PARENTING ADOLESCENTS: A REVIEW OF REVIEWS Initial summary, 28th September 2012 John McAteer,1 Ruth Jepson,1 Danny Wight,2 and Caroline Jackson1 1
Scottish Collaboration for Public Health Research and Policy, Edinburgh 2
MRC Social and Public Health Sciences Unit, Glasgow
Scottish Collaboration for Public Health Research and Policy 20 West Richmond Street, Edinburgh EH8 9XD Tel +44 (0) 131 651 1591/ 1594 www.scphrp.ac.uk
INTRODUCTION Parenting has been shown to influence adolescent behaviours and adaptation, and increased uptake of health services and susceptibility to illness in later life (Collins et al, 2000; Stewart-Brown, 2012; Fergusson et al, 2005; Temcheff et al, 2011; Stewart-Brown et al, 2005; Beveridge and Berg, 2007). This importance of parenting is reflected in policy, with The Scottish Government describing the role of parents as one of providing ‘good basic care, stimulation, emotional warmth, guidance and boundaries, safety and stability’ (Scottish Executive, 2005). In the UK, the structure of the family has changed over the past 10 years (The Office of National Statistics, 2007). There are many different types of families within Scottish society; nuclear families, extended families, reconstituted or step-families, and single parent families to name but a few.
To illustrate, household data from the 2001
Scottish Census show that of 2,192,246 households, 7 per cent were lone parent households with dependent children, 17% were married couple households with dependent children and 3% were cohabiting couple households with dependent children (General Register Office for Scotland, 2012).1 This report defines parents broadly as anyone directly involved in bringing up an adolescent. The National Parenting Strategy will build on existing policy work to improve the support available to families throughout Scotland, as part of a wider commitment to ensure that all families across Scotland receive the support that they need, when they need it (Scottish Executive, 2012a; 2012b). This document reports a review of reviews of parenting and adolescents conducted to inform development of the National Parenting Strategy. Understanding the link between parenting and adolescent health and wellbeing outcomes can provide the foundation for parental advice and service provision.
review sought to identify parenting styles and parenting behaviours influencing adolescent health and wellbeing outcomes. Hoeve et al (2009) define parenting styles as configurations of ‘behaviours of parents towards their child that create a context or climate’.
Parenting styles can therefore be
conceptualised as umbrella terms under which fall specific parenting behaviours, as shown in Figure 1.
Household data for the 2011 census is not yet available.
Parenting behaviour W
Parenting behaviour V
Parenting behaviour X
Parenting behaviour Y
Parenting behaviour Z
Figure 1. Parenting styles and parenting behaviours Parenting styles vary according to levels of parental warmth and parental control, as shown in Figure 2.
Parental warmth refers to parenting behaviours that make the child feel
comfortable and approved.
Parental control refers to parenting behaviours that involve
placing demands and exercising control. Baumrind (1966; 1968; 1971) initially identified three parenting styles: Authoritative (high warmth, high control), Authoritarian (low warmth, high control) and Permissive (high warmth, low control) (Baumrind, 1996; 1968; 1971). Maccoby and Martin (1983) later identified a fourth parenting style: Neglectful (low support, low control) control.
Low warmth Figure 1. Baumrindâ€™s Parenting Styles Model (Neglectful parenting style added later by Maccoby and Martin, 1983) 3
This review had two aims: 1. To identify parenting styles associated with adolescent health and wellbeing outcomes 2. To identify parenting behaviours associated with adolescent health and wellbeing outcomes This document reports the initial findings, with the full review becoming available in December 2012.2 METHOD A broad brush review was conducted to identify existing reviews of evidence relating to parental factors associated with adolescent health and wellbeing outcomes. All types of reviews were considered for inclusion, including non-systematic, systematic and metaanalyses.
Language was restricted to English.
Primarily, we sought reviews of
observational studies examining links between parenting and any health and wellbeing outcomes. A basic search string was applied to the Web of Science database to identify titles containing the words ‘parent*’ and ‘adolescen* or youth* or teen*’ over the past 15 years. A total number of 9,027 papers were identified.
The search was limited by document type to
identify reviews, which resulted in 292 papers. Titles and abstracts of these reviews were scanned, and relevant reviews obtained. Findings are narratively reported. FINDINGS A total of 11 reviews were identified, shown in Table 1. Reviews examined links between parenting and a range of adolescent health and wellbeing outcomes.
across the reviews were predominantly conducted within North America. It is unclear how many UK based studies were included, as geographical study information was rarely reported within the reviews. Author
method Becona et al
Substance use, including alcohol use
Healthy eating, physical activity, BMI
(2011) Berge et al (2009)
This review also examined the effectiveness of parenting programmes specifically targeting parents of adolescents, the findings of which will be included in the full review, December 2012.
Hoeve et al (2009)
Physical activity Delinquency
analysis Kawabata et al
Markham et al
Sexual and reproductive health
Miller et al (2001)
Adolescent pregnancy risk
Newman et al
Use of alcohol, drugs, & tobacco / unhealthy sexual
behaviours / intentional & unintentional injury
Racz & McMahon
Conduct problems, including aggression, oppositionality, delinquency and anti-sociality
Ryan et al (2010)
Table 1. Included reviews, review methods and outcomes examined
PARENTING STYLES ASSOCIATED WITH ADOLESCENT HEALTH AND WELLBEING OUTCOMES Four reviews examined associations between parenting styles and adolescent health and wellbeing outcomes (Becona et al, 2011; Berge et al, 2009; Newman et al, 2009; Spera, 2005).
