Parental bonding and suicidality in adulthood

OBJECTIVE: The short-term effect of an adverse parental child rearing style on suicidality in adolescence has been extensively discussed. Nevertheless, little is known about the long-term effect of adverse parental child rearing on lifetime suicidality in adulthood. So the present study aims to examine the relation between parental bonding on the one hand and suicidality in adulthood on the other. METHOD: We used data from 7740 respondents of the European Study of Epidemiology of Mental Disorders project, a cross-sectional household survey carried out in six European countries. The data were assessed with the World Mental Health Composite International Diagnostic Interview, a comprehensive, fully structured psychiatric diagnostic interview. Suicidality was categorized as follows: 'no ideation', 'ideation', 'attempt'. Parental bonding was assessed by means of a three-factor ('care', 'overprotection', 'authoritarianism') short form of the Parental Bonding Instrument. Using a multinomial-logistic regression model to investigate the association between these two constructs, we also adjusted for mood disorders, anxiety disorders, alcohol abuse/dependence and possible country effects. RESULTS: We found associations between low maternal and paternal care on the one hand and suicidality on the other. Country-specific differences proved negligible. CONCLUSIONS: Prevention programs can help better equip parents in their child-rearing role to create a more caring parenting environment. This can be a protective factor for suicidality in adulthood. Nevertheless, more efforts are necessary to better describe the paths that lead from child-rearing behaviour to suicidality in adulthood.     

Parenting style and mental disorders in a nationally representative sample of US adolescents

Purpose

We examined associations between parenting style and past-year mental disorders in a nationally representative cross-sectional survey of US adolescents and whether the associations differed by adolescent demographic characteristics.

Methods

The sample included 6483 adolescents aged 13–18 years who were interviewed for a full range of DSM-IV mental disorders. Parenting style was assessed by adolescent-reported maternal and paternal care and control using items from the Parental Bonding Instrument. We controlled for socio-demographics, parental history of mental disorders, stressful life events, sexual violence, inter-parental conflict, and household composition. We also tested for two-way interactions between parental care and control and adolescent age, sex, and race/ethnicity.

Results

In adjusted models, high maternal care was associated with lower odds of depressive, eating, and behavioral disorders, and high maternal control was associated with greater odds of depressive, anxiety, eating, and behavioral disorders. High paternal care was associated with lower odds of social phobia and alcohol abuse/dependence. High paternal control was associated with greater odds of agoraphobia and alcohol abuse/dependence but with lower odds of attention-deficit/hyperactivity disorder. Associations of maternal and paternal control with anxiety disorders and substance abuse/dependence differed by sex. High paternal care was associated with lower odds of anxiety disorders only among Hispanics and non-Hispanic blacks.

Conclusions

Perceived parental care and control were associated with adolescent mental disorders after controlling for multiple potential confounders. Differential patterns of association were found according to adolescent sex and race/ethnicity. Findings have implications for prevention and intervention programs that incorporate familial contextual factors.

     

Temperament and parenting predicting anxiety change in cognitive behavioral therapy: The role of mothers,fathers, and children

ObjectiveA considerable amount of children with anxiety disorders do not benefit sufficiently from cognitive behavioral treatment. The present study examines the predictive role of child temperament, parent temperament and parenting style in the context of treatment outcome.MethodParticipants were 145 children and adolescents (ages 8–18) with DSM-IV-TR anxiety disorders who received a 12-session CBT program and were assessed at pretreatment, posttreatment and three months follow-up. Multiple-regression analyses were used to evaluate the following pretreatment and posttreatment variables as potential predictors of treatment response at follow-up: baseline level of anxiety symptoms, child reported maternal and paternal rearing style (emotional warmth, rejection, and overprotection), parent reported child temperament traits (negative affect, effortful control, and extraversion), and mothers’ and fathers’ self-report temperament traits.ResultsMore maternal negative affect and less emotional warmth as perceived by the child before treatment were related to less favorable treatment outcome (accounting for 29% of the variance in anxiety at follow-up). Furthermore, maternal negative affect and children's extraversion measured after treatment also predicted anxiety at follow-up (together accounting for 19% of the variance). Paternal temperament and parenting style were unrelated to treatment outcome, as were children's pretreatment temperament traits.ConclusionThe results suggest that tailoring intervention to include strategies to reduce maternal negative affect and promote an emotional warm rearing style may improve treatment outcome.     

