Maternal image and the mental health of left-behind children

doi:10.21203/rs.3.rs-3239428/v1

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Maternal image and the mental health of left-behind children

https://doi.org/10.21203/rs.3.rs-3239428/v1

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To explore the maternal image of left-behind children (LBC) and the impact of mothers’ absence on their mental health, we randomly selected 2,623 participants (546 LBC and 2,077 non-LBC) whom we tested using the Mental Health Inventory of Middle-School Students (MMHI-60) and the Maternal Image Scale. The scores of LBC on the Positive Maternal Image Scale were significantly lower than those of non-LBC; the scores of LBC on the Negative Maternal Image Scale were significantly higher than those of non-LBC, and the mental health level of LBC was significantly lower than that of non-LBC. In addition, positive maternal image (PMI) and negative maternal image (NMI) fully mediate the time mothers spend at home and their children’s mental health. The findings indicate that as mothers spent less time at home, the maternal image of LBC became damaged; the children’s mental health also declined.

left-behind children

mental health

maternal image

the time mothers spend at home

China’s State Council (2016) defines left-behind children (LBC) as ‘minors under the age of 16 whose parents have migrated to find work or one of their parents has migrated to find work and the other is unable to care for the children’. China’s Ministry of Civil Affairs (2016) further clarified that parents of LBC leave the home to work for 6 months or more. This special group of LBC is prevalent in developing countries. For example, in the Philippines, LBC account for 27% of all children; this figure is 37% in Ghana, 36% in Moldova, and 39% in Georgia (Cebotari et al., 2017; 2018; Cortes, 2015). In China, the number of LBC is huge. According to statistics from China National Radio and the Ministry of Civil Affairs (2020), there are 9.02 million LBC under the age of 16 in rural regions whose parents have both left to work in urban areas.

Due to the special environment in which they grow up, LBC face various mental health problems (Tao Jing et al., 2015). They suffer from loneliness, depression, and anxiety (Wang & Mesman, 2015; Wen & Lin, 2012; Wu et al., 2015). They also have behavioral problems (Gao et al., 2013; Wickramage et al., 2015; Yang et al., 2016; Qu et al., 2018) and a higher probability of suicide (Fellmeth et al., 2018) and depression (Shuang et al., 2022). Pribilsky (2001) affirmed that depressive disorder in LBC may be caused by the disturbance of the parent-child attachment. Prolonged physical contact, high-quality care, and strong emotional engagement are key factors in maintaining good attachment relationships (Cassidy & Shaver, 2008). Parents’ presence helps children build trust in themselves as well as in others (Engler, 2010), especially in terms of boosting boys’ confidence and developing masculine identity (Kiyingi, 2012). However, for children who are left behind, due to a lack of parental care and family affection, the development of their attachment behavior is disrupted, which causes them to distrust the outside world and to have a negative attitude toward interpersonal communication and society (Zhao Jingxin & Liu Xia, 2010).

Separation from one’s parents leads to a significantly increased risk of anxiety and depression in children (Liu et al., 2009). During infancy and adolescence, a lack of parental emotion can harm children’s self-esteem (Magangi, 2018); children may also experience severe psychological imbalance (Biu, 2011), a disorganized personality, and an increased likelihood of health problems (Raths, 2007). Previous studies have focused on the impact of fathers’ absence on children (East et al., 2006; Sigle-Rushton & McLanahan, 2004), which harms children’s social-emotional growth. Boys may be more vulnerable than girls, and the effect of the psychological trauma caused by fathers’ absence can last a lifetime (McLanahan, 2013).

Mothers’ absence adversely affects children’s mental health (Antia, 2020), with a more severe impact on girls’ mental health (Fan Xiaoxiao, 2020). Children whose mothers are absent tend to suffer from loneliness, sadness, and helplessness due to a lack of maternal companionship (Cui Xiaohui & Guo An, 2010). Mothers’ absence can lead to depression in adolescents, and more companionship from mothers may help relieve symptoms of depression in adolescents (Yu et al., 2022). As such, parental companionship is crucial to the healthy development of children’s psyche, especially the companionship of mothers, whose presence is vital for children to build secure attachments since mothers play a significant role in children’s healthy growth (Freud, 1964).

