Abstract: Family dysfunction, characterized by a family's failure to fulfill its roles or the lack of positive characteristics, is a critical factor influencing the mental health of children and adolescents. The nature of this relationship, however, remains a topic of debate. This three-level meta-analysis, grounded in family system theory and the two-factor model of mental health, aimed to explore the relationship relatively comprehensively between family dysfunction (both subjective and objective) and mental health (both positive and negative) in children and adolescents. Literature published up to March 1, 2022, was meticulously reviewed and screened, resulting in the inclusion of 97 studies encompassing 173 effect sizes and a total of 130,227 participants.
The main effect analysis revealed that single-parent families adversely affect the mental health of children and adolescents, exacerbating mental health issues. Other factors such as parental divorce, incarceration, substance abuse, mental illness, and subject family dysfunction also contribute to worsening mental health issues in this demographic. Additionally, the moderating effect analysis indicated that the negative impact of single-parent families is more pronounced in boys. Furthermore, in collectivist cultures, the detrimental effects of parental incarceration on children's and adolescents' mental health are more significant.
Firstly, this study thoroughly investigated the relationship between both subjective and objective family dysfunction and the varied mental health states (positive and negative) of children and adolescents. The inclusion criteria for family dysfunction encompassed subjective indicators measured through research tools and objective indicators reflecting actual situations. This approach minimized biases and limitations associated with considering subjective or objective factors in isolation. Additionally, the study evaluated both positive and negative indicators of mental health, offering a more comprehensive understanding of the changes in mental health among children and adolescents. The findings indicated a moderate positive correlation between subjective family dysfunction and negative mental problems. Objective family dysfunction, including single parenting, was linked to the positive mental health of children and adolescents, while parental divorce, incarceration, substance abuse, and mental illness were associated with negative mental health statuses. These results suggested that family dysfunction may impair positive mental health and exacerbate negative health conditions, thus intensifying mental problems in children and adolescents.
Secondly, the study found that children and adolescents face increased risks of mental problems regardless of the form of family dysfunction, and these risks may vary depending on gender and cultural differences. This finding underscored the importance of addressing and enhancing the mental health of children and adolescents in the context of family dysfunction. The implications for maintaining and improving their mental health include: (1) Encouraging children and adolescents to seek social support and adopt appropriate methods for emotional regulation and expression, such as seeking help from teachers or peers, or using cognitive reappraisal strategies to alleviate negative emotions; (2) Urging parents to establish and maintain healthy marital and parent-child relationships to prevent or mitigate family dysfunction; (3) Calling on schools, society, and governments to provide more support to children and adolescents from dysfunctional families, including high-quality psychological assistance and life support.
Finally, the study's findings on how family dysfunction impacts the mental health of children and adolescents, along with the observed gender and cultural differences, highlighted the need to focus not only on reducing negative mental health conditions but also on enhancing positive mental health. This approach should consider cultural backgrounds and provide targeted interventions for gender differences.
For future empirical research, it would be beneficial to simultaneously explore the relationship between family dysfunction (both subjective and objective) and mental health (both positive and negative). In meta-analytical research, models could include external family factors, such as peer relationships, as moderating variables. Additionally, considering situations where multiple family dysfunctions coexist could provide insights into cumulative effects and enhance our understanding of the relationship between family dysfunction and the mental health of children and adolescents.

Key words: children and adolescents, family dysfunction, mental health, three-level meta-analysis