Daughters-in-law Help Reduce Depression Among Chinese Elders, But Help From Own Kids Can Increase Depression, Study Finds

"The inability to secure assistance from children may induce depression not only because needs are likely to go unmet but because the absence of such support may induce feelings of helplessness and strain intergenerational relations," says Zhen Cong, who received her Ph.D. in May 2008 from the USC Davis School of Gerontology.

Cong and Professor Merril Silverstein of the USC Davis School of Gerontology were intrigued by earlier findings showing that intergenerational support, particularly hands-on care, had inconsistent effects on the psychological well-being of Chinese elders.

"Unlike emotional and financial support, instrumental support—in spite of its apparent cultural and practical significance—has shown inconsistent effects on the psychological well-being," Silverstein explains.

Cong and Silverstein looked at rural Anhui province, where rates of depression are twice that of their urban counterparts (though still much lower than in the West). They found that "instrumental support" – such as personal care and household chores – had a positive effect on well-being, depending on who was providing the service.

When women shared a home with their in-laws, their presence and support was particularly beneficial to the psychological well-being of older mothers. Daughters-in-law provided the overwhelming majority of personal care for older women in a household, the researchers found.

However, household support and personal care from sons was particularly damaging and increased depressive symptoms, according to the study, appearing in the August 2008 issue of the Journal of Marriage and Family.

Similarly, mothers who received an increase in household support from daughters-in-law had fewer depressive symptoms, while those who experienced an increase in household support from their own daughters had more depressive symptoms.

"A general pattern emerged that supported the prolific and meaningful contributions of daughters-in-law in the support systems of older people in rural China," Silverstein says.

The study confirms prior research by Silverstein and others showing that perceived appropriateness of support is often more important to subjective well being than the support itself.

As Cong explains: "Aversion to household support from daughters and sons was sufficiently strong among older mothers and fathers to cause negative psychological outcomes, affirming the adverse emotional consequences that result when traditional expectations are violated."

The researchers note that almost two-thirds of the older population in China lives in rural areas, making it the largest concentration of older adults in the world.

"Our results suggest that attachment to traditional expectations for support may make elders more depressed in such a rapidly changing society as China," says Cong. "Elders will be psychologically disadvantaged unless they contemporize their expectations to match the changing social realities of Chinese society.

The research was supported by a grant from the Fogarty International Center of the National Institutes of Health.