Relationship between parenting practices and behavioral problems of children attending a Tertiary Mental Health Institute of North East India

Amina Ahmed; A Baruah; LB Siddeswara

doi:10.4103/iopn.iopn_20_21

ORIGINAL ARTICLE

Year : 2021 | Volume : 18 | Issue : 2 | Page : 89-94

Relationship between parenting practices and behavioral problems of children attending a Tertiary Mental Health Institute of North East India

Amina Ahmed, A Baruah, LB Siddeswara
Department of Psychiatric Nursing, LGBRIMH, Tezpur, India

Date of Submission	27-Feb-2021
Date of Decision	18-Jun-2021
Date of Acceptance	22-Jun-2021
Date of Web Publication	21-Dec-2021

Correspondence Address:
Dr. Amina Ahmed
Department of Psychiatric Nursing, LGBRIMH, Tezpur - 784 001, Assam
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/iopn.iopn_20_21

Abstract

Introduction: The parent plays a vital role in promoting and supporting the overall development of children from infancy to adulthood. Parenting practices are related to different outcomes in children's life. Hence, the researcher aimed to assess the relationship between parenting practices and behavioral problems of children. Subjects and Methods: A quantitative approach and correlational design was used. Total 80 primary caregivers of children (6–17 years), attending a Tertiary Mental Health Institute of North East India were selected using systematic random sampling technique. Data were collected using Sociodemographic Pro forma, Alabama Parenting Questionnaire, Strength and Difficulties Questionnaire after obtaining written informed consent from the participants. Results: Overall 55% of the participants had scored toward more positive parenting practices and 56.2% toward less negative parenting practices. Regarding behavioral problems of children, 77.5% had total difficulty levels in the abnormal range with 52.5% at substantial risk for emotional symptoms, 78.8% for conduct problems, 43.8% for hyperactivity/inattention, and 73.8% for peer problems. Participant's negative parenting practices were positively correlated with total difficulty score as well as with conduct problems, hyperactivity, and peer problems. Finding further showed that participant's positive parenting practices had a significant association with their educational status, occupation, family income, place of residence, children's birth order, use of mobile phone by children, and negative parenting practices had a significant association with their history of substance use, fights between parent, and children's last academic performance. These findings can be incorporated for developing intervention module for parents of children in the hospital setting as well as in the community.

Keywords: Behavioral problems, children, negative parenting, parent, parenting practices, positive parenting

How to cite this article:
Ahmed A, Baruah A, Siddeswara L B. Relationship between parenting practices and behavioral problems of children attending a Tertiary Mental Health Institute of North East India. Indian J Psy Nsg 2021;18:89-94

How to cite this URL:
Ahmed A, Baruah A, Siddeswara L B. Relationship between parenting practices and behavioral problems of children attending a Tertiary Mental Health Institute of North East India. Indian J Psy Nsg [serial online] 2021 [cited 2023 May 28];18:89-94. Available from: https://www.ijpn.in/text.asp?2021/18/2/89/332791

Introduction

Children are the future of our nation and healthy children build a healthy nation. According to the World Health Organization report, worldwide 10%–20% of children and adolescents experience mental disorders.^[1] The prevalence rates for mental health problems vary across various studies conducted in different parts of the world. One study reported 30.8% of school children were found to have behavioral problems^[2] whereas others reported 31.8% in Assam,^[3] 22.7% in Utter Pradesh,^[4] and 15%, in Gujarat.^[5]

Behavioral problems in early childhood have negative consequences in later life such as poor scholastic achievement, school dropout, peer rejection, conduct disorder, poor employment prospects, antisocial behaviors, teenage pregnancy, and substance use.^[1],[6] Mental health issues in early childhood create a significant burden not only on family, community but also on public health, resources, and workforce of low- and middle-income countries.^[7] A large body of research provides strong evidence that parents and the home environment are the most influential forces in shaping children's early learning.^[8],[9],[10] Abnormal psychosocial environments and negative parenting practices as risk factors for emotional and behavioral problems among the children.^[11],[12] Poor parenting practices are related to both internalizing^[13] as well as externalizing behaviors.^[14],[15] However, this type of investigation is limited in North East India. Moreover, findings from this study will be the basis for developing intervention module for the parents of children with different mental health issues. Hence, researchers felt the need to find out the parenting practices and behavioral problems of children, their correlation and association with the sociodemographic variables of both primary caregivers and children, attending a Tertiary Mental Health Institute of North East India.

Subjects and Methods

In the present study, researchers have used a quantitative approach and correlational research design. A total of 80 primary caregivers of children between the age group of 6 and 17 years, who registered as a new patient, attended the Outpatient department (OPD) of a Tertiary Mental Health Institute of North East India, over 3 months (November 2020 to January 2020) were recruited for the study. Children attended the OPD with a person who is not the primary caregiver or does not involve in the care of the child, or has severe psychological disturbances were excluded from the study. Participants who fulfill the eligibility criteria and gave consent for data collection were recruited using systematic random sampling technique. Confidentiality and anonymity were assured to the participants. The Institutional ethical committee has approved the study protocol and related documents.