The mother archetype is a critical concept in analytical (Jungian) psychology, which represents people’s expectations of their mothers. Jung (1960) argued: ‘The mother-child relationship is certainly the deepest and most poignant one we know…This is not only true for individuals, but even more so in a historical sense. It is the absolute experience of our species, an organic truth…Thus, in the collectively inherited image of the mother, the archetype inherently has the same strong relationship that instinctively drives the child to attach to the mother’. The concept of the mother archetype is widely used in research on literature, art, history, and culture. Past studies have mostly used the method of text analysis, trying to answer ‘Who is the mother’? and what ‘mother’ means at the individual, spiritual level (Zhao Qian, 2008; Shi Rubo, 2004).

Fan Hongxia (2008) developed a questionnaire on the Chinese mother archetype, which describes the maternal image among Chinese people and serves as a tool for empirical research on this image. The questionnaire divides the maternal image into a positive one and a negative one. In general, positive maternal image (PMI) embodies people’s expectations of the role of motherhood, while negative maternal image (NMI) reflects people’s dislike of motherhood. The mothers of LBC are not at home most of the time, which makes it difficult to maintain the parent-child relationship and may lead to a gap between the actual maternal image in children’s psyche and the expected maternal image. This also makes the maternal image of non-LBC very different from that of LBC. Further, the maternal image can affect the mental health of LBC.

The mental health of LBC is worrisome and is deeply impacted by the presence or absence of mothers at home. As such, how does the time that mothers spend at home affect their children’s mental health? Does maternal absence destroy children’s inner image of their mothers, thereby affecting their mental health? In order to explore the mechanism of the effect of mothers’ absence on children’s mental health, we used the two variables of the time mothers spend at home and maternal image to examine the link between these two variables and LBC’s mental health. We posited the following:

(1) Compared with non-LBC, the mental health of LBC is poorer.

(2) The time mothers spend at home is significantly and negatively correlated with LBC’s mental health.

(3) Maternal image (positive and negative) plays a mediating role between the time mothers spend at home and LBC’s mental health.

(4) PMI is significantly and positively correlated with the time mothers spend at home, and significantly and negatively correlated with LBC’s mental health. NMI is significantly and negatively correlated with the time mothers spend at home, and significantly and positively correlated with LBC’s mental health.

2.1 Research participants

For this study, we selected a total of 2,623 middle school students aged 11–16 (1,271 boys, 1,324 girls, and 28 missing participants); 2,077 were non-LBC and 546 were LBC. Their average age was 13.96 years old, SD = 0.95. Table 1 presents demographic details.

Table 1

Demographics
Demographic variable	Category	Amount	Proportion (%)
Age	11	1	0
	12	118	4.5
	13	685	26.1
	14	1003	38.2
	15	573	21.8
	16	126	4.8
	Missing	117	4.5
	Total	2623	100
Sex	Male	1271	48.5
	Female	1324	50.5
	Missing	28	1.1
	Total	2623	100
LBC/non-LBC	LBC	546	20.8
	Non-LBC	2077	79.2
	Total	2623	100
Note: LBC = left-behind children

2.2 Research methods

2.2.1 The Mental Health Inventory of Middle-School Students (MMHI-60)

MMHI-60, developed by Wang Jisheng et al. (1997), contains 60 items and 10 subscales (compulsion, paranoia, hostility, interpersonal sensitivity, depression, anxiety, learning pressure, maladjustment, emotional instability, and psychological imbalance). The MMHI-60 uses a 5-point Likert scale (with 1 representing ‘none’ and 5 denoting ‘severe’), with higher scores indicating more serious psychological problems. The subscales and overall α coefficients in this study were .68, .84, .85, .79, .84, .89, .86, .76, .80, .79, and .97.

2.2.2 Maternal Image Scale

The Maternal Image Scale is derived from the Maternal Image Persona Scale and the Maternal Image Shadow Scale, which were developed by Fan Hongxia (2008, 2014). The maternal image persona refers to what mothers should exhibit when facing the outside world, while the maternal image shadow refers to the fewest number of behavioral characteristics and qualities that mothers should have when facing the outside world (Fan Hongxia, 2008). This study explored the participants’ PMI through the Maternal Image Persona Scale and examined the participants’ NMI through the Maternal Image Shadow Scale.

The Maternal Image Persona Scale is divided into three dimensions: social requirements (13 items reflecting social requirements for mothers from mothers’ own perspectives), self-ideal (10 items representing the mother’s wishes and goals), and psycho-physical structure (8 items reflecting whether the mother has the basic structure required for relevant behaviors at the physical or psychological level). The α coefficients of the three dimensions and the overall α coefficient in this study were .95, .89, .80, and .96 respectively.

