Gender differences in the impact-factors of adolescent dissociative symptoms: a structural equation model approach

Abstract

Background Few studies have investigated the gender-specific impact of adolescent dissociative symptoms (ADSs) in China. The purpose of this study was to examine gender differences in the impact factors of ADSs in Hangzhou City, China, as well as to investigate further the direct and interactive effects between ADSs and impact factors by constructing a structural equation model (SEM). Methods A school-based, two-center cross-sectional study was conducted in Hangzhou City, China. The sample comprised 2,160 adolescents aged 13–18 years who were randomly selected using a multi-phase, stratified, cluster sampling technique. We used a SEM to explore the direct and interactive effects between ADSs and influencing factors by gender stratification. Results A total of 1,916 participants were included in the two-center cross-sectional study. The male SEM model showed that the significant standardized paths (P < 0.05) were between psychological factors and environment factors, both positively related to ADSs (psychological factors and environment factors). In addition, a significant correlation was also observed between teacher-student conflict relationship and ADSs. The female SEM model indicated that there were the significant standardized paths between peer interpersonal interaction relationship and psychological factors, in which peer interpersonal interaction relationship was negatively correlated to ADSs, and psychological factors tended to correlate positively with ADSs. We also found that there was a correlation between peer interpersonal interaction relationship and hostility. Our findings indicated that the strongest effect was psychological factors for male (total standardized β = 0.365) or female ADSs (total standardized β = 0.674). The SEM model fit indices indicated that the proposed models fit the data for both male and female ADSs. Conclusions Our findings suggested that health resources and strategies could be allocated and performed rationally to enhance their utilization efficiency during ADSs screening and other public health actions. To reduce the risks of adolescent dissociative disorders and other mental disorders, we urgently need to develop gender-specific intervention strategies for ADSs.