Parental depressive symptoms and shared reading practices among preschool children in western China: cross-sectional study

Abstract

Background Shared reading supports early child development, but parental depressive symptoms may reduce its frequency and quality. Most previous studies assumed linear relationships with small samples. This large cross-sectional study examined linear and non-linear associations between parental depressive symptoms and shared reading practices in Chinese preschoolers. Methods We recruited 21,366 parent-child dyads (children aged 3–6 years) from 189 kindergartens in western China. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Shared reading was assessed using the StimQ READ subscale. Multivariable linear regression, piecewise linear regression with threshold estimation, and natural spline analysis were performed, adjusting for sociodemographic covariates. Results Higher CES-D scores were linearly associated with lower total reading scores (adjusted β = –0.074 per point, 95% CI: –0.081 to –0.067). Piecewise regression identified a significant estimated breakpoint at CES-D score = 19.0 (95% CI: 11.9–26.1), below this threshold the slope was steeper (β = –0.085) than above (β = –0.051). Natural spline analysis confirmed non-linearity (P = 0.026) and located the point of maximum curvature at CES-D score = 10.9, indicating the most rapid change in slope occurred at subclinical symptom levels. The association was consistent across all subgroups (after Bonferroni correction). Conclusions Parental depressive symptoms are negatively associated with shared reading in a non-linear, breakpoint-dependent manner. Even subclinical symptoms (CES-D score≈ 11) are associated with steeper declines, while the association attenuates at higher levels (CES-D score ≈ 19). Interventions targeting parental mental health, especially at subclinical to moderate symptom levels, may help preserve high-quality home literacy environments.