Parental separation in childhood and self-reported psychological health: A population-based study

Association of early parent-child separation with depression, social and academic performance in adolescence and early adulthood: a prospective cohort study

OBJECTIVE

The present study aimed to investigate the long-term effects of parent-child separation during infancy and early childhood on depression, social relationships including parent-child and peer relationships, and academic performance during adolescence and early adulthood.

METHODS

Data from the China Family Panel Studies (CFPS) were analyzed, which included a sample of 3829 children aged 4-15 years from 25 provinces over a period of 8 years. The study examined the association between early parent-child separation and outcomes related to depression, social and academic performance, comparing outcomes between individuals with and without early separation experiences. A series of subgroup analyses were conducted to further explore these associations.

RESULTS

Parent-child separation lasting 3 months or longer was found to be associated with moderate to severe levels of depression and impaired social relationships during adolescence and early adulthood, particularly among males, adolescents, urban dwellers, and those with less educated mothers. Children who experienced parent-child separation for 3 months or longer showed a positive correlation between separation duration and depression. Short-term separations under 3 months did not show this association. The duration of separation also had a negative correlation with parent-child and peer relationships, as well as academic performance.

CONCLUSION

Early parent-child separation has significant adverse effects on the mental health, social and academic performance of adolescents and early adulthood, especially among males, adolescents, urban residents, and those with lower maternal education. The severity of depression was found to be related to the duration of separation, highlighting the importance of minimizing separation to less than 3 months for children under the age of 3. These findings underscore the critical role of early parental care and the need for targeted interventions for high-risk populations.

Parental absence as an adverse childhood experience among young adults in sub-Saharan Africa

BACKGROUND

Parental absence in childhood has been associated with multiple negative consequences, such as depression and anxiety in young adulthood.

OBJECTIVE

To assess whether parental absence for six months or more in childhood is associated with poor mental health and substance use in young adulthood and whether parental absence accounts for additional variance beyond those explained by other adverse childhood experiences (ACEs) among youth in sub-Saharan Africa.

PARTICIPANTS AND SETTINGS

We used combined Violence Against Children and Youth Survey (VACS) data from Cote d'Ivoire (2018), Lesotho (2018), Kenya (2019), Namibia (2019), and Mozambique (2019). Analyses were restricted to 18-24-year-olds (nf = 7699; nm = 2482).

METHODS

We used logistic regression to examine sex-stratified relationships between parental absence in childhood (defined as biological mother or father being away for six months or more before age 18) and mental health problems and substance use and whether parental absence explained additional variance beyond those explained by other ACEs.

RESULTS

In sub-Saharan Africa, parental absence in childhood was common (30.5 % in females and 25.1 % in males), significantly associated with poor mental health and substance use among females and males and accounted for additional variance beyond those explained by conventional ACEs. For example, after controlling for study covariates and other ACEs, females who experienced any parental absence had 1.52 (95 % CI = 1.02-2.26) higher odds of experiencing moderate/serious psychological distress compared with those who did not.

CONCLUSION

The observed association between parental absence and poor mental health suggests that this experience has significant adverse consequences and merits consideration as an ACE.

A comparative study of mental health status among left-behind, migrant, and local adolescents in China

OBJECTIVE

Influence of migration on mental impairments among adolescents has been well assessed. However, there lack empirical data on multiple mental health problems and comparisons of children who suffer from different parental migration. This study aims to compare the mental health status among left-behind adolescents (LBA), migrant adolescents (MA), and local adolescents (LA).

METHODS

A total of 67,532 adolescents were investigated on depression, anxiety, sleep disturbance, and psychotic-like experiences (PLEs). The LBA were registered in Shenzhen's hukou (household register system) and are living in Shenzhen while their parent(s) has/have migrated to work elsewhere for over 6 months. MA, defined as adolescents who immigrated with parents from other places, are living but not registered in Shenzhen hukou. LA referred to adolescents who were registered in Shenzhen hukou and are living with their parents. Social-demographics, family function, and school climate were also evaluated as influential factors.

RESULTS

The prevalence of overall mental health problems was 37.4 % for LBA, which was higher than that of MA (27.9 %) and LA (27.1 %). Females, adolescents with chronic physical illness, and with family history of mental disorders are all contributed to the increased occurrence of mental health issues. Poorer family function and school climate were also negatively associated with mental health among the three types of adolescents.

CONCLUSION

LBA is at a higher risk for poor mental health than other adolescents. Interventions that promoting family function and improving school climate may be helpful, especially for girls with chronic physical illness, or with family history of mental disorders.

