Association between parental visitation and depressive symptoms among institutionalized children in Japan: a cross-sectional study

• Published in: BMC psychiatry Vol. 19; no. 1; p. 129
• Main Authors: Yazawa, Aki, Takada, Saeko, Suzuki, Hanako, Fujisawa, Takashi X, Tomoda, Akemi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.04.2019; BioMed Central; BMC
• Subjects: Adolescent; Attachment; Babies; Behavior; Care and treatment; Caregivers; Child; Child & adolescent psychiatry; Child abuse & neglect; Child care; Child development; Child health; Child maltreatment; Child, Institutionalized - psychology; Childhood depression; Childhood mental disorders; Children; Children & youth; Communication; Cross-Sectional Studies; Depression (Mood disorder); Depression - diagnosis; Depression - epidemiology; Depression - psychology; Depressive symptoms; Families & family life; Family; Female; Foster care; Health; Health psychology; Humans; Institutionalization; Institutionalized children; Japan - epidemiology; Male; Mental depression; Mental disorders; Mental Health; Parent-child relations; Parental visitation; Parenting; Parents & parenting; Parents - psychology; Pediatric research; Personal relationships; Psychiatric patients; Psychiatry; Psychological aspects; Questionnaires; Regression analysis; Social aspects; Social support; Surveys and Questionnaires; Teenagers; Visitors to Patients - psychology; Japan; New York; United States > US; Depressive symptoms; Attachment; Child maltreatment; Institutionalized children; Parental visitation
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-019-2111-x

Mental health problems are an important issue among institutionalized children. Although positive communication with parents is essential for children's well-being, it has not been sufficiently verified how interactions with parents affect mental health among institutionalized children, who have experienced childhood adversity and likely lack secure attachment formation with their parents. The objectives of this study were to investigate the association between parental visitation and depressive symptoms among institutionalized children in Japan, and to explore whether the established security of attachment interacts with that association. A cross-sectional data from 399 institutionalized children aged 9 to 18 in Japan was used for the analysis. A mixed effects regression analysis was conducted to investigate the associations. Institutionalized children who had parental visitation showed higher depressive symptoms than those who did not. In particular, father's visitations were significantly associated with higher depressive symptoms. There was a significant interaction with score of secure attachment; children with low scores on secure attachment showed higher levels of depression with their father's visitation, whereas children with high scores on secure attachment did not. Findings suggested that parental visitation and the frequency of visitation were not actually associated with better psychological status, but that instead, father's visitations were associated with higher depressive symptoms among institutionalized children. It should be noted that our cross-sectional results cannot infer any causal relationship and do not emphasize that parental visitation should be avoided. However, it may be important to conduct careful assessment before starting parental visitation, especially when children seem to have problems with attachment formation.