Pathways from parent mental health to child outcomes in Liberia: Testing cross-sectional and longitudinal serial mediation models

Children in humanitarian settings face complex adversities that impact development. The interplay of caregiver mental health, couples' relationship quality, and parenting practices can both protect against adversity and contribute to it. The purpose of the study was to examine whether caregiver depressive symptoms are associated with increased couples' distress, in turn predicting fewer positive parent-child interactions and then worse child emotional and behavioral outcomes. This study took place in four urban settlements in Monrovia, Liberia. Participants (N ​= 569) included parents or caregivers of children three- or four-years-old. Using structural equation modeling, the serial mediation pathway from depressive symptoms to child outcomes through couples' distress and reduced positive parent-child interactions was tested cross-sectionally and longitudinally across three time points. In the cross-sectional model, two statistically significant, but very small, indirect effects were found: 1) a serial mediation from parent depressive symptoms to child problems through increased couples' distress and reduced positive parent-child interactions and 2) a specific mediation effect through couples’ distress. The longitudinal model yielded null direct and indirect effects. These mixed results suggest that, while these processes may be related, the specific pathways linking these family indicators are not well understood, especially over time and in humanitarian settings.