Intergenerational transmission of mental health: the mediating effects of offspring self-esteem and attachment

Abstract

Depression and anxiety are prevalent and disabling psychological disorders for individuals and the community according to the World Health Organisation. More and more research has discovered that these disorders can be passed down from one generation to another, particularly from mothers to their children. However, more studies are needed to look at the mechanisms or mediators of the transmission processes as time goes by, including how modifiable factors such as child self-esteem and attachment can mediate transmissions. This direction is beneficial for understanding what factor is important for the disorder's transmission and can potentially help to ‘break the chain’ of transmission.

This thesis utilises data from the Millennium Cohort Study to explore how maternal psychological disorders’ impact at early childhood on a child's mental health and wellbeing at late adolescence. It applies mediation analysis and path analysis to estimate to what extent maternal impacts on children indirectly through the child’s self-esteem and attachment at early adolescence. The study controls for several potential confounders, including child gender, child baseline mental health at ages 3 and 14, paternal psychological distress, maternal ethnicity, education, age of birth, alcohol usage, and family socioeconomic status.

This thesis observed positive associations between poorer maternal mental health conditions and greater child mental health symptoms. In addition, child self-esteem and attachment at early adolescence partially mediated the associations between maternal mental health and child mental health. The strength of all the associations effects decreased after gradually adjusting for confounding variables, and all the mediated associations were non-significant when adjusting for all confounding variables.

This thesis provides improved evidence that maternal psychological distress can pass onto the child, and that self-esteem and attachment are important mediators of the transmission. Understanding the transmission process across time provides targets for psychological interventions of patients who were affected by the mental health of their mothers.