School of Economics, Zhejiang Gongshang University, Hangzhou, China.
College of Economics and Management, China Agricultural University, Beijing, China.
Econ Hum Biol. 2021 May;41:100994. doi: 10.1016/j.ehb.2021.100994. Epub 2021 Mar 4.
Although mental illness among the middle-aged and the elderly has become a global public health issue and there is a burgeoning interest in the intergenerational transmission of mental health concerns in recent years, the long-term impact of parental mental health problems on child mental health conditions in developing countries remains unknown. Using the China Health and Retirement Longitudinal Study (CHARLS), which provides both contemporaneous and retrospective data collected from a nationally representative sample of Chinese residents aged 45 years and above, this study employed a multilevel modeling approach to investigate the association between early-life exposure to parental mental distress and adulthood depression among the middle-aged and elderly Chinese. Our study showed that childhood parental mental health problems predicted mid- and late-life depression in Chinese contexts and the result remained robust to a suite of robustness checks. Our exploration of potential pathways of the relationship found the following adversities that were associated with the exposure to parental mental distress in early life and may have contributed to the depression among the middle-aged and elderly: higher rates of childhood physical abuse by parents, poor childhood health, lower levels of educational attainment, poor physical health and individual economic status in adulthood. Further, our heterogeneity analysis indicated that the transmission effect was stronger for the elderly than the middle-aged and that the improvement of childhood SES mitigated the intergenerational transmission. We also found that childhood parental mental distress was potentially a moderator, which inhibited the recovery from depression. The findings will inform the design, implementation, and evaluation of relevant public health policies. It highlights the need for more efforts to prevent and mitigate the profound impacts of childhood parental mental distress on the late-life well-being of child generations.
尽管中老年人群的精神健康问题已成为全球性公共卫生问题，近年来人们对精神健康问题代际传递的兴趣也与日俱增，但父母的精神健康问题对发展中国家儿童精神健康状况的长期影响仍不得而知。本研究利用中国健康与养老追踪调查（CHARLS），该调查从全国范围内 45 岁及以上的中国居民中抽取了有代表性的样本，收集了同期和回溯数据，采用多层线性模型方法，调查了中老年中国人在生命早期接触父母精神困扰与成年后抑郁之间的关系。研究表明，童年时期父母的精神健康问题可以预测中国中老年人群的中晚年抑郁，且这一结果在一系列稳健性检验中仍然成立。我们还探索了这种关系的潜在途径，发现了一些与生命早期接触父母精神困扰有关的逆境，这些逆境可能导致了中老年人群的抑郁：父母对子女的童年期身体虐待发生率更高、童年期健康状况较差、教育程度较低、成年后身体健康状况较差、个人经济状况较差。此外，我们的异质性分析表明，这种传递效应在老年人中比在中年人中更强，而童年时期社会经济地位的提高则减轻了代际传递。我们还发现，童年时期父母的精神困扰可能是一个调节因素，它抑制了抑郁的恢复。研究结果将为相关公共卫生政策的设计、实施和评估提供信息。它强调了需要付出更多努力来预防和减轻儿童时期父母精神困扰对后代晚年福祉的深远影响。
