803708

research-article2018
HPQ0010.1177/1359105318803708Journal of Health PsychologyLi et al.

Article

Journal of Health Psychology

The longitudinal associations among

2021, Vol. 26(1) 140­–155
© The Author(s) 2018
Article reuse guidelines:
grandparent–grandchild cohesion, sagepub.com/journals-permissions
DOI: 10.1177/1359105318803708
https://doi.org/10.1177/1359105318803708
cultural beliefs about adversity, and journals.sagepub.com/home/hpq

depression in Chinese rural left-

behind children

Qianyu Li, Wenxin Zhang and Jingxin Zhao

Abstract
This study examined the effects of grandparent–grandchild cohesion on the cross-lagged associations
between depression and cultural beliefs about adversity in a sample of 625 rural left-behind children in China.
Grandparent–grandchild cohesion was concurrently and longitudinally associated with children’s depression
and cultural beliefs about adversity. Cultural beliefs about adversity mediated the associations between
grandparent–grandchild cohesion and children’s depression, while depression mediated the associations
between grandparent–grandchild cohesion and children’s beliefs about adversity. Left-behind status
differences were also found in mediation models. These findings suggest the important role of grandparent–
grandchild cohesion in left-behind children’s adjustment.

Keywords
Chinese cultural beliefs about adversity, depression, grandparent–grandchild cohesion, left-behind children,
longitudinal study