Maternal, not paternal, PTSD is related to increased risk for PTSD in offspring of Holocaust survivors

BACKGROUND: A significant association between parental PTSD and the occurrence of PTSD in offspring has been noted, consistent with the idea that risk for the development of PTSD is transmitted from parent to child. Two recent reports linking maternal PTSD and low offspring cortisol prompted us to examine the relative contributions of maternal vs. paternal PTSD in the prediction of PTSD and other psychiatric diagnoses in offspring. METHODS: One hundred seventeen men and 167 women, recruited from the community, were evaluated using a comprehensive psychiatric battery designed to identify traumatic life experiences and lifetime psychiatric diagnoses. 211 of these subjects were the adult offspring of Holocaust survivors and 73 were demographically comparable Jewish controls. Participants were further subdivided based on whether their mother, father, neither, or both parents met diagnostic criteria for lifetime PTSD. RESULTS: A higher prevalence of lifetime PTSD, mood, anxiety disorders, and to a lesser extent, substance abuse disorders, was observed in offspring of Holocaust survivors than controls. The presence of maternal PTSD was specifically associated with PTSD in adult offspring of Holocaust survivors. However, other psychiatric diagnoses did not show specific effects associated with maternal PTSD. CONCLUSION: The tendency for maternal PTSD to make a greater contribution than paternal PTSD to PTSD risk suggests that classic genetic mechanisms are not the sole model of transmission, and paves way for the speculation that epigenetic factors may be involved. In contrast, PTSD in any parent contributes to risk for depression, and parental traumatization is associated with increased anxiety disorders in offspring.     

Paternal Anxiety in Relation to Toddler Anxiety: The Mediating Role of Maternal Behavior

Despite robust investigations examining the impact of maternal anxiety and parenting behaviors and child anxiety risk, less is understood about the impact of paternal anxiety and parenting behaviors on child anxiety risk, particularly within the broader family context. An Actor Partner Interdependence Model (APIM) was used to examine whether paternal anxiety longitudinally predicted child anxiety risk indirectly through maternal and paternal parenting behaviors, while controlling for maternal anxiety. Both fathers and mothers of 12- to 30-month-olds (n?=?94) provided self-report of their anxiety and parenting behaviors. Child inhibited temperament (i.e., anxiety risk) was coded. Two APIMs separately considering encouragement of independence and overprotection were examined. These models revealed no direct relation between parent and child anxiety while controlling for parenting behaviors. Models did suggest that paternal anxiety is indirectly linked with future child anxiety through lower maternal encouragement of independence, but not through maternal overprotection or paternal parenting behaviors.     

Perceived quality of early paternal relationships and mental health in adulthood

ABSTRACT: We aimed to determine the association between perceived paternal relationships and mental health and social functioning among adults in the community. Data were drawn from the National Comorbidity Survey (N = 8098), a nationally representative sample of adults aged 15 to 54 years in the United States. Multiple logistic regression analyses were used to assess the relationships between quality of paternal relationship in childhood and current mental disorders, quality of current social relationships, and attachment style. Poor paternal relationship was associated with a significantly increased likelihood of mood and anxiety disorders. Poorer quality of paternal relationships was also associated with poorer current social functioning and avoidant and dependent attachment styles. Our findings suggest that quality of paternal relationships is associated with mental health and social functioning in adulthood and highlight a need for increased understanding of the role of paternal relationships in social/emotional development.     

