Household Income and Children’s Mental Health Outcomes: The Mediating Role of Maternal Wellbeing and Parent-Child Relationship Quality

Household Income and Children’s Mental Health Outcomes: The Mediating Role of Maternal Wellbeing and Parent-Child Relationship Quality | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Household Income and Children’s Mental Health Outcomes: The Mediating Role of Maternal Wellbeing and Parent-Child Relationship Quality Naomi Wilson, Helen Minnis, Shari McDaid, Anna Pearce This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4635487/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 07 Jun, 2025 Read the published version in European Child & Adolescent Psychiatry → Version 1 posted 10 You are reading this latest preprint version Abstract Introduction : Uncertainty remains about the mechanism(s) through which household income influences mental health across the life course. The family stress model suggests the role of parental mental health and child-parent relationship quality may be significant, however few studies have explored this longitudinally. The present study aimed to decompose the pathways from low household income at age 3 to children's mental wellbeing at age 6, via maternal wellbeing (age 4) and parent-child relationship quality (age 5). Methods : We included four sweeps of the Growing Up in Scotland Study (n = 3639). Weights and multiple imputation were used. Low income was defined as the two bottom quintiles of equivalised household income. Potential mental health difficulties were determined using the Strengths and Difficulties Questionnaire. Mediators were assessed using the Depression, Anxiety and Stress Scale and the Pianta Child-Parent Relationship Scale. A causal mediation analysis was conducted. Confounding factors adjusted for included ethnicity, family type, maternal age, education and employment. Results : Children from low-income households at age 3 were more than twice as likely to have a potential mental health difficulty at age 6 compared to all other children (adjusted odds ratio (OR) 2.16 (95% CI 1.50 to 3.80). Reduced maternal wellbeing mediated 11.21% of the TE. Adding perceived child-parent relationship quality to this model increased the proportion mediated to 30.89%. Discussion : Increasing the incomes of young families will improve child mental health. Given the long-term risks associated with childhood mental health difficulties this should be a public health priority. Inequalities Child and Adolescent Psychiatry Attachment Public Health Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 07 Jun, 2025 Read the published version in European Child & Adolescent Psychiatry → Version 1 posted Editorial decision: Revision requested 10 Mar, 2025 Reviews received at journal 10 Mar, 2025 Reviews received at journal 18 Feb, 2025 Reviewers agreed at journal 06 Feb, 2025 Reviewers agreed at journal 03 Feb, 2025 Reviewers agreed at journal 17 Jul, 2024 Reviewers invited by journal 15 Jul, 2024 Editor assigned by journal 25 Jun, 2024 Submission checks completed at journal 25 Jun, 2024 First submitted to journal 25 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4635487","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":327201092,"identity":"9648da4c-e582-4668-9bec-2bc9863be291","order_by":0,"name":"Naomi Wilson","email":"data:image/png;base64,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","orcid":"","institution":"University of Glasgow","correspondingAuthor":true,"prefix":"","firstName":"Naomi","middleName":"","lastName":"Wilson","suffix":""},{"id":327201093,"identity":"9be31dc4-5610-4f3e-b8e3-677c777ae7c9","order_by":1,"name":"Helen Minnis","email":"","orcid":"","institution":"University of Glasgow","correspondingAuthor":false,"prefix":"","firstName":"Helen","middleName":"","lastName":"Minnis","suffix":""},{"id":327201094,"identity":"996cea94-1b2d-4adf-9745-5b0acece1067","order_by":2,"name":"Shari McDaid","email":"","orcid":"","institution":"Mental Health Foundation","correspondingAuthor":false,"prefix":"","firstName":"Shari","middleName":"","lastName":"McDaid","suffix":""},{"id":327201095,"identity":"6a27d522-7096-4e36-b299-81230dffe8f0","order_by":3,"name":"Anna Pearce","email":"","orcid":"","institution":"University of Glasgow","correspondingAuthor":false,"prefix":"","firstName":"Anna","middleName":"","lastName":"Pearce","suffix":""}],"badges":[],"createdAt":"2024-06-25 10:00:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4635487/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4635487/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s00787-025-02765-y","type":"published","date":"2025-06-07T15:57:29+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":84243202,"identity":"813e135f-a8c6-4d2c-8b38-0ad5d5a753af","added_by":"auto","created_at":"2025-06-09 16:12:57","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":449542,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4635487/v1_covered_82ceb55b-7425-4ede-8ffe-545b9bf87aad.