Associations between Parental Relationship Quality and Internalizing or Externalizing Problems among Children: A Cross-Sectional Study
Kailun Zhang, Xuanshu Wang, Xiwen Wang, Yaqin Liu, Tingyue Wan, Weijie Gong, Ruoqing ChenBackground:
Positive family interactions are vital for child development, yet the impact of parental relationship quality at different stages on child behaviors remains unclear. The study aims to investigate the associations between parental relationship quality at ages five and nine and internalizing and externalizing problems at age nine.
Methods:
The study included 671 children from the Future of Families and Child Wellbeing Study (FFCWS). Parental relationship quality was measured using a three-item scale adapted from the Marital Instability Index and classified as poor, moderate, or good. Child internalizing and externalizing problems were assessed using the Child Behavior Checklist (CBCL/6-18). Multivariable logistic regression was used to assess the associations. Inverse probability weighting (IPW) was applied to mitigate potential selection bias and assess the robustness of the findings.
Results:
After adjusting for potential confounders, per unit decrease in mother-reported parental relationship quality at age five was associated with increased risks of both internalizing (odds ratio [OR]: 1.27, 95% confidence interval [CI]: 1.03-1.56) and externalizing problems (OR: 1.26, 95% CI: 1.04-1.52). At age nine, poor mother-reported parental relationship quality was associated with a higher risk of internalizing problems (OR: 4.50, 95% CI: 1.61-12.58), while a dose-response relationship based on both paternal and maternal reports was observed for externalizing problems. These results remained robust in models using IPW. Deterioration in relationship quality from ages five to nine was associated with higher risks of both behavioral problems. Stratified analyses suggested that these associations may vary by child sex and parental marital status.
Conclusions:
Poor and deteriorating parental relationship quality are associated with increased risks of internalizing and externalizing problems in children, with patterns differing by developmental stage and reporter. These findings highlight the importance of supportive interparental relationships for child behavioral health.