[Effects of childhood abuse experience, recent life events and coping styles on depressive symptoms of medical students].

Objective: To analyze the influence of childhood abuse experience, recent life events and coping styles on depression symptoms of medical students based on the model of "vulnerability-stress-coping".

Methods: A longitudinal study design was adopted to select freshmen from Hefei City and Anqing City in Anhui province by cluster sampling. A total of 4211 questionnaires were collected at baseline from November to December 2019. Follow-up surveys were conducted in November to December 2020, and a total of 3662 medical students were finally included in this study. The childhood trauma questionnaire, adolescent self-rating life events checklist, coping style questionnaire and self-rating depression scale were used to evaluate childhood abuse experience, recent life events, coping styles and depression symptoms of medical students. The PROCESS software model 1(double interaction analysis) and model 3(triple interaction analysis) were used to investigate the independent and interactive effects of childhood abuse experience, recent life events, and different coping styles on depressive symptoms of medical students during follow-up.

Results: Among the 3662 medical students, 976 were male and 2686 were female, with an average age of(19.2±1.0) years. Spearman correlation analysis showed that childhood abuse experience, recent life events, self-blame, fantasy, problem avoidance, and rationalization coping style were positively related to depressive symptoms(P<0.05). The coping style of problem solving and seeking help was negatively related to depressive symptoms(P<0.05). In model 1, both childhood abuse experience(β=0.097, 95%CI 0.065-0.129) and recent life events(β=0.102, 95%CI 0.073-0.132) had a positive predictive effect on depressive symptoms, and they also had positive interaction on depressive symptoms(β=0.030, 95%CI 0.025-0.004). In model 3, there was a negative interaction between childhood abuse, recent life events and seeking help(β=-0.034, 95%CI-0.061--0.007) or fantasy(β=-0.039, 95%CI-0.065--0.013) coping styles on depressive symptoms.

Conclusion: Childhood abuse experience and recent life events are the predisposition factors for depressive symptoms of medical students, and they can mutually promote depression, while seeking help and fantasy coping styles could weaken the promoting effects of both.