Parent–Child Relationship Quality and Youth Mental Health In Zambia: Buffering the Effects of Neighborhood Risk

Background and Purpose

Parent–child relationship quality is a key determinant of youth well-being, shaping emotional development and mental health across diverse contexts. In low-income urban settings, children are exposed to poverty-related environmental risks, including neighborhood violence and safety instability, which may heighten vulnerability to psychological distress. In these contexts, parent–child relationships may play a critical role in buffering mental health difficulties. This study examined the association between parent–child relationship quality and mental health symptoms among Zambian youth, and explored whether relationship quality buffers the negative effects of neighborhood risk exposure on mental health.

Methods

Data were drawn from a school-based sample of 140 children (ages 9 -15, grade 5) in high-risk neighborhoods in Lusaka, Zambia. Participants completed child and parent reported measures of mental health and parent–child relationship quality. Relationship quality was assessed using the Child–Parent Relationship Scale (closeness α = .79; conflict α = .74) and a child-reported parental closeness scale adapted from the WHO Global School-Based Student Health Survey (α = .85). Depression and anxiety symptoms were measured using the Patient Health Questionnaire-9 (α = .74) and the Generalized Anxiety Disorder-7 scale (α = .83), and psychosocial distress using the Pediatric Symptom Checklist (α = .81). Neighborhood risk was assessed using the Child Exposure to Community Violence Checklist. Multiple linear regression examined associations between relationship quality and mental health outcomes, controlling for age, gender, socioeconomic status, family type, and orphanhood; moderation was tested using interaction terms.

Results

The sample had a mean age of 12.2 years (SD = 1.16), and 55% were female; 21.6% of children were identified by caregivers as having significant psychosocial impairment on the Pediatric Symptom Checklist. In multivariate analyses, parent–child conflict was positively associated with psychosocial distress (b = .15, p < .001), and neighborhood risk predicted higher levels of depression and anxiety. Parent–child relationship variables were not significantly associated with depression or anxiety in adjusted models. Moderation analyses indicated that child-reported caregiver closeness buffered the association between neighborhood risk and both depression (b = −.43, p < .05) and anxiety (b = −.42, p < .05). Family type was the only significant demographic predictor (b = .30, p < .05), with children from non–two-parent households reporting higher anxiety.

Conclusions and Implications

Findings suggest that parent–child relationships shape youth mental health through both risk and protective pathways in this sample. While relationship conflict was associated with greater psychosocial distress, supportive caregiver relationships buffered the effects of neighborhood risk on mental health. This underscores the need for interventions that integrate relational supports alongside efforts to address environmental risks. Future research can examine larger, more diverse samples with culturally grounded measures to better understand how family relationships shape children's mental health.