The sociodemographic data were collected using Sociodemographic pro forma developed by the researcher and validated by two experts. It consisted of sociodemographic details of participants (12 items) and sociodemographic details of their children (07 items). Parenting practices were assessed by the Alabama parenting questionnaire (APQ) which is a 5 point Likert scale consisted of 42-items. It has five domains, positive involvement and positive parenting constructs directed toward more positive parenting practices and poor monitoring and supervision, inconsistent discipline, and corporal punishment directed toward more negative parenting practices. Tool consisted of 35 items that assess these five parenting constructs and seven additional items those measure specific discipline practices other than corporal punishment.^[16] Elevated scores for the positive parenting scales (Parental Involvement and Positive Parenting) on the APQ were considered to be those scores that are one standard deviation (SD) below the sample mean. With respect to the negative parenting scales (Poor Monitoring/Supervision, Inconsistent Discipline, and Corporal Punishment), elevated scores were considered to be those that are one SD above the mean.^[17] All subscales had moderate-to-adequate-internal consistency, validity, and good test-retest stability.^[18] A recent study reported subscales reliability for the positive parenting composite and negative parenting composite were obtained 0.86 and 0.71, respectively.^[19] Strengths and Difficulties Questionnaire (SDQ) was used to assess behavioral and emotional problems of children which is a 3-point Likert type scale consisted of 25 items divided into five domains such as emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behaviors but for the present study first four domains were taken for assessing behavioral problems of children. Total difficulty score was calculated by adding the scores of all four domains and the score was further categorized as normal (score ≤13) and high (borderline [14–16] and abnormal (17–40)]. Similarly, each subscale was also categorized into normal, high, and abnormal.^[20] Cronbach's alpha was found to be above. Seventy for all SDQ subscales except peer problems and for total difficulties.^[19]

Results

Data were analyzed using both descriptive and inferential statistics. Frequency and percentage distributions were used for categorical data. The Pearson correlation coefficient was used to find the correlation between continuous data and the Chi-square was used to find out the association between the categorical data of the variables.

Sociodemographic characteristics participants

Out of 80 participants, majority 36 (45%) of the participants were mothers, though most of the participants 43 (53.8%) were found to be male this is because this study included primary caregivers. The mean age of the participants was 41.3 (SD = 10.814, Range = 54). The majority 50 (62.5%) of the participants were belong to Islam. Regarding education, 21 (26.2%) had no formal education, 26 (32.5%) had 1^st to 8^th level education, 22 (27.5%) had 9^th to 12^th level and 11 (13.8%) had graduate and above level of education. Regarding occupation, 32 (40%) were homemakers or unemployed, 18 (22.4%) were farmer/daily wage earner, 15 (18.8%) were businessmen, 8 (10%) had private service, and 7 (8.8%) had a government job. Most of the participants 71 (88.8%) were married and 67 (83.8%) had nuclear family, 46 (57.5%) had income up to 10,000, 72 (90%) were from rural area, 60 (75%) had 2–4 number of children. Participants reported that 23 (28.8%) of them had a history of some chronic illness, 8 (10%) had a history of some type of psychiatric illness, and 18 (22.5%) had a history of substance use. Regarding fights, 47 (38%) had a history of occasional fight and only 2 (2.5%) had a history of frequent fight with their spouse.

Sociodemographic characteristics of their children

The average age of the children was 13.69 (SD = 2.94 and Range = 10). The majority of the children, 43 (53.8%) were male, 43 (53.8%) were in between 2^nd and 4^th birth order, 31 (38.8%) were studying in between 1^st and 5^th standard, 41 (51%) had poor academic performance in the past year, 32 (40%) used leisure time by playing and watching TV or mobile phone, and 59 (73.8%) used mobile phone.

Participant's parenting practices

[Table 1] included data regarding participant's positive and negative parenting practices and [Table 2] included the mean, SD, minimum score, and maximum scores of all the domains of APQ.

Table 1: Participant's parenting practices (n=80)

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Table 2: Participant's parenting practices (n=80)

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Behavioral problems among children

[Figure 1] included the frequency distribution of the total difficulty score of emotional and behavioral problems as well as its all domains emotional symptoms, conduct problems, hyperactivity, and peer problems.

Figure 1: Frequency distribution of behavioral problems of the children

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Correlation between participant's parenting practices and behavioral problems of children

[Table 3] consisted correlation of participant's positive and negative parenting practices with behavioral problems of children and [Table 4] included the correlation between different domains of parenting practices and domains of behavioral problems.

Table 3: Correlation between positive and negative parenting practices and behavioral problems of the children (n=80)

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Table 4: Correlation between different domains of parenting practices and behavioral problems of the children (n=80)

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Association of parenting practices and behavioral problems with participant's sociodemographic variables

[Table 5] revealed the associations of participant's positive parenting practices, negative parenting practices, and children's behavioral problems with participant's sociodemographic variables.