Dimensions of parenting among mothers and fathers in relation to social anxiety among female adolescents

Social anxiety is the most common anxiety disorder among youth; theoretical and empirical work suggest specific parenting behaviors may be relevant. However, findings are inconsistent, particularly in terms of maternal as compared to paternal effects. In the current study, we evaluated the indirect effects of perceived psychological control on the relation between anxious rearing behaviors and child social anxiety among 112 community-recruited girls (ages 12–15 years). In addition to self-report, adolescent participants completed a laboratory-based social stress task. In line with hypotheses, results indicated indirect effects of psychological control on the relation between anxious rearing behaviors and child social anxiety in maternal but not paternal models. Findings are discussed in terms of their theoretical and empirical implications for clarifying the role of parental relations in adolescent social anxiety.     

Effects of parenting style on personal and social variables for Asian adolescents

Impact of perceived parenting style on adolescents' self-reliance, interpersonal relations, sense of inadequacy, and attitude to school, after controlling for effects of adolescents' self-esteem, was examined in a sample of 548 Asian adolescents. Fathers' perceived parenting style was significantly associated with adolescents' sense of inadequacy for the entire sample as well as for Chinese adolescents. Fathers' perceived parenting style was also significantly associated with Malay adolescents' self-reliance. Mothers' perceived parenting style was significant only for Malay adolescents' attitude to school. The meaning and consequences of parenting styles, in particular, the authoritarian parenting style, and the differential impact of paternal parenting style versus maternal parenting style on adolescent outcomes in an Asian context will be discussed. Implications for educators and mental health practitioners working with adolescents and their families will also be explored.     

Parental bonding and suicidality in pregnant teenagers: a population-based study in southern Brazil

Purpose

To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents.

Methods

A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data.

Results

Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18–19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14–5.59) for the maternal ‘affectionless control’ and a PR of 2.91 (95 % CI 1.10–7.70) for the paternal ‘neglectful parenting.’

Conclusions

We found that maternal ‘affectionless control’ and paternal ‘neglectful parenting’ were independent predictors of suicidality in this sample of pregnant teenagers.     

The role of depression in perceived parenting style among patients with anxiety disorders

Despite a long tradition of research on the relationship between parenting style and anxiety disorders, few studies have taken the effect of comorbid depression into account. This study investigated perceived parenting in 504 outpatients with panic disorder/agoraphobia, social phobia or obsessive–compulsive disorder, and in 210 psychology students. The anxiety group reported both parents as less caring and their fathers as more controlling than did the student group. However, these between-group differences disappeared when taking self-reported depressive symptoms into consideration. Also no differences in parental style were found between the three diagnostic anxiety groups, when depressive symptoms were taken into account. Self-reported depressive symptoms were more consistently associated with negatively perceived parenting style than with self-reported anxiety symptoms in both the anxiety group and the student group. Results do not support theories of parental control as a specific risk factor for anxiety disorders, but they are in accordance with prior findings showing an association between depression and perceived lack of parental care.     

Characterizing the association between parenting and adolescent social phobia

ObjectivesFor characterizing the association between parenting and offspring social phobia (SP), contrasting maternal vs. paternal contributions, putative predictors of unfavorable parenting behaviors and its specificity for SP are warranted to delineate targeted prevention and intervention strategies.MethodsA population-based sample of 1053 adolescents was followed-up using the M-CIDI. Parenting was assessed via questionnaire in offspring passing the high risk period for SP-onset. Natal complications and childhood serious health problems as assessed by maternal reports were hypothesized to relate to unfavorable parenting.ResultsThe pattern of maternal overprotection, paternal rejection and lower emotional warmth was associated with SP, but not with other offspring anxiety disorders. Natal complications were related to overprotection and lower emotional warmth; trend-level associations emerged for serious health problems and unfavorable parenting.ConclusionsPaternal behavior appears particularly relevant for SP. The pattern of maternal overprotection, paternal rejection and lower emotional warmth was observed in SP only, suggesting that its detailed assessment provides a promising opportunity for targeted prevention and intervention in SP.     

