American Sociological Association

How Adult Children Influence Older Parents' Mental Health: Integrating Stress-process and Life-course

How Adult Children Influence Older Parents’ Mental Health:
Integrating Stress-process and Life-course Perspectives

Melissa A. Milkie
University of Maryland
Alex Bierman
California State University--Northridge
Scott Schieman
University of Toronto

Direct correspondence to Melissa A. Milkie, Department of Sociology, University of Maryland, 2112 Art-Sociology Building, College Park MD 20742;  We thank Kathleen Denny for editorial assistance.  The study is supported by a National Institute of Aging grant award (AG17461; Leonard I. Pearlin, Principal Investigator).  


In this study, we integrate insights from the life-course and stress-process perspectives to argue that adult children’s negative treatment of parents, as well as negative events that children experience, detrimentally affect elderly parents’ mental health over time. We argue that these strains may affect mothers more than fathers, and blacks more than whites, because of the greater importance of the parental role to these groups in late life.  Using data from more than 600 older African American and white parents over a four-year period, we show that negative treatment by adult children is positively related to changes in depression and anger, but effects on depression are limited to black parents and effects on anger are limited to mothers.  Adult children becoming ill or unemployed positively relates to changes in distress over time, but only for black parents.  Surprisingly, marital dissolution by adult children is related to decreases in anger for black parents.  This research indicates that the social-psychological implications of the parental role do not end when children are adults; however, the influence on mental health in old age may vary by social status.
Children are a source of great pleasure for their parents, but scholarly work demonstrates that parenting also has adverse repercussions for mental health (Nomaguchi and Milkie 2003; Evenson and Simon 2005; Umberson and Gove 1989).  Research commonly examines the negative mental health consequences of parenting during the “active” years when offspring are in childhood and adolescence.  We argue, however, that although the deeply felt responsibility of ensuring that children have stable, successful lives may wax and wane, parenting is a continually active role.  Here, we use longitudinal data from older adults to demonstrate how children can continue to influence a parent’s depression and anger, even when the “children” are middle-aged adults and the parents are in the latter stages of life.


    We base this study in an integration of two theoretical frameworks: a life-course perspective and the stress-process model.  The life-course perspective emphasizes that development is a lifelong process in which roles that are established early on continue to be important later in life (Elder, Johnson, and Crosnoe 2003).  This perspective sensitizes us to the way that the parental role persists in importance over time.  A life-course framework also emphasizes the idea of “linked lives.”  The linked lives concept directs attention to the way that stress experienced by adult children may in turn impact parents.  Indeed, the success of and relations with adult children may be one of the most consistent indications of personal accomplishment available for parents in old age, making the strength of the interconnection between parent and adult child that much more significant.
    A stress-process model forms an important complement to a life-course perspective when examining older parents (Pearlin and Skaff 1996).  It guides us to focus specifically on measures of mental health—depression and anger—linked to roles across the life course.  It encourages us to be sensitive to stressors occurring through longstanding strains, and from specific events (Wheaton 1999).  A stress-process perspective also emphasizes that core social statuses are fundamental for each aspect of the stress process (Pearlin 1999).  Social statuses like race and gender are important because they are markers for how some groups are advantaged and others are disadvantaged both objectively and subjectively (Pearlin 1999; McLeod and Nonnemaker 1999).  These advantages and disadvantages in turn condition how stress influences mental health across the life course.
    Race and socioeconomic status are likely to be particularly important for creating differences in parental mental health among current cohorts of older adults.  For both women and racial minorities, the parent role has likely provided relatively more power and rewards throughout much of their lives than a work or community role, thanks in large part to the pervasive occupational discrimination of the earlier parts of the twentieth century.  Thus, both groups may have greater investment in the parent role, and may expect more positive connections to children than their male and white counterparts (Mancini and Blieszner 1989; Pillemer and Suitor 1991), leading to more psychological distress when troubles arise in interactions with children or in the trajectories of children’s lives (Cook 1988).  
Uniting the two perspectives helps frame this study of parenting in late life.  Life-course principles encourage us to examine the linked lives of offspring and parents --- and not simply during one stage of “active” parenting.  The effects of stressful events that occur to adult children may still impact parents.  We also study the effects of adverse interactions between parents and children, because these are likely indicative of long-standing patterns occurring among the partners within this key social relationship.  The stress process model encourages us to examine mental health outcomes of important, life long social roles, and to pay careful attention to the race and gender of the parents.
    In sum, the role of parent has a great deal of importance for psychological well-being during an individual’s later years.  Adult children’s successes or failures, and the way adult children treat elderly parents, should affect parents’ mental health.  Here we examine how parent-child relationships and negative events in the lives of adult children affect the psychological well-being of African-American and white elderly mothers and fathers over a four-year period.  


Sample and Data
We gathered data from the respondents in our study twice.  The first time, we interviewed a sample of 1,167 adults 65 years and older living in the District of Columbia and two adjoining Maryland counties, Prince George’s and Montgomery.  Our sample was socially and economically diverse.  Four years later, we were able to re-interview 789 respondents—a 67.6% retention rate.  This let us study how parent-child relationships are related to changes in mental health over time.  Because we were interested in the effects of parent-child relationships and negative events to children, we selected only those respondents who had at least one biological or adoptive child alive over the four years (N = 678).


