The mediating role of childhood emotional neglect in the association between childhood neighborhood quality and adult depression outcomes: A nationwide longitudinal analysis

Background: Depression is a prevalent mental health disorder with personal and societal costs. Childhood experiences, including neighborhood quality and emotional neglect, may influence adult depression risk. Objective: To examine the relationships between childhood neighborhood quality (CNQ), childhood emotional neglect (CEN), and adult depressive symptoms, and investigate the potential mediating role of CEN. Participants and setting: 15,730 Chinese adults aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS). Methods: Weighted multiple regression, Karlson-Holm-Breen (KHB) mediation and Bootstrap mediation analyses were conducted to assess the relationships between CNQ, CEN, and adult depressive symptoms and depression risk, using longitudinal data. Results: Higher CNQ was associated with lower depressive symptoms (beta = -0.316, p < 0.001) and depression risk (beta = -0.084, p < 0.001). Higher CEN was associated with increased depressive symptoms (beta = 0.084, p < 0.01) and depression risk (beta = 0.020, p > 0.05). CEN partially mediated the relationship between CNQ and depressive symptoms (KHB: beta = -0.010, p <0.01; Bootstrap: beta = -0.007, p < 0.05) and depression risk (KHB: beta = -0.003, p < 0.05; Bootstrap: beta = -0.002, p > 0.05), accounting for 3.50 % (KHB) and 2.36 % (bootstrap) of the total effects for depressive symptoms, and 3.82 % (KHB) and 1.97 % (bootstrap) for depression risk. Conclusions: Both CNQ and CEN independently influence adult depression, with CEN partially mediating the CNQ-depression relationship. These findings suggest that interventions targeting both neighborhood conditions and family environments may be crucial for preventing adult depression.