Child Health Nurs Res.  2025 Oct;31(4):248-256. 10.4094/chnr.2025.028.

Mediating role of parental alienation and moderating effect of subjective health in the link between parental and adolescent depression in South Korea: a cross-sectional study

• Lim S
• Kim Y

• KMID: 2573413
• DOI: http://doi.org/10.4094/chnr.2025.028

Abstract

Purpose
This study aimed to examine whether perceived parental alienation mediates the relationship between parental and adolescent depressive symptoms, and, if so, whether parents’ subjective health moderates this indirect effect.
Methods
This cross-sectional study utilized secondary data from the 2021 wave of the Panel Study on Korean Children, enrolling 541 parent–child dyads. Parental depression was measured using the Kessler Psychological Distress Scale-6, a self-rated health item, the Korean version of the Center for Epidemiological Studies Depression Scale for Children, and a 6-item perceived alienation scale. Descriptive statistics, Pearson correlations, and variance inflation factor checks were conducted, followed by mediation and moderated mediation analyses using PROCESS Models 4 and 7 with 10,000 bootstraps in IBM SPSS ver. 27.0.
Results
Parental depression did not directly predict adolescent depression (B=.02, t=.87) but was significantly related to perceived alienation (B=.16, p<.001), which in turn predicted higher adolescent depression (B=.20, p<.001). The indirect effect of alienation was also significant (B=.039; 95% confidence interval, 0.005–0.066). Subjective health moderated the depression–alienation link (interaction B=.19, p<.001), with stronger indirect effects observed among parents with better health.
Conclusion
Parental depression symptoms indirectly increase adolescent depression through perceived alienation, particularly when parents viewed their health positively. These results suggest that interventions targeting parental mental health and fostering open-family communication may help reduce adolescent depression.

Keyword

Adolescent; Depression; Health status; Mental health; Parent-child relations