Associations Between Traumatic Event Exposure and Depressive Symptoms Among Chinese University Freshmen: A Conditional Process Analysis of Interpersonal Difficulties and Only-Child Status.

Depressive symptoms are highly prevalent among university students, yet the psychosocial correlates linking exposure to potentially traumatic or severe adverse events with depressive symptoms remain incompletely understood. This study examined the association between traumatic event exposure and depressive symptoms among Chinese university freshmen, focusing on the mediating role of interpersonal difficulties and the moderating role of only-child status. A cross-sectional survey was conducted among 8079 freshmen from three universities in Shandong Province, China. Depressive symptoms were measured using the PHQ-9, traumatic event exposure was assessed using the Severe Traumatic Events Questionnaire, and interpersonal difficulties were evaluated using the Comprehensive Diagnostic Scale of Interpersonal Relationships. Mediation and moderated mediation analyses were performed using Hayes' PROCESS macro (Model 15), controlling for sex, age, and residence. Results showed that traumatic event exposure was positively associated with depressive symptoms (β = 0.194, 95% CI [0.169-0.221]). A statistically significant indirect association through interpersonal difficulties was observed (indirect effect = 0.110, 95% bootstrap CI [0.097-0.124]). Only-child status moderated both the direct association between traumatic event exposure and depressive symptoms and the association between interpersonal difficulties and depressive symptoms. These findings suggest that interpersonal difficulties may represent an important factor associated with the relationship between traumatic event exposure and depressive symptoms, and that only-child status may influence the strength of these associations among university students.