Erinnertes elterliches Erziehungsverhalten und aktuelle Bindungsorganisation im Erwachsenenalter

What's past is prologue: Recalled parenting styles are associated with childhood cancer survivors' mental health outcomes more than 25 years after diagnosis

BACKGROUND

With the increased survival rates of childhood cancer, long-term survivors' well-being over the life span has come into focus. A better understanding of the determinants of childhood cancer survivors' (CCS) mental health outcomes contributes to the identification of vulnerable individuals as well as to the development of evidence-based prevention and intervention efforts. It has been noted that psychosocial factors such as parental rearing behavior shape individual differences in mental health. There is also evidence that parents show altered parenting behavior in the face of childhood cancer, e. g. that they express more emotional support, but also more worries. However, little is known about the relevance of different parenting styles for CCS' mental health decades after diagnosis and treatment.

METHODS

We examined the associations of recalled parenting styles and disease-related factors with lifetime diagnoses of depression and anxiety disorders in a German, registry-based sample of adult CCS (N = 948, 44.50% women) with survival times >25 years. We conducted logistic regression analyses of lifetime diagnoses of depression and anxiety disorders, respectively, on dimensions of recalled parental rearing behavior (measured with a validated German short version of the EMBU) controlling for relevant adjustment variables such as the presence of physical illnesses.

RESULTS

Recalled parenting styles of both parents had statistically relevant associations with CCS' lifetime depression and anxiety diagnoses. Maternal emotional warmth was related to fewer lifetime diagnoses of depression and fewer lifetime diagnoses of anxiety. Memories of paternal control and overprotection were positively associated with lifetime diagnoses of anxiety.

CONCLUSION

The results indicate that mental representations of one's caregivers are associated with psychological long-term outcomes. Thus, medical professionals should involve the parents and support them in accompanying their child through the difficult times of treatment and survivorship. Interventions aimed at fostering survivors' quality of life should consider the sustained relevance of early relationships.

Is a mother's recalled parental rearing behavior, her attributions of her child's behavior, and her psychopathology associated with her mother-child relationship quality?

BACKGROUND

The mother-child relationship quality (MCRQ) may represent a transgenerational transmission mechanism of mental health problems. In this context, we examine the mother's recalled parental rearing behavior, actual attributions of her child's behavior, and her current psychopathology.

METHOD

A clinical sample of mother-child dyads was assessed with the Questionnaire for the Assessment of Recalled Parental Rearing Behavior, the Parent Cognition Scale, and the Symptom Checklist at the Child Psychiatric Family Day Hospital for preschool children in Münster, Germany, at admission. MCRQ was assessed with the Parent-Infant Relationship Global Assessment Scale, a structured interview with the child (Strukturiertes Interview zur Erfassung der Kind-Eltern-Interaktion), and the Multiperspective Parent-Child Relationship Questionnaire.

RESULTS

Multiple regression analyses showed no direct association between the mother's recalled parental rearing behavior and any measure of the MCRQ. However, maternal dysfunctional attributions about her child's behavior and her actual psychopathology showed the expected negative associations with the multiperspective measures of MCRQ. The relationship quality assessments did not correlate significantly with each other.

CONCLUSION

The divergent measures of MCRQ, which seem to assess different aspects, are a barrier to investigate the association between the mother's recalled parental rearing behavior and MCRQ. However, low MCRQ is associated with increased maternal psychopathology and maternal dysfunctional attributions on child behavior.

Changes of attachment characteristics during psychotherapy of patients with social anxiety disorder: Results from the SOPHO-Net trial

Objectives

Within a randomized controlled trial contrasting the outcome of manualized cognitive-behavioral (CBT) and short term psychodynamic therapy (PDT) compared to a waiting list condition (the SOPHO-Net trial), we set out to test whether self-reported attachment characteristics change during the treatments and if these changes differ between treatments.

Research design and methods

495 patients from the SOPHO-Net trial (54.5% female, mean age 35.2 years) who were randomized to either CBT, PDT or waiting list (WL) completed the partner-related revised Experiences in Close Relationships Questionnaire (ECR-R) before and after treatment and at 6 and 12 months follow-up. The Liebowitz Social Anxiety Scale (LSAS) was administered at pre-treatment, post-treatment, and at 6-month and 1-year follow-up. ECR-R scores were first compared to a representative healthy sample (n = 2508) in order to demonstrate that the clinical sample differed significantly from the non-clinical sample with respect to attachment anxiety and avoidance.

Results

LSAS scores correlated significantly with both ECR-R subscales. Post-therapy, patients treated with CBT revealed significant changes in attachment anxiety and avoidance whereas patients treated with PDT showed no significant changes. Changes between post-treatment and the two follow-ups were significant in both conditions, with minimal (insignificant) differences between treatments at the 12- month follow-up.

Conclusions

The current study supports recent reviews of mostly naturalistic studies indicating changes in attachment as a result of psychotherapy. Although there were differences between conditions at the end of treatment, these largely disappeared during the follow-up period which is line with the other results of the SOPHO-NET trial.

Trial registration

Controlled-trials.com ISRCTN53517394

The relationship of parental rearing behavior and resilience as well as psychological symptoms in a representative sample

Background

Recalled parental rearing behavior is one of the factors influencing the strength of resilience. However, it is unclear whether resilience is a relatively stable personality trait or has a relational character whose protective strength changes over the course of life. Therefore, the association between recalled parental rearing and resilience as well as symptoms of anxiety and depression was investigated in respect to age and gender.

