Paternal psychological distress, parenting, and child behaviour: A population based, cross-sectional study

Background: Child behaviour problems are common and can lead to later mental health problems. Poor maternal mental health and adverse parenting practices are known risk factors for child behaviour problems. Less is known about the association between paternal mental health and parenting, and child behaviour. We aimed to explore the association between paternal psychological distress and parenting (harsh discipline, low warmth, unreasonable expectations, and overinvolved/protectiveness) with children's internalising and externalising behaviour at 3 years of age. Methods: Cross-sectional surveys of 669 (80% response) fathers of 3-year-old children, nested within a randomised controlled trial. Main outcomes of behaviour (Child Behavior Checklist), parenting (Parent Behavior Checklist and overinvolved/protective parenting scale), and psychological distress (Kessler-6) were measured. Regression modelling examined the associations between paternal factors and child behaviour, adjusting for maternal mental health and parenting, as well as child and family variables. Results: In adjusted analyses, paternal psychological distress (b = 0.43, 95% confidence interval [CI] [0.26–0.60], p < 0.001), harsh discipline (b = 0.20, 95% CI [0.13–0.27], p < 0.001), and maternal mental health (b = 0.08, 95% CI [0.03–0.12], p = 0.001) were associated with externalising symptoms. However, only paternal psychological distress, harsh discipline, and being a boy were associated with borderline/clinical levels of externalising problems (all p < 0.05). Paternal psychological distress, harsh discipline, overinvolved parenting, maternal mental health, and difficult child temperament were associated with internalising symptoms (all p < 0.05). However, only paternal harsh discipline and overinvolved parenting were associated with borderline/clinical internalising problems. Conclusions: Paternal mental health and parenting are independently associated with child behaviour. Treatments for children with behavioural problems should also address paternal mental health and parenting.