Abstract
OBJECTIVES: To exploratorily examine whether parental rearing styles mediate the association between parental mental health and children's anxiety tendencies and to explore whether these associations differ between local urban and rural-to-urban migrant children in China. DESIGN: Cross-sectional survey. SETTING: Two primary schools in Hangzhou, eastern China: one primarily serving rural-to-urban migrant children and one serving local urban children. PARTICIPANTS: A total of 929 children in grades 4-6 and 1273 parents participated. Inclusion criteria were parental consent and child assent; exclusion criteria were inability to complete questionnaires. PRIMARY AND SECONDARY OUTCOME MEASURES: Children's mental health was assessed using the Mental Health Test; parental anxiety and depression were measured with the Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9. Parental rearing styles were assessed with the Egna Minnen Beträffande Uppfostran and the Hereford Parents' Attitudes Survey. Mediation and structural equation modelling were applied to test associations. RESULTS: In exploratory analyses, maternal anxiety was significantly associated with children's self-blaming and sensitivity tendencies. Parental rearing styles, particularly overprotection and emotional warmth, mediated the relationship between maternal anxiety and children's mental health outcomes. Mediation effects were stronger among urban children compared with migrant children. CONCLUSIONS: Our results indicate that maternal anxiety is associated with children's mental health, with parental rearing styles acting as mediators. Although the cross-sectional and exploratory nature limits causal inference, the findings suggest that interventions addressing both parental mental health and rearing practices may be helpful in promoting children's mental well-being, particularly in migrant populations. Further longitudinal research is needed to clarify these pathways and to understand how contextual factors shape parent-child dynamics.