Introduction families, 44 percent of them have been left in

With China’s rapid industrialization and urbani-
zation over the past 30 years, a massive surplus
of rural labors have migrated to cities to earn a
living. As a result of the large scale of rural-to-
urban migration, millions of children aged
17 years or younger have been left in their rural
hometowns by one or both migrant parents.
According to data from the Chinese sixth
national census in 2010, the number of left-
behind children has reached 61,025,500, which
accounts for 21.88 percent of all children in
China (National Bureau of Statistics of China,
2011). Among these left-behind children,
70 percent of them have been left in the care of
their grandparent(s) in both-parent-migrant
the care of grandparent(s) in father-migrant
families, and 50 percent of them have been left
in the care of grandparent(s) in mother-migrant
families (All-China Women’s Federation,
2013). Under these circumstances, grandpar-
ents may play a key role in left-behind chil-
dren’s development in rural China (Zhao et al.,
2015). However, the majority of existing
Shandong Normal University, P.R. China
Corresponding author:
Jingxin Zhao, School of Psychology, Shandong Normal
University, No.88 East Wenhua Road, Jinan 250014, P.R.
China.
Email: jingxinzhao@126.com
Li et al. 141
studies paid scant attention to the impact of
grandparents on left-behind children’s develop-
ment. Considering the potential unique roles of
grandparents in left-behind children’s lives, the
main purpose of this study was to investigate
the grandparent–grandchild relationship in left-
behind children’s psychosocial adjustment in
rural China.
Grandparent–grandchild cohesion can be
defined as the intimate emotional bond between
a child and his or her grandparents, which is
reflected in the feelings of closeness or positive
interactions within the grandparent–grandchild
system (Zhang and Fuligni, 2006; Zhao et al.,
2016). As one of the positive aspects of the
grandparent–grandchild relationship, grandpar-
ent–grandchild cohesion has been proved to
play important roles in reducing children’s
depression (Lussier et al., 2002; Ruiz and
Silverstein, 2007). For left-behind children who
lack parental care, the emotional bond between
a child and his or her grandparents may serve as
a potential protective factor against left-behind
children’s depression (Zhao et al., 2016).
Although the relations between grandpar-
ent–grandchild cohesion and depression among
left-behind children are important to under-
stand, so are the potential mechanisms that
account for these relations. Chinese cultural
beliefs about adversity, which refers to concepts
about the nature of adversity, such as its causes,
consequences, and proper coping behaviors
(Shek, 2005), might play a significant role in
these relations. Grandparent–grandchild cohe-
sion can provide grandparents with more oppor-
tunities to transmit positive cultural values and
life beliefs to their grandchildren and strengthen
the children’s endorsement of positive cultural
beliefs about adversity, which may contribute to
less depression in the children. However, these
relations might operate in the opposite direc-
tion. The children who experience depressive
symptoms might endorse negative cultural
beliefs about adversity because of their cogni-
tive deficits. To better understand the associa-
tions among grandparent–grandchild cohesion,
Chinese cultural beliefs about adversity, and
depression among left-behind children, this
study used longitudinal data to examine two
mediation models: the associations between
grandparent–grandchild cohesion and depres-
sion via Chinese cultural beliefs about adversity
and the associations between grandparent–
grandchild cohesion and Chinese cultural
beliefs about adversity via depression.
Grandparent–grandchild cohesion and
depression
Parental absence, as a consequence of parents’
rural-to-urban migrations, often has substantial
detrimental effects on children’s depression (He
et al., 2012; Wu et al., 2015; Yin et al., 2017). In
recent years, many studies have reported high
prevalence rates of depression among left-
behind children in China (Cheng and Sun,
2015; He et al., 2012; Wu et al., 2015) and dem-
onstrated that left-behind children were at
greater risk for developing depression than non-
left-behind children (Liang et al., 2017; Wang
et al., 2015; Wu et al., 2015; Zhao et al., 2015).
In addition, attachment theory posits that pro-
longed separations from parents are likely to
spark emotional distress, because these separa-
tions disrupt a child’ s access to his or her pri-
mary attachment figures as havens of safety and
security in times of distress, leading to prob-
lems with emotion distress, such as depression
(Bowlby, 1977). Considering the harmful
effects of depression on children’s normal
development (Birmaher et al., 2002; Günther
et al., 2004; Yu et al., 2018), identifying the pro-
tective factors that may buffer against left-
behind children’s depression is critical.
Grandparents often serve as a positive influ-
ence in their grandchildren’s emotional adapta-
tion (Attar-Schwartz et al., 2009; Lussier et al.,
2002; Ruiz and Silverstein, 2007). In the con-
text of parental absence, grandparents may
compensate for parents’ physical and emotional
unavailability by providing emotional support
and supervision, encouraging academic suc-
cess, discussing appropriate behaviors, and
helping children with homework (Dunifon,
2013). From a family solidarity approach
(Bengtson and Roberts, 1991), affectual
142 Journal of Health Psychology 26(1)
solidarity or cohesion can promote the quality
of interactions between grandchildren and
grandparents and have a positive impact on the
development of each. Consequently, grandpar-
ent–grandchild cohesion may protect their left-
behind grandchildren from depression.
Indeed, empirical evidence shows associa-
tions between grandparent–grandchildren cohe-
sion and children’s depression. For example,
closeness with grandparents was associated
with lower levels of depression (Lussier et al.,
2002). Ruiz and Silverstein (2007) also found
that cohesion with grandparents was negatively
associated with depressive symptoms, particu-
larly among grandchildren whose families were
absent a parent. Similarly, in a sample of left-
behind children in rural China, grandparent–
grandchild cohesion was negatively associated
with left-behind children’s depression (Zhao
et al., 2016). Although evidence exists for asso-
ciations between grandparent–grandchild cohe-
sion and children’s depression, the majority of
studies are cross-sectional, and few studies
have linked grandparent–grandchild cohesion
to depression among left-behind children. This
study aims to move beyond previous research
by considering the associations over time with a
sample of left-behind children.
Grandparent–grandchild cohesion
and Chinese cultural beliefs about
adversity
As previously mentioned, Chinese cultural
beliefs about adversity can influence how peo-
ple perceive, experience, and approach adversi-
ties in life and supply a person with the cognitive
resources to cope with adversity (Lee et al.,
2010). Shek (2005) classified Chinese cultural
beliefs about adversity into two categories: pos-
itive beliefs about adversity, which emphasize
the positive value of adversity and people’s
ability to overcome adversity, and negative
beliefs about adversity, which emphasize the
negative impact of adversity and people’s ina-
bility to change adversity. Positive cultural
beliefs about adversity play an important role
for one’s values and behaviors, especially
among children who face adversity in life. In
migrant families, left-behind children who
endorse positive cultural beliefs about adversity
may build optimism and hope against the
adverse conditions of parental absence. Thus,
positive Chinese cultural beliefs about adver-
sity may be an important protective factor for
left-behind children’s psychosocial adjustment.
Chinese tend to adopt positive cultural val-
ues of adversity, rooted in Confucian thoughts,
with inner strengths and virtues (e.g. persever-
ance; Shek, 2005). Grandparents—as sources
of stability, wisdom, and family identity in fam-
ilies—often act as transmitters of traditional
values, cultural beliefs, and customs (Wiscott
and Kopera-Fyre, 2000). In rural China’s
migrant families, grandparents can provide a
resource for their left-behind grandchildren to
cope successfully with life’s stresses by trans-
mitting a positive outlook on life, positive val-
ues about the meaning of adversity, and norms
to cope with difficulties (Zhao et al., 2016). In
this respect, closeness with grandparents may
exert significant influences in shaping left-
behind children’s cultural beliefs about adver-
sity. Thus, grandparent–grandchild cohesion is
expected to improve positive beliefs about
adversity among left-behind children.
To the best of our knowledge, no study has
examined the associations between grandpar-
ent–grandchild cohesion and cultural beliefs
about adversity among Chinese children.
Although some studies have investigated the
influence of grandparents on their grandchil-
dren’s general belief system (e.g. religious
beliefs, political beliefs), few studies have
directly linked grandparent–grandchild cohe-
sion to Chinese cultural beliefs about adversity,
especially among left-behind children.
However, encouraging evidence was obtained
in a cross-sectional study of left-behind chil-
dren. In this study, caregivers’ support was pos-
itively associated with cultural beliefs about
adversity, suggesting that social support from
grandparents may have a positive impact in
shaping children’s cultural beliefs about adver-
sity (Zhang et al., 2014). This study extends the
literature by examining the associations
Li et al. 143
between grandparent–grandchild cohesion and
Chinese cultural beliefs about adversity over
time in a sample of left-behind children.
Chinese cultural beliefs about
adversity and depression
Chinese cultural beliefs about adversity may
exert protective effects on children’s emotional
adjustment (Shek, 2005). Individuals with
stronger endorsements of positive cultural
beliefs about adversity tend to act positively
when faced with stress, difficulties, and chal-
lenges, which may contribute to better emo-
tional adjustment (Leung and Shek, 2013). In
contrast, individuals with negative cultural
beliefs about adversity may have a sense of
learned helplessness, which may contribute to
cognitive interference, motivational deficit, and
affective reaction (e.g. depression; Leung and
Shek, 2013). Indeed, empirical support exists
for the linkage between Chinese cultural beliefs
about adversity and children’s emotional adjust-
ment. A series of studies (Shek, 2004, 2005;
Shek et al., 2003) found that positive Chinese
beliefs about adversity were associated with
children’s well-being. Researchers also found
that positive cultural beliefs about adversity
