Adhikari Sirjana, Rana Hari, Joshi Mahesh Prasad, Cheng Sabrina, Castillo Theresa, Huang Keng-Yen
CWIN-Nepal, Ravi Bhawan, Kathmandu, Nepal.
Adolescent Mental Health Unit, Mental Hospital, Lagankhel, Nepal.
BMC Pediatr. 2025 Jan 6;25(1):6. doi: 10.1186/s12887-024-05358-x.
Children's social-emotional development and mental well-being are critical to adult mental health. However, little is known about the mechanisms or factors that contribute to poor child mental health in low- and middle-income countries. Given the lack of child mental health research to guide interventions or social-emotional learning programs and policy planning, the present study aimed to address these knowledge gaps by examining the psychopathology mechanism involved in the development of childhood mental health problems.
This cross-sectional study recruited parents (N = 393) whose children attended preschool to primary classes in the Arghakhanchi district of Nepal. Data were gathered through parent interviews. Structural Equation Modeling was used to examine the pathways of the mediational mechanism that examined the influence of parental well-being on parenting and children's mental health outcomes.
Approximately 22% of the parents were at risk for moderate to severe mental health problems (anxiety: 24%, depression:19%). Parental mental health problems were higher in families who reported food insecurity, among female parents, less educated parents, and those who perceived themselves on a lower social ladder. Parental mental health, social support, and perceived class were associated with parent-child conflict. Greater parent-child conflict was associated with decreased social competence and increased anger, anxiety, and depression in children.
The results partially support the mediational model that Nepali parents' well-being (especially in mental health symptoms, social support, and perception of family's social class domains) is associated with less optimal parenting and, in turn, greater child mental health problems and lower social competence. This study provides new evidence of cross-cultural consistency in child psychopathology and guides the development of evidence-based programs to prevent and promote mental health among Nepali children and families.
儿童的社会情感发展和心理健康对成人心理健康至关重要。然而，对于中低收入国家儿童心理健康状况不佳的机制或因素，我们知之甚少。鉴于缺乏儿童心理健康研究来指导干预措施、社会情感学习项目和政策规划，本研究旨在通过研究儿童心理健康问题发展过程中的精神病理学机制来填补这些知识空白。
这项横断面研究招募了尼泊尔阿尔加坎奇地区孩子就读于学前班至小学班级的家长（N = 393）。通过家长访谈收集数据。采用结构方程模型来检验中介机制的路径，该机制考察了父母幸福感对养育方式和儿童心理健康结果的影响。
约22%的家长存在中度至重度心理健康问题风险（焦虑：24%，抑郁：19%）。在报告粮食不安全的家庭、女性家长、受教育程度较低的家长以及那些认为自己社会地位较低的家长中，父母心理健康问题更为普遍。父母心理健康、社会支持和感知到的阶层与亲子冲突相关。更大的亲子冲突与儿童社交能力下降以及愤怒、焦虑和抑郁情绪增加有关。
研究结果部分支持中介模型，即尼泊尔父母的幸福感（特别是在心理健康症状、社会支持和家庭社会阶层认知方面）与不太理想的养育方式相关，进而与儿童更严重的心理健康问题和较低的社交能力相关。本研究为儿童精神病理学的跨文化一致性提供了新证据，并指导制定基于证据的项目，以预防和促进尼泊尔儿童及其家庭的心理健康。