The Maternal Image Shadow Scale is also divided into three dimensions: social criticism (21 items reflecting the characteristics of behaviors that are criticized, suppressed, and disapproved of by society), self-rejection (9 items reflecting the characteristics of behaviors that society believes mothers are generally unwilling to accept), and personality tendencies (5 items reflecting society’s views on mothers’ underlying characteristics). The α coefficients of the three dimensions and the overall α coefficient in this study were .96, .79, .87, and .96, respectively.

2.3 Statistical methods

We employed the software SPSS 21.0 to process and analyze the data. We built the structural equation model using Mplus 7.0 software. We used maximum likelihood estimation to determine the model’s parameters.

In order to examine the impact of mothers’ absence on children’s mental health and their internal maternal image, we used LBC as the independent variable. As for the dependent variables, we used the total score of the MMHI-60 and the scores of its 10 subscales, PMI and its scores in the three corresponding dimensions, and NMI and its scores in the three corresponding dimensions. We also performed independent samples t-tests and investigated gender differences in LBC.

3.1 A comparison of mental health between non-LBC and LBC

Table 2

The mental health scale scores between LBC and non-LBC
Items	Non-LBC (N = 2,077)	LBC (N = 546)	t
Compulsion	2.21 ± .70	2.39 ± .70	-5.20^***
Paranoia	1.92 ± .78	2.07 ± .80	-3.77^***
Hostility	1.88 ± .86	2.04 ± .86	-3.79^***
Interpersonal relationships	2.04 ± .82	2.20 ± .82	-4.13^***
Depression	2.09 ± .88	2.30 ± .89	-4.97^***
Anxiety	2.20 ± .97	2.42 ± .99	-4.64^***
Learning pressure	2.20 ± .92	2.43 ± .96	-5.17^***
Maladjustment	1.90 ± .72	2.01 ± .76	-3.19^**
Emotional instability	2.21 ± .82	2.38 ± .78	-4.31^***
Psychological imbalance	1.62 ± .67	1.74 ± .75	-3.24^**
Total	2.03 ± .70	2.20 ± .70	-4.973^***
Note: LBC = left-behind children, ^p < .01, ^*p < .001

As seen in Table 2, there are significant differences between non-LBC and LBC in the total scores as well as in the scores of the 10 subscales of the MMHI-60. The scores of LBC are significantly higher than those of non-LBC. This suggests that LBC have worse mental health than non-LBC.

3.2 A comparison of the maternal image between LBC and non-LBC

Table 3

The maternal image scale scores between non-LBC and LBC
Items	Non-LBC (N = 2,077)	LBC (N = 546)	t
Social requirements	4.20 ± .75	3.96 ± .87	5.69^***
Self-ideal	3.69 ± .80	3.43 ± .86	6.57^***
Psycho-physical structure	3.83 ± .77	3.58 ± .85	6.31^***
Total scores of PMI	3.91 ± .70	3.66 ± .80	6.59^***
Social criticism	1.26 ± .57	1.36 ± .67	-3.06^**
Self-rejection	1.64 ± .64	1.72 ± .65	-2.50^**
Personality tendencies	1.22 ± .56	1.29 ± .67	-2.44^**
Total scores of NMI	1.38 ± .57	1.46 ± .63	-2.85^**
Note: LBC = left-behind children, NMI = negative maternal image, PMI = positive maternal image, ^p < .01, ^*p < .001

As shown in Table 3, there are significant differences between non-LBC and LBC in the total scores of PMI and NMI as well as in the scores of the respective three dimensions for each kind of image. The total score of PMI and the scores of its three dimensions (social requirements, self-ideal, and psycho-physical structure) were significantly higher for non-LBC compared with LBC. The total score of NMI and the scores of its three corresponding dimensions (social criticism, self-rejection, and personality tendencies) were significantly lower for non-LBC compared with LBC. This implies that compared with non-LBC, LBC’s inner maternal image contains fewer positive elements and more negative ones.