were negatively associated with loneliness
among left-behind children in rural China
(Zhang et al., 2014; Zhao et al., 2013). However,
most of the research on Chinese cultural beliefs
about adversity and emotional adjustment has
been cross-sectional, and few studies have
linked Chinese cultural beliefs about adversity
to depression in a sample of left-behind chil-
dren. Thus, longitudinal research is needed to
fill this gap and explore these relationships over
time among left-behind children.
Although some studies have been done on the
links between Chinese cultural beliefs about
adversity and depression, these relations might
operate in the opposite direction. The children
who experience depression may be withdrawn
and depleted of cognitive and emotional
resources (Davis et al., 2016), leading them to
endorse negative Chinese cultural beliefs about
adversity. To our knowledge, no research
examines depression predicting Chinese cultural
beliefs about adversity among left-behind chil-
dren. Thus, this study extends this work among
left-behind children to examine the directionality
of Chinese cultural beliefs about adversity and
depression, and associations between grandpar-
ent–grandchild cohesion and Chinese cultural
beliefs about adversity via depression over time.
Potential left-behind status differences
In addition to examining the relations among
grandparent–grandchild cohesion, Chinese cul-
tural beliefs about adversity, and depression,
potential moderating variables in these relations
should be considered. In rural China, both-par-
ent-migrant families and father-migrant fami-
lies are common patterns for migrant families
(Zhao et al., 2015, 2017b). Previous research
has demonstrated the differences in depression
between left-behind children with a migrant
father and children with two migrant parents.
Specifically, children with two migrant parents
may be more prone to report depressive symp-
toms compared to those with only a migrant
father (Wang et al., 2011; Zhao et al., 2015,
2016). Moreover, left-behind status differences
in Chinese cultural beliefs about adversity have
also been documented. Previous research has
demonstrated that left-behind children in both-
parent-migrant families endorse weaker posi-
tive cultural beliefs about adversity than
children in father-migrant families (Zhao et al.,
2017a). Because children with a migrant father
and children with two migrant parents may dif-
fer in depression and Chinese cultural beliefs
about adversity, left-behind status differences
were examined in the longitudinal associations
among grandparent–grandchild cohesion,
Chinese cultural beliefs about adversity, and
depression.
This study
This study’s purpose was to examine the effects
of grandparent–grandchild cohesion on the
cross-lagged associations between cultural
beliefs about adversity and depression in
144 Journal of Health Psychology 26(1)
Chinese rural left-behind children. We had three
aims. The first was to examine the effects of
grandparent–grandchild cohesion on children’s
Chinese cultural beliefs about adversity and
depression. It was hypothesized that grandpar-
ent–grandchild cohesion would directly and
negatively associate with depression at Time 1
(T1) and Time 2 (T2, 6 months later; Hypothesis
1) and would directly and positively associate
with Chinese cultural beliefs about adversity at
both times (Hypothesis 2). The second aim was
to examine dynamic associations between
Chinese cultural beliefs about adversity and
depression among left-behind children using
cross-lagged models. We hypothesized bidirec-
tional effects, with positive Chinese cultural
beliefs about adversity at T1 prospectively pre-
dicting left-behind children’s depression at T2
and children’s depression at T1 predicting
Chinese cultural beliefs about adversity at T2
(Hypothesis 3). The third aim was to examine
how perceived cohesion with grandparents was
associated with left-behind children’s cultural
beliefs about adversity and depression using
two short-term longitudinal mediation models.
It was hypothesized that Chinese cultural
beliefs about adversity at T1 would serve as a
mediator in the effect of grandparent–grand-
child cohesion at T1 on depression at T2
(Hypothesis 4) and depression at T1 would
mediate the effect of grandparent–grandchild
cohesion on Chinese cultural beliefs about
adversity at T2 (Hypothesis 5). In addition, con-
sidering the potential differences in these asso-
ciations between children with two migrant
parents and those with a migrant father, varia-
tions in our mediation models according to left-
behind status were also examined.
Method
Participants
The first wave of the study was conducted in
June 2015 (T1) and included participants from
three junior high schools in two rural countries
of Shandong Province, which is a Chinese
region with a large migration population. A
sample of 677 left-behind children (55.1%
male, Mage = 15.82, SD = 0.88, age range 14–
19 years old) from families with migrant
parent(s) participated at T1. In all 628 children
(53.7% male) also took part in the follow-up
assessment (T2) 6 months later. Of participants
who provided data at both times, three children
with incomplete questionnaires were excluded.
In addition, considering that only 23 left-behind
children from migrant-mother families were
included in the initial sample, they were eventu-
ally excluded from the final sample. Thus, the
final sample for analysis consisted of 625 left-
behind children from two-parent families,
including 185 children (102 male and 83
female) from both-parent-migrant/grandparents
caregiver families and 440 children (233 male
and 207 female) from father-migrant/mother
and grandparents caregiver families. The eth-
nicity of all participants was Han, and all par-
ticipants were Chinese-language speaking.
None of the adolescents had a physical or intel-
lectual handicap.
Among the left-behind children with two
migrant parents, 85.32 percent of the fathers
and 89.68 percent of the mothers had an educa-
tional level of junior high school or below; oth-
ers had an educational level of high school to
college or higher. For employment, most of the
fathers were unskilled laborers while the
majority of the mothers were housewives and
casual workers. Among the left-behind chil-
dren with migrant fathers, 89.31 percent of the
fathers and 91.80 percent of the mothers had an
educational level of junior high school or
below; others had an educational level of high
school to college or higher. Most of the fathers
were unskilled laborers, while the mothers
were largely housewives.
Procedures
The study has been approved by the Institutional
Review Board of Shandong Normal University.
With the help of school administrators, informed
consent forms were distributed to all participants
and their parents or guardians. Graduate students
in psychology provided verbal instructions in
Li et al. 145
addition to the written instructions that accompa-
nied the questionnaires. The students were
informed that there were no right or wrong
answers. Then, they were asked to finish the
questionnaires alone and to not discuss their
answers with others. Six months after the first
assessment, students were asked to participate
for a second time.
To check for selective attrition, scores were
compared on the variables of grandparent–
grandchild cohesion, Chinese cultural beliefs
about adversity, and depression at T1 for par-
ticipants who participated at both time points
against participants who participated only at
T1. According to t tests, no differences were
found for study variables (ps > 0.05), indicating
that selective attrition played no significant role
in subsequent findings.
Measures
Perceived cohesion with grandparents.  The chil-
dren’s perception of cohesion with their grand-
parents was measured using the cohesion
subscale of the Family Adaptation and Cohe-
sion Evaluation Scale (FACES) II Inventory
(Olson et al., 1979) at T1. The cohesion sub-
scale consisted of 10 items (e.g. “He or She and
I feel very close to each other”). Each item was
scored on a 5-point scale ranging from 1
(“almost never”) to 5 (“almost always”).
Responses were averaged to produce a measure
of children’s cohesion with their grandparents,
with a higher score indicative of a higher level
of grandparent–grandchild cohesion. The scale
has been used in previous research on children’s
family relationships (Zhang and Fuligni, 2006;
Zhao et al., 2016) and has been proven reliable
and valid in Chinese samples. The internal reli-
ability for the scale was 0.68 in this study.
Depression. Children’s depression was meas-
ured by the Chinese version of the Children’s
Depression Inventory (CDI; Kovacs, 1992; Yu
and Li, 2000) at both T1 and T2. Each of the 27
items provided three alternative responses
describing depressive states from normal to
severely clinical. Each participant was asked to
choose the one that best described him or her in
the past 2 weeks. The items reflected a given
thought, feeling, or behavior associated with
depression. Responses were averaged to pro-
duce a measure of children’s depression, with a
higher score indicative of greater depression.
The scale has been proven to be reliable and
valid in Chinese children (He et al., 2012; Wu
et al., 2015). In this study, internal reliabilities
for the CDI across the two times were 0.83 and
0.85.
Chinese cultural beliefs about adversity.  The chil-
dren’s beliefs about adversity were measured
by the Chinese Beliefs about Adversity Scale
(CBAS) developed by Shek (2005) at both T1
and T2. The CBAS included nine items focused
on beliefs about adversity in the context of the
Chinese culture. For instance, “Chi de ku zhong
ku, fang wei ren shang ren” (hardship increase
stature). Each item was scored on a 6-point
scale ranging from 1 (“strongly disagree”) to 6
(“strongly agree”). The average response scores
were calculated, with higher scores indicating
higher degrees of agreement with positive Chi-
nese beliefs about adversity. The scale has been
proven to be reliable and valid in Chinese chil-
dren in previous studies (e.g. Shek, 2004, 2005;
Zhao et al., 2013). In this study, internal relia-
bilities across the two times were 0.63 and 0.65.
Additional covariates. The participants were
asked to provide data on their sex, age, and
family socioeconomic status (SES), which were
included as covariates in analyses. Family SES
included perceived economic stress (Current
Economic Stress Scale: CESS; Shek, 2003) and
parent’s education (elementary school or below,
middle school, high school, college, undergrad-
uate, or higher). The CESS consisted of four
items (e.g. “in the past six months, has your
family had inadequate money to cope with fam-
ily expenses?”). Each item was scored on a
4-point scale ranging from 1 (“never”) to 4
(“always”). The scale has been proven to be
reliable and valid in Chinese children (Shek,
2003). In this study, the internal reliability for
the CESS was 0.61. Responses to the CESS and
146 Journal of Health Psychology 26(1)