The Development of Emotion Understanding among Five- and Six-Year-Old Left-Behind Children in Rural China

The left-behind children (LBC), separated from their mother/father or parents for a long period of time, have long been discussed as a subject of concern in China. Existing research has concluded that rural children who did not migrate with parents are subject to emotional risks. In the present study, the purpose is to study the impact of parental migration on early emotional understanding. Purposeful sampling was used to recruit 180 children aged five to six years in rural areas of Guangdong province, including LBC and non-left-behind children (NLBC). Their level of emotional understanding (EU) was assessed by the emotional comprehension test (TEC) adapted to the Chinese context. The results showed that, on the three levels (External, Internal, Reflective) of emotional understanding, LBC aged five- to six- years old scored significantly lower than NLBC as counterparts. On the whole, the emotional comprehension ability of preschool LBC was significantly lower than that of NLBC. However, there were no significant differences within LBC nurtured by single parents, grandparents, and other relatives. This study confirmed that parental migration in early childhood considerably impacted rural LBC's emotional understanding and affectional adjustment, which provided a significant basis for increasing parental care and early childhood companionship in rural areas.

Child and family factors associated with positive outcomes among youth born extremely preterm

BACKGROUND

To analyze the relationship of child behavioral and communication disorders, and adverse family events, to later-in-life child health and cognitive function among youth born extremely preterm.

METHODS

The study participants were 694 children enrolled in the Extremely Low Gestational Age Newborn Study. At ages 2 and 10, we assessed internalizing and externalizing behaviors, and at age 10, we assessed adverse life events within the family. Associations were evaluated between these child and family factors and positive child health at age 10 years, and global health and cognitive function at age 15 years.

RESULTS

Lower T-scores for internalizing or externalizing behaviors at age 2 were associated with more positive health at age 10. The absence of internalizing behaviors at age 10 was associated with better global child health and better cognitive function at age 15. The absence of communication deficits at age 10 was associated with better cognitive function at age 15. The absence of parent job loss was associated with better global child health at age 15.

CONCLUSION

Among individuals born extremely preterm, child health and cognitive outcomes might be improved by timely interventions to address child behavioral symptoms and the impact of adverse life events in the family.

IMPACT

The absence of child behavioral and communication disorders, and adverse family events, were associated with more positive health, higher global health, and better cognitive function among youth born extremely preterm. Interventions to address behavioral disorders in early childhood, and to reduce the impact of adverse life events on the family, might promote improved health and developmental outcomes for adolescents born extremely preterm.

Adolescents' mental health problems increase after parental divorce, not before, and persist until adulthood: a longitudinal TRAILS study

Parental divorce is one of the most stressful life events for youth and is often associated with (long-lasting) emotional and behavioral problems (EBP). However, not much is known about the timing of the emergence of these EBP in adolescents relative to the moment of parental divorce, and its longitudinal effects. We therefore assessed this timing of EBP in adolescents of divorce and its longitudinal effects. We used the first four waves of the TRacking Adolescent's Individual Lives Survey (TRAILS) cohort, which included 2230 10-12 years olds at baseline. EBP were measured through the Youth Self-Report (YSR), as internalizing and externalizing problems. We applied multilevel analysis to assess the effect of divorce on EBP. The levels of both internalizing and externalizing problems were significantly higher in the period after parental divorce (β = 0.03, and 0.03, respectively; p < 0.05), but not in the period before divorce, with a persistent and increasing effect over the follow-up periods compared to adolescents not experiencing divorce. Adolescents tend to develop more EBP in the period after parental divorce, not before. These effects are long-lasting and underline the need for better care for children with divorcing parents.

Impact of parent-child separation on children's social-emotional development: a cross-sectional study of left-behind children in poor rural areas of China

BACKGROUND

Parent-child separation is a considerable adversity for left-behind children (LBC), but there is little evidence on the association between detailed characteristics of parent-child separation and social-emotional development among LBC. This study examined the characteristics of parent-child separation and its impacts on developmental delay among under-3 LBC in poor rural China.

METHODS

We used data from 811 LBC surveyed in five poor counties in rural China in 2018. Detailed characteristics of their parental migration were recalled by their primary caregivers in face-to-face interviews. The children's social-emotional development was measured by using the Ages and Stages Questionnaire: Social-Emotional. Logistic regression was employed to examine the association of detailed characteristics of parent-child separation with early social-emotional problems after adjusting for the children's and primary caregivers' sociodemographic characteristics.

RESULTS

287 (35.4%) children were left behind by fathers and cared for by mothers (FM-MC), while 524 (64.6%) were left behind by both parents and cared for by grandparents (PM-GC). The rate of social-emotional problems among LBC was 36.8% (PM-GC vs FM-MC: 40.6% vs 29.5%; aOR 1.51, 95% CI: 1.06 to 2.16). For paternal migration, the medians of the child's age at the first migration and average duration per migration were 3 months (IQR: 1 to 9 months) and 4.48 months (IQR: 2.38 to 7.54 months), respectively. For maternal migration, the corresponding values were 9 months (IQR: 6 to 13 months) and 4.65 months (IQR: 2.71 to 7.62 months), respectively. On average, LBC had been separated from fathers for 72% of their life due to paternal migration and from mothers for 52% of their life due to maternal migration. No significant association was found between the detailed characteristics of paternal migration and social-emotional development among LBC, while social-emotional problems among LBC were significantly associated with the proportion of cumulative duration of maternal migration in the child's lifetime (aOR 2.83; 95% CI: 1.13 to 7.10).

CONCLUSIONS

LBC under 3 years had a high risk of social-emotional problems in poor rural China. Cumulative exposure to maternal migration may be detrimental to LBC's early social-emotional development. Programs are necessary to support these children as well as their families.

