The Effect of Economic Status and Parental Depression on Childhood Depression: Exploring the Mediating Role of Parenting Behaviors in Rural China

Background/Purpose

      An increasing number of studies indicate that Chinese children suffered the same or even higher rate of depression when compared to Western children. Depression puts children at increased risk of multiple sequelae that can have short-term effects on their suicidal ideation, poor academic performance, and disruptive and aggressive behavior, as well as long-term effects on adult functioning including later delinquency and psychiatric problems.

      The Family Stress Model posits that economic hardships and parental emotional distresses affect childhood depression through family processes, especially disrupted parenting and family conflict. Substantial evidence indicates that children who live in poverty are at greater risk for the development of mental health problems, suggesting that those children are a particularly vulnerable group to study. In China, most of the children living in poverty come from rural areas, but they are a population being studied less extensively. In addition, most of the studies have focused on the negative effect of maternal depression on child mental health; there is a paucity of literature regarding the role of both maternal and paternal depression.

      The objective of this study is to examine longitudinally the effects of both maternal and paternal depression and family economic status on rural Chinese children’s depression, in order to find out their joint and respective effects. Additionally, parenting behaviors are assessed as possible pathways mediating this effect.

Methods

      The analysis sample included 910 participants (10-17 years old) from China Family Panel Studies (CFPS) in 2010, 2012, and 2014. Maternal, paternal, and childhood depression are assessed using Center for Epidemiological Studies Depression Scale (CES-D). Family economic status is assessed by parental report of household income. Parenting behaviors are assessed by variables regarding parental warmth, control, and withdrawal. The covariates are child age, gender, parents age, and parents’ marital status.

      Stata 14.1 was used for these analyses. We examined bivariate relationships to determine the association between variables. Ordinary least squares regressions were used to assess the joint and independent effect of maternal depression, paternal depression, and family economic status. Baron and Kenny’s method was used to determine the extent to which parenting behaviors mediated this relationship.

Results

      The results demonstrated that 26.0% of children, 29.3% of mothers, and 29.1% of fathers met the criteria for depression. Parental depression, family economic disadvantage, and disruptive parenting behaviors all independently predicted higher levels of childhood depression. Maternal and paternal depression predicted 25% and 23% higher levels of child depression respectively. In regards to the mediating effect, parenting behavior was a shared mechanism through which both parental depression and economic status affected child depression. To be specific, parental warmth predicted 44% lower levels of child depression scores, while parental control predicted 34% higher levels of child depression scores.

Implications

      These findings suggest that both mothers and fathers should be involved in the treatment of childhood depression. Additionally, parenting behaviors with high warmth and low control is an important and feasible target for intervention with rural Chinese children and families dealing with depression and economic disadvantage.