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Household Income and Children’s Mental Health Outcomes: The Mediating Role of Maternal Wellbeing and Parent-Child Relationship Quality","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-child-and-adolescent-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ecap","sideBox":"Learn more about [European Child \u0026 Adolescent Psychiatry](http://link.springer.com/journal/787)","snPcode":"787","submissionUrl":"https://submission.nature.com/new-submission/787/3","title":"European Child \u0026 Adolescent Psychiatry","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Inequalities, Child and Adolescent Psychiatry, Attachment, Public Health","lastPublishedDoi":"10.21203/rs.3.rs-4635487/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4635487/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cb\u003eIntroduction\u003c/b\u003e: Uncertainty remains about the mechanism(s) through which household income influences mental health across the life course. The family stress model suggests the role of parental mental health and child-parent relationship quality may be significant, however few studies have explored this longitudinally. The present study aimed to decompose the pathways from low household income at age 3 to children's mental wellbeing at age 6, via maternal wellbeing (age 4) and parent-child relationship quality (age 5).\u003c/p\u003e \u003cp\u003e \u003cb\u003eMethods\u003c/b\u003e: We included four sweeps of the Growing Up in Scotland Study (n\u0026thinsp;=\u0026thinsp;3639). Weights and multiple imputation were used. Low income was defined as the two bottom quintiles of equivalised household income. Potential mental health difficulties were determined using the Strengths and Difficulties Questionnaire. Mediators were assessed using the Depression, Anxiety and Stress Scale and the Pianta Child-Parent Relationship Scale. A causal mediation analysis was conducted. Confounding factors adjusted for included ethnicity, family type, maternal age, education and employment.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e: Children from low-income households at age 3 were more than twice as likely to have a potential mental health difficulty at age 6 compared to all other children (adjusted odds ratio (OR) 2.16 (95% CI 1.50 to 3.80). Reduced maternal wellbeing mediated 11.21% of the TE. Adding perceived child-parent relationship quality to this model increased the proportion mediated to 30.89%.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDiscussion\u003c/b\u003e: Increasing the incomes of young families will improve child mental health.\u003c/p\u003e \u003cp\u003eGiven the long-term risks associated with childhood mental health difficulties this should be a public health priority.\u003c/p\u003e","manuscriptTitle":"Household Income and Children’s Mental Health Outcomes: The Mediating Role of Maternal Wellbeing and Parent-Child Relationship Quality","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-17 05:24:20","doi":"10.21203/rs.3.rs-4635487/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-10T20:23:39+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-10T12:58:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-19T00:22:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"287279268722779450508199961138445266781","date":"2025-02-06T18:03:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"89788933888727298724713850516052766132","date":"2025-02-03T22:38:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17491912785939414071760685235039372751","date":"2024-07-17T12:37:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-15T11:51:29+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-25T11:34:36+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-25T11:33:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Child \u0026 Adolescent Psychiatry","date":"2024-06-25T09:59:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-child-and-adolescent-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ecap","sideBox":"Learn more about [European Child \u0026 Adolescent Psychiatry](http://link.springer.com/journal/787)","snPcode":"787","submissionUrl":"https://submission.nature.com/new-submission/787/3","title":"European Child \u0026 Adolescent Psychiatry","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"3d90efa9-8dc2-4f80-a7ee-b85cc6624439","owner":[],"postedDate":"July 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-06-09T16:11:45+00:00","versionOfRecord":{"articleIdentity":"rs-4635487","link":"https://doi.org/10.1007/s00787-025-02765-y","journal":{"identity":"european-child-and-adolescent-psychiatry","isVorOnly":false,"title":"European Child \u0026 Adolescent Psychiatry"},"publishedOn":"2025-06-07 15:57:29","publishedOnDateReadable":"June 7th, 2025"},"versionCreatedAt":"2024-07-17 05:24:20","video":"","vorDoi":"10.1007/s00787-025-02765-y","vorDoiUrl":"https://doi.org/10.1007/s00787-025-02765-y","workflowStages":[]},"version":"v1","identity":"rs-4635487","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4635487","identity":"rs-4635487","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}