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Although evidence in supporting the associations between childhood maltreatment (CM), parenting style and anxiety in children and adolescents exists, few high-quality analytical epidemiological studies which focusing on clinically diagnosed anxiety disorders (AD) had been published. The aim of this study was to further corroborate the associations between CM, parenting style, and AD in a large representative sample of Chinese children and adolescents. Study subjects were derived from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a population-based cross-sectional program. Individually matched case-control study design was adopted. Univariate and multivariate conditional binary logistic regression models were used to estimate the associations between CM, parenting style and AD. Dose-response trends were estimated using the Cochran-Armitage Chi-square test. A series of stratified analyses were conducted to explore effect modification on exposure-outcome association by some important features. Totally we screened out 202 cases and 404 matched controls, with an age mean of 14.43 years. Conditional logistic regression models revealed that EA and a higher level of parental over-protection were significantly associated with increased risk of AD, with adjusted ORs of 3.39 (95 % CI: 2.07–5.56) and 1.93 (95 % CI: 1.28–2.90). Stratified analysis identified noticeable effect modification by sex, age, and whether the only child in the family. Major findings of this study suggested that children and adolescents who had experienced EA or raised up by over-protective parents are at increased risk of AD. Targeted intervention measures should be developed and implemented for these high-risk youths. [ABSTRACT FROM AUTHOR]

The independent associations among childhood maltreatment (CM), parenting style, and school bullying in children and adolescents have not been adequately discussed. Epidemiological evidence of higher quality is still scarce. We intend to investigate this topic by using a case–control study design in a large sample of Chinese children and adolescents. Study participants were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a mega ongoing cross-sectional study. The combined database from four study sites was used. The population-based case–control study was individually matched by study site, age, sex, race, left-behind status, whether a single child, and whether a boarding student. Cases were observed to have a significantly higher prevalence of CM, higher scores for parental rejection and over-protection, and lower scores for parental emotional warmth. Multiple conditional logistic regression revealed that CM, especially emotional abuse (EA) and sexual abuse (SA), were associated with a prominently increased risk of school bullying involvement, with adjusted odds ratio (OR) of 2.28 (95 % CI: 2.03, 2.57) and 1.90 (95 % CI: 1.67, 2.17). Subsequent analysis further corroborated the robustness of EA–bullying and SA–bullying associations. Although parenting style generally showed a weaker association with school bullying, a higher level of parental rejection was related to an increased risk of bullying victimization. Chinese children and adolescents who are victims of EA or SA, or experienced a higher level of parental rejection, are more vulnerable to school bullying. Targeted interventions should be designed and implemented. • CM, especially EA and SA, were associated with increased risk of school bullying involvement. • Parental rejection was related to school bullying victimization. • Victims of EA and SA, and adolescents reported higher level of parental rejection should be targeted for intervention. [ABSTRACT FROM AUTHOR]