3.3 The mental health of male versus female LBC

Table 4

The scores of mental health of male versus female LBC
Items	Male (N = 282)	Female (N = 258)	t
Compulsion	2.38 ± .74	2.40 ± .66	− .32
Paranoia	2.06 ± .85	2.07 ± .76	− .08
Hostility	2.01 ± .86	2.08 ± .86	-1.00
Interpersonal relationships	2.19 ± .87	2.23 ± .77	− .59
Depression	2.21 ± .87	2.39 ± .91	-2.40^*
Anxiety	2.32 ± .98	2.53 ± .99	-2.43^*
Learning pressure	2.42 ± 1.03	2.45 ± .89	− .38
Maladjustment	2.03 ± .80	2.00 ± .71	.53
Emotional instability	2.34 ± .78	2.42 ± .78	-1.21
Psychological imbalance	1.76 ± .78	1.72 ± .72	.54
Total	2.17 ± .72	2.23 ± .67	− .96
Note: LBC = left-behind children, ^*p < .05

Through a separate analysis of the mental health scale scores of 546 LBC, we found that the scores of male and female LBC on the MMHI-60 were only significantly different in the factors of depression and anxiety; the scores of female LBC were significantly higher than those of male LBC. This indicates that female LBC are more likely to have the two psychological symptoms of depression and anxiety compared with male LBC.

3.4 Maternal image among male versus female LBC

Table 5

The scores for maternal image between male and female LBC
Items	Male (N = 282)	Female (N = 258)	t
Social requirements	3.95 ± .91	3.97 ± .82	− .29
Self-ideal	3.44 ± .91	3.42 ± .81	.20
Psycho-physical structure	3.62 ± .88	3.54 ± .80	1.05
Total scores of PMI	3.67 ± .84	3.65 ± .75	.32
Social criticism	1.40 ± .71	1.31 ± .61	1.53
Self-rejection	1.71 ± .70	1.73 ± .59	− .23
Personality tendencies	1.33 ± .74	1.25 ± .57	1.44
Total scores of NMI	1.48 ± .68	1.44 ± .57	.77
Note: LBC = left-behind children, NMI = negative maternal image, PMI = positive maternal image

As seen in Table 5, there are no significant gender differences in the scores of male versus female LBC on the Maternal Image Scale and its three corresponding dimensions, indicating no significant difference between male and female LBC in terms of their inner maternal image.

3.5 Correlations among the time mothers spend at home, PMI, NMI, and mental health

Table 6

Correlations among the time mothers spend at home, PMI, NMI, and mental health
Dimension	Time mothers spend at home	Compulsion	Paranoia	Hostility	Interpersonal relationships	Depression	Anxiety	Learning pressure	Maladjustment	Emotional instability	Psychological imbalance	Total
Time mothers spend at home	-	− .117^***	− .089^***	− .088^***	− .094^***	− .124^***	− .111^***	− .105^***	− .082^***	− .098^***	− .083^***	− .116^***
Social requirements	.152^***	− .161^***	− .225^***	− .222^***	− .226^***	− .229^***	− .251^***	− .230^***	− .229^***	− .266^***	− .232^***	− .268^***
Self-ideal	.158^***	− .127^***	− .181^***	− .163^***	− .185^***	− .168^***	− .202^***	− .221^***	− .175^***	− .198^***	− .156^***	− .209^***
Psycho-physical structure	.168^***	− .110^***	− .154^***	− .140^***	− .133^***	− .150^***	− .160^***	− .181^***	− .157^***	− .163^***	− .152^***	− .176^***
Total scores of PMI	.174^***	− .145^***	− .203^***	− .191^***	− .196^***	− .199^***	− .223^***	− .229^***	− .203^***	− .228^***	− .196^***	− .237^***
Social criticism	− .111^***	.129^***	.208^***	.200^***	.191^***	.184^***	.174^***	.125^***	.170^***	.156^***	.266^***	.208^***
Self-rejection	− .087^***	.223^***	.276^***	.272^***	.284^***	.262^***	.271^***	.212^***	.221^***	.254^***	.282^***	.294^***
Personality tendencies	− .078^***	.114^***	.196^***	.186^***	.174^***	.166^***	.169^***	.120^***	.164^***	.148^***	.254^***	.195^***
Total scores of NMI	− .101^***	.170^***	.245^***	.238^***	.241^***	.219^***	.220^***	.164^***	.202^***	.200^***	.288^***	.252^***

Note: NMI = negative maternal image, PMI = positive maternal image, ^***p < .001

As seen in Table 6, there are significant correlations among the time mothers spend at home, PMI and its three corresponding dimensions, NMI and its three corresponding dimensions, and the ten subscales of the MMHI-60.

