Al Ali, Areej; (2021) The impact of family's physical health on a child's mental health: Findings from the Millennium Cohort Study. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Chronic physical illness of parents and children is highly prevalent worldwide, has a large impact on families and can contribute to a child’s emotional and behavioural problems. This PhD thesis has three aims: (1) to determine whether selected chronic physical illnesses in families during early childhood (age 3) are associated with children’s mental health at ages 5-14; (2) to investigate the potential pathways through which these associations may function; and (3) to identify trajectories in children’s mental health between ages 3-14. This thesis used longitudinal data from the UK Millennium Cohort Study, following children from age 3-14 years. Multivariable linear regression analysis examined the long-term effect of growing up in households with physical health stressors, including asthma, obesity, and chronic illness of a parent, on children’s mental health, across the childhood-adolescence period. Structural equation modelling tested the family stress model to explore potential mediating pathways linking family chronic illness to adolescents’ adverse mental health outcomes. Using growth mixture models, different trajectories of mental health status between age 3 -14 were explored. A multinomial logistic regression model examined physical health predictors for group membership. Mothers’ chronic illness and childhood asthma at age 3 were associated with worse mental health at age 5-14 in both sexes. Consistent with the family stress model, the effect of these two factors’ on adolescents’ mental health were mediated by maternal mental health, family dysfunction and child self-esteem. Regarding trajectories of mental health scores between ages 3-14, asthmatic children and those of chronically ill mothers tended to have a significant change in pattern of their mental health trajectories over time, compared to those without such conditions. Evidence presented suggests that public health prevention and interventional strategies targeting family and child physical health in the UK can have long-term benefits in improving children’s mental health.

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