Examining the Association Between Parenting and Depression of Chinese Children: A Systematic Review

Background/Purpose: In the year 2010, the population of Chinese children ranked the second largest in the world. An increasing number of researches on the prevalence of Chinese children’s depression show that Chinese children suffer the same or even higher mental health problems when compared to children in Western world. Theoretical models including attachment theory, social learning theory, cognitive life stress, and interpersonal model of depression have hypothesized that parenting plays a major causal role in the development and maintenance of child depression. To date, there is no published systematic literature review documenting the association between parenting and Chinese children’s depression.

The purpose of this review is to systematically examine and summarize the association between parenting and depression of Chinese children, in order to come up with family-based interventions for Chinese children with depression.

Methods: A computer based information search is conducted on a range of electronic databases including PubMed, PsycINFO, SocINDEX, Social Services Abstracts, Sociological Abstracts, CINAHL (EBSCO), and Social Work Abstracts PLUS (Ovid). We use the following depression-related and parenting-related key terms and synonyms: Depress-, Dysthy-, Internaliz-, Sad-, and Suicid-; Mother-, Maternal, Father-, Paternal, Parent-, and Rearing. Key terms also include Child-, China, or Chinese.

Inclusion criteria are as follows: 1) a measure of parenting of one parent or both parents’ behaviors toward child; 2) a measure of childhood depression, or the diagnosis of childhood depressive disorder; 3) the association between parenting and childhood depression has to be tested; 4) the samples are Chinese children aged 0–12 years. These steps produce a pool of 13 studies in peer-reviewed, English language journals from 1960 to 2016.

Results: Results are reported from two perspectives. One is parenting styles, including authoritative and authoritarian; the other is subdimension of parenting including parental warmth/support, control, parent-child relationship, harsh punishment, indifference, and two indigenous Chinese parenting behavior -- Guanjiao (Parental monitoring and teaching), and critical comparison and shaming. The studies report good validity and reliability. Results show that in general, authoritative parenting is negatively associated with children's depression, while the interactions between authoritarian parenting and effortful control prospectively predict children's internalizing problems. Parental monitoring, psychological control, harsh discipline, indifference, and critical comparison and shaming are associated with higher levels of Chinese children’s depression. Parental education, warmth and support, and parent-child relational quality are associated with lower level of Chinese children’s depression. However, most of the studies are cross-sectional study without well-identified theoretical framework.

Conclusions and Implications: Our findings contribute to a growing body of evidence that suggests parenting is associated with childhood depression in the population of Chinese children. There is a need for more longitudinal studies providing evidence of causation, more rigorous sampling strategy to enhance generalizability, using well-identified theoretical framework, and more indigenous measures of parenting within the Chinese cultural context. Certain clinical implications from the findings include involving parents to the treatment of Chinese children’s depression, and targeting parenting behaviors associated with childhood depression in interventions.