[Parental Separation - Is the Accumulation with Other Adverse Childhood Experiences the Main Burden? Analysis of a Representative Sample of the German Population]

INTRODUCTION

Adverse childhood experiences (ACEs) tend to co-occur. The more forms of childhood adverse are experienced, the higher are the psychological and physical impairments in adulthood. The present study therefore examines the extent to which the experience of parental separation is related to the risk of other forms of ACEs and the extent to which the accumulation of ACEs is related to impairment in adulthood.

METHODS

A cross-sectional analysis of a representative sample of the German population from the age of 18 onwards was performed (N=2466; mean age=49.5 years (18-93); f: 1368 (55.5%); m: 1098 (44.5%)). The demographic data were assessed by interview, the remaining data were collected by questionnaires. Current depressive and anxiety symptoms self-perceived somatic health and life quality were assessed, while ACEs were assessed retrospectively by the Adverse Childhood Experiences (ACE)-Questionnaire.

RESULTS

Child maltreatment and mental illness of household members, substance abuse of household members, incarceration of household members and violence against the mother were more frequent when participants reported separation of parents. Parental separation was not associated with an increased rate of psychological impairment and, in women, physical impairment when no other forms of ACEs were present.

CONCLUSION

Children and adolescents whose parents have separated more often experience other forms of ACEs than their peers. It seems to be this accumulation of ACEs that is associated with impairments in adulthood.

Long-term effects of parental divorce on mental health - A meta-analysis

The aim of this study was to estimate the long-term effects of parental divorce on their offspring's mental health as well as substance-based addiction. We performed a systematic literature search on PubMed, Medline, PsyINFO, PsyARTICLES and PsycNET for the time period from 1990 until March 2018 in English language. In total 54 studies were included in the meta-analysis resulting in 117 effect sizes as well as a total sample of 506,299 participants. A significant association between parental divorce and every aspect of mental health was found with the following pooled ORs (95% CIs): Depression 1.29 (1.23-1.35), anxiety 1.12 (1.04-1.12), suicide attempt 1.35 (1.26-1.44), suicidal ideation 1.48 (1.43-1.54), distress 1.48 (1.37-1.6), alcohol 1.43 (1.34-1.53), smoking 1.64 (1.57-1.72) and drugs 1.45 (1.44-1.46) could be estimated. There was significant association between the effect sizes and the publication date specifically for distress (r = -0.995, p = .005). The results of the meta-analysis show a consistent direction of influence regarding the long-term effect of parental divorce on their children. Individuals affected by parental divorce have a higher risk of developing a variety of mental health conditions, although the effect sizes decreased from 1990 to 2017. Further research should focus on developing programmes to promote the resilience of children affected by divorce.

Sexual orientation, suicide ideation and suicide attempt: A population-based study

The aim is to investigate associations between sexual orientation and experience of suicide thoughts and suicide attempts. The 2012 public health survey in Scania, southern Sweden, is a cross-sectional population-based study including 28,029 participants aged 18-80 with 51.7% participation. The associations between sexual orientation and experience of suicide thoughts and attempts were investigated in multiple logistic regressions. A 8.2% proportion of men and 11.3% of women reported suicide thoughts more than a year ago, and 4.0% of men 4.1% of women had experienced such thoughts during the past year. A 2.6% proportion of men and 4.6% of women reported suicide attempt more than a year ago, and 0.6% of men and 0.7% of women during the past year. In the age- and multiple adjusted models, bisexual and homosexual men and bisexual women had significantly higher odds ratios of suicide thoughts than heterosexual men and women. Bisexual and homosexual men and bisexual women had significantly higher odds ratios of suicide attempt than heterosexual men and women. After multiple adjustments these patterns largely remained. The results indicate that bisexual men and women and homosexual men have an increased risk of experience of suicide thoughts and suicide attempt.

Economic stress and low leisure-time physical activity: Two life course hypotheses

The aim was to investigate associations between economic stress in childhood and adulthood, and low leisure-time physical activity (LTPA) in adulthood from two life course perspectives. The public health survey in Scania in the southernmost part of Sweden in 2012 is a cross-sectional study based on a stratified random sample with 28,029 respondents aged 18-80 (51.7% response rate). Associations between childhood and adult economic stress, and low LTPA were analyzed with logistic regressions. A 14.8% prevalence of men and 13.5% of women had low LTPA (sedentary lifestyle). Low LTPA was associated with higher age, being born abroad, low socioeconomic status, low trust, smoking, poor self-rated health, and economic stress in childhood and adulthood. The odds ratios of low LTPA increased with more accumulated economic stress across the life course in a dose-response relationship. There was no specific critical period (childhood or adulthood), because economic stress in childhood and adulthood were both associated with low LTPA but the associations were attenuated after the introduction of smoking and self-rated health. The accumulation hypothesis was supported because the odds ratios of low LTPA indicated a graded response to life course economic stress. The critical period hypothesis was thus not supported. Economic stress across the life course seems to be associated with low LTPA in adulthood.