Cumulative Risk and Mental Health of Left-behind Children in China: A Moderated Mediation Model

Based on the dual-factor model of mental health (DFM) and the cumulative risk (CR) model, this study aimed to investigate the impact of CR on left-behind children’s mental health and the underlying mechanism involved, specifically the mediating role of coping style and the moderating role of gratitude in the relationship between CR and mental health. The random cluster sampling method was applied to collect data on CR, coping style, gratitude, life satisfaction, and depression from 705 left-behind children (374 boys, M(age =) 12.20 ± 1.25). The moderated mediation analyses indicated that: (1) the moderated mediation model of CR and depression was significant: coping style mediated the relationship between CR and depression, and gratitude moderated this mediating effect with gratitude strengthening the negative association between CR and coping style; and (2) gratitude moderated the relationship between CR and life satisfaction and it also strengthened the negative association between CR and life satisfaction. The findings suggest that the mechanisms of coping style may differ in the relationships between CR and positive and negative indicators of mental health in left-behind children and that gratitude as a protective factor has limited capacity to buffer the negative effect of accumulated risk. These findings provide evidence for differentiated intervention approaches to promote disadvantaged children’s life satisfaction and depression.