Family Structure and Child Mental Health

Seminar no. 1214
16 May 2023 Time 12.30 – 13.30 hrs.

Speaker: Udomluk Ratchasombat

Background: As a result of demographic and socioeconomic changes, the proportion of children residing in households without at least one parent has been increasing globally. Research findings from Western countries are inconclusive regarding whether parental absence in the household leads to a higher risk of child mental health issues, potentially through adverse childhood experiences (ACEs). The study aims (1) to examine the association between family structure and child mental health, and (2) to investigate whether ACEs act as a mediator through which family structure may affect child mental problem. Methods: This study was based on cross-sectional survey data, part of the “Child Ecology of Thai Z-alpha Generation” project, conducted in 5 provinces across Thailand during 2019 – 2020. The sample included 931 children aged 6-14 years and their primary caregivers. Measurements were as follows: (1) exposure – family structure (including 2-married parent, 2-cohabiting parent, single-mother, single-father, and non-parent households), (2) outcome – child mental problem (assessed by a total difficulties score on the Strength and Difficulties Questionnaire), and (3) mediator – ACEs (covering experiences of child abuse, child neglect, and family conflict). Ordinal logistic regression and mediation analysis were performed to test the hypotheses. Results: Using those living with 2-married parents as the reference group, children living in households with parental absence were independently associated with higher risk of mental problem (i.e. AOR 3.4, 95%CI 1.7 – 6.6, p = 0.000 for single-father households; AOR 2.4, 95%CI 1.3 – 4.3, p = 0.004 for non-parent households; and AOR 2.0, 95%CI 1.2 – 3.4, p = 0.010 for single-mother households). When the associations were further adjusted for ACEs, the adjusted odd ratios only slightly decreased for the non-parent (from 2.4 to 2.1) and single-mother households (from 2.00 to 1.8), while that of single-father households remained unchanged. Conclusion: Given the increased risk of mental health problems for children living in households with parental absence, it may be beneficial to develop targeted screening and treatment programs to identify and address mental health issues in this population. Future research should explore other types of adverse childhood experiences (ACEs) as well as non-ACEs that may mediate the relationship pathways. This could help to better understand the mechanisms by which family structure affects mental health outcomes and inform the development of more effective prevention and intervention strategies.

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