Associations were reported between the authoritative parenting style and lower
levels of adolescent alcohol, smoking, cannabis and ecstasy use (Becona et al). Additionally, adolescents raised in authoritative households demonstrated more positive behaviours and less risk behaviours than those raised in permissive, neglectful and authoritarian households (Newman et al). An association was also reported between the authoritative parenting style and delay of adolescentsâ€™ first sexual experience, but only for adolescents between the ages of 15-16 and not for older adolescents (Newman et al). Additionally, the authoritative parenting style was linked to lower BMI, availability of fruit and vegetables in the home, consumption of fruits, vegetables and dairy products, physical activity, and lower consumption of sugary beverages, and higher levels of academic achievement (Edwardson and Gorely; Spera). In general, less positive associations were reported between the authoritarian, permissive, and neglectful parenting styles and adolescent health and wellbeing outcomes.
Associations were reported between the 5
authoritarian parenting style and use of alcohol and other substances, and the neglectful and permissive parenting styles and tobacco, alcohol, cannabis, cocaine and ecstasy use (Becona et al, 2011; Newman et al, 2009). Similarly, both the authoritarian and neglectful parenting styles were associated with higher BMI, availability of unhealthy foods, and poor dietary intake and lack of physical activity (Berge et al). The majority of studies reported in these reviews were conducted in North America, and it is difficult to draw firm conclusions when generalising findings to other cultures and populations.
Becona et al (2011) report that some studies conducted in Spain have
identified the permissive parenting style as the most protective against substance use. Similarly, Becona et al also report that studies conducted with Asian populations have shown the authoritarian parenting style to be associated with reduced alcohol use, and in South Africa to be associated with the development of coping strategies in white adolescents, with similar findings reported in Arab populations. In regards to the impact of the authoritative parenting style on lowered BMI, dietary intake and physical activity, Berge et al report that these findings hold with adolescents across diverse ethnic backgrounds. PARENTING
WELLBEING OUTCOMES The reviews examined links between a number of parenting behaviours and adolescent health and wellbeing outcomes. Associations were reported between parental monitoring and lower levels of substance use, with parental rejection associated with greater levels (Becona et al, 2011).
knowledge and monitoring was also found to be a protective factor for sexual risk behaviour (Markham et al, 2010; Miller et al, 2001). Associations were also reported between parental knowledge and monitoring and delaying sexual initiation, and for increasing condom and contraceptive use (Markham et al). Newman et al (2009) and Markham et al (2010) report an association between sexual risk taking and parental monitoring and communication. Adolescents who were closely monitored by their parents had lower amounts of sexual risk taking than those who were monitored less. Racz and McMahon (2011) identified parental knowledge and monitoring as a protective factor against conduct problems across ethnicities, with more similarities than differences between groups. Racz and McMahon state that parental knowledge and monitoring is associated more strongly with lower levels of delinquent behaviour in girls than in boys, but report that this may be linked to the finding that girls tend to be monitored more frequently than boys.
Associations were also reported between parent-child connectedness/communication and adolescent health and wellbeing outcomes. Markham et al identified an association between adolescent sexual and reproductive health outcomes and parent-child connectedness, and general and sexuality specific parent adolescent communication.
connectedness was associated with a reduction in frequency of sexual behaviour in sexually active youth. Markham also state that whilst connectedness and parental monitoring have protective effects for both male and female offspring, parent-adolescent sexual communication may have a protective influence amongst females only.
emphasise that much of the literature in this area has been conducted in relation to white and African American youths, with a lack of studies amongst other ethnicities. Berge et al (2009) emphasise the importance of frequent family meals for impacting upon adolescent lower BMI and healthy dietary intake, with studies showing an association between family meal frequency and greater consumption of fruit and vegetables, less fried food and soda, less saturated and trans fat, and healthier dietary intake. Associations were also reported between parental encouragement of health behaviours, parental modelling of healthy behaviours, nurturance, open communication, acceptance, autonomy granting, and adolescent health and wellbeing outcomes (Berge et al, 2009; Edwardson and Gorely, 2010; Ryan et al, 2010; Kawabata et al, 2011). INITIAL CONCLUSIONS It is clear from the literature that the authoritative parenting style generally appears to be the parenting style that has the most positive impact upon adolescent health and wellbeing outcomes. In line with this, many of the parenting behaviours identified as protective for adolescent health and wellbeing outcomes could be categorised as falling within the context of an authoritative parenting style, i.e. behaviours involving a high degree of warmth but also a high degree of control.
The optimal parental style would appear to be authoritative,
including behaviours such as monitoring, parental modelling, positive parent-child communication, high parent-child connectedness, and parental encouragement of healthy behaviours, as shown in Figure 3 (overleaf). Contextual factors are likely to play a role in determining the effectiveness of parenting styles and behaviours. For example, Racz and McMahon state that studies have observed more parental knowledge and monitoring in higher SES and intact families compared to low SES and single-parent families, with barriers within the latter including isolation, limited financial resources, low social support and stress. In order to facilitate parenting behaviours that have been shown to be effective, the needs of all groups should be taken into account and the necessary support and resources provided.
Associated with positive adolescent health and wellbeing outcomes
Monitoring, parental modelling, positive parent-child communication, high parent-child connectedness, and parental encouragement of healthy behaviours
Low support Generally associated with less positive adolescent health and wellbeing outcomes
Generally associated with less positive adolescent health and wellbeing outcomes
Psychologically controlling parenting, negative/harsh parenting and uninvolved parenting
Not associated with positive adolescent health and wellbeing outcomes
Figure 3. Parenting styles and parenting behaviours associated with positive and negative adolescent health and wellbeing outcomes 8
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