3.6 Correlations among the time mothers spend at home, PMI, NMI, and mental health

According to the theoretical model outlined in Fig. 1, we hypothesized that the time mothers spend at home would be positively related to PMI and negatively related to NMI and mental health. PMI is negatively tied to mental health, and NMI is positively linked to mental health. Further, PMI and NMI played a mediating role between the time mothers spent at home and their children’s mental health. As presented in Table 6, all variables used in the study had significant correlations, and the correlations met our expectations.

3.7 Model parameter testing

Figure 2 depicts the model and the results regarding the influence of the time mothers spend at home on the mental health of their children (middle school students). We tested a potential pathway model in which we used the time mothers spend at home to predict PMI, NMI, and mental health, while we used PMI and NMI as predictors of mental health. We set the time fathers spend at home as the control variable. Overall, this model had a good fit. All goodness-of-fit statistics (χ²/df = 16.33; CFI = .95; TLI = .94; RMSEA = .036) met the recommended critical values for a good model fit. All parameter estimates (i.e. factor loadings and path coefficients) were statistically significant as expected, except that the correlation between the time mothers spend at home and mental health was not significant.

As anticipated, the overall effect of the time mothers spend at home on mental health was significant (β = − .09, p < .001), but the direct effect was not significant (β = − .04, p = .13). The two indirect influence paths of the time mothers spend at home on their children’s mental health were significant. Path 1: The time mothers spend at home → PMI → mental health. The time mothers spend at home was significantly and positively correlated with PMI (β = .15, p < .001); PMI was significantly and negatively correlated with mental health (β = − .19, p < .001). Path 2: The time mothers spend at home → NMI → mental health. The time mothers spend at home was significantly and negatively correlated with NMI (β = − .14, p < .001), and NMI was significantly and positively correlated with the children’s mental health (β = .18, p < .001).

We used the time mothers spend at home and maternal image to explore the impact of mothers’ absence on the mental health of LBC. By building a structural equation model for the time mothers spend at home, children’s mental health, PMI, and NMI, and controlling for the time fathers spend at home, we examined the relationship between the time mothers spend at home and their children’s mental health, and the effect of PMI and NMI on these two factors. The time mothers spent at home had a significant impact on the mental health of LBC, and as mothers spent more time at home, their children’s mental health improved. However, when we further scrutinized the effects of the time mothers spend at home, PMI, and NMI on children’s mental health, we observed that the direct effect of the time mothers spend at home on children’s mental health was not significant. Instead, it had an indirect effect on children’s mental health entirely through PMI and NMI, which implies that PMI and NMI play a fully mediating role between the time mothers spend at home and children’s mental health. This outcome indicates that the longer mothers stay at home, the higher the scores on the Positive Maternal Image Scale. Further, the lower the scores of LBC’s mental health, the healthier the children were. The less time mothers spent at home, the higher the scores on the Negative Maternal Image Scale, the higher the scores of LBC’s mental health, and the less healthy the children were.

In this study, the total scores of the MMHI-60 and the scores of its 10 subscales among LBC were significantly higher than those of non-LBC. This suggests that the situation of being left behind has a significant negative impact on children’s mental health, which is consistent with previous studies (Fan et al., 2010; Graham, & Jordan, 2011). For example, Fan Fang and Sang Biao (2005) revealed that an adverse family environment is an important factor for negative personality traits, worsening academic performance, and behavioral problems among LBC; these three factors are closely related and aggravate each other. Zhou Zongkui et al. (2005) showed that due to a lack of parental upbringing, the ability of LBC to develop interpersonal relationships and self-confidence is significantly lower than that of ordinary children. In a study about LBC, Fan Xinghua et al. (2009) found that compared with ordinary children, LBC exhibited lower self-esteem, more intense loneliness, and poorer social adaptability. Due to the long-term lack of parental companionship and care, LBC may become introverted, inferiority, pessimistic, withdrawn, insecure, and emotionally closed (Liang Yingnan & Zhang Liying, 2022). In addition, their risk of cognitive, emotional, and social problems continues to increase (Amato, 2005), and the prolonged absence of one’s mother increases the odds of developing depressive symptoms in adolescents (Yu et al., 2022). Lack of parental companionship is a typical feature of LBC; it is also a major factor in their psychological distress.