Table 1.  Means, standard deviations, and intercorrelations of study variables.

Variable 1 2 3 4 5
1. Grandparent–grandchild cohesion (T1) – – – – –
2. Cultural beliefs about adversity (T1) 0.33*** – − − −
3. Cultural beliefs about adversity (T2) 0.25*** 0.52*** – − −
4. Depression (T1) –0.37*** –0.29*** –0.28*** – −
5. Depression (T2) –0.30*** –0.27*** –0.33*** 0.69*** –
M 3.57 4.91 5.01 1.35 1.36
SD 0.55 0.59 0.60 0.23 0.24

T1: Time 1; T2: Time 2.

*p < 0.05.
**p < 0.01.
***p < 0.001.

parent’s education were summed to produce a
measure of family SES (Zhao et al., 2017a),
with a higher score indicative of a higher level
of family SES.
Analysis plan
The analyses were conducted in the following
steps. First, correlational analyses were conducted
to describe the bivariate associations between the
study variables. Second, two direct models were
conducted to examine the associations between
grandparent–grandchild cohesion and depression
and associations between grandparent–grandchild
cohesion and Chinese cultural beliefs about adver-
sity at two different time points. Third, a cross-
lagged model was estimated for Chinese cultural
beliefs about adversity and depression to examine
Hypotheses 3. Fourth, grandparent–grandchild
cohesion was added as a predictor in the cross-
lagged model to examine Hypotheses 4 and 5. In
this model, Chinese cultural beliefs about adver-
sity and depression at both times were predicted
by grandparent–grandchild cohesion. The indirect
paths were also estimated to test the extent to
which Chinese cultural beliefs about adversity
mediated the effects of grandparent–grandchild
cohesion on children’s depression at T2 and the
extent to which children’s depression mediated
the effects of grandparent–grandchild cohesion on
Chinese cultural beliefs about adversity at T2. In
addition, to test whether the paths differed across
both-parent-migrant group and the father-migrant
group, multi-group analysis and Wald tests were
conducted to compare all the modeled pathways
across left-behind status in mediation models. All
models controlled for child sex, age, and family
SES.
Models were estimated using Mplus version
7 (Muthén and Muthén, 2010). Mediation anal-
yses were performed with a maximum likeli-
hood (ML) estimator and bias-corrected
bootstrapped 95  percent confidence intervals
(CIs; b = 1000). The models’ goodness-of-fit
was evaluated according to chi-square test, the
comparative fit index (CFI), the root-mean-
square error of approximation (RMSEA) and
the standardized root mean square residual
(SRMR).
To effectively use all available data, missing
data were addressed using the full information
ML estimation. In this study, the percentage of
missing data across all variables ranged from
0 percent to 0.01 percent. Little’s test of missing
completely at random (MCAR) indicated that
the data were MCAR (χ2(5) = 10.43, p > 0.05).
Results
Preliminary analyses
Means, standard deviation, and intercorrelations
among grandparent–grandchild cohesion at T1
and Chinese cultural beliefs about adversity and
depression at both time points are presented at
Table 1. As shown, grandparent–grandchild
Li et al. 147
Figure 1.  A cross-lagged model of Chinese cultural beliefs about adversity and depression at T1 and T2.
Paths are presented as standardized estimates. Control variables include child sex, age, and family SES.
*p < 0.05.
**p < 0.01.
***p < 0.001.
cohesion at T1 was negatively correlated with
left-behind children’s depression at both times.
Chinese cultural beliefs about adversity were
also negatively correlated with left-behind chil-
dren’s depression at both T1 and T2 and between
T1 and T2. Grandparent–grandchild cohesion at
T1 was positively correlated with left-behind
children’s Chinese cultural beliefs about adver-
sity at both times.
Direct models
Two separate direct models were conducted to
investigate the effects of grandparent–grand-
child cohesion on Chinese cultural beliefs
about adversity and depression at two times.
Given that the model had zero degrees of free-
dom, the model fit was perfect. The results
indicated that grandparent–grandchild cohe-
sion was directly and negatively associated
with depression at T1 (β = −0.33, p < 0.001)
and T2 (β = −0.26, p < 0.001) and positively
associated with cultural beliefs about adversity
at two times (β = 0.31, p < 0.001; β = 0.22,
p < 0.001). The first model accounted for
18.6 percent and 14.9 percent of the variance in
T1 depression and T2 depression, respectively.
The second model accounted for 13.4 percent
and 7.8 percent of the variance in T1 and T2
cultural beliefs about adversity, respectively.
Cross-lagged models
A cross-lagged path analysis was conducted to
investigate the reciprocal associations between
cultural beliefs about adversity and depression
at two times. Given that the model had zero
degrees of freedom, the model fit was perfect.
As illustrated in Figure 1, T1 cultural beliefs
about adversity negatively predicted T2 depres-
sion (β = −0.07, p < 0.01), and T1 depression
negatively predicted T2 cultural beliefs about
adversity (β = −0.13, p < 0.001), indicating that
positive cultural beliefs about adversity led to a
decrease in subsequent depression over time
while depression led to a decrease in subse-
quent positive cultural beliefs about adversity.
The model accounted for 29.2 percent of the
variance in T2 cultural beliefs about adversity
and 49.0 percent in T2 depression.
Mediation analyses
In the next step, grandparent–grandchild cohe-
sion was added as a predictor into the previous
cross-lagged model. To distinguish between
148 Journal of Health Psychology 26(1)

Figure 2.  A mediation model for the associations among grandparent–grandchild cohesion, cultural
beliefs about adversity, and depression at T1 and T2. Paths are presented as standardized estimates.
Control variables include child sex, age, and family SES.
*p < 0.05.
**p < 0.01.
***p < 0.001.

