Parental bonding and mental health in adolescence

Adolescence, Summer, 1997 by Laura Canetti, Eytan Bachar, Esti Galili-Weisstub, Atara Kaplan De-Nour, Arieh Y. Shalev

INTRODUCTION

Bowlby (1969) and Ainsworth, Bell, and Stayton (1975) emphasized the central role of the relationship between parent and child in normal development. Bowlby postulated that the attachment behavior that we observe from six months onward is made up of a number of instinctual responses which mature at different times, serve the function of binding the child to the mother, and contribute to the reciprocal dynamics of that binding. As such, the behavior includes clinging, crying, calling, greeting, and smiling. Infants use these behaviors to signal that they discriminate between the mother or mother figure and everyone else, while the mother interprets the signals and provides appropriate responses.

Many psychiatric disorders are attributed either to deviations that have occurred in the development of attachment behavior or more rarely to a general failure of its development (Bowlby, 1988). Bowlby also suggested that most individuals who suffer from psychiatric disorders show a degree of impairment in their capacity for affectional bonding. Such impairment frequently reflects disturbance of bonding during childhood. Bowlby theorized that a parent must be available, loving, responsive, and helpful when the child encounters adverse or frightening situations. If the parent fails to meet the child's needs, is inconsistent, or rebuffs the child's requirement for comfort or protection, normal development is thwarted (Bowlby, 1988). Bowlby's assumptions predicts a higher frequency of mental distress and disorders in children and adolescents whose attachment has been less than optimal.

Several studies have assessed the effects of parental attitudes on adolescents' psychopathology. These studies generally indicate that lack of a supportive and accepting environment correlates with poorer well-being and impaired behavioral adjustment (Rutter, Graham, Chadwick, & Yule, 1976; Gould, 1980). Kendel and Davies (1982) found that the greater the orientation away from parents and toward peers, the greater the depressive symptomatology. They also found that lack of closeness with parents correlates with a higher degree of depression. Walker and Greene (1987) studied the relationship between the degree of emotional bonding among family members and symptom levels in adolescents. They found that adolescents who perceived their families as low in cohesion, reported more psychophysiological symptoms than did those with high family cohesion (e.g., loss of appetite, feeling tired in the morning, hands trembling, heart pounding, trouble sleeping, upset stomach). Kashani, Strober, Rosenberg, and Reid, (1988) similarly showed that adolescents with severe psychopathology reported more abuse, less affection, more overprotection, and more concerns about family rapport than did well-adjusted adolescents. Finally, studies show a link between parental attitudes and behavior problems; for example, Jurich, Polson, Jurich, and Bates (1985) found that drug abusers often reported a communication gap between themselves and their parents and either laissez faire or authoritarian discipline in their families.

These studies have used a variety of measures to assess the parent-child relationship. The Parental Bonding Instrument (PBI), developed by Parker (Parker et al., 1979) was designed to measure the quality of attachment or "bond" between parent and child. Development of the instrument was based on previous research (Roe & Seligman, 1963; Schaefer, 1965; Raskin et al., 1971) which has shown that the parental bonding has two principal dimensions: "care" and "control/overprotection." The care dimension involves, at one end, affection, emotional warmth, empathy, and closeness, and on the other, emotional coldness, indifference, and neglect. One end of the control dimension is defined by control, overprotection, intrusion, excessive contact, infantilization, and prevention of independent behavior, while the other end is defined by allowance of independence and autonomy.

Various studies have shown the relationship between psychopathology and the dimensions measured by the PBI. Neurotic depressives reported less parental care and greater maternal control relative to healthy controls, whereas manic-depressives' scores were similar to those of healthy controls. Depressive experience in a nonclinical group was negatively correlated with parental care, and positively correlated with parental control (Parker, 1979a). Patients with anxiety neurosis reported less parental care and greater control (Parker, 1981). Symptom severity of agoraphobics was negatively correlated with maternal care, and symptom severity of social phobics was positively correlated with maternal care and maternal control. Both groups were lower on maternal care when compared with medical treatment controls, and social phobics were also higher on parental control, relative to the medical treatment group (Parker, 1979b). Medical patients who scored high on hypochondriasis reported higher levels of maternal care and of paternal control as compared to low scorers on hypochondriasis (Parker & Lipscombe, 1980). Patients with obsessive-compulsive neurosis reported low care and high control (Hafner, 1988). Hospitalized schizophrenics rated their parents as less caring and more controlling relative to a control group (Parker et al., 1982).