@article{ref1,
title="Stressful psychosocial school environment and suicidal ideation in Chinese adolescents",
journal="Social psychiatry and psychiatric epidemiology",
year="2014",
author="Shang, Li and Li, Jian and Li, Yan and Wang, Tao and Siegrist, Johannes",
volume="49",
number="2",
pages="205-210",
abstract="PURPOSE: Suicide is one of the leading causes of death during adolescence worldwide. This study, using a sample of Chinese adolescents, examines associations of a stressful psychosocial school environment with suicidal ideation, which were rarely investigated so far. METHODS: A total of 1,004 Chinese students (468 boys and 536 girls) from Grade 7-12 were recruited into our questionnaire survey. Psychosocial school environment was measured by the effort-reward imbalance questionnaire adapted to the school setting, and suicidal ideation was assessed by a standardized question. Multivariate logistic regression was applied, adjusting odds ratios for age, gender, grade, smoking, alcohol drinking, physical activity, family wealth, and self-rated health. RESULTS: In school settings, 10.86 % students reported suicidal ideation during the last 6 months, which was found to be significantly related to both effort and reward. Remarkably, effort-reward imbalance was associated with elevated risk of suicidal ideation (odds ratio = 1.77, 95 % confidence interval = 1.34-2.35). CONCLUSIONS: This study finds significant associations between a stressful psychosocial school environment in terms of effort-reward imbalance and suicidal ideation in Chinese adolescents. Preventive actions aiming at reducing this imbalance may define a promising approach towards a healthy psychosocial school environment.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-013-0728-5",
url="http://dx.doi.org/10.1007/s00127-013-0728-5"
}