partial and full mediation, we have included
the direct paths from grandparent–grandchild
cohesion to cultural beliefs about adversity,
and depression at both times in the mediation
model. This model was saturated and has a per-
fect fit. However, the direct paths from grand-
parent–grandchild cohesion to T2 cultural
beliefs about adversity and T2 depression were
not significant (ps > 0.05). Hence, following
the procedure outlined by Ouellette and
Sénéchal (2017), an alternative model was
respecified by deleting two nonsignificant
direct paths from the saturated model. The
alternative model fit the data well,
RMSEA = 0.00, CFI = 1.00, SRMR = 0.01.
Next, the alternative model was tested against
this saturated model to determine whether the
alternative model under consideration provided
as reasonable a fit to the data. To do so, the chi-
square difference test was used, and found that
the alternative model was not significantly dif-
ferent from the saturated model, χ2(2,
N = 625) = 1.71, p = 0.43, which shows that the
alternative model provides as good a fit to the
data as does the best-fitting saturated model.
Importantly, the alternative model is more par-
simonious (i.e. it has fewer paths) than the sat-
urated model and, as such, is preferred (Figure 2
depicts the standardized parameter estimates
for the mediation model). As the results (see
Figure 2) indicated, first, analyses of the medi-
ation model did not change the results of the
cross-lagged analyses (the autoregressive paths
and the reciprocal paths remained significant).
Second, a significant direct path emerged from
grandparent–grandchild cohesion to T1 cul-
tural beliefs about adversity (β = 0.31,
p < 0.001) and T1 depression (β = −0.33,
p < 0.001). Third, the results showed that the
indirect path from grandparent–grandchild
cohesion on T2 depression via T1 cultural
beliefs about adversity was significant (indirect
effect = −0.02, 95% CI = (−0.041, −0.001),
p < 0.05), indicating that T1 cultural beliefs
about adversity mediated the effect of grand-
parent–grandchild cohesion on T2 depression.
In addition, the indirect path from grandpar-
ent–grandchild cohesion on T2 cultural beliefs
about adversity via T1 depression was signifi-
cant (indirect effect = 0.04, 95% CI = (0.017,
0.070), p <  0.01), which indicated that T1
depression mediated the effect of grandparent–
grandchild cohesion on T2 cultural beliefs
about adversity. The model explained 29.2 per-
cent of the variance in T2 cultural beliefs about
adversity and 49.0 percent in T2 depression.
Li et al. 149
Figure 3.  A mediation model, with standardized coefficients in father-migrant group outside of
parentheses and standardized coefficients in both-parent-migrant group inside of parentheses. Control
variables include child sex, age, and family SES.
*p < 0.05.
**p < 0.01.
***p < 0.001.
Additional analyses
Multigroup analysis was conducted to compare
pathways in the mediation model across the
both-parent-migrant and the father-migrant
groups (see Figure 3). We compared the first
model, which allows the structural paths to vary
across left-behind status, with the second
model, which constrains the paths across left-
behind status to equal. The unconstrained model
(χ2(4, N = 625) = 2.58, p = 0.63, RMSEA = 0.00,
CFI = 1.00, SRMR = 0.01) and the constrained
model (χ2(8, N = 625) = 13.47, p = 0.10,
RMSEA = 0.05, CFI = 0.99, SRMR = 0.03) fit
the data well. A significant difference was found
between the both-parent-migrant and the father-
migrant groups, Δχ2(4, N = 625) = 10.89,
p < 0.05. Further tests were conducted using
Wald tests of parameter constraints to identify
the source of the difference in each path. The
results indicated that the path from grandpar-
ent–grandchild cohesion to T1 Chinese cultural
beliefs about adversity differed significantly
across groups, W(1) = 4.50, p < 0.05, indicating
that grandparent–grandchild cohesion might
have a stronger positive effect on children’s cul-
tural beliefs about adversity in the both-parent-
migrant group (β = 0.41, p < 0.001) compared
to the father-migrant group (β = 0.26, p < 0.001).
In addition, the path from T1 depression to T2
cultural beliefs about adversity differed signifi-
cantly across groups, W(1) = 6.39, p < 0.05.
Although the link between T1 depression and
T2 Chinese cultural beliefs about adversity was
negative and significant in the father-migrant
group (β = −0.19, p < 0.001), the link in the
both-parent-migrant group was not significant
(β = 0.01, p > 0.05). Moreover, the results indi-
cated that the path from grandparent–grand-
child cohesion to T2 Chinese beliefs about
adversity via T1 depression differed signifi-
cantly across groups, W(1) = 5.68, p < 0.05.
Specifically, T1 depression mediated the effect
of grandparent–grandchild cohesion on T2 cul-
tural beliefs about adversity (β = 0.06, 95%
CI = (0.030, 0.094)) in the father-migrant group,
while the mediated paths were not significant in
the both-parent-migrant group (β = −0.004,
95% CI = (−0.050, 0.043)).
Discussion
The protective roles of grandparent–grandchild
cohesion in the development of left-behind
children should be understood to develop
150 Journal of Health Psychology 26(1)
effective intervention programs to improve
these children’s psychological adjustment in
rural China. This study aimed to contribute to
the existing research on perceived cohesion
with grandparents and children’s psychosocial
adjustment by examining the associations
between grandparent–grandchild cohesion and
depression and to consider the role of Chinese
cultural beliefs about adversity across 6 months
among children left behind by both of their
rural-to-urban migrant parents compared to
those with only a migrant father. The findings
revealed complex relationships among grand-
parent–grandchild cohesion, cultural beliefs
about adversity, and depression in Chinese rural
left-behind children.
The present results indicated that grandpar-
ent–grandchild cohesion was directly and nega-
tively associated with depression at both times.
These findings confirm and extend the prior
research that demonstrates simultaneous cross-
sectional associations between grandparent–
grandchild cohesion and left-behind children’s
depression (Zhao et al., 2016). These results
suggest that grandparent–grandchild cohesion
has both an immediate and a long-term effect in
lessening left-behind children’s depression.
Under the vulnerable context of parental
absence, if children have grandparents who are
close to them and in whom they can confide,
grandparents may be more prone to provide
critical emotional and instrumental support
with left-behind children who are experiencing
depression (Zhao et al., 2016). Left-behind chil-
dren can also benefit from the high level of
cohesion with their grandparents. This explana-
tion is consistent with intergenerational solidar-
ity theory (Bengtson and Roberts, 1991), which
states that positive affectual solidarity and
cohesion with grandparents may positively
influence children’s development. Thus, grand-
parent–grandchild cohesion may serve as a pro-
tective factor against depression in Chinese
left-behind children.
As hypothesized, grandparent–grandchild
cohesion was also found to be concurrently and
longitudinally associated with left-behind chil-
dren’s positive cultural beliefs about adversity.
These findings partially support the notion that
interactions among family members in different
generations prompt the construction and devel-
