Parent-child interactions predict anxiety in Mexican adolescents

Adolescence, Winter, 1996 by Laura Hernandez-Guzman, Juan Jose Sanchez-Sosa

Anxiety during adolescence has been strongly associated with mal-adaptive problems such as school failure (Benjamin, Costello, & Warren, 1990; Comunian, 1993; Goodyear & Altham, 1991; Kochgaway, 1993); substance abuse (Eisen, Youngman, Grob, & Dill, 1992; Kovasznay, Bromet, Schwartz, & Ram, 1993; Rich, Sherman, & Fowler, 1990); eating disorders (Soukup, Beiler, & Terrel, 1990), psychosomatic complaints (Beidel, Christ, & Long, 1991; Garber, Walker, & Zeman, 1991; Gerritsma, 1991; Rauste von Wright & Von Wright, 1992) and even suicide behavior (Connell & Meyer, 1991; Kosky, Silburn, & Zubrick, 1990; Rich, Sherman, & Fowler, 1990; Rubenstein, Heeren, Housman, & Rubin, 1989; Simonds, McMahon, & Armstrong, 1991).

Psychosomatic complaints, for example, are among those more clearly associated with anxiety, demanding not only mental but general health services, leading to increased financial, social, and personal costs (Wasserman, Whittington, & Rivara, 1988). Among other psychological disorders, anxiety accounts for 50% of cases seeking general health services in both developed and developing countries (Sartorius, Ustun, Costa e Silva, & Goldberg, 1993). The traditional approach to the problem of anxiety-induced psychosomatic complaints consists of waiting until a clear-cut diagnosis can be reached and then conducting some type of therapeutic intervention. This approach, in addition to its poor cost-benefit ratio, does very little in the way of ameliorating the psychosocial features of the problem.

Thus, prevention efforts should be conducted in order to reduce psychological dysfunction, including anxiety. It has been proposed that mental health evolves as described by the public health model (Cowen, 1983). Some theorists (e.g., Jacob, Favorini, Meisel, & Anderson, 1978) view mental health as evolving along with an individual's general development, constantly interacting with personal characteristics, life crises, and other circumstances provided by the social environment, mainly represented during childhood and adolescence by the family.

Quality of family of origin and nuclear family relationships have been associated with psychological health and distress, life stress, and health-enhancing behaviors of young adults (Werner, 1992) and middle-aged adults (Harvey, Curry, & Bray, 1991). Early recognition of risk factors associated with the later occurrence of psychological problems should provide a basis for preventing or at least ameliorating their occurrence. Prevention research should be aimed at generating knowledge concerning those psychosocial and personal factors predicting either dysfunction (risk factors) or health (protective factors) (Coie et al., 1993).

Investigators interested in the influence of the family on anxiety have studied such variables as family environment (Burt et al., 1992); Paluszny, Davenport, & Kim, 1991; Wells & Whittington, 1993), family conflict (Mechanic & Hansell, 1989), family cohesion (Sharma & Ram, 1987; Walker & Green, 1987), parents' alcoholism (Roosa, Sandler, Gehring, & Beals, 1988; West & Prinz, 1988), parental stress (Compas, Howell, Phares, & Williams, 1989) or perceived acceptance of mother (Harris & Howard, 1987). These studies, however, have addressed variables only in a broad perspective, allowing for only limited analysis of the specific parent-child interactions responsible for their results. Consequently, they do not clearly contribute either to the explanatory systems assuming family relations as predictors of mental health or to the development of effective intervention programs fostering healthy interaction patterns.

Other research has tried to clarify the role of the family by exploring parenting styles during childhood. Results have suggested associations between parenting styles and child's anxiety (Hock & Krohne, 1987; Hock & Krohne, 1989; Krohne & Hock, 1991; Woodall & Matthews, 1989). However, these studies analyzed only mother-child interaction, ignoring the father's role, and did not address anxiety in adolescents. A study by Shek (1989) reported correlations among anxiety, depression, and psychosomatic complaints. Although comparisons were made in this study between Chinese adolescents' recollections of their parents' rearing styles and reported symptoms, the definition of rearing styles did not allow a detailed characterization of behaviors involved in parent-child relations for predicting anxiety later in life. More precise knowledge is needed concerning parenting patterns as possible risk factors if preventive strategies are to be developed.

The purpose of the present study was to provide further information on specific early parent-child interactions and their potential association with later anxiety during adolescence by retrospectively analyzing adolescents' history of interaction with parents and relating it to current psychological functioning.

METHOD

Participants

Male and female adolescents between 15 and 18 years of age were selected through their class sections from 14 preparatory schools located in 14 different geographical areas of Mexico City. The total sample that completed a questionnaire consisted of 3,432 subjects - 1,664 boys and 1,768 girls.