Maternal cognitive and affective empathy related to preschoolers' emotional-behavioral problems: moderation of maternal depression

Zichen Zhang; Yujiao Deng; Tingyu Rong; Yiding Gui; Yunting Zhang; Jin Zhao; Wenjie Shan; Qi Zhu; Guanghai Wang; Fan Jiang

doi:10.1038/s41390-024-03770-8

Maternal cognitive and affective empathy related to preschoolers' emotional-behavioral problems: moderation of maternal depression

Pediatr Res. 2024 Dec 30. doi: 10.1038/s41390-024-03770-8. Online ahead of print.

Authors

Zichen Zhang^#^{1

2

3}, Yujiao Deng^#⁴, Tingyu Rong^{1

2

3}, Yiding Gui^{1

2

3}, Yunting Zhang⁵, Jin Zhao^{1

5}, Wenjie Shan⁶, Qi Zhu², Guanghai Wang^{7

8

9

10}, Fan Jiang^{11

12

13

14}

Affiliations

¹ Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁴ Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Child Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁶ Department of International Clinic, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁷ Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [email protected].
⁸ Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [email protected].
⁹ MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [email protected].
¹⁰ Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China. [email protected].
¹¹ Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [email protected].
¹² Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [email protected].
¹³ MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [email protected].
¹⁴ Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China. [email protected].

^# Contributed equally.

PMID: 39738563
DOI: 10.1038/s41390-024-03770-8

Abstract

Background: Low maternal cognitive empathy and higher affective empathy have been linked to increased emotional-behavioral problems (EBPs) in young children, but it remains unclear whether the associations are distinct according to maternal depression. This study aims to explore the moderating role of maternal depression in the association between maternal empathy and EBPs in preschoolers.

Methods: Cross-sectional and representative data were from 19,965 Chinese preschoolers. Maternal cognitive and affective empathy and depression were evaluated with Questionnaire of Cognitive and Affective Empathy and World Health Organization Five Well-Being Index, respectively. The Strengths and Difficulties Questionnaire was used to assess child EBPs.

Results: Lower maternal cognitive empathy was associated with increased child EBPs (aOR: 0.97, 95% CI: 0.96-0.97) with moderation of maternal depression (p = 0.002), and was slightly stronger in mothers at low risk for depression (aOR: 0.96, 95% CI: 0.95-0.97). Higher maternal affective empathy was associated with increased child EBPs (aOR: 1.03, 95% CI: 1.02-1.04), without significant moderation (p = 0.79).

Conclusions: Lower maternal cognitive empathy and higher affective empathy were associated with more EBPs in preschoolers. Maternal depression moderated only the cognitive empathy-EBPs association. Tailored strategies targeting maternal empathy according to various depression levels should be considered in clinical practices.

Impact: We found lower maternal cognitive empathy and higher maternal affective empathy were associated with more emotional-behavioral problems (EBPs) in a large-scale and representative sample of preschoolers in Shanghai. We demonstrated the moderating role of maternal depression in the association between maternal cognitive empathy and EBPs in preschoolers, with the association being slightly stronger in mothers at low risk for depression than in mothers with depressive symptoms. The study highlights that, aside from maternal depression, promoting interventions on inappropriate maternal empathy may confer significant benefits on the psychological well-being of preschool children.