opment of values, attitudes, and beliefs that
bind multigenerational family members
together (Bengtson and Roberts, 1991). In tra-
ditional Chinese families, grandparents often
provide wisdom, advice, knowledge, and com-
fort to the young (Luo and Zhan, 2012). As cul-
ture keepers in families (Wiscott and
Kopera-Fyre, 2000), grandparents are responsi-
ble for the transmission of cultural beliefs to
their left-behind grandchildren. High-quality
grandparent–grandchild relationships may pro-
vide grandparents more opportunities to teach
their grandchildren about essential Chinese
inner strength and virtues when facing adver-
sity, such as forbearance, perseverance, and
self-discipline. Consequently, grandparent–
grandchild cohesion may play an influential
role in shaping left-behind children’s cultural
beliefs about adversity.
In line with Hypothesis 3, the results indi-
cated significant reciprocal associations
between positive cultural beliefs about adver-
sity and depression among left-behind chil-
dren. First, Chinese cultural beliefs about
adversity negatively predicted left-behind
children’s subsequent depression. These find-
ings are consistent with previous evidence that
cultural beliefs can decrease the emotional
pain associated with negative emotions and
supply people with the cognitive resources
that give a sense of control over life (Shek,
2005). In the vulnerable environment of paren-
tal absence, left-behind children who endorse
positive cultural beliefs about adversity may
think positively about themselves, their par-
ent’s migration, and the future, thereby
contributing to less depression. Similarly, pre-
dictive effects of depression on left-behind
children’s cultural beliefs about adversity were
found, reflecting the fact that left-behind chil-
dren who experience depression may debili-
tate emotional and cognitive resources (Davis
et al., 2016), ultimately leading to weaker
identification of positive cultural beliefs about
adversity.
Li et al. 151
Another research question was to examine
the mediating mechanism through which
Chinese cultural beliefs about adversity medi-
ated the effects of grandparent–grandchild
cohesion on left-behind children’s depression
and the extent to which children’s depression
mediated the effects of grandparent–grandchild
cohesion on Chinese cultural beliefs about
adversity. The present results demonstrated,
first, that the effect of grandparent–grandchild
cohesion on the left-behind children’s subse-
quent depression was mediated via Chinese cul-
tural beliefs about adversity (Hypothesis 4).
These results partially support and extend
recent studies in rural China that demonstrate
that the effect of grandparent–grandchild cohe-
sion on left-behind children’s depression was
mediated via cognitive appraisals for left-
behind hassles (Zhao et al., 2016). Grandparents
may transmit positive cultural values and
beliefs about adversity to left-behind children
through interactions and communications,
which supply children with cognitive resources
and then reduce their depressive symptom.
Second, the effect of grandparent–grandchild
cohesion on the left-behind children’s subse-
quent Chinese cultural beliefs about adversity
was also mediated via depression (see
Hypothesis 5). These findings not only support
the associations between grandparent–grand-
child cohesion and left-behind children’ depres-
sion in rural China (Zhao et al., 2016) but also
extend the previous research by demonstrating
a process through which left-behind children’s
cultural beliefs about adversity is positively
affected by grandparent–grandchild cohesion.
In migrant families, grandparents may play a
parent-like role by providing immediate emo-
tional support, comfort, and guidance for their
left-behind grandchildren to effectively over-
come depressive moods, which contributes to a
strong endorsement of positive cultural beliefs
about adversity.
Left-behind status differences
The results also indicated significant moderat-
ing effects of left-behind status on the relations
among grandparent–grandchild cohesion,
Chinese cultural beliefs about adversity, and
depression. First, the link between grandpar-
ent–grandchild cohesion and cultural beliefs
about adversity were different across the both-
parent-migrant and the father-migrant groups.
As demonstrated, grandparent–grandchild
cohesion was particularly beneficial for improv-
ing the endorsement of positive cultural beliefs
about adversity among children with two
migrant parents than children with only a
migrant father. This benefit is possibly because
the role of grandparents is different in both-par-
ent-migrant families and father-migrant fami-
lies (Zhao et al., 2016). In both-parent-migrant
families, grandparents play a primary caregiv-
ing role by serving as functional substitutes for
parents. They have more opportunities to inter-
act with their grandchildren to transmit positive
values and beliefs about adversity (Zhao et al.,
2016). However, grandparents may play merely
an auxiliary role in father-migrant families.
Children with a migrant father can benefit from
both grandparents and mothers staying with
them at home (Zhao et al., 2016). Taken
together, these findings highlight the influential
role of grandparent–grandchild cohesion in
shaping positive cultural beliefs about adversity
for left-behind children in adapting to the vul-
nerable situation of parental absence, especially
for left-behind children with two migrant
parents.
Second, the link between depression and
Chinese cultural beliefs about adversity also
appeared to be different across two groups.
Children’s depression significantly predicted
subsequent Chinese cultural beliefs about
adversity in the father-migrant group but not in
the both-parent-migrant group. The precise
mechanisms underlying these findings are not
clear. One possible explanation is that left-
behind children with two migrant parents, to a
certain degree, are immune to some emotional
distress. Due to the detrimental influence of
both parents’ absence in life, children with two
migrant parents may suffer the most among
left-behind children (Zhao et al., 2015).
However, as two parents’ migration recedes in
152 Journal of Health Psychology 26(1)
time, left-behind children may adapt them-
selves to the family environment with both par-
ents’ absence, become immune to the existing
difficulties and problems, or both, leading to
depression’s weakened impact on them (Li
et al., 2020). With regard to children from
father-migrant families, they may encounter
less difficulty than children with two migrant
parents (Zhao et al., 2016), which maintains the
functionality of depression in debilitating chil-
dren’s cognitive resources (Davis et al., 2016).
Future research is clearly needed to further
explore why the predictive effects of depression
on left-behind children’s cultural beliefs about
adversity are different among children with two
migrant parents compared to those with only a
migrant father.
Third, the results indicated that indirect
effects from grandparent–grandchild cohesion
to children’s Chinese cultural beliefs about
adversity via depression were only for children
with a migrant father but not children with two
migrant parents. These findings are possibly
because in both-parent-migrant families, the
majority of caregivers of left-behind children
are elders who seem to face numerous chal-
lenges including less energy, health concerns,
poor supervision, insufficient knowledge about
