How do parent-child interactions impact children’s mental health and prosocial development?

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Ioannis Katsantonis,  a PhD candidate in Psychology and Education at the University of Cambridge, shares his research on the role parent-child interactions have on children’s mental health.

Inspiration for the study and significance

This study was inspired by the changing nature of the relationship between mental health and prosociality and the role of parent-child interactions in this association.

Although scholars know that having a warm and consistent parenting style is predictive of better child adjustment (e.g. Katsantonis & Symonds and Bayer et al.), there is little evidence on whether the quality of the parent-child relationships in early childhood is predictive of the stable traits of mental health and prosociality from early childhood to late adolescence after removing any situational/contextual influences (e.g., income, or intergenerational transmission of mental health). Particularly, there was less evidence on how parent-child interactions predicted whether children will build a ‘personality’ trait of being kind, helpful, and compassionate.

What is prosociality?

Prosociality is something that is generally considered highly sought after in most societies. Prosocial behaviour or prosociality is defined as voluntary behaviour that aims to benefit another person [1] by caring, showing empathy, and offering psychological and/or physical assistance.

What is internalising mental health symptoms?

Internalising mental health symptoms is a broad ‘umbrella’ term to describe covert behaviours and over-restrictive patterns of reactions. Common examples of internalising symptoms in the general population of children include emotional symptoms (e.g., being unhappy or downhearted) and peer problems (e.g., being socially withdrawn, having few friends).

How are externalising mental health symptoms defined?

Externalising mental health symptoms is another ‘umbrella’ term used to describe overt behavioural difficulties. In the general child population, common types of externalizing difficulties include hyperactivity (e.g., being restless or fidgety) and conduct problems (e.g., bullying other children or having temper tantrums) (see Katsantonis & Symonds and Goodman et al.).


To address the research question of how children’s mental health and prosociality were related over time, data from the nationally representative Millennium Cohort Study were utilised. Access to the data was obtained from the UK Data Service. Multiple waves of data from the Millennium Cohort Study were used and, specifically, data at ages 5, 7, 11, 14, and 17 years were utilised in the present research study. Children’s data were merged over time, so that I had the exact same children that participated at least once across waves.

The parents of the children filled in the standardised and validated Strengths and Difficulties Questionnaire (SDQ), which comprises questions about children’s internalising and externalising mental health, as well as children’s prosocial behaviours.

The SDQ provided information on children’s emotional symptoms (i.e., being unhappy or suffering from headaches), peer problems (i.e., social relationships difficulties), conduct problems (e.g., socially inappropriate behaviour), and hyperactivity (e.g., being restless or overactive). The summed score of peer problems and emotional symptoms was the internalising mental health score, whereas the summed score of the conduct problems and hyperactivity was the externalising score. As part of the SDQ prosocial scale, parents reported also on their children’s kindness and being helpful.

To analyse the data, I used a model called Trait-State-Occasion (TSO) [2] to look at how children’s mental health and prosociality change over time. I and my co-author wanted to understand the influence of parent-child relationships on these changes.

The TSO model helped me to predict how the way parents and children interact (like arguments, closeness, or mistreatment) affects the more consistent, long-term aspects of children’s mental health and prosociality. The TSO model also allowed us to estimate how children’s internalising and externalising mental health symptoms were related to their prosociality over time.

What we found

  • Essentially, taking time to build warm, close, comforting and understanding relationships between parents and children in early childhood tends to predict children’s resilience against mental health difficulties and increases their levels of prosociality throughout childhood and adolescence.
  • Fractious, angry and manipulative relationships will have the opposite effect.
  • If parents also take steps to prevent aggressive behaviour and conduct problems early, they could also be supporting their child’s future prosociality (the chances of them acting kindly and considerately).
  • Unfortunately, greater than average prosociality was not a salient predictor of lower than usual mental health symptoms.
  • On the other hand, if children build a “trait”, that is, a habit, of being prosocial over time, then children usually have stable low levels of mental health symptoms.

Our recommendations for parents

The key is to take steps early when both mental health and prosociality are more malleable. The current study showed that building warm and close relationships with children at age 3 is very crucial for later-life prosocial habits and resilience. This might include something as simple as finding the time to bond with children early on.

It is also important to share physical comfort, to make the children realize the benefits of valuing the parents’ relationship with them, to praise the children, and be approachable. In contrast, maladaptive parent-child interactions characterized by conflict (e.g., anger, struggling, bad moods) and maltreatment (e.g., smacking) are harmful for the children’s mental health and prosocial ‘traits’.

It is completely natural for parents to feel overwhelmed at times, especially when juggling multiple responsibilities such as work, finances, and parenting. Parents forming a close bond with their child does not always mean engaging in elaborate activities or dedicating vast amounts of uninterrupted time. Often, it is the small moments—the spontaneous hugs, the bedtime stories, the shared laughter over a silly joke—that foster deep connections.

Every parent’s journey is unique, and there is no one-size-fits-all approach to building a bond with the child. What matters most is genuine love, presence, and the intention behind each interaction.

Future directions

Having concluded with this study, another chapter in my research journey has opened. The current study led to several important conclusions, but also raised awareness of how much we do not actually know about the dynamic interplay between parent-child interactions, child mental health, and child prosocial behaviours.

The next step for me would be to examine how children’s close and conflicting parent-child relationships are associated with within-child development in mental health and prosociality. I believe that it is important to not only look at correlations between variables that drive children’s mental health, but to adopt robust within-child longitudinal perspectives to examine how change within parents in the quality of parent-child relationships is related to change within children in mental health and prosociality.

This new strand of research can lead to further insights that can help shape future family policies and assist parents with making the right decisions for their children’s mental health and prosociality.


You can read the study this post is based on here. The study was co-authored with Associate Prof. Ros McLellan at the University of Cambridge, UK.

About the author

Ioannis Katsantonis is a PhD candidate in Psychology and Education at the University of Cambridge, UK. Ioannis holds an MPhil from the University of Cambridge, UK (2021) and a B.Ed(Hons) from the University of Patras, Greece. Since 2020, Ioannis is engaging in cutting-edge research on child and adolescent educational attainment and school engagement, child development, and parenting research. His expertise lies in analysing long- and short-term survey data to answer pressing questions in Psychology of Education and Human Development.


  1. Eisenberg N, Guthrie IK, Murphy BC, Shepard SA, Cumberland A, Carlo G. Consistency and development of prosocial dispositions: A longitudinal study. Child development. 1999;70: 1360–1372.
  2. Cole DA. Latent state-trait models. In: Hoyle R, editor. Handbook of structural equation modeling. New York, NY, USA: The Guilford Press; 2012. pp. 585–600

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