Parenting stress in Chinese mothers of children with autism spectrum disorders

Objective

Elevated parenting stress has been observed among mothers of children with autism spectrum disorders (ASDs) in western countries, but little is known about mothers of Han Chinese children. The aim of the current study was to further the knowledge about stress experienced by Chinese mothers of children with ASD by examining maternal parenting stress in Heilongjiang province of China.

Methods

In this cross-sectional study, data about participants’ demographic characteristics, parenting stress, anxiety, depression, child’s behavioral problems, coping strategies, and social support were collected though a questionnaire survey. The participants included 150 families with ASD children, who were consecutively admitted to the clinics of the Children Development and Behavior Research Center in Harbin Medical University, Heilongjiang Disabled Persons Federation, and Mudanjiang Child Welfare Home.

Results

The participants reported elevated parenting stress. Mothers’ parenting stress was associated with levels of depression and anxiety, and child’s behavioral symptoms. Child’s behavioral symptoms, maternal anxiety, maternal depressive symptoms, and lack of governmental financial support were associated with overall parenting stress.

Conclusions

Government support may play an important role in reducing parenting stress in this population.     

A Multi-Informant Examination of Maternal Symptoms and Autonomy Granting in Youth Anxiety

Evidence suggests the important role of (a) parenting behaviors and (b) parental psychopathology in the development and maintenance of youth anxiety. Using a multi-informant approach, the current study examined the association of maternal autonomy granting and maternal symptoms (i.e., anxiety and depression) with youth anxiety among mothers and 88 youth (ages of 6–17) diagnosed with a principal anxiety disorder. Results from the generalized estimating equations (GEE) analyses indicated that mothers reported higher youth anxiety symptoms compared to youth self-reports. Youth-perceived maternal autonomy granting was inversely associated with youth anxiety, and maternal self-reported anxiety and depressive symptoms significantly moderated this relationship: As mothers reported higher anxiety and depressive symptoms, the inverse association between parental autonomy granting and youth anxiety weakened. The interaction between parenting behavior and parental psychopathology significantly influenced youth anxiety symptoms, which presents important clinical implications to integrate into parenting work in the treatment of youth anxiety disorders.     

Maternal depression, parent-child relationships, and resilient outcomes in adolescence

OBJECTIVE: To examine the relationship between maternal depression, parent-child relations, and resilient outcomes in the context of risk in a cross-sectional study of 816 15-year-olds in Australia. METHOD: Resilient outcomes were defined as the following: no current Axis I diagnosis, no history of depressive disorder diagnoses, no current internalizing problems, and no indication of current social functioning difficulties. Parent-child relationship qualities were measured using the Five-Minute Speech Sample, the Children's Report of Parent Behavior Inventory, and a child report questionnaire concerning perceived maternal warmth and hostility. The role of the father's psychiatric status in resilient outcomes was also assessed. RESULTS: Results revealed that low levels of parental psychological control, high levels of maternal warmth, and low levels of maternal overinvolvement all interacted with maternal depression to predict resilient outcomes in youth. CONCLUSIONS: Targeting maternal and paternal parenting qualities may be a useful method of increasing the likelihood of resilient outcomes in children of depressed mothers.     

Parenting practices and their relation to anxiety in young adulthood

Two-hundred introductory psychology students and their parents participated in a study of parenting perceptions and trait anxiety. Using student perceptions of parenting, this study replicates and extends research on the relation between parental control/autonomy granting, rejection/acceptance, and trait anxiety. The study was notable for incorporating data concerning both maternal and paternal influence in the model. Based upon prior research, parental control, parental rejection, and parent anxiety were expected to be associated with student anxiety. Further, perceptions of maternal parenting were expected to emerge as stronger correlates of student anxiety than paternal factors. Results indicated that for both females and males, perceptions of maternal control and paternal acceptance proved to have the strongest relations with student anxiety. However, large differences between males and females emerged in the model, with maternal control and paternal acceptance proving to be significant correlates only for female undergraduates. Maternal, but not paternal, self-reports of trait anxiety were related to student trait anxiety, but the relation was marginally significant in this sample.     