modern parenting practices, and a generation
gap (Dolbin-Macnab, 2006; Dunifon, 2013;
Fan et al., 2010; Wang and Wang, 2005). They
may be unfamiliar with childhood issues such
as depression, anxiety and conduct disorder,
school violence, and peer pressure (Dunifon,
2013). Consequently, old grandparents find it
challenging to parent a left-behind child with
emotional and behavioral problems, especially
for old grandparents in rural areas in China.
However, grandparents play merely an auxil-
iary role in father-migrant families: they often
provide childcare assistance to the children’s
mothers who stay at home to support and super-
vise their left-behind children. Left-behind chil-
dren can benefit from warm relationships with
both grandparents and mothers. When left-
behind children experience depression, grand-
parents and mothers may find their children’s
emotional problems in time and provide
immediate emotional support as well as coping
skills to cope with depressive mood (Zhao
et al., 2016). Left-behind children with
decreased depression then endorse the positive
cultural beliefs about adversity transmitted by
grandparents and mothers. This explanation is
consistent with previous research indicating
that multiple sources of social support can help
people successfully manage stressful life events
and improve their psychosocial well-being (Ai
and Hu, 2016; Ciarrochi et al., 2017; Helsen
et al., 2000; Li et al., 2020). Overall, these pat-
terns demonstrated that the protective mecha-
nisms of grandparent–grandchild cohesion on
left-behind children’s development varied
across the left-behind status.
Limitations and future directions
This study has some limitations. First, this
study was correlational, and we cannot draw
causal conclusions. Although two waves of lon-
gitudinal data were used to test temporal asso-
ciations, some associations were still examined
concurrently. Future research should further
explore the directionality of the associations
among these constructions of interest by using
multiple time points of measurement for all key
variables in the model. Second, we only used
data from two rural countries in Shandong
province with a nonrandomized sampling
method, so the generalizability of the findings
to left-behind children from other communities
also needs to be investigated. Third, all meas-
ures of the key variables were self-reported;
self-presentation biases and common-method
biases might influence the associations between
the variables. Future studies might benefit from
the collection of data from multiple reporters
(e.g. grandparents or parents) to account for
these potential biases. Fourth, this study did not
diagnose or screen depression in the samples at
baseline. Considering that grandparent–grand-
child cohesion may exert different influences
on children with depressive disorders and chil-
dren with depressive symptoms, future work
should discern subgroups of children with
depression to further clarify the mechanism of
Li et al. 153
grandparent–grandchild cohesion on left-
behind children’s development. Finally, left-
behind children from mother-migrant/father
caregiver families were excluded in these anal-
yses because mother-only migration was not a
typical type of migrant family. However, previ-
ous research has found that, compared to two-
parent migration and father-only migration,
mother-only migration has a more detrimental
effect on children’s development (Wen and Lin,
2012). Thus, future research should examine
the effects of grandparent–grandchild cohesion
on children’s development in this type of
family.
Despite these limitations, this study makes
an important contribution to the existing
research and has essential practical implica-
tions. First, to our knowledge, this is the first
longitudinal study to describe the associations
among grandparent–grandchild cohesion, cul-
tural beliefs about adversity and depression in
Chinese rural left-behind children, which
advance a better understanding of the protective
mechanism of grandparent–grandchild cohe-
sion on left-behind children’s well-being.
Second, grandparent–grandchild cohesion pre-
dicted left-behind children’s depression and
their cultural beliefs about adversity, while
reciprocal relations existed between cultural
beliefs about adversity and depression. These
findings suggest that facilitating positive inter-
actions and closeness between grandparents
and left-behind children may be effective in
promoting emotional and cognitive adaptation
among children from migrant families. In addi-
tion, encouraging left-behind children to
endorse positive Chinese cultural beliefs about
adversity may be helpful in mitigating their
depression. The reduction of children’s depres-
sion is beneficial to improving their endorse-
ment of positive cultural beliefs about adversity,
especially for left-behind children with a
migrant father. Finally, this study demonstrates
that the protective effects of grandparent–
grandchild cohesion on left-behind children are
different among children with a migrant father
and those with two migrant parents, which indi-
cates that left-behind children are not a
homogeneous population (Zhao et al., 2015).
Future research is necessary to investigate the
differentiated protective mechanisms of left-
behind children’s adjustment.
Acknowledgements
We are grateful to all the children, parents, and teach-
ers who participated or contributed to this project.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of inter-
est with respect to the research, authorship, and/or
publication of this article.
Funding
The author(s) disclosed receipt of the following
financial support for the research, authorship, and/or
publication of this article: This study was supported
by the National Project for Educational Sciences
Planning in China (Grant number: Project No.
CBA130126).
ORCID iD
Jingxin Zhao https://orcid.org/0000-0003-3140
-8845
References
Ai H and Hu J (2016) Psychological resilience mod-
erates the impact of social support on loneliness
of “left-behind” children. Journal of Health
Psychology 21(6): 1066–1073.
All-China Women’s Federation (2013) China’s
rural left-behind children, rural and urban
migrant children research report. Available at:
http://www.china.com.cn/news/txt/2013-05/18/
content_28862083.htm
Attar-Schwartz S, Tan J, Buchanan A, et al. (2009)
Grandparenting and adolescent adjustment in
two-parent biological, lone-parent, and step-fam-
ilies. Journal of Family Psychology 23: 67–75.
Bengtson VL and Roberts REL (1991)
Intergenerational solidarity in aging families:
An example of formal theory construction.
Journal of Marriage and Family 53: 856–870.
Birmaher B, Arbelaez C and Brent D (2002) Course
and outcome of child and adolescent major
depressive disorder. Child and Adolescent
Psychiatric Clinics of North America 11(3):
619–637.
154 Journal of Health Psychology 26(1)
Bowlby J (1977) The making and breaking of affec-
tional bonds. I. Aetiology and psychopathology
in the light of attachment theory. British Journal
of Psychiatry 130: 201–210.
Cheng J and Sun YH (2015) Depression and anxi-
ety among left-behind children in China: A
systematic review. Child: Care, Health and
Development 41(4): 515–523.
Ciarrochi J, Morin AJS, Sahdra BK, et al. (2017)
A longitudinal person-centered perspective on
youth social support: Relations with psycho-
logical wellbeing. Developmental Psychology
53(6): 1154–1169.
Davis AN, Carlo G, Schwartz SJ, et al. (2016) The
longitudinal associations between discrimi-