Table 5: Association of parenting practices and behavioral problems with participants sociodemographic variables (n=80)

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Association of parenting practices and behavioral problems with children's sociodemographic variables

[Table 6] revealed the associations of participant's positive parenting practices, negative parenting practices, and children's behavioral problems with children's sociodemographic variables.

Table 6: Association of parenting practices and behavioral problems with children's socio demographic variables (n=80)

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Discussion

Present study findings revealed that the majority of participants had scored toward more positive parenting practices and less negative parenting practices. With respect to specific domains of parenting practices, participants practiced mostly positive involvement followed by poor monitoring/supervision, inconsistent discipline, specific disciplinary practices, positive parenting, and corporal punishment. All primary caregivers love their children, wanted their children to be one of the best. However, researchers felt that as the majority of the participants were uneducated or had primary level education, having less income to run the family, number of children were more than one, from rural areas, frequency of children's deviant behaviors, lack of awareness and cultural believes, all these variables affect the participants to be more involved in bread earning for their family, and could spend very less time in quality care for their children and affects their parenting practices.

Regarding behavioral problems, 77.5% of children had total difficulty levels in the abnormal range with 52.5% at substantial risk for emotional symptoms, 78.8% for conduct problems, 43.8% for hyperactivity/inattention, and 73.8% for peer problems. Present study findings were found to be more because this study conducted among parents of children who came for treatment in a tertiary mental health setup compared to other studies which were conducted among school students.^{[2],[3],[4],[5],[21],[22],[23]}

Present study findings further revealed that participant's negative parenting practices had positive correlation with behavioral problems (r = 0.457, P = 0.000), which is found to be consistent with the studies conducted by Pinquart,^[14] Triguero,^[15] Barlow,^[24] and Duncombe.^[25] Poor monitoring/supervision (r = 0.440, P = 0.000), inconsistent discipline (r = 0.503, P = 0.000), corporal punishment (r = 0.442, P = 0.014), and specific disciplinary practices (r = 0.241, P = 0.031) had positive correlation with conduct problems which are continuously found to be consistent with studies done in different setting^{[25],[26],[27],[28]} and inconsistent discipline (r = 0.362, P = 0.001), corporal punishment (r = 0.274, P = 0.014), and specific disciplinary practice (r = 0.244, P = 0.029) had positive correlation with hyperactivity problems. Similar findings were found by Li et al.^[29] and Hawes et al.^[30] inconsistent discipline (r = 0.244, P = 0.029) and specific disciplinary practices (r = 0.220, P = 0.050) had positive correlation with peer problems which were consistent with Cook and Fletcher^[31] There was no correlation found between participant's positive parenting practices and behavioral problems of their children.

Participant's positive parenting practices had a significant association with their educational status (χ² = 12.626a, P = 0.006 (χ² = 13.556a, P = 0.021)), family income (χ² = 13.556a, P = 0.001) and place of residence (χ² = 6.487a, P = 0.011) and negative parenting practices had a significant association with history of any substance use (χ² = 4.956a, P = 0.026), and fights among parent (χ² = 7.691a, P = 0.021). Similar and contradictory findings have been seen in earlier studies which revealed that negative parenting practices were associated with parents educational status, occupation, family income^[32] and history of substance use, and family chaos.^[32],[33] Participant's positive parenting practices had a significant association with their children's birth order (χ² = 8.620a, P = 0.013) and use of mobile phone (χ² = 5.166a, P = 0.023), and negative parenting practices had a significant association with children's last academic performance (χ² = 13.684a, P = 0.001). Earlier studies revealed a positive relation between positive parenting and academic achievement.^[34] There was no association has been found between the behavioral problems of children with any of the sociodemographic variables of the participants and their children.

Strength, limitation, and future direction

Strength: Before collecting data, participants were made comfortable and understandable regarding the purpose of collecting data on parenting practices as they felt they were being judged. Hence, researcher believed that participants revealed their real parenting practices. Participants were recruited using systematic random sampling techniques.

Limitation: Present study conducted on participants who attended this setting where most of the participants had no education or less education, unemployed or daily wage earner or farmer, poor income and residing in rural areas, hence findings may not be generalizable for the caregivers who are opposite to these. Moreover, participant's self-reported data on parenting practices were assessed, direct observations at home setting were not made, hence reported parenting practices might vary than the real ones.

Future direction: Similar study can be done for different populations and in different settings as well comparison can be made to find out the difference.

Conclusion

Findings revealed that negative parenting practices were positively correlated with children's behavioral problems, but no relationship was found between positive parenting practices and the behavioral problems of children. Positive parenting practices had a significant association with their educational status, occupation, family income, residence, children's mobile phone use and birth order, and negative parenting practices had a significant association with their history substance use, fights with between parent and children's past academic performance. These findings can be used for developing a parent management intervention module for the primary caregiver of children in the hospital setting as well as in the community.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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