Beliefs regarding child anxiety and parenting competence in parents of children with separation anxiety disorder

BACKGROUND AND OBJECTIVES: Despite the fact that numerous developmental models have highlighted the role of parental cognitive processes in connection with anxiety disorders in children and adolescents, the role of parents' beliefs about their children and parenting remains largely unexplored. This study investigated the specific association between parental beliefs and child separation anxiety. METHOD: Parents of children with a diagnosis of Separation Anxiety Disorder (SAD) reported on beliefs and expectations related to their child's fears and own parenting competence. To study the potential specificity of relationships, a clinical control group of mothers of children with social phobia (SoP) and a group of mothers of children without a mental disorder (healthy controls, HC) were included. RESULTS: Results indicated that parents of anxious children had significantly higher levels of dysfunctional beliefs than the parents in the HC group. Mothers of children with SAD showed lower levels of parenting self-efficacy than mothers of children with SoP. They also demonstrated lower parenting self-efficacy and satisfaction compared to mothers of healthy children. Parental dysfunctional beliefs about child anxiety and paternal parenting self-efficacy were significantly positively associated with child anxiety. The effects remained significant after controlling for parental anxiety and depression. LIMITATIONS: Due to the cross-sectional design of the study, causality of the found effects cannot be inferred. DISCUSSION: Data suggest that children's anxiety and parents' beliefs about their child's anxiety, coping skills and parenting are strongly associated. Further research is needed to investigate whether addressing parental cognitions in addition to parents' anxiety may improve prevention and intervention of child anxiety.     

The relationships of child and parent factors with children's anxiety symptoms: Parental anxious rearing as a mediator

A considerable body of research has identified various child and parent factors that contribute to and maintain anxiety symptoms in children. Yet relatively few studies have examined child factors (including threat-based cognitive bias, neuroticism, gender, puberty and age) as well as parent factors (including maternal anxiety and child-rearing style) in association with child anxiety symptoms, and the extent to which these factors serve as unique predictors of child anxiety. Moreover, research is lacking on whether parent factors such as child-rearing style, which is often targeted in early intervention and treatment programs, might mediate the association between child factors such as neuroticism, and child anxiety symptoms. In a sample of 85 children between 7 and 12 years of age with varying levels of anxiety, including those with diagnosed anxiety disorders, results showed that children were more anxious when they were reported to be more advanced in pubertal status by their parents, when they had a tendency to interpret more threat in ambiguous situations, and when they self-reported more neuroticism. Regarding parent factors, maternal self-reported trait anxiety and children's perceptions of their mother as having an anxious child-rearing style were associated with higher levels of child anxiety. Moreover, when these correlates of child anxiety were examined in a multivariate model to identify those that had direct as well as indirect associations via maternal anxious child-rearing style, child neuroticism remained as a significant and unique predictor of child anxiety that was also mediated by maternal anxious-rearing. Child neuroticism also mediated the relationship between child pubertal stage and anxiety symptoms. Results are discussed in terms of relevant theory and empirical evidence regarding the roles of both child and parent factors in the development of child anxiety.     