Methods

N = 4,782 healthy subjects aged 14-92 (M = 48.1 years) were selected by the random-route sampling method. In this sample, an ultra-short form of the Recalled Parental Rearing Behavior Questionnaire, the German short version of the resilience scale, and two screening instruments for depression and anxiety (PHQ-2, GAD-2) were filled out. Structural equation modelling was used to analyze the data estimated with the maximum likelihood method approach.

Results

The data revealed that rejection and punishment were clearly associated with lower resilience. Moreover, resilience had a strong connection to the symptoms of anxiety and depression. Resilience had the same quality of association in both men and women with respect to anxiety and depression. Furthermore, the effect of resilience did not vary across several age groups even though challenges may differ over a lifetime.

Conclusion

Recalled parental rearing behavior such as rejection and punishment as well as control and overprotection exert a significant association on the strength of resilience. Resilience has an effect independent of gender and does not affect people of different age groups differently.

An ultra-short screening version of the Recalled Parental Rearing Behavior questionnaire (FEE-US) and its factor structure in a representative German sample

BACKGROUND

The Recalled Parental Rearing Behavior questionnaire (FEE, [1,2]) assesses perceived parental rearing behavior separately for each parent. An ultra-short screening version (FEE-US) with the same three scales each for the mother and the father is reported and factor-analytically validated.

METHODS

N = 4,640 subjects aged 14 to 92 (M = 48.4 years) were selected by the random-route sampling method. The ultra-short questionnaire version was derived from the long version through item and factor analyses. In a confirmatory factor analysis framework, the hypothesized three-factorial structure was fitted to the empirical data and tested for measurement invariance, differential item functioning, item discriminability, and convergent and discriminant factorial validity. Effects of gender or age were assessed using MANOVAs.

RESULTS

The a-priori hypothesized model resulted in mostly adequate overall fit. Neither gender nor age group yielded considerable effects on the factor structure, but had small effects on means of raw score sums. Factorial validities could be confirmed. Scale sums are well-suited to rank respondents along the respective latent dimension.

CONCLUSION

The structure of the long version with the factors Rejection & Punishment, Emotional Warmth, and Control & Overprotection could be replicated for both father and mother items in the ultra-short screening version using confirmatory factor analyses. These results indicate that the ultra-short screening version is a time-saving and promising screening instrument for research settings and in individual counseling. However, the shortened scales do not necessarily represent the full spectrum covered by the full-scale dimensions.

The assessment of recalled parental rearing behavior and its relationship to life satisfaction and interpersonal problems: a general population study

Background

Parental rearing behavior is a significant etiological factor for the vulnerability of psychopathology and has been an issue of clinical research for a long time. For this scope instruments are important who asses economically recalled parental rearing behavior in a clinical practice. Therefore, a short German instrument for the assessment of the recalled parental rearing behavior Fragebogen zum erinnerten elterlichen Erziehungsverhalten (FEE) was psychometrically evaluated [Recalled Parental Rearing Behavior].

Methods

This questionnaire was evaluated in a representative population sample (N = 2.948) in Germany which included 44.2% male and 55.8% female persons with a mean age of M = 47.35 (SD = 17.10, range = 18–92). For the content evaluation of the FEE the Life Satisfaction Questionnaire (FLZ) and the Inventory of Interpersonal Problems (IIP) was filled out by the participants.

Results

The FEE scales yielded a good to satisfactory internal consistency and split-half reliability. Its three factors (rejection/punishment, emotional warmth, control/overprotection) correlated positively with most of the areas of life satisfaction. Furthermore, positive associations between interpersonal problems and parental rejection and control could be identified.

Conclusion

The FEE is a short, reliable and valid instrument that can be applied in the clinical practice. In addition, the data proved an association between recalled parental rearing behavior, life satisfaction and interpersonal problems conform to the literature. Finally, specific problems with the retrospective assessment of parental rearing behavior were addressed as well.

Stabilität und Stimmungsabhängigkeit retrospektiver Berichte elterlichen Erziehungsverhaltens

Zusammenfassung. Theoretischer Hintergrund: Retrospektiver Daten zum elterlichen Erziehungsverhalten sind in klinischer Psychologie und Psychotherapieforschung von Bedeutung, da Zusammenhänge zur Manifestation psychischer Störungen im Erwachsenenalter bestehen. Fragestellung: Bleibt das retrospektiv berichtete Erziehungsverhalten zeitlich stabil und welchen Einfluss nimmt die aktuelle Stimmung auf die Einschätzung? Methode: 105 Patienten wurden zu zwei Zeitpunkten im mittleren Abstand von 2,2 Jahren anhand des Kindheitsfragebogens und der Symptom-Checkliste-27 befragt. Ergebnis: Die Einschätzung des Erziehungsverhaltens weist in fast allen der erfassten Erziehungsstildimensionen hohe Stabilität auf. Signifikante Stimmungseffekte zeigten sich bei 3 von 20 Skalen. Die durch die Stimmung aufgeklärte Varianz beträgt 1, 2 und 5%. Schlussfolgerung: Retrospektive Berichte elterlichen Erziehungsverhaltens sind zeitlich stabil, die Stimmung nimmt einen geringen Einfluss auf die Einschätzung des elterlichen Erziehungsstils.