Conclusion

For plateau soldiers, stress significantly predicts insomnia, with parent-child alienation playing a mediating role. Furthermore, a higher level of expressive suppression can effectively buffer the influence of stress on insomnia.

Issue
Effect of childhood trauma experiences on post-traumatic stress disorder symptoms in military officers at high altitude: mediating role of parent-child alienation
Journal of Army Medical University 2024, 46(14): 1640-1646
Published: 30 July 2024
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Objective

To explore the current status of post-traumatic stress disorder (PTSD) symptoms among military officers at high altitude, determine the effects of childhood trauma experiences on the symptoms, and investigate the role of parent-child alienation in the process.

Methods

A cross-section study was conducted on 238 male military officers at high altitude subjected with cluster sampling. All of them were surveyed with childhood trauma question (CTQ), inventor of alienation toward parents (IAP), and Post-traumatic Stress Disorder Checklist (PCL-C) in October 2021. Then the mediating effect of parent-child alienation on childhood trauma and PTSD symptoms was investigated.

Results

① The prevalence of PTSD-positive symptoms was 8.5% among the military officers at high altitude.②The prevalence of PTSD-positive symptoms was 15.6% for the military officers with childhood trauma, which was significantly higher than that of those without childhood trauma (5.1%, Chi-square=7.27, P < 0.01).③PTSD symptoms, childhood trauma experiences and parent-child alienation were significantly positively correlated with each other (r=0.35~0.76, P < 0.01).④Both childhood physical abuse (β=1.05, P < 0.001) and parent-child alienation (β=0.39, P < 0.01) could positively predict the severity of PTSD symptoms for them.⑤Parent-child alienation played a partial mediating role in the association between physical abuse and PTSD symptoms (β=1.16, 95%CI: 0.54~1.75).

Conclusion

Military officers at high altitude with childhood trauma have a higher prevalence of PTSD-positive symptoms and more severe symptoms. Childhood physical abuse can not only directly affect PTSD symptoms, but also indirectly affect its severity through parent-child alienation.

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