In order to capture a broader array of mental health outcomes (Aneshensel 2005), we studied both depression and anger as outcome variables.  Depression was measured by five symptoms, such as “feel downhearted or blue.”  Anger was also measured by five symptoms, such as “feel angry.”  Respondents indicated the number of days in the last week they had experienced each symptom (with a top category of “5 or more days”).  
Negative treatment by children was measured using an index composed of four experiences of negative treatment such as, “treat you as though your feelings don’t matter.”  Respondents indicated how often each treatment occurred, from a scale of 1 = never) to 4 = frequently.
Negative events to children were measured using a list of negative life events, including a serious accident or injury, a physical or mental illness, serious money problems, divorced or separation, and unemployment (being laid off or fired).  Each measure of the event is a sum of the number of times the event occurred.
    Gender and race are our two central social status variables.  Our sample was approximately equally divided between Blacks and whites, men and women.We control for a number of important background factors, measured at Time 1, including age, SES, work/family, functional limitations, and integration variables that are linked to well-being.  



Milkie Table 1

                                                  * p


    Statistically significant findings are summarized in Table 1 (Complete OLS regression results available in the original article).  Although there is no overall relationship between treatment and parental depression, a more nuanced look shows that relationships with parental depression differ by race.  Greater negative treatment is positively related to change in depression for African-American but not for white parents.   We also find a relationship between negative life events and depression among African American respondents.  Two negative events in particular, a child’s illness and a child’s unemployment, are positively related to change in depression among African-American respondents (although the effect of illness is marginally significant).  


    We also find differences in relationships with anger.  This time, though, gender is also important for creating different relationships.  Greater negative treatment is positively related to change in anger, but only for mothers.  Race still creates important differences in relationships with negative events.  An adult child’s illness is related to increases in anger over the course of the study, but only for black parents.  Somewhat surprisingly, adult children’s divorce or separation is negatively related to anger for black parents.  Although we can only speculate, the unexpected relationship between parental anger and a child’s divorce could be due to the differing contexts of marriage for black versus white adults today.  Whereas for white adults marriage is normal and expected, the same meanings may not be attached to marriage or partnerships for younger black adults.  If younger black people are largely unattached, then older black parents may not see the end of a relationship as so distressing, and may indeed feel “relief” if their child is getting out of a bad situation.
    In all, the results show that the power of children’s lives to influence elderly parents’ emotional well-being is quite evident, though contingent on social statuses.  


The Long Reach of Earlier Life Roles into Later Life Mental Health
    In this study, we show that parents’ emotional well-being is tied to children’s life courses well into late life, not just during an offspring’s childhood and adolescence.  Indeed, as alternative roles and social ties diminish in old age, the parental role may take on renewed significance.  Consequently, stressors and conflicts associated with the parental role may be particularly pernicious for older adults’ mental health.
    We also show that being an older parent is not an equivalent experience across different social locations.  Those from less advantaged social locations—African Americans and women—may be especially affected by experiences within this intergenerational tie.  For women, family ties and connections with others may be especially deep due to socialization processes (Chodorow 1978).  For African Americans, limited social and economic opportunities may contribute to the forging of deeper ties with family members (Stack 1974).  Thus, the results underscore how studies of the social psychology of interpersonal stressors in late life may overlook important aspects of stress if differences in experiences due to social statuses are not taken into account.

The Potential Integration of Stress-process and Life-course Perspectives

This research shows how a synthesis of life-course and stress-process perspectives provides a more holistic social psychology of aging.  Influences on psychological well-being in late life may be indirect, occurring through the social relationships that older adults establish throughout their lives.  A stress-process perspective does not typically examine events that happen to others (Pearlin et al. 2005; Thoits 1995; Wethington 2000), but this research demonstrates how network stressors are important for mental health.  Negative events that happened to children during the four-year period were related changes in parents’ mental health, at least among certain elders, complementing earlier research on older parents (Greenfield and Marks 2006; Pillemer and Suitor 1991).  
    This research also shows how the stress-process perspective enhances life-course scholars’ research on older parents.  A stress-process perspective treats mental health as an outcome of role strains and adverse events.  This is important to incorporate more explicitly into life-course research, because life-course research more often focuses on other social psychological outcomes, such as attitudes or satisfaction.  Indeed, Wheaton (2001) convincingly argues that mental health is the ultimate dependent variable of interest for sociologists of all bents.
A second key aspect of the stress-process model is that social and economic statuses are an explicit part of the model.  Social statuses mark individuals in ways that advantage some and disadvantage others, creating differences in how people are affected by stressors (Pearlin 1999).  Although life-course researchers sometimes take social status into consideration, it should become a more formal part of the perspective put forth by Elder and others (e.g., Giele and Elder 1998; Elder, Johnson, and Crosnoe 2003).  


    Although the parenting experience is undoubtedly enriching in various ways across the years, the negative facets related to this role continue to exert themselves decidedly into late life.  These negative facets occur in part through a process of linked lives.  Indeed, the social bonds forged by the parental role may be especially critical at older ages as adults increasingly look to these bonds as a source of social and instrumental support.  Overall, we demonstrate how the integration of life-course and stress-process frameworks provides rich opportunities for a more complete social psychology of aging, one with a distinctly sociological perspective.  


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