nation, depressive symptoms, and prosocial
behaviors in U.S. Latino/a recent immigrant
adolescents. Journal of Youth and Adolescence
45(3): 457–470.
Dolbin-Macnab M (2006) Just like raising your
own? Grandmothers’ perceptions of parenting
a second time around. Family Relations 55(5):
564–575.
Dunifon R (2013) The influence of grandparents
on the lives of children and adolescents. Child
Development Perspectives 7(1): 55–60.
Fan F, Su L, Gill MK, et al. (2010) Emotional
and behavioral problems of Chinese left-
behind children: A preliminary study. Social
Psychiatry and Psychiatric Epidemiology 45:
655–664.
Günther T, Holtkamp K, Jolles J, et al. (2004) Verbal
memory and aspects of attentional control in
children and adolescents with anxiety disorders
or depressive disorders. Journal of Affective
Disorders 82(2): 265–269.
He B, Fan J, Liu N, et al. (2012) Depression risk of
“left-behind children” in rural China. Psychiatry
Research 200: 306–312.
Helsen M, Vollebergh W and Meeus W (2000) Social
support from parents and friends and emotional
problems in adolescence. Journal of Youth and
Adolescence 29: 319–335.
Kovacs M (1992) Children’s Depression Inventory
Manual. North Tonawanda, NY: Multi-Health
Systems Inc.
Lee TY, Kwong WM, Cheung CK, et al. (2010)
Children’s resilience-related beliefs as a pre-
dictor of positive child development in the face
of adversities: Implications for interventions
to enhance children’s quality of life. Social
Indicators Research 95: 437–453.
Leung JTY and Shek DTL (2013) Psychometric
properties of the Chinese cultural beliefs about
adversity scale. Research on Social Work
Practice 23(3): 326–335.
Li C, Jiang S and Fang X (2020) Effects of multi-
dimensional social capital on mental health
of children in poverty: An empirical study in
mainland China. Journal of Health Psychology
25(6): 853–867.
Li C, Yin X and Jiang S (2020) Effects of multidi-
mensional child poverty on children’s mental
health in mainland China. Journal of Health
Psychology 25(3): 400–415.
Liang Y, Wang L and Rui G (2017) Depression
among left-behind children in China. Journal of
Health Psychology 22(14): 1897–1905.
Luo B and Zhan H (2012) Filial piety and functional
support: Understanding intergenerational soli-
darity among families with migrated children in
rural China. Ageing International 37(1): 69–92.
Lussier G, Deater-Deckard K, Dunn J, et al. (2002)
Support across two generations: Children’s
closeness to grandparents following paren-
tal divorce and remarriage. Journal of Family
Psychology 16(3): 363–376.
Muthén LK and Muthén BO (2010) Mplus User’s
Guide (6th edn). Los Angeles, CA: Muthén &
Muthén.
National Bureau of Statistics of China (2011)
National Bureau of Statistics of People’s
Republic of China on major figures of the 2010
population census. Available at: http://www.
chinadaily.com.cn/china/2011-04/28/con-
tent_12415526.htm
Olson DH, Sprenkle DH and Russell CS (1979)
Circumplex model of marital and family sys-
tems: Cohesion and adaptability dimensions,
family types, and applications. Family Process
18: 3–28.
Ouellette G and Sénéchal M (2017) Invented spell-
ing in kindergarten as a predictor of reading
and spelling in Grade 1: A new pathway to
literacy, or just the same road, less known?
Developmental Psychology 53: 77–88.
Ruiz SA and Silverstein M (2007) Relationships
with grandparents and the emotional well-being
of late adolescent and young adult grandchil-
dren. Journal of Social Issues 63(4): 793–808.
Shek DTL (2003) Economic stress, psychological
well-being and problem behavior in Chinese
adolescents with economic disadvantage.
Journal of Youth and Adolescence 32: 259–266.
Li et al. 155
Shek DTL (2004) Chinese cultural beliefs about
adversity: Its relationship to psychological
well-being, school adjustment and problem behav-
ior in Hong Kong adolescents with and without
economic disadvantage. Childhood 11: 63–80.
Shek DTL (2005) A longitudinal study of Chinese
cultural beliefs about adversity, psychological
well-being, delinquency and substance abuse in
Chinese adolescents with economic disadvan-
tage. Social Indicators Research 71: 385–409.
Shek DTL, Tang V, Lam C, et al. (2003) The rela-
tionship between Chinese cultural beliefs about
adversity and psychological adjustment in
Chinese families with economic disadvantage.
American Journal of Family Therapy 31(5):
427–443.
Wang D and Wang L (2005) A research on the
related factors of the mental health of parent-
absent middle school students. Psychological
Science 28(2): 477–479(in Chinese).
Wang L, Feng Z, Yang G, et al. (2015) The epide-
miological characteristics of depressive symp-
toms in the left-behind children and adolescents
of Chongqing in China. Journal of Affective
Disorders 177: 36–41.
Wang X, Hu X and Shen J (2011) Affection of
left-behind children’s friendship quality on
loneliness and depression. Chinese Journal of
Clinical Psychology 19: 252–254(in Chinese).
Wen M and Lin D (2012) Child Development in rural
China: Children left behind by their migrant
parents and children of nonmigrant families.
Child Development 83: 120–136.
Wiscott R and Kopera-Fyre K (2000) Sharing of cul-
ture: Adult grandchildren’s perceptions of inter-
generational relations. International Journal of
Aging and Human Development 51(3): 199–
215.
Wu YL, Zhao X, Ding XX, et al. (2015) A pro-
spective study of psychological resilience and
depression among left-behind children in China.
Journal of Health Psychology 22(5): 627–636.
Yin X, Li C and Jiang S (2017) The mediating
effect of self-esteem on the relationship of
living environment, anxiety, and depression of
underprivileged children: A path analysis in
Chinese context. Journal of Health Psychology.
Epub ahead of print 1 November. DOI:
10.1177/1359105317739966.
Yu DW and Li X (2000) Children’s depression inven-
tory: The application in China. Chinese Journal
of Mental Health 4: 225–227(in Chinese).
Yu R, Branje S, Meeus W, et al. (2018) Victimization
mediates the longitudinal association between
depressive symptoms and violent behaviors
in adolescence. Journal of Abnormal Child
Psychology 46: 839–848.
Zhang L, Wang Q and Zhao J (2014) Caregiver’s
support, beliefs about adversity and loneliness
in rural left-behind children. Chinese Journal
of Clinical Psychology 22(2): 350–353(in
Chinese).
Zhang W and Fuligni AJ (2006) Authority, auton-
omy, and family relationships among ado-
lescents in urban and rural China. Journal of
Research on Adolescence 16: 527–537.
Zhao J, Liu X and Wang M (2015) Parent-child
cohesion, friend companionship and left-behind
children’s emotional adaptation in rural china.
Child Abuse & Neglect 48: 190–199.
Zhao J, Liu X and Zhang W (2013) Peer rejection,
peer acceptance and psychological adjustment
of left-behind children: The roles of parental
cohesion and children’s cultural beliefs about
adversity. Acta Psychologica Sinica 45(7):
797–810(in Chinese).
Zhao J, Luan F, Sun P, et al. (2017a) Parental cohe-
sion, beliefs about adversity and left-behind
children’s positive /negative emotion in
rural China. Psychological Development and
Education 33(4): 441–448(in Chinese).
Zhao J, Sun P, Wang M, et al. (2017b) Left-behind
adolescents’ hopes and fears for the future in
rural China. Journal of Adolescence 63: 64–74.
Zhao J, Zhang T and Lin L (2016) Grandparent-
grandchild cohesion and depression in left-
behind children: The mediating role of
cognitive appraisals for left-behind hassles.
Chinese Journal of Clinical Psychology 24(6):
1092–1097(in Chinese).