The scores of the Maternal Image Scale showed that the scores of LBC’s PMI were significantly lower than those of non-LBC, while the scores of LBC’s NMI were significantly higher than those of non-LBC. The length of maternal companionship directly affected whether the maternal image was positive or negative in the children’s minds, and PMI played a key role in protecting their mental health. One’s mother is the first object of the individual, and as the person who gave birth to the child and the nurturer of the child during infancy, the mother is crucial to the child’s survival. Contemporary object relations theory emphasizes the pre-Oedipal mother-infant relationship, placing the mother at the center of the individual’s psyche (Clair, 1986). Bowlby (1980) asserted that maternal companionship is vital during children’s growth and is an important factor for children to build a sense of security and stable attachment. Bowlby (1988, p. 121) claimed, ‘When humans are threatened, they seek the company of someone they feel is “stronger and/or wiser” than themselves in order to gain a sense of security’. Main indicated that children strongly prefer their mothers even after their mothers leave home to find work and their fathers become the primary caregivers (Wallin, 2007). This finding underscores the irreplaceability of mothers. Main affirmed that starting from the time of gestation, a baby begins to develop a preference for his/her mother in the womb, identifying the mother as the primary attachment figure. Hence, the mother is the primary object for the child to seek help from and to establish a sense of security, which has an all-encompassing influence on psychological development.

From a very early stage, a child forms an image of his/her mother in his/her mind, which represents his/her original expectation of his/her mother. PMI denotes the image of a mother who meets social requirements, strives to self-fulfillment, cares for her children, and takes care of her family. In a situation where children are left behind, being separated from their mothers for a long time as well as being unable to have a long-term, stable upbringing and care from their mothers may lead them to develop an insecure attachment pattern; such an attachment pattern may be sustained and even exacerbated when the mother’s presence is lacking. LBC may lack maternal care for a long time and cannot obtain an effective response when they encounter dangers or difficulties and seek help. This might lead LBC to become disappointed in and resent their mothers, which greatly harms the mother-child relationship and can end up ruining the maternal image in children’s minds.

When children have formed PMI, this means they trust their mothers and feel safe with their mothers, even in the outside world. The protection and support provided by mothers help children to build a ‘safe base’ from which to explore the outside world and serve as an ‘emotional buffer’ for children to cope with external pressures. PMI has a protective effect on children’s mental health, which NMI undermines. Thus, when children are exposed to psychological pressure and crisis events, they may lack timely support in real life as well as protection and a buffer against the mother archetype. This situation aggravates their psychological problems.

Children’s mental health is closely tied to companionship with their mothers. Constructing PMI in children’s minds is conducive to their healthy mental development. Hence, how can we effectively construct PMI in children’s minds? If it is not possible to change the amount of time that mothers spend at home, are there any other undiscovered factors to moderate the relationship between the time mothers spend at home and maternal image? This would enable LBC to develop PMI and maintain a healthy psychological state, even without the care of their mothers. This is an important question that requires further exploration.

Compared with non-LBC, the mental health of LBC is poorer. The time mothers spend at home is significantly associated with PMI, NMI, and mental health. PMI and NMI play a fully mediating role between the time mothers spend at home and children’s mental health. The findings can be used to improve healthcare policies、government plans, etc.

Ethical Approval

The study protocol was approved by the Medical Ethics Committee of Dali University.

Competing interests

The authors declared no competing of interests.

Authors' contributions

Kai Li and Xue Zou wrote the main manuscript text and Yu He prepared Table 1-6，Fang Ying prepared figures 1-2. All authors reviewed the manuscript.

Funding

This research was supported by the National Planning Office of Philosophy and Social Science of CN (No.19BSH118)

Availability of data and materials

all of the material is owned by the authors and/or no permissions are required.

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Maternal image and the mental health of left-behind children

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Abstract

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1. INTRODUCTION

2. RESEARCH PARTICIPANTS AND RESEARCH METHODS

2.1 Research participants

2.2 Research methods

2.2.1 The Mental Health Inventory of Middle-School Students (MMHI-60)

2.2.2 Maternal Image Scale

2.3 Statistical methods

3. RESULTS

3.1 A comparison of mental health between non-LBC and LBC

3.2 A comparison of the maternal image between LBC and non-LBC

3.3 The mental health of male versus female LBC

3.4 Maternal image among male versus female LBC

3.5 Correlations among the time mothers spend at home, PMI, NMI, and mental health

3.6 Correlations among the time mothers spend at home, PMI, NMI, and mental health

3.7 Model parameter testing

4. DISCUSSION

5. CONCLUSION

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References

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