The Relationship between Family Relationships and Children's Mental Health: A Three-Level Meta-Analysis

Zhao Chengjia; Huang Xiaoxiao; Yu Guoliang

doi:10.16719/j.cnki.1671-6981.20250616

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Journal of Psychological Science ›› 2025, Vol. 48 ›› Issue (6) : 1481-1496. DOI: 10.16719/j.cnki.1671-6981.20250616

Research on Social Psychological Service in the New Era

The Relationship between Family Relationships and Children's Mental Health: A Three-Level Meta-Analysis

Zhao Chengjia¹, Huang Xiaoxiao^2,3, Yu Guoliang⁴

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Abstract

Family relationships play a crucial role in children’s mental health development, serving as the primary social context for psychological growth and adjustment. However, existing research demonstrates inconsistent findings regarding their relative importance and impacts on children’s mental health outcomes. While some studies emphasize the dominant role of parent-child relationships, others highlight the significance of marital relationships. Similarly, the role of sibling relationships remains debated, with mixed evidence on their unique contributions. Furthermore, theoretical perspectives offer contrasting predictions: the protective theory posits that positive family relationships promote mental health, the contagion risk theory cautions against potential negative effects even within positive relationships, and the multiple influence theory underscores the complex interplay of family subsystems. This three-level meta-analysis addresses these inconsistencies by (1) examining associations between three family relationship types (parent-child, marital, sibling) and children’s mental health (depression, anxiety, well-being), (2) quantifying their relative impacts via relative weight analysis, and (3) exploring moderating effects of gender ratio, developmental stage, cultural background, and family relationship informants.
The analysis synthesized findings from 312 studies (2010~2023), comprising 320 independent samples (N = 427,585). Three-level meta-analytic models revealed significant associations between family relationships and children's mental health outcomes. Positive family relationships showed negative correlations with depression (parent-child: r = -.30, 95%CI = [-.35, -.28]; marital: r = -.18, 95%CI = [-.34, -.01]; sibling: r = -.15, 95%CI = [-.21, -.09]) and anxiety (parent-child: r = -.22, 95%CI = [-.29, -.17]; marital: r = -.21, 95%CI = [-.36, -.08]), while demonstrating positive correlations with well-being (parent-child: r = .41, 95%CI = [.38, .49]). Negative family relationships exhibited opposite patterns, showing positive correlations with depression (parent-child: r = .30, 95%CI = [.27, .34]; marital: r = .30, 95%CI = [.27, .35]; sibling: r = .26, 95%CI = [.13, .40]) and anxiety (parent-child: r = .33, 95%CI = [.27, .42]; marital: r = .27, 95%CI = [.18, .36]), and negative correlations with well-being (parent-child: r = -.19, 95%CI = [-.37, -.02]; marital: r = -.29, 95%CI = [-.37, -.22]). Relative weight analysis revealed that parent-child relationships contributed the most variance to depression (positive: 68.86%; negative: 35.32%) and anxiety (positive: 53.11%; negative: 63.04%), followed by marital relationships (depression-positive: 17.78%, depression-negative: 34.94%; anxiety-positive: 46.89%, anxiety-negative: 36.96%), and sibling relationships (depression-positive: 13.36%, depression-negative: 29.72%). However, for well-being, marital relationships demonstrated stronger effects than parent-child relationships, with negative marital relationships explaining 75.51% of the variance compared to 24.49% for negative parent-child relationships. Moderator analyses identified significant effects of cultural background, and relationship reporters. Associations were consistently stronger in collectivistic cultures than in individualistic cultures. Children-reported marital conflict showed stronger associations with depression compared to parental-reported. Gender ratio and developmental stage showed no significant moderating effects, suggesting the universality of these family relationship impacts across gender and age groups.
This study provides robust support for protective theory by demonstrating that positive family relationships correlate with better mental health outcomes in children, whereas negative relationships show stronger associations with elevated risks of depression and anxiety. Relative weight analysis revealed differential correlational strengths across subsystems: parent-child relationships exhibited the strongest correlations with depression and anxiety, consistent with their proximal “developmental cornerstone” role, while negative marital relationships demonstrated a stronger inverse correlation with well-being compared to negative parent-child relationships, underscoring the unique salience of marital dynamics in emotional climate formation. Cultural context and family relationship informants significantly moderated these associations: collectivistic cultures showed stronger correlations overall, and child-reported marital conflict correlated more strongly with depression than parental reports. These patterns align with multiple influence theories, advocating for interventions that prioritize culturally attuned parent-child support programs and marital conflict resolution strategies to target subsystem-specific correlations.

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children / family relationships / mental health / three-level meta-analysis / relative weight analysis

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Zhao Chengjia, Huang Xiaoxiao, Yu Guoliang. The Relationship between Family Relationships and Children's Mental Health: A Three-Level Meta-Analysis[J]. Journal of Psychological Science. 2025, 48(6): 1481-1496 https://doi.org/10.16719/j.cnki.1671-6981.20250616

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