Factors promoting mental health in children of parents with mental health problems: Results of the BELLA cohort study.

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Mental health problems in parents represent a well-established risk factor for a wide variety of maladaptive cognitive, psychosocial, and behavioral outcomes in their children. More than half of these children develop psychiatric disorders in childhood or adolescence constituting a risk for psychiatric disorders being two to three times higher than in the total population. Furthermore, children of parents with mental health problems rate their health-related quality of life significantly worse than do children from the general population. However, not all children exposed to parental mental health problems develop psychiatric disorders later in life, and some of these children function better than expected, given the level of exposure to risk factors they have experienced. Recent findings suggest that personal resources such as the cognitive and social capabilities of the youth, as well as positive family relationships and social support, act as protective factors for children of parents with mental health problems. In order to develop specific support programs for this high-risk group, protective factors, especially those that can be influenced by therapeutic or preventive interventions, should be studied in greater detail. The aim of the present study therefore was to identify factors associated with good mental health and good health-related quality of life in children of parents with mental health problems. We examined the data of N = 165 parents with mental health problems and their children aged 13-17 years from the fourth measurement point of the BELLA study (the mental health module of the German National Health Interview and Examination Survey for children and adolescents). Parental mental health problems were measured using the SCL-K 9, children’s mental health and health-related quality of life were measured using the SDQ and the KIDSCREEN-10, respectively. Furthermore, personal resources (self-efficacy, optimism, social competence), familial resources (family climate, parental support), and social resources (social support, school climate) were assessed. All data were self-reported. Multiple linear regressions demonstrated that a combination of personal, familial, and social resources predicted both good mental health and health-related quality of life. More specifically, good mental health of the children was predicted by social competence, parental support, and school climate. Good health-related quality of life was predicted by self-efficacy, optimism, family climate, and school climate. The combination of personal, familial, and social resources positively influences the mental health and health-related quality of life of children with parents with mental health problems. School climate proved to be an important factor promoting both mental health and health-related quality of life. This finding supports the hypothesis that particularly resources outside of the family are important for children of parents with mental health problems. These results provide valuable information for preventive and therapeutic interventions for children of parents with mental health problems.