We carried out a cross-sectional study among children and parents in an urban setting, with children in a local school comparted to a school for migrant children. We found large differences in parental rearing styles and attitudes, and mental health of both parents and children between families from two schools. Parental rearing skills were associated with the mental health of both parents and children, but the parents-reported had a stronger association with the mental health of parents while the children-reported had more impacts on the mental health of children. The association between parents’ rearing skills and children’s mental health is stronger in urban children than in migrant children. Mothers’ anxiety can significantly increase the self-blaming tendency and sensitive tendency of children from two schools, while it only increases the somatic anxiety of local children. In SEM, several factors of PAS and EMBU can mediate the effect of mothers’ anxiety on the anxiety tendency of children, including overprotection/over-interference (EMBU-C), emotional warmth (EMBU-C), and self-confidence (PAS) had significant impacts.
The higher prevalence of mental health problems among migrant children and their parents has previously been described [1, [14]. Risk factors for the poor mental health of migrant workers include long working hours and poor pay, lack of social support, job dissatisfaction etc. [12]. Most of these risk factors are strongly related to low socioeconomic status (SES). In this study, most of the differences in anxiety tendency between migrant children and urban children became non-significant after adjusting for demographic and socioeconomic characteristics of parents. Although low parental SES is the main risk factor for the mental health problem of both parents and children, there is no easy way to improve it. As parental SES is a multidimensional concept and acts through different pathways, we may find a target of intervention by elucidating the specific pathways. In a review of the association between parental SES and the mental health of children, the author proposed that children from lower SES families are often victims of bullying by their classmates due to different shortcomings [28]. There is very little chance that this pathway is applicable to our sample, as migrant children are at a different school from local children and their parents have similar SES. In addition, parents with low SES cannot offer a satisfactory living environment for their children. The influence of living environment on psychological stress and mental health has been well-established, with inadequate housing, crowding, social disorder, violence, and lack of green spaces acting as stressors on people’s mental health [29]. According to a recent review, the residential environment of migrant workers in China features marginalized housing conditions, poor neighborhood environments, and residential segregation, which has significant impacts on mental health [30]. Finally, parents with low SES tend to lack knowledge and concepts about parenting skills. A previous study among Chinese parents showed that SES was positively related to authoritative parenting (rational and issue-oriented) and negatively related to authoritarian parenting (controlling and punitive) [31]. We also found parents of migrant children had more negative parenting styles (e.g., over-protection, over-interference, favoritism, rejection, and punishment) and less positive parenting styles (e.g., emotional warmth, self-confidence, acceptance, and understanding).
Mothers’ anxiety affects the anxiety tendency of children through changing parenting styles and attitudes, including increasing overprotection/over-interference (EMBU-C), and decreasing emotional warmth (EMBU-C) and self-confidence (PAS). Overprotection/over-interference refers to parents being fearful, controlling of the child, and having anxiety for her safety and high expectations regarding her achievement. Cognitive theories for anxiety suggest that anxiety leads to a narrowing of attention and an attentional bias towards threat [32]. Mothers with anxiety may detect threats in their children’s environments at a higher rate, leading them to engage in overprotective behaviors [16, [33]. Emotional Warmth is shown through support, loving attention, stimulation, and acceptance. Warmth assessed by the Parental Acceptance and Rejection/Control Questionnaire is reported to be associated with fathers’ depression but not mothers’ in a previous study done in America [34]. In addition to different questionnaires being used in two studies, cultural differences which have been reported between European parents and Japanese parents may also explain the inconsistent findings [35]. No study has reported the association between maternal anxiety and self-confidence in parenting but in a comparative study, anxious patients had significantly less positive self-appraisal (positive view of self) than euthymic patients [36]. In addition, anxiety is often comorbid with depression, which makes people feel worthless and self-blaming and thus lack self-confidence.
Only mothers’ anxiety, but not mothers’ depression, fathers’ anxiety and depression was found significantly related to the mental health of children. We also found mothers spent time with their children more frequently and a higher percentage of mothers participated in this study, which may partly explain why mothers have more influence on children. Our findings are also consistent with other studies in China that found stronger effects from mothers on children than fathers. For example, maternal parenting stress had a more substantial effect on adolescent depressive symptoms than paternal parenting stress [37]. In the traditional Chinese culture, mothers are expected to take more responsibility in taking care of the household and children while fathers should work in employment to support the whole family. This situation is changing gradually but has not totally changed with time. The effect of mothers’ depression on the sensitive tendency of children is significant before correcting for multiple comparisons (p = 0.008, qFDR =0.09), so the difference between mothers’ anxiety and mothers’ depression is smaller than that between mothers’ mental health and fathers’ mental health. We infer that mothers with depression were less involved in parenting than mothers with anxiety, and thus has less effect on their children. Although we have not found studies that compare the parenting skills of mothers with anxiety and mothers with depression, we make the inference based on core symptoms of depression, i.e. a loss of interest in activities may prevent them from taking care of children actively.
We found significant interactions between the children group and mothers’ anxiety and parental rearing styles/attitudes, where the direction of the association was the same between the two children groups but the association was stronger in migrant children. We infer that the associations in migrant children were relatively weak because the parent-child relationship between migrant children and their parents was not as close as their urban local counterparts. One study compared the parent-child attachment among migrant children, LBC, and control children, finding that the quality of parent-child attachment among migrant children was statistically significantly lower than the other two groups [38]. The author reason that low parent-child attachment might be caused by deficient in communication between children and parents as migrant workers are busier with livelihoods and occupations than local [38]. We suppose this can also be caused by left-behind experiences. It is possible that the children were left behind and taken care of by their grandparents before the age of going to school when they started to migrate with their parents for better education. Unfortunately, we did not collect information on the left-behind experiences of migrant children and the majority of the published studies failed to address the diverse migration/left-behind experiences. There is only one study in rural China that divided LBC and non-LBC further into those with or without previous migration experience [39]. Surprisingly, non-LBC with migration experience had the highest score for the problem subscale of mother-adolescent communication, significantly higher than LBC and non-LBC without previous migration experience [39]. The reason for this difference is not clear and needs further study.
This study has several limitations. First, we did not collect information on the left-behind experiences of migrant children and did not evaluate their relationship with parents, which limit our ability to analyze why parents have a relatively weak effect on migrant children. Second, the response rate for parents, especially for fathers is not very high, 79.1% for mothers and 48.2% for fathers. As a result, the statistical power is lower for the analysis with fathers included. Third, local children and migrant children were from two different schools, so the differences between them may be confounded by factors other than migration experiences that are different between the two schools. This is hard to change because migrant children usually study in different schools, but we tried to reduce the differences between the two schools by selecting them from the same district, which should reduce their differences. Fourth, this is a cross-sectional study, so it is difficult to determine the direction of the relationship between the mental health of parents and children.