Family planning and child mental health in China: the Nanjing Survey
Authors: W S Tseng, T Kuotai, J Hsu, J H Chiu, L Yu, V Kameoka
Journal: American Journal of Psychiatry (1988)

The authors studied the impact of China's one-child-per-couple family planning policy on child development in 697 preschool children in the city of Nanjing and in two rural areas surrounding Nanjing. A home-visit questionnaire survey including a Chinese version of Achenbach's Child Behavior Checklist was used. The behavior problem profiles of children who were their parents' only children and those who had siblings were compared, revealing a significant difference between girls who were only children and those who had siblings. Girls who were only children tended to have slightly higher scores on the factors of depression, moody, and temper.The 1 child per family policy was begun in China in 1980 in order to keep the population down to 1.15 billion by year 2000. By 1985, 80-90% of urban families and 50-60% of rural families had only 1 child. This study of 697 children aged 3-6 in urban, suburban-rural, and remote rural areas in and around Nanjing was designed to determine whether only children developed significantly more behavior problems than did children with siblings. The survey used the Child and Family Questionnaire and a Chinese version of the Achenbach Child Behavior Checklist. The age of the parents ranged from 25-40 years, and 99% of the marriages were not arranged. 60% of the families were nuclear, and 40% were stem, i.e., the married couple lived with either the husband's or the wife's parents. Only 1/4 of the families had wanted children for traditional reasons, such as to continue a clan, to provide labor, or to provide old-age security. 29% had wanted only 1 child, 63% preferred 2, and 3% preferred 3 children. The remote rural families wanted the most children. 54% of families indicated no preference for a boy or a girl, and 51.59% of the children were boys, and 48.5% were girls. 71% of the children attended public day care institutions and were thus exposed to socialization even if they were only children. 89% of the children slept in the same bed as their parents, the usual custom in China. Behavior problems included in the questionnaire were immaturity, regression, schizoid behavior, depression, moodiness, neuroses, and aggression. Single factor and multifactor analyses of variance were used to determine the effects of demographic variables and presence or absence of siblings on behavior problems. Boys who were only children and who were cared for by grandparents had more anxious aggression than only children cared for by parents. But boys who had siblings and were cared for by grandparents scored lower for anxious aggression. All boys who were cared for by grandparents had more anxious aggression than boys cared for by parents. Girls who were only children of parents who preferred 2 children scored high for moodiness, but girls who had siblings and whose parents preferred 1 child had highest scores for obsessive-neurotic behavior and aggression. Girls who were only children and lived in rural areas had higher temper scores than did only children girls in the country. But for girls with siblings temper scores were higher in the city. Girls who were only children and lived in nuclear families had higher temper scores than those who lived in stem families, but girls who had siblings and lived in nuclear families had lower temper scores than those who lived in stem families. In general, the behavior patterns of only children were significantly different only for boys. The results of this study indicate that the 1 child per family policy will not result in problem behavior among children.