Evidence map›Paper›PMID 42289712›Full record

ArticleChild and adolescent psychiatry and mental health2026

Mechanisms linking family socioeconomic status to children's depressive symptoms: a longitudinal moderated mediation analysis.

Haifan Bai, Tingting Wang, Yuting Yang, Haijiang Lin, Xiaoxiao Chen, Yixuan Liu, Jingyi Wang, Chaowei Fu

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Article in Child and adolescent psychiatry and mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Haifan Bai *School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
Tingting Wang *Taizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang, China.
Yuting Yang *School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
Haijiang LinTaizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang, China.
Xiaoxiao ChenSchool of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
Yixuan LiuSchool of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
Jingyi WangSchool of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China. jingyi_wang@fudan.edu.cn.
Chaowei FuSchool of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China. fcw@fudan.edu.cn.

Funding

the China Medical Board #22472the General Project of Shanghai Municipal Health Commission 202240115the National Natural Science Foundation of China 72104053the Special Support Program for High Level Talents in Taizhou TZ2022-2
6 · The paper itself

Abstract

backgroundFamily socioeconomic status (SES) is a well-established determinant of children's mental health, yet the mechanisms linking SES to depressive symptoms in primary school children remain insufficiently understood. This study aimed to investigate whether loneliness, perceived social support, and parent-child relationship mediate the association between family SES and depressive symptoms, and whether these pathways are moderated by sex and household registration.

methodsA three-wave longitudinal survey was conducted among primary school students in Taizhou City, Zhejiang Province, China (2021-2023). Data were collected via online questionnaires completed by students and their parents. Family SES indicators (parents' education, family economic status, and average living space per person) were assessed at baseline (T1), interpersonal experiences (loneliness, perceived social support, and parent-child relationship) at wave 2 (T2), and depressive symptoms at wave 3 (T3). Structural equation modeling was used to examine direct, mediated, and moderated effects, adjusting for relevant covariates.

resultsA total of 2,164 students (mean age = 9.3 ± 1.4 years, 46.5% female) who completed all three waves were included in the analysis. Higher parents' education was directly associated with lower depressive symptoms and indirectly associated via reduced loneliness (indirect effect - 0.02, 95% CI -0.03 to -0.001; 13.2% of the total effect) and greater perceived social support (indirect effect - 0.02, 95% CI -0.03 to -0.01; 16.3%). Better family economic status was linked to fewer depressive symptoms both directly and indirectly through greater perceived social support (indirect effect - 0.01, 95% CI -0.02 to -0.001; 11.1%). Larger average living space per person was associated with lower depressive symptoms only indirectly through increased perceived social support (indirect effect - 0.01, 95% CI -0.02 to -0.002; 43.5%). Household registration moderated the indirect pathway via perceived social support: the indirect effect of family economic status was significant among urban children but not among rural children. No significant moderation by sex was observed.

conclusionsFamily SES was associated with depressive symptoms in primary school children partly through loneliness and perceived social support, with the latter pathway contingent on household registration. These findings underscore the importance of interpersonal processes and contextual conditions in shaping socioeconomic inequalities in childhood mental health and highlight the need for context-sensitive prevention strategies.

Indexed as

ChildrenDepressive symptomsFamily socioeconomic statusLonelinessParent-child relationshipPerceived social support

Identifiers

PMID42289712
PMCPMC13531815

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