School of Social Development and Public Policy, Beijing Normal University, Beijing, China.
School of Psychology, Laval University, Quebec City, QC, Canada.
Health Soc Care Community. 2020 Jul;28(4):1310-1322. doi: 10.1111/hsc.12964. Epub 2020 Mar 2.
The prevalence of depressive symptoms in older Chinese adults has increased recently. Intergenerational relationships play an important role in the mental health conditions of older adults, especially in Chinese culture. Therefore, this study aims to unravel the complex connection between intergenerational relationships and depression, and to explore the potential mediating roles of loneliness and nighttime insomnia symptoms within that connection. A cross-sectional household survey was conducted in China with 2038 participants aged 65 years or above. Variables were measured using the Center for Epidemiologic Studies Short Depression Scale, the Intergenerational Relationship Quality Scale for Aging Chinese Parents (IRQS-AP), three nighttime insomnia symptoms extracted from the Insomnia Severity Index and the De Jong Gierveld Six-Item Loneliness Scale. The IRQS-AP includes four subdimensions: consensual-normative solidarity, structural-associational solidarity, affectual closeness and intergenerational conflicts. Path analyses were performed in Mplus to investigate regression coefficients and mediating effects. Results showed that three general intergenerational relationships (consensual-normative solidarity, affectual closeness and intergenerational conflicts) were significantly correlated with all mental health outcomes, including their symptoms of loneliness, insomnia and depression. A serial mediation model suggested that loneliness mediated the connection between those constructs of intergenerational relationships and depression, with an independent path to insomnia symptoms via loneliness. The proposed mediators fully mediated the effects of affectual closeness on depression. Nighttime insomnia symptoms alone mediated only the relationship between intergenerational conflicts and depression independently from paths involving depression. Removal of sleep item from CES-D did not affect the results of paths. Our findings highlight the importance of intergenerational relationships for mental health, especially for the mediating effects of loneliness and nighttime insomnia symptoms on the relationship between intergenerational relationships and depression. Effective mental health services for older adults can address their feelings of loneliness and sleep problems, especially for those who have a poor relationship with their adult children.
最近，老年华人中抑郁症状的患病率有所增加。代际关系对老年人的心理健康状况起着重要作用，尤其是在中国文化中。因此，本研究旨在揭示代际关系与抑郁之间的复杂联系，并探讨孤独感和夜间失眠症状在这种联系中的潜在中介作用。本研究在中国进行了一项横断面家庭调查，共有 2038 名 65 岁及以上的参与者。使用流行病学研究中心短抑郁量表、《中国老年父母代际关系质量量表》（IRQS-AP）、从失眠严重程度指数和 Jong Gierveld 六项目孤独感量表中提取的三个夜间失眠症状来测量变量。IRQS-AP 包括四个亚维度：共识规范性团结、结构关联团结、情感亲密和代际冲突。在 Mplus 中进行路径分析，以调查回归系数和中介效应。结果表明，三种一般代际关系（共识规范性团结、情感亲密和代际冲突）与所有心理健康结果显著相关，包括孤独感、失眠和抑郁症状。一个串联中介模型表明，孤独感中介了代际关系结构与抑郁之间的联系，通过孤独感与失眠症状之间的独立路径。提出的中介因素完全中介了情感亲密对抑郁的影响。夜间失眠症状仅通过独立于涉及抑郁的路径对代际冲突和抑郁之间的关系进行中介。从 CES-D 中删除睡眠项目并不影响路径的结果。我们的研究结果强调了代际关系对心理健康的重要性，特别是孤独感和夜间失眠症状对代际关系与抑郁之间关系的中介作用。为老年人提供有效的心理健康服务可以解决他们的孤独感和睡眠问题，特别是对那些与成年子女关系不好的老年人。