Parental bonding in pathological gambling disorder

The purpose of this study was to examine the role of perceived parenting behavior in the childhood of patients with pathological gambling disorder (PGD). Thirty-three outpatient subjects with DSM-IV pathological gambling disorder, and no other current Axis I disorders, completed the Parental Bonding Instrument (PBI), which measures subjects' recollections of parenting on dimensions of care and protection. PBI scores of pathological gamblers were compared to normal controls. Subjects with PGD had significantly lower maternal and paternal care scores than the control subjects (22.6 ± 8.9 vs. 26.9 ± 7.3 on maternal care [p = 0.010], and 17.4 ± 9.6 vs. 23.8 ± 7.6 on paternal care [p = 0.001]). In terms of parental bonding patterns based on a combination of care and protection, the pathological gamblers reported low rates of optimal parenting and high rates of neglectful parenting. These preliminary findings suggest that neglectful parenting appears to be associated with pathological gambling disorder.     

Specificity of familial transmission of anxiety and comorbid disorders

This study examines the specificity and impact of comorbid disorders in probands on the familial transmission of panic and social anxiety disorders. It employs a contemporary family study design with 225 probands (with and without panic and social anxiety disorders) sampled from outpatient clinics and the local community. Their 1053 adult first-degree relatives were assessed for lifetime disorders, based on best estimate diagnoses derived from semi-structured psychiatric diagnostic interviews (Schedule for Affective Disorders and Schizophrenia), multi-informant family history information, and medical records. Generalized estimating equations were used to examine the familial aggregation of panic and social anxiety disorders, and the contributions of comorbid disorders. Results show specificity of familial aggregation of both panic disorder and social anxiety in probands and relatives (i.e., panic odds ratio=3.7, 95%CI 1.5-9.3; social anxiety odds ratio=1.8, 95%CI 1.1-2.9) after controlling for comorbid disorders. There was no contribution of common comorbid disorders (depression, alcoholism, generalized anxiety disorder and agoraphobia) in probands on the familial aggregation of either disorder. These findings confirm prior studies of specificity of familial transmission of panic and social anxiety disorders, and demonstrate that the association between these disorders in probands is not attributable to comorbid mood, anxiety or substance use disorders. Therefore, despite the high magnitude of co-occurrence of panic disorder and social anxiety, there may be distinct etiologic factors underlying each disorder. These findings have implications for studies of the etiology, genetics, and treatment of these disorders.     

Parent–child agreement and prevalence estimates of diagnoses in childhood: Direct interview versus family history method

Diagnostic information on children is typically elicited from both children and their parents. The aims of the present paper were to: (1) compare prevalence estimates according to maternal reports, paternal reports and direct interviews of children [major depressive disorder (MDD), anxiety and attention‐deficit and disruptive behavioural disorders]; (2) assess mother–child, father–child and inter‐parental agreement for these disorders; (3) determine the association between several child, parent and familial characteristics and the degree of diagnostic agreement or the likelihood of parental reporting; (4) determine the predictive validity of diagnostic information provided by parents and children. Analyses were based on 235 mother–offspring, 189 father–offspring and 128 mother–father pairs. Diagnostic assessment included the Kiddie‐schedule for Affective Disorders and Schizophrenia (K‐SADS) (offspring) and the Diagnostic Interview for Genetic Studies (DIGS) (parents and offspring at follow‐up) interviews. Parental reports were collected using the Family History – Research Diagnostic Criteria (FH‐RDC). Analyses revealed: (1) prevalence estimates for internalizing disorders were generally lower according to parental information than according to the K‐SADS; (2) mother–child and father–child agreement was poor and within similar ranges; (3) parents with a history of MDD or attention deficit hyperactivity disorder (ADHD) reported these disorders in their children more frequently; (4) in a sub‐sample followed‐up into adulthood, diagnoses of MDD, separation anxiety and conduct disorder at baseline concurred with the corresponding lifetime diagnosis at age 19 according to the child rather than according to the parents. In conclusion, our findings support large discrepancies of diagnostic information provided by parents and children with generally lower reporting of internalizing disorders by parents, and differential reporting of depression and ADHD by parental disease status. Follow‐up data also supports the validity of information provided by adolescent offspring. Copyright © 2009 John